[Constant flow enteral feeding with an elemental diet in the treatment of severe protracted diarrhea in early childhood]. 1985

L Gobio Casali, and G Gambaretto, and R Astolfi

The enteric nutrition with constant flow (ENCF) with elemental and semielemental diets is a very useful therapeutic approach in the management of severe and protracted diarrhoea in young infants. It can be proceeded or not by a period of total parenteral nutrition according to age of the patient, the entity and duration of the diarrhoea and the degree of the malnutrition and the presence or not of an infection. The indication of the enteric alimentation with a constant flow has been done in cases of severe diarrhea prolonged more than 14 days without response to the traditional dietetic treatment and/or a state of malnutrition with weight - 2 SD with respect to the average of the age/height ratio and/or a plasma proteins less than or equal to 4.5 g% and an albuminemia less than 2.8 g%. The casuistry is made up of 19 cases, from the age of 1 month to 20 month. The duration of the treatment was between 13 and 123 days. The enteric alimentation was done with elemental or semielemental diet with an osmolarity of 320 m OSM/C. freshly preparated; each of the ingredients could be modified independently one from the other. The decision to modify qualitatively and quantitatively the diet is always the consequence of a daily evaluation of the nutritional needs of the child and at the same time of the digestive tolerance valued according to precise clinical and biological criteria. The results obtained were: arrest of diarrhoea in 90% of the cases (17/19), continuation of diarrhoea in 10% (2/19) and death in 1 case. The weight increase was obtained in 90% of the cases (M = 13.2 gr./die). The Authors discuss the criteria to decide 1) if a period of TPN had to proceed the ENCF, 2) the more adapt components to utilize for elemental and semielemental diet, 3) the modality of practial realization, 4) the criteria of clinical and biological supervision, 5) the possible mechanical and metabolical complications. The Authors conclude that the ENCF with elemental and semielemental diets is an important progress in the therapeutic approach in serious and protracted diarrhoea in young infants. The knowledge of the problem, a careful clinical and biological supervision are the best methods to obtain the maximum and the minimum risks of mechanical and metabolical complications.

UI MeSH Term Description Entries
D007223 Infant A child between 1 and 23 months of age. Infants
D008903 Minerals Native, inorganic or fossilized organic substances having a definite chemical composition and formed by inorganic reactions. They may occur as individual crystals or may be disseminated in some other mineral or rock. (Grant & Hackh's Chemical Dictionary, 5th ed; McGraw-Hill Dictionary of Scientific and Technical Terms, 4th ed) Mineral
D008991 Monitoring, Physiologic The continuous measurement of physiological processes, blood pressure, heart rate, renal output, reflexes, respiration, etc., in a patient or experimental animal; includes pharmacologic monitoring, the measurement of administered drugs or their metabolites in the blood, tissues, or urine. Patient Monitoring,Monitoring, Physiological,Physiologic Monitoring,Monitoring, Patient,Physiological Monitoring
D009994 Osmolar Concentration The concentration of osmotically active particles in solution expressed in terms of osmoles of solute per liter of solution. Osmolality is expressed in terms of osmoles of solute per kilogram of solvent. Ionic Strength,Osmolality,Osmolarity,Concentration, Osmolar,Concentrations, Osmolar,Ionic Strengths,Osmolalities,Osmolar Concentrations,Osmolarities,Strength, Ionic,Strengths, Ionic
D001835 Body Weight The mass or quantity of heaviness of an individual. It is expressed by units of pounds or kilograms. Body Weights,Weight, Body,Weights, Body
D003968 Diarrhea, Infantile DIARRHEA occurring in infants from newborn to 24-months old. Infantile Diarrhea,Diarrheas, Infantile,Infantile Diarrheas
D004040 Dietary Carbohydrates Carbohydrates present in food comprising digestible sugars and starches and indigestible cellulose and other dietary fibers. The former are the major source of energy. The sugars are in beet and cane sugar, fruits, honey, sweet corn, corn syrup, milk and milk products, etc.; the starches are in cereal grains, legumes (FABACEAE), tubers, etc. (From Claudio & Lagua, Nutrition and Diet Therapy Dictionary, 3d ed, p32, p277) Carbohydrates, Dietary,Carbohydrate, Dietary,Dietary Carbohydrate
D004041 Dietary Fats Fats present in food, especially in animal products such as meat, meat products, butter, ghee. They are present in lower amounts in nuts, seeds, and avocados. Fats, Dietary,Dietary Fat,Fat, Dietary
D004044 Dietary Proteins Proteins obtained from foods. They are the main source of the ESSENTIAL AMINO ACIDS. Proteins, Dietary,Dietary Protein,Protein, Dietary
D004750 Enteral Nutrition Nutritional support given via the alimentary canal or any route connected to the gastrointestinal system (i.e., the enteral route). This includes oral feeding, sip feeding, and tube feeding using nasogastric, gastrostomy, and jejunostomy tubes. Enteral Feeding,Force Feeding,Nutrition, Enteral,Tube Feeding,Gastric Feeding Tubes,Feeding Tube, Gastric,Feeding Tubes, Gastric,Feeding, Enteral,Feeding, Force,Feeding, Tube,Feedings, Force,Force Feedings,Gastric Feeding Tube,Tube, Gastric Feeding,Tubes, Gastric Feeding

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