Ch 25: Pulmonary Disease Flashcards
What is considered prolonged mechanical ventilation?
Vent dependence for more than 21 days for at least 6 hours per day
True or false: An enteral formula characterized by anti-inflammatory lipid profile should be used in patients with ARDS
In ARDS, APSEN/SCCM did NOT make a recommendation for the routine use an enteral formula characterized by anti-inflammatory lipid profile in patients with ARDS
To identify malnutrition, ASPEN recommends which characteristics be present?
ASPEN recommends 2 of the following 6 characteristics should be present: insufficient energy intake, weight loss, loss of muscle mass, loss of subcutaneous fat, localized or generalized fluid accumulation that may sometimes mask weight loss, and diminished functional status as measured by hand grip strength.
What are the four types of respiratory failure?
Hypoxemic, Hypercapnic, Mixed Hypoxic-hypercapnic , and Shock Related Respiratory Failure
In which type of pulmonary patient is a fluid restricted formula appropriate?
Patients with ARDS (severe type I respiratory failure)
What defines chronic critical illness?
ICU stay > 14 days with low grade organ dysfunction; vent dependence and malnutrition are central components to chronic critical illness
How often should CF patients should be screened for malnutrition and vitamin deficiency?
Quarterly; • Most common deficiencies include ADEK b/c patients with CF are prone to malabsorption secondary to pancreatic insufficiency, fat soluble vitamins should be checked yearly.
How often does ASPEN/SCCM recommend energy expenditure be evaluated in critically ill patients?
More than weekly, though no specific time intervals are outlined
What causes malnutrition in CF?
Aancreatic insufficiency or steatorrhea with nutrient deficiencies; patients with CF have greater overall energy requirements then individuals without CF who are of similar height/weight
What should not be given to critically ill or pulmonary failure patients?
Glutamine supplementation
What defines the term pulmonary cachexia syndrome?
BMI < 17 in men and < 14 in women; malnutrition in COPD may be as high as 60% for inpatients
True or false: Gut peristalsis is inhibited by paralytic medications and sedatives
False; peristalsis is NOT inhibited by paralytic medications or sedatives
What situation improves EFA profiles in patients with CF?
Lung transplant
Although supplementation with omega 3 fatty acids are sometimes used in the management of CF, results from clinical trials have shown mixed results and further trials are needed to determine the efficacy of routine EFA supplementation in the management of CF
Which type of EN formula should be considered for patients with Chyle leaks?
Elemental enteral formulas, which contain individual amino acids and contain <2-3% of total calories from long-chain fatty acids, are ideal for patients with chyle leak
