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Biomedical subjects

P Guenter

Publications and source records attributed to P Guenter.

12 recordsLinked to original sources
PubMed1997

Enteral nutrition therapy.

Nursing care is key to positive outcomes in patients who require enteral nutrition. Understanding the decision-making process for the use of this therapy along with the steps of feeding initiation, advancement, monitoring, and complication prevention, gives nursing personnel the tools they need to deliver nutrition in a safe, cost-effective manner. This article presents this essential information to help nurses care for patients who are receiving enteral nutrition.

Contraindications↗
PubMed1995

Long-term central venous catheters in patients with acquired immunodeficiency syndrome.

BACKGROUND: As long-term vascular access becomes more prevalent among patients with AIDS, it is becoming more important to consider their potential complications. METHODS: One hundred two central venous access devices placed in 84 patients with AIDS were reviewed for septic and mechanical complications. Catheters were inserted by one surgeon by means of the cephalic vein cutdown technique. The sample included 88 implanted venous reservoir catheters (86.3%) and 14 tunneled central venous catheters (13.7%). RESULTS: Mean catheter life was 141 +/- 15 days. Total number of catheter days was 14,383. The catheter-related infection rate was 0.125 episodes/100 catheter-days. Staphylococcus aureus was the most commonly isolated pathogen in the sample. Mechanical complications were rare (0.05 episodes/100 catheter-days). CONCLUSION: When these data are compared with other, smaller series in the literature, the findings suggest that long-term central venous catheters inserted in patients with AIDS are safe and effective for the multiple infusion therapies required in these patients.

Acquired Immunodeficiency Syndrome↗
PubMed1993

Relationships among nutritional status, disease progression, and survival in HIV infection.

This investigation retrospectively studied relationships between survival in human immunodeficiency virus-seropositive outpatients receiving recent therapies (n = 77) and two markers of nutritional status, serum albumin and percent of usual body weight. Subjects were observed for an average of 186 +/- 8 days; 19% died within the study period. Kaplan-Meier curves and Cox regressions showed that older subjects who had lower CD4 counts, lower albumin levels, or had lost more weight demonstrated poorer survival. Albumin levels and weight loss were related to CD4 counts. The relative risk of death for subjects with low albumin levels (< 3.5 g/dl) was 3.6 times greater (p < 0.021, with 95% confidence limits [95%CL] of 1.2-10.9) than that for subjects with normal albumin levels (> or = 3.5 g/dl), even after controlling for age and CD4 counts. Similarly, after controlling for CD4 counts and age, subjects whose baseline body weights were < 90% of their usual weight had a greater relative death risk (8.3 times greater, p < 0.002, 95% CL 2.3-34.1) than those who had lost less. Survivors and nonsurvivors who had similar CD4 counts differed significantly in albumin levels (p < 0.05). Thus, nutritional status influences survival independent of CD4 counts.

Adult↗
PubMed1989

Percutaneous endoscopic gastrostomy feeding tube in neuroscience patients.

Despite a few associated complications, the PEG is considered an excellent feeding tube for long-term enteral nutritional support, especially in the patient with neurologic dysfunction. The tube can be easily removed if the patient is able to resume oral intake and no longer needs supplemental nutrition. This tube can be easily converted to a gastro-jejunal tube if it is later determined a patient needs to be fed distal to the pylorus. Neuroscience nurses should be aware of this feeding tube, its indications, method of insertion and care in order to better provide adequate and safe nutritional therapy.

Enteral Nutrition↗
PubMed1987

Enteral nutrition in the critically ill.

Although total parenteral nutrition has greatly influenced the clinical management of the critically ill, enteral nutrition can provide much needed support in the intensive care unit. In order to employ the best enteral nutrition, one must understand its rationale, delivery principles, equipment, feeding techniques, and diets, as well as patient selection and monitoring.

Critical Care↗
PubMed1985

Energy expenditure in acute trauma to the head with and without barbiturate therapy.

The increased energy expenditure associated with severe trauma to the head appears genuine but exhibits wide variation in its magnitude. Patients with severe acute trauma to the head without barbiturate treatment are hypermetabolic with an average energy expenditure 26 per cent over predicted. Barbiturate therapy abolishes this hypermetabolism and decreases energy expenditure to 14 per cent below predicted. In the individual patient, there appears to be a close relationship between the degree of suppression of energy expenditure and the serum barbiturate level. However, this relationship would appear to be different in each patient, and therefore, for this group, a significant correlation between energy expenditure and serum barbiturate level does not exist. The wide variability of energy expenditure in individual patients makes the estimation of energy expenditure by population predictive formulas imprecise. This may lead to incorrect estimates of caloric requirements and inappropriate provision of exogenous energy substrates. Although for those patients receiving energy expenditure and serum barbiturate levels in the individual may further aid in estimating the caloric expenditure for each individual, in order to provide appropriate amounts of calories to the patient with trauma to the head, energy expenditure should be measured in each instance.

Adolescent↗