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Chronic Hypothermia And Energy Expenditure In A Neurodevelopmentally Disabled Patient: A Case Study, Jane Gervasio, Roland Dickerson, Rex Brown, J. Matthews
Chronic Hypothermia And Energy Expenditure In A Neurodevelopmentally Disabled Patient: A Case Study, Jane Gervasio, Roland Dickerson, Rex Brown, J. Matthews
Jane M. Gervasio
Hypothermia is defined as a core body temperature of <35°C and results in a decrease in measured resting energy expenditure. A 51-year-old mentally disabled patient experienced chronic hypothermia from neurologic sequelae. Because of her continued weight gain and increased body fat in the presence of presumed hypocaloric nutrition, indirect calorimetry measurements were performed twice in a 3-month period. The resting energy expenditure measurements prompted a reduction of her daily caloric intake to prevent further overfeeding. Hypothermia reduces oxygen consumption and, as a consequence, decreases resting energy expenditure. In patients for whom chronic hypothermia is a problem, nutritional intake must be …
Measured Energy Expenditure Of Tube-Fed Patients With Severe Neurodevelopment Disabilities, Roland N. Dickerson, Rex O. Brown, Jane M. Gervasio, Emily B. Hak, Lawrence J. Hak, John E. Williams
Measured Energy Expenditure Of Tube-Fed Patients With Severe Neurodevelopment Disabilities, Roland N. Dickerson, Rex O. Brown, Jane M. Gervasio, Emily B. Hak, Lawrence J. Hak, John E. Williams
Jane M. Gervasio
Objective: To determine measured resting energy expenditure (REE) of nonambulatory tube-fed patients with severe neurological neurodevelopmental disabilities. Methods: Twenty patients were prospectively studied. Only steady state indirect calorimetry measurements were taken. All measurements were conducted using a canopy system. Nutritional needs were met entirely by enteral feedings via a permanent ostomy. Results: REE was widely distributed from 16 kcals/kg/day to 39 kcals/kg/day. The mean REE (888 ±176 kcals/day) of the patients was significantly (p < 0.01) lower than predicted as estimated by the Harris-Benedict equations (1081 ± 155 kcals/day) and World Health Organization equations (1194 ± 167 kcals/day). Fat-free mass (FFM) …
Nutrition Support Therapy In Acute Kidney Injury: Distinguishing Dogma From Good Practice, Jane M. Gervasio, Ann B. Cotton
Nutrition Support Therapy In Acute Kidney Injury: Distinguishing Dogma From Good Practice, Jane M. Gervasio, Ann B. Cotton
Jane M. Gervasio
Acute kidney injury (AKI) is a frequently observed complication in critically ill patients. Its presentation may range from the early risk of renal dysfunction to complete renal failure. Morbidity and mortality in the AKI patient increase with the decline of renal function. Appropriate nutrition therapy is essential in the medical management of the AKI patient. Assessment of nutritional requirements should take into account the patient’s underlying complication, comorbid medical conditions, and severity of the renal dysfunction. Various stages of AKI determine the direction of nutrition therapy. Additionally, understanding the macro- and micronutrient modifications and electrolyte and vitamin alterations that should …