Respiratory System KNH 411

Respiratory System Nutritional status and pulmonary function are interdependent Macronutrients fueled using oxygen and carbon dioxide Malnutrition can evolve from pulmonary disorders And can contribute to declining pulmonary status Fat, protein and carbohydrates aid the issues

Nutrition and Pulmonary Health Protein-energy malnutrition Antioxidants and lung function protects the lungs, vitamin c, vitamin e, betacarotene, seleneum Cigarette smokers increased intake of vitamin C, low fiber and antioxidants Early satiety, anorexia, weight loss, cough, dyspnea during eating multiple small feedings would be best Using so much energy just to try to breathe high amount of calories and will be using calories for breathing instead of using for your body Weight history, nutrient intake, what meds they are on, biochemical markers

Bronchopulmonary Dysplasia (BPD) Growth failure d/t decreased nutrient intake, increased requirements, hypoxemia, delayed skeletal mineralization and osteopenia Compromised breathing because of the prematurity of the babyl get enough calories in Caloricly densed foods, or add supplemental calorie needs for mother

Bronchopulmonary Dysplasia (BPD) Treatment/Nutrition Therapy Energy and macronutrient needs: 15-20% higher 120-130 kcal/kg/day or higher Protein 3-4 g/kg/day Vitamins and minerals Vitamin A 1500-2800 Ius put in the formula or supplement mother milk that that amount Closely monitor electrolyte balance Sufficient minerals for bone growth Because of increased oxygen needs

Bronchopulmonary Dysplasia (BPD) Treatment/Nutrition Therapy Mechanical ventilation  infant who is born prematurely to strengthen lungs Nutrition support Feed, Grow, and Go is the motto May need fluid and sodium restriction Specialty infant formulas most have high calorie and high phosperous Breast milk preferred  human milk fortifier that increases the calories, but still want the enzymes from the mothers milk Education and support to caregivers

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Chronic Obstructive Pulmonary Disease COPD – progressive disease which limits airflow through inflammation of bronchial tubes (bronchitis) Primary risk factor – smoking For adults Decrease their lung function to less then half, and can still function obstruction of the brochrial tubes or the obstruction of the alvielali OR BOTH

COPD Nutrition Therapy Low dietary intake Altered taste perceptions and appetite altered mouth breathing, or depression Elevated REE  related to the breathing Increased inflammation of that area

COPD Nutrition Therapy - Interventions Maintain optimal energy balance body weight Overfeeding concern with ventilation Glucose >5 mg/kg/min increases CO2 production Commercial formulas - low CHO (30%) and higher lipid (50%) 25-35 calories per kilo 25-156% energy needs meets above Based on their weight Unable to eat lower cabohydrates, and higher lipids

COPD Nutrition Therapy - Interventions Supplement antioxidants Monitor serum phosphate could be because of their medication Monitor status of calcium and vit. D-> 400 Ius of vitamin d, 400-600 mg of calcium Identify specific nutrition problems Manage weight Vitamin C, A, E, betacarotene

Cystic Fibrosis Nutrition Poor digestion, absorption, malnutrition d/t pancreatic insufficiency Abnormal growth Risk for osteopenia and osteoporosis Stunted growth Increases respiratory problems Decreased pulmonary function Malabsorption and poor digestiong pancreatic dysfunction Impaired bone function with osteoporosis Phosphorous, magnesium, vit D, vit K, Treatment: Multidisciplinary approach special attention goes towards growth and the nutrition status

Cystic Fibrosis Nutrition Assessment National CF Foundation consensus guidelines - nutrition guidelines Special attention to poor growth: Use growth charts – CDC Timeline From birth- 12 months of age usually have stunted growth look at growth right before the reach puberty Head circumference and their weight and length circumferance risks are if they are following below the 10th percentile they are the greatest risk

Cystic Fibrosis Pancreatic enzyme therapy Given with food and beverages Individualized Adequate kcal for normal growth based on weight gain patterns Higher fat intake (35-45% kcal) MCT Glucose intolerance common convert to a diabetic because the pancreas is so stressed, continues to increase in fat and mucus build up converted to diabetic type 2 Do not have lypase and amalyase, proteayse. Take pancreatic enzyme before each meal Want to give them easily absorbed fat Water soluble

Cystic Fibrosis Monitor vitamin & mineral status Monitor sodium levels Assess iron and zinc status Recommend breast feeding more kilocalories, immune fighting properties Developmentally appropriate recommendations Formulas or nutritional supplements Specifically the fat soluble ones Weight status, head circumference and height length

Respiratory Failure Nutrition Meet nutrition needs Energy needs vary widely; may be hypermetabolic Avoid overfeeding Indirect calorimetry preferred method Preserve and restore LBM; respiratory muscle mass Would be on lung transplant lists working with them until they get their new lung Preserve lean body mass End stages of CF IC setting using 25 calories per kilo or 130 percent of their resting ending expenditure 1.2-1.5 calories per kilo

Respiratory Failure Nutrition Maintain fluid balance Facilitate weaning from ventilation Specialty formulas available EPA and GLA can reduce severity of inflammation fish oils Supplementation with antioxidants Phosphate supplementation helps with the normal contractions of the diaphram 1.5-2 calories per CC is usually a supplement Batacrotene, vit C prevent or slow down the oxidated damage