Experts insights on optimal nutritional care along the patient journey

Understand how enteral feeding solutions and/or Oral Nutrition Support can be tailored to individual patient nutritional needs along the patient journey from the Intensive Care Unit to the community.

Six international experts in dedicated learning sessions outline either  the nutritional challenge and needs of ICU patients, nutritional solutions for tube-fed patients to address malabsorption, the optimal and long term nutritional care or the role of the muscle-targeted nutritional intervention in patients with sarcopenia.

Session 1: Nutritional challenges of ICU patients: Choosing the right products at the right time

In this session, Prof van Zanten gives insights into the challenges of meeting patients’ nutritional requirements with available products. He discusses the different options of meeting high protein targets without overfeeding energy. The audience asks key clinical questions on the preferred type of protein, protein targets and other best practices.

Session 2: Nutritional needs from ICU to recovery, what does evidence and practice tell us now?

In this session, Prof Wischmeyer highlights how patients in the ICU are more difficult to feed than ever, with increasing complications.  It is therefore imperative that a personalized approach is taken and that nutrition is adjusted accordingly by right dose, for the right patient at the right time.  There is no one size fits all approach. He outlines that this needs to be extended beyond the ICU stay and that based on LEEP COVID data, showing increased metabolic needs, that patients will require ongoing nutrition support even beyond hospital discharge.

Session 3: Addressing malabsorption, what are the nutritional solutions for tube feeding patients? A deep dive into Nutrison Peptisorb Plus HEHP*

In this session, Ben Green asks two Dietitians key questions on their experience of using a new high energy, high protein peptide based product in their clinical caseload.  The audience also asks key clinical questions on specific cancer, pancreatitis and other patient groups where peptide feeds are often used.

*Nutrison Peptisorb Plus HEHP is a Food for Special Medical Purpose and must be used under medical supervision.

Session 4: The new Flocare® DirectPEG. What is it and who can benefit?

Mr. Dwayne Troutman brings his product expertise on the new Flocare direct puncture gastrostomy feeding tube intended to use for long term intragastric feeding . Throughout few questions, the speaker will address this direct puncture method, its advantages, benefits, target population as well as the materials the DirectPEG is made of.

Session 5: Muscle-targeted nutritional intervention to optimize recovery: what HCPs need to know

Dr Cereda discusses key questions on the optimum care for patients with sarcopenia, detailing the role of ‘muscle-targeted’ interventions, namely the synergistic role of nutrition and exercise1. Sufficient amounts of key nutrients including high quality protein (e.g. whey), leucine, and vitamin D are required to optimize muscle protein synthesis and promote rebuilding of muscle mass during recovery2,3. To ensure nutritional intervention is targeted to the right patient at the right time, appropriate screening and assessment is required.

Measurement of muscle strength and/or physical performance is essential for tracking progression of sarcopenia in clinical practice2,3.

Session 6: Optimizing nutritional care in nursing homes: learnings from the OPEN study

The Older Person’s Exercise and Nutrition (OPEN) study4 investigated the effects of combining Sit-To-Stand (STS) exercise with Fortimel® Compact Protein in nursing homes residents in Sweden. Whilst no difference between intervention group and control was observed for the primary outcome (30sCST), post-hoc analysis showed that patients who adhered  to the combined intervention were significantly more likely to maintain or improve physical function and gain fat-free mass. This finding highlighting the importance for addressing adherence barriers in order to support successful outcomes Interviews with residents and staff performed during the OPEN study offer insights on opportunities and barriers which need to be addressed to ensure better adherence and long-term success5,6.

  1. Cruz-Jentoft AJ, Bahat G, Bauer J, Boirie Y, Bruyère O, Cederholm T, et al. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing. 2019;48:16-31.
  2. Bauer J, Biolo G, Cederholm T, Cesari M, Cruz-Jentoft AJ, Morley JE, et al. Evidence-based recommendations for optimal dietary protein intake in older people: a position paper from the PROT-AGE Study Group. J Am Med Dir Assoc. 2013;14:542-59.
  3. Rondanelli M, Cereda E, Klersy C, Faliva MA, Peroni G, Nichetti M, et al. Improving rehabilitation in sarcopenia: a randomized-controlled trial utilizing a muscle-targeted food for special medical purposes. J Cachexia Sarcopenia Muscle. 2020;11:1535-1547
  4. Grönstedt H, et al. Effect of Sit-to-Stand Exercises Combined With Protein-Rich Oral Supplementation in Older Persons: The Older Person’s Exercise and Nutrition Study. JAMDA. 2020; 21:1229-1237.
  5. Vikström S, et al.. A health concept with a social potential: an interview study with nursing home residents. BMC Geriatr. 2020; 20:324.
  6. Vikström S, et al. Experiences of supporting older persons in completion of an exercise and nutrition intervention: an interview study with nursing home staff. BMC Geriatr. 2021; 21:109.

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