PubMed · 7973379
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L C Hammond. 1994. When organs fail one by one.. https://pubmed.ncbi.nlm.nih.gov/7973379/
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This review article discusses the evidence documenting the interrelationship between nutritional status and clinical outcome of the renal patient population. The limitations of accurately assessing the nutritional status of this patient group with commonly used indices are detailed. An overview of the history of nutrition supplementation as an intervention for the malnourished renal patient reveals that the efficacy of both enteral and parenteral methods has not been adequately explored to draw any firm conclusions. Based on available data, recommendations for providing nutrition care for the malnourished patient are provided. Therapeutics that are currently under investigation as future interventions for malnutrition are identified.
Whilst much has been written on the implications of withholding or withdrawing nutritional support therapy from the terminally ill, the comatose or vegetative patients relatively little has been published on the ethical implications of nutritional therapy in other groups. This article outlines a surgeon's view of ethical issues as they apply to nutrition and concludes that failure to provide nutritional support in one form or another for patients who have or who are expected to have seven days or more of inadequate oral intake should now be considered unethical.
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