Browsing by Author "Mauricio, Silvia Fernandes"

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    Evolução dos balanços energético e proteico no pós-operatório de pacientes submetidos a operações abdominais de grande porte.
    (2021) Silva, Thales Antônio da; Zocrato, Maria Clara Arantes; Mauricio, Silvia Fernandes; Correia, Maria Isabel Toulson Davisson; Generoso, Simone de Vasconcelos
    Introdução: Acompanhar os balanços energético e proteico é de extrema importância para avaliação e monitoramento do estado nutricional de pacientes cirúrgicos. A adequação das necessidades nutricionais desses indivíduos representa um desafio perante os vários fatores que interferem no estado nutricional, tolerância e aceitação da terapia nutricional. Diante disso, este trabalho objetivou avaliar a evolução dos balanços energético e proteico no pós-operatório de pacientes submetidos a operações abdominais de grande porte, além de observar as repercussões nutricionais e clínicas (complicações pós-operatórias, tempo de internação e óbito) associadas à inadequação das neces- sidades nutricionais preconizadas para o paciente cirúrgico. Método: Sessenta e um pacientes submetidos a operações abdominais eletivas tiveram o gasto energético de repouso mensurado no pré-operatório imediato. Foram realizadas avaliações nutricionais, antropométricas e funcionais no pré-operatório imediato, no 3o e no 7o dia pós-operatório, além de terem sido coletados Recorda- tórios Alimentares de 24 horas. Dados de infusão de dietas enterais e parenterais para cálculos de consumo e adequação calórica e proteica, também, foram registrados. Os desfechos clínicos foram coletados em prontuário. Resultados: 70,5% da amostra apresentou algum grau de desnutrição prévio à internação hospitalar, conforme a Avaliação Global Subjetiva (AGS). Em relação aos balanços energético e proteico, foram observados valores negativos, mesmo naqueles pacientes que estavam em uso de terapia nutricional, sem diferença estatística significativa entre os grupos. Observou-se correlação positiva entre o balanço energético negativo e o tempo de internação, assim como associação negativa entre o estado nutricional obtido pela AGS e as complicações pós-operatórias. Conclusões: As necessidades calóricas e proteicas dos pacientes no período pós-operatório não são alcançadas, mesmo entre aqueles que recebem terapia nutricional, impactando no tempo de internação. Sugere-se mais estudos com outras estratégias metodológicas para avaliação acerca do impacto no estado nutricional desse cenário em pacientes cirúrgicos.
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    Preoperative and postoperative resting energy expenditure of patients undergoing major abdominal operations.
    (2021) Silva, Thales Antônio da; Maia, Fernanda de Carvalho Pazzini; Zocrato, Maria Clara Arantes; Mauricio, Silvia Fernandes; Correia, Maria Isabel Toulson Davisson; Generoso, Simone de Vasconcelos
    Background: Nutrition therapy plays a major role in the perioperative management of surgical patients. Understanding energy metabolism and correctly establishing the adequate energy needs is a crucial step to provide optimal nutrition care. The aim of this study was to assess the resting energy expenditure (REE) after major abdominal procedures and its associated factors. Methods: This was a prospective observational study conducted at a single center. REEs of patients admitted for gastrointestinal surgical procedures were measured by indirect calorimetry 24 hours prior to the procedure and reassessed at least once within the fifth postoperative day. Substrate oxidation was calculated according to the Frayn equation. Nutrition status was evaluated using subjective global assessment. Results: There were no significant changes in the REEs throughout the study period; however, there was a decrease in the respiratory quotient during the postoperative period, as well as a decrease in carbohydrate oxidation and an increase in lipid oxidation. Only 33.3% of the patients presented a postoperative increase in REE > 10%. Those patients presented higher blood-monocyte levels. Conclusion: Postoperative REE is not increased in most of the patients. In patients who had increased REE, associated factors included higher levels of monocytes.
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    Short-term effect of whey protein supplementation on the quality of life of patients waiting for liver transplantation : a double blinded randomized clinical trial.
    (2021) D´Alessandro, Michelle Carvalho de Oliveira; Gomes, Amanda Dias; Morais, Jéssica França; Mizubuti, Yani Glaúcia Gomide; Silva, Thales Antônio da; Mauricio, Silvia Fernandes; Mendes, Larissa Loures; Correia, Maria Isabel Toulson Davisson; Generoso, Simone de Vasconcelos
    Background: Chronic liver disease is associated with malnutrition that negatively impacts a patient’s health-related quality of life (HRQoL). Aim: To evaluate the short-term effect of whey protein supplementation on the HRQoL and nutritional and functional status of patients waiting for liver transplantation. Methods: This was a double-blind randomized clinical trial with patients waiting for liver transplantation who were randomized into two groups: WP (whey protein supplementation) and the control (casein supplementation). Both groups received 40 g (20 g in the morning and 20 g in the evening) for 15 days. Nutritional and functional status were evaluated. Energy balance was calculated as the difference between energy intake (24-hour recall) and total energy expenditure (assessed by indirect calorimetry). The chronic liver disease questionnaire was used to assess HRQoL. All measurements were performed before and after the intervention. Results: Fifty-six patients were evaluated. Malnutrition was present in 56.9%, and it was directly associated with a poor HRQoL (p<0.05). No improvement on the nutritional and functional status was observed, in either group after protein supplementation. HRQoL improved after WP and casein supplementation, with no differences between groups (p>0.05). Patients who met protein requirements and had a positive energy balance demonstrated a higher HRQoL score (4.9, p<0.05), without between-group differences. Conclusion: Malnutrition substantially reduces HRQoL. Short-term WP or casein supplementation improved similarly the HRQoL.