Recommendations of Berry and Fischer for Nutrition in a Patient with an Enterocutaneous Fistula

Description

Many patients with an enterocutaneous fistula will develop malnutrition, which will affect the patient's chances of fistula closure. Berry and Fischer listed recommendations for the nutritional support for these patients. The authors are from the University of Cincinnati.

Parameters:

(1) output from fistula

(2) preferred route of nutrition

(3) total calorie requirement

(4) protein requirements

(5) lipid requirements

(6) minerals and electrolytes (magnesium, potassium, sodium, bicarbonate, zinc)

(7) vitamins

Output in mL per Day	Severity of Fistula
< 200 mL/day	low output
200 - 500 mL/day	intermediate output
> 500 mL/day	high output

Parameter	Low Output	Intermediate Output	High Output
route	enteral	enteral	enteral, may require parenteral for part or all
total calories	resting energy expenditure (REE)	1.25 * REE	1.5 * REE
protein	1.0 - 1.5 g/kg/day	1.25 - 2.0 g/kg/day	1.5 - 2.5 g/kg/day
lipid	20-30% of total	20-30% of total	20-30% of total
minerals	not a problem	monitor	monitor
vitamins	RDA, increased vitamin C	1.5 times RDA, increased vitamin C	2 times RDA

where:

• Calculation of protein requirements in the implementation is based on ideal body weight, since this would prevent problems from excessive weight loss or obesity.

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Recommendations of Berry and Fischer for Nutrition in a Patient with an Enterocutaneous Fistula

Description

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