Nutrition Evaluation and Intervention

1. After the patient is administered into the ICU, the nutritionist will conduct the first nutrition evaluation in 2 working days and provide proper nutrition formula. The formula will be adjusted every working day.
2. After the patient is transferred to the average ward:
   • Patient of Tube Feeding: The nutritionist will conduct the first nutrition evaluation during working days and provide proper nutrition formula. Patients of tube feeding receiving stable feeding shall be tracked once every seven days. In case if anyone suggests the abnormal gastrointestinal function during the period, the nutritionist will visit in person and adjust the nutrition formula.
   • Patient of oral feeding: The physician and registered nurses will consult with the nutritionist when the patient has nutritional problems.

Common Gastrointestinal Complications and Treatment Measures for Patients of Tube Feeding

Common Diet Problems and Response Measures for Oral Intake

1. Poor appetite and reduced weight

• Small quantity and multiple meals: Adjust 3 meals a day to 6 meals, increasing the number of meals.
• Choose food with small size and high calorie.
• Adjust clear soup into thick soup.
• Choose food with thickening sauce: Noodle, stewed rice, and noodle with thickened sauce.
• Eat food with rich content in “zinc” to help improve the appetite, taste and promote wound healing.
• Source of animal food: Seafood and meat.
• Source of plant food: beans, nuts and seeds.
• Oral nutrition supplements.
• If the hospitalized patients have inadequate intake from the mouth, use low-calorie IV supplement.

2. Poor wound healing

• Adequate intake of calorie and protein.
• For inadequate calorie intake, refer to the diet strategies for “poor appetite and reduced weight.”
• Food with rich content of protein includes: meat, seafood, milk, soybean products (tofu, bean curd, and soybean milk).
• Intake of food rich in zinc
• Source of animal food: Seafood, meat
• Source of plant food: Beans, nuts and seeds.
• Intake of food rich in vitamin C.
• Vitamin C participates in the synthesis with collagen. Collagen is the affixture substance between cells, which helps the formation of the connective tissue of the body, promotes wound healing, and increasing the resistance to wound and infection as well as other pressure.
• Source of food rich in vitamin C: Guava has the richest content of vitamin C. Citrus fruits such as orange, tangerine, grapefruit, and lemon are also rich in vitamin C. Additionally, the content of vitamin C is high in kiwi fruit, tomato, strawberry, pineapple, and persimmon.
• Intake of food rich in Vitamin A: Deficiency of vitamin A will affect the synthesis of epithelium and therefore the healing of the wound.
• Source of animal food: Mostly found in liver and egg yolk.
• Source of plant food: Carrots, dark-green and dark-orange or yellow vegetable and fruits a rich in β carotene, which can be converted into vitamin A in the body. Since vitamin A is fat-soluble vitamin, cooking with oil can reinforce the absorption of vitamin A.

Nutrition for Immunity

1. Recommended dosage for Arginine: At least 4.5 grams/day; 15~30 grams/day is the safe dosage.
2. Recommended dosage for fish oil: 2 grams/day.
3. Glutamine: 0.3~0.5 grams/kilo/day.