Nutrition in palliative careNutriția în paliație

[:en]Niţipir Cornelia (a,b), Tebeica Ana-Maria (b), Iaciu Ion-Cristian (b), Barbu Maria Alexandra (b), Radu Irina (b), Panteleimon Juliana (b), Emilescu Radu Andrei (b)

(a): MD, PhD, senior oncologist, University of Medicine and Pharmacy Carol Davila, Bucharest, Romania
(b): MD, oncologist, SUU Elias, Department of Oncology, Bucharest, Romania

Corresponding author: Niţipir Cornelia: e-mail: nitipir2003@yahoo.com

Abstract

Cancer patients eligible for nutritional support while receiving palliative care are those which have an advanced stages of the disease or are expected to die of other reasons than the tumor.

The experts in nutrition recommend oral feeding when the patient is able to swallow and chew. Nasogastric tube feeding is limited to cases in which the oral route is contraindicated.

Venous nutrition is recommended in severe cases or when it is not possible to supply nutrition via oral or nasogastric tube.

During parenteral nutrition several complications may be encountered. These may be related to the venous catheter insertion (thrombosis, pulmonary embolism, hydro-pneumatic hematotorax, sepsis), electrolyte disturbances (hypokalemia), metabolic disorders (hypercalcemia, hypoglycemia, hyperosmolar coma), and hepatic dysfunction (steatosis, cholestasis, sludge bile).

Anorexia and cachexia are describe to occur frequently in patients with advanced neoplastic disease and are associated with fatigue, loss of appetite, early satiety, aversion to food and weight loss, known as ‘Wasting Syndrome “. These patients usually have a short survival time, do not respond to chemotherapy and they manifested increased toxicity to this.

The complexity of the palliative treatment of patients with cancer is an ongoing challenge especially for oncologists. Guided or inspired by the Hippocratic Oath, they should struggle to defend the concept of dignity of the human being, regardless their personal or social position.

Key words: anorexia, cachexia, parenteral nutrition, enteral nutrition, cancer

(Full text in Romanian)

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