{"id":1872,"date":"2023-02-01T10:03:49","date_gmt":"2023-02-01T13:03:49","guid":{"rendered":"https:\/\/lam.unitedforclinicalnutrition.com\/pt-br\/?p=1872"},"modified":"2023-02-01T10:07:04","modified_gmt":"2023-02-01T13:07:04","slug":"manuseio-nutricao-parenteral-2","status":"publish","type":"post","link":"https:\/\/lam.unitedforclinicalnutrition.com\/pt-br\/manuseio-nutricao-parenteral-2\/","title":{"rendered":"Quais os cuidados essenciais no manuseio e administra\u00e7\u00e3o da nutri\u00e7\u00e3o parenteral?"},"content":{"rendered":"

Embora seja um procedimento comum em ambiente hospitalar, a nutri\u00e7\u00e3o parenteral (NP) requer que sejam seguidas diretrizes adequadas para a sua administra\u00e7\u00e3o. Dessa forma, \u00e9 poss\u00edvel reduzir alguns dos riscos associados a essa interven\u00e7\u00e3o, fundamental para a garantia da energia e dos nutrientes necess\u00e1rios<\/a> para o bem-estar e a recupera\u00e7\u00e3o do paciente.<\/p>\n

Com isso, ainda que possa haver lacunas no conhecimento cient\u00edfico a respeito de determinadas orienta\u00e7\u00f5es, as institui\u00e7\u00f5es hospitalares devem seguir e conhecer os cuidados essenciais no manuseio e administra\u00e7\u00e3o da nutri\u00e7\u00e3o parenteral, sempre de acordo com as melhores pr\u00e1ticas.1<\/a><\/p>\n

 <\/p>\n

Diretrizes para administra\u00e7\u00e3o da nutri\u00e7\u00e3o parenteral<\/h2>\n

Em geral, a via parenteral (ou seja, venosa) \u00e9 indicada nas situa\u00e7\u00f5es em que o trato gastrointestinal n\u00e3o est\u00e1 dispon\u00edvel ou ainda quando as vias enteral e oral s\u00e3o incapazes de garantir o suporte nutricional adequado. O acesso para essa terapia pode ser perif\u00e9rico (geralmente nos membros) ou central (concentrado em art\u00e9rias como a jugular interna, a subcl\u00e1via ou a femoral).<\/p>\n

Quadros hemodinamicamente inst\u00e1veis, de insufici\u00eancia card\u00edaca cr\u00f4nica acompanhada de reten\u00e7\u00e3o h\u00eddrica ou de insufici\u00eancia renal cr\u00f4nica sem di\u00e1lise, via de regra, podem contraindicar a prescri\u00e7\u00e3o de nutri\u00e7\u00e3o parenteral. A contraindica\u00e7\u00e3o tamb\u00e9m \u00e9 v\u00e1lida para todas as situa\u00e7\u00f5es em que o risco for superior aos benef\u00edcios.2<\/a><\/p>\n

 <\/p>\n

Cuidados de verifica\u00e7\u00e3o, conserva\u00e7\u00e3o e instala\u00e7\u00e3o da NP<\/h2>\n

Feita a prescri\u00e7\u00e3o m\u00e9dica da nutri\u00e7\u00e3o parenteral, o profissional respons\u00e1vel deve seguir uma s\u00e9rie de diretrizes para o manuseio adequado da f\u00f3rmula e dos demais itens necess\u00e1rios para a administra\u00e7\u00e3o correta e segura.<\/p>\n

No momento do recebimento das bolsas com as f\u00f3rmulas industrializadas, \u00e9 essencial conferir se o produto recebido \u00e9 compat\u00edvel com aquele que foi prescrito<\/a>. \u00c9 indispens\u00e1vel confrontar tais informa\u00e7\u00f5es com aquelas presentes na prescri\u00e7\u00e3o. Al\u00e9m disso, deve ser feita uma avalia\u00e7\u00e3o da integridade e das informa\u00e7\u00f5es presentes no r\u00f3tulo.1<\/a><\/p>\n

Nesse est\u00e1gio, diversas estrat\u00e9gias podem contribuir para reduzir a margem para erros: prescri\u00e7\u00f5es com o nome do paciente, n\u00famero de leito e do registro hospitalar e r\u00f3tulos diferenciados s\u00e3o algumas das mais simples.1<\/a> As solu\u00e7\u00f5es em nutri\u00e7\u00e3o parenteral da Fresenius Kabi,<\/a> por exemplo, contam com r\u00f3tulos em cores diferentes de acordo com a f\u00f3rmula, o que acrescenta mais uma camada de seguran\u00e7a na verifica\u00e7\u00e3o do item.<\/p>\n

