De Luis Román Daniel, Domínguez Medina Eduardo, Molina Baena Begoña, Matía-Martín Pilar
Center of Investigation Endocrinology and Nutrition, Hospital Clínico Universitario de Valladolid, Medicine School University, 47002 Valladolid, Spain.
Center for Research in Molecular Medicine and Chronic Diseases (CiMUS), 15782 Santiago de Compostela, Spain.
Nutrients. 2021 Jun 3;13(6):1922. doi: 10.3390/nu13061922.
Nutritional management of patients with intestinal failure often includes the use of oligomeric formulas. Implementing the use of oligomeric formulas in surgical patients with maldigestion or malabsorption could be a nutritional strategy to be included in clinical protocols. We aim to generate knowledge from a survey focused on the effectiveness of nutritional therapy with oligomeric formulas with Delphi methodology. Each statement that reached an agreement consensus among participants was defined as a median consensus score ≥7 and as an interquartile range ≤3. The use of oligomeric formulas in surgical patients, starting enteral nutrition in the post-operative phase in short bowel syndrome and in nonspecific diarrhea after surgical procedures, could improve nutritional therapy implementation. Stakeholders agreed that early jejunal enteral nutrition with oligomeric formula is more effective compared to intravenous fluid therapy and it is useful in patients undergoing upper gastro-intestinal tract major surgery when malabsorption or maldigestion is suspected. Finally, oligomeric formulas may be useful when a feeding tube is placed distally to the duodenum. This study shows a practical approach to the use of oligomeric formulas in surgical patients with intestinal disorders and malabsorption, and it helps clinicians in the decision-making process.
肠衰竭患者的营养管理通常包括使用低聚配方奶粉。在患有消化功能不良或吸收不良的外科患者中应用低聚配方奶粉可能是临床方案中应纳入的一种营养策略。我们旨在通过德尔菲法,从一项聚焦于低聚配方奶粉营养治疗效果的调查中获取知识。参与者之间达成共识的每项陈述被定义为中位数共识得分≥7且四分位间距≤3。在外科患者中使用低聚配方奶粉,在短肠综合征术后阶段开始肠内营养以及在手术后的非特异性腹泻中使用,可能会改善营养治疗的实施。利益相关者一致认为,与静脉输液治疗相比,早期使用低聚配方奶粉进行空肠肠内营养更有效,并且在怀疑有吸收不良或消化功能不良的上消化道大手术患者中有用。最后,当喂养管放置在十二指肠远端时,低聚配方奶粉可能会有用。本研究展示了在患有肠道疾病和吸收不良的外科患者中使用低聚配方奶粉的实用方法,并有助于临床医生进行决策。