抄録
Nutritional support has advanced and is now widely accepted as a basic component of patient care. However, the inadequate administration of total parenteral nutrition and catheter-related sepsis has become increasingly problematic. One of the earliest nutrition support teams was established in Boston City Hospital in 1973, and similar teams have subsequently been established all over the world, including Japan. A nutrition support team was developed at the Nippon Medical School Hospital in March 2005. The team is composed of certified nutrition support physicians, nurses trained in nutrition support, dieticians, a pharmacist, and other staff members. At first, nutritional screenings for malnourished patients were performed by evaluating serum albumin levels. The percentage of malnourished patients whose serum albumin levels were less than 3.0 g/dl was 31.8% (310 of 974 patients). Enteral nutrition was performed in 3.8% of the admitted patients. Total parenteral nutrition was performed in 6.4% of the admitted patients. Next, the energy intake from food consumption, via both enteral and parenteral nutrition, was evaluated for 3 days from April 29 through May 1, 2005. The mean energy intake of the 155 admitted patients was 1,295 ± 526 kcal/day. Of these patients, 86% ate food and consumed 80 ± 26% of the served meals. Energy from the oral intake of food amounted to 1,362 ± 501 kcal/day, whereas that from enteral nutrition amounted to 945 ± 497 kcal/day and that from parenteral nutrition amounted to 1,003 ± 405 kcal/day. No nutritional support was performed in 4.5% of patients. The results of this study demonstrate that at least 25% of the patients were malnourished and inquired additional nutritional support by the newly developed nutrition support team.