No mais, a complexidade da composi\u00e7\u00e3o das f\u00f3rmulas faz com que a estabilidade de cada uma seja diferente. Desse modo, h\u00e1 poss\u00edveis reflexos de efic\u00e1cia cl\u00ednica. Assim, a temperatura, o tipo de armazenamento, a presen\u00e7a de determinados componentes na formula\u00e7\u00e3o e o tipo de envase podem afetar as prepara\u00e7\u00f5es de nutri\u00e7\u00e3o parenteral.3,<\/a>4,<\/a>5<\/a><\/p>\n

Para adultos, n\u00e3o h\u00e1 ainda diretriz espec\u00edfica para a fotoprote\u00e7\u00e3o das bolsas com f\u00f3rmulas individualizadas e industrializadas. O mesmo n\u00e3o acontece nas bolsas individualizadas destinadas a pr\u00e9-termos<\/a>: elas devem ter prote\u00e7\u00e3o individualizada completa da a\u00e7\u00e3o da luz.1<\/a><\/p>\n

O tempo m\u00e1ximo de infus\u00e3o deve respeitar o prazo informado pelo fabricante e nunca superar 24 horas. Al\u00e9m disso, a cada bolsa ou a cada 24 horas deve ser feita a troca do conjunto de administra\u00e7\u00e3o. Refor\u00e7ar a aten\u00e7\u00e3o desde o momento da escolha do acesso, da instala\u00e7\u00e3o do cateter e nos cuidados di\u00e1rios subsequentes reduz o risco de complica\u00e7\u00e3o, em especial \u00e0quelas relacionadas \u00e0 infec\u00e7\u00f5es.1<\/a><\/p>\n

\"\"<\/p>\n

Algumas das interven\u00e7\u00f5es necess\u00e1rias para reduzir riscos<\/h2>\n

No mais, algumas interven\u00e7\u00f5es e o acompanhamento adequado da terapia nutricional via parenteral podem contribuir de forma adicional para a redu\u00e7\u00e3o dos riscos. Nos casos de oclus\u00e3o do cateter, por exemplo, \u00e9 fundamental identificar a causa do bloqueio. Na presen\u00e7a de obstru\u00e7\u00f5es n\u00e3o tromb\u00f3ticas podem ser usadas solu\u00e7\u00f5es espec\u00edficas para desfaz\u00ea-las. Solu\u00e7\u00f5es fibrinol\u00edticas s\u00e3o indicadas para resolver problemas relativos a obstru\u00e7\u00f5es tromb\u00f3ticas.1<\/a><\/p>\n

No geral, recomenda-se n\u00e3o trocar rotineiramente cateteres perif\u00e9ricos em menos de 96 horas e de forma recorrente para acessos centrais, exceto diante de sinais da presen\u00e7a de infec\u00e7\u00f5es ou de um mau funcionamento do dispositivo.1<\/a><\/p>\n

Com tudo isso, por se tratar de um processo complexo, todos os cuidados relativos ao manuseio e administra\u00e7\u00e3o da nutri\u00e7\u00e3o parenteral devem ser redobrados e compartilhados por todos os profissionais envolvidos no suporte ao paciente.<\/p>\n

 <\/p>\n

Aproveite e saiba mais sobre as diretrizes da Braspen para enfermagem em terapia nutricional<\/a>.<\/p>\n","protected":false},"excerpt":{"rendered":"

Embora seja um procedimento comum em ambiente hospitalar, a nutri\u00e7\u00e3o parenteral (NP) requer que sejam seguidas diretrizes adequadas para a sua administra\u00e7\u00e3o. Dessa forma, \u00e9 poss\u00edvel reduzir alguns dos riscos associados a essa interven\u00e7\u00e3o, fundamental para a garantia da energia e dos nutrientes necess\u00e1rios para o bem-estar e a recupera\u00e7\u00e3o do paciente. Com isso, ainda […]<\/p>\n","protected":false},"author":5902,"featured_media":1875,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[49],"tags":[120,206,81,67,143],"class_list":["post-1872","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-artigo-5","tag-cateter","tag-complicacoes","tag-nutricao-clinica","tag-nutricao-parenteral","tag-terapia-nutricional"],"acf":[],"yoast_head":"\nSaiba como aprimorar o manuseio e administra\u00e7\u00e3o da nutri\u00e7\u00e3o parenteral.<\/title>\n<meta name=\"description\" content=\"Refor\u00e7ar determinados cuidados nu manuseio e na administra\u00e7\u00e3o da nutri\u00e7\u00e3o parenteral reduz o risco de complica\u00e7\u00f5es\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" 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