Managing GI issues in complex patients
What is a complex patient?
A complex patient is someone who requires specialised artificial nutritional support in terms of dietary composition. Patients who experience failure of one or more organs make nutritional support challenging, and a common complication of complex patients is the malabsorption of nutrients, which include macro and micronutrients.
Examples of complex patients include those with:
- Short bowel syndrome, multiple surgery or trauma
- Chylothorax
- Acute or chronic Pancreatitis
- Acute liver failure
- Respiratory failure requiring mechanical ventilation
- High output stomas
The aim of meeting these patients’ nutritional requirements includes:
- Optimising nutrient absorption
- Providing key substrates to minimise loss of lean body mass
- Feeding the gut as far as possible to reduces chance of bacterial translocation, degradation of gut-barrier function and maintaining bowel function
- Optimising Leucine intake to promote muscle anabolism
- Providing optimal nutrient levels without increasing osmolarity of feeds
- Reducing the amount of insulin resistance often experienced in this patient group