Nutrição enteral em pacientes oncológicos: diferenças entre o que é prescrito e administrado

EnglishIntroduction: Enteral nutritional therapy is an essential therapy for recovery and/or maintenance of nutritional status. This can be interrupted by numerous factors that compromise your infusion. Objective: To analyze the adequacy of enteral nutritional therapy by comparing volume, calories and proteins prescribed and infused up to the seventh day of therapy and correlate with gastrointestinal complications and reported complications. Methods: Retrospective clinical study with review of electronic medical records of patients admitted from September 2016 to April 2017 at a public and private oncology hospital in the city of Juiz de Fora - MG. Statistical analysis was performed using the software SPSS Statistics 17. Results: 68.75% of the patients were male, 54.16% were elderly, 65.2% were treated early, 95.8% received a normocaloric diet 70.8% presented nasoenteric catheter access and 100% of the patients did not reach the volume, calories and proteins prescribed in seven days of enteral nutritional therapy, presenting a significant difference between prescribed and infused values. Among the gastrointestinal complications and intercurrences, nausea and obstruction of the catheter were the most frequent, 29.2% and 11.5%. The mean time of use of enteral nutritional therapy was 34.66 ± 22 days and 42.7% of the patients died. Discussion: The higher prevalence of cancer in men and the elderly is also reported by other studies, as well as the inadequacy of prescribed and administered enteral diet, which may negatively interfere with the nutritional status and evolution of the patient, and death is frequently reported. Conclusion: Most of the patients did not receive the prescribed volumes, calories and proteins, supposedly due to the influence of the interruptions of the therapy and the occurrence of gastrointestinal complications and intercurrences. portuguesIntroducao: A terapia nutricional enteral e uma terapeutica essencial para a recuperacao e/ou manutencao do estado nutricional. Esta pode ser interrompida por inumeros fatores que comprometem a sua infusao. Objetivo: Analisar a adequacao da terapia nutricional enteral, comparando volume, calorias e proteinas prescritas e infundidas ate o setimo dia de terapia e correlacionar com as complicacoes gastrointestinais e intercorrencias relatadas. Metodos: Estudo clinico retrospectivo com revisao de prontuarios eletronicos de pacientes admitidos no periodo de setembro de 2016 a abril de 2017 em um hospital oncologico publico e privado do municipio de Juiz de Fora - MG. A analise estatistica foi realizada por meio do software SPSS Statistics 17. Resultados: 68,75% dos pacientes eram do genero masculino, 54,16% idosos, 65,2% receberam a terapia de forma precoce, 95,8% receberam dieta normocalorica normoproteica com fibras, 70,8% apresentavam a via de acesso por sonda nasoenterica e 100% dos pacientes nao atingiram em sete dias de terapia nutricional enteral o volume, calorias e proteinas prescritas, apresentando diferenca significativa entre valores prescritos e infundidos. Dentre as complicacoes gastrointestinais e intercorrencias, nausea e obstrucao da sonda foram as mais frequentes, 29,2% e 11,5%. O tempo medio de uso da terapia nutricional enteral foi de 34,66 ± 22 dias e 42,7% dos pacientes foram a obito. Discussao: A maior prevalencia de câncer em homens e idosos tambem e relatada por outros estudos, assim como a inadequacao de dieta enteral prescrita e administrada, o que pode interferir negativamente no estado nutricional e evolucao do paciente, sendo obito frequentemente relatado. Conclusao: A maioria dos pacientes nao receberam os volumes, calorias e proteinas prescritas, supostamente por influencia das interrupcoes da terapia e a ocorrencia de complicacoes gastrointestinais e intercorrencias.