A.S.P.E.N. Enteral Nutrition Practice Guidelines (2009)

Clinicians working with tube feeding patients/clients will be interested in these practice guidelines that A.S.P.E.N. published online yesterday. You can access them without a password.

Enteral Nutrition Practice Recommendations

Critical Care Nutrition

Until earlier today, I didn't know about this valuable site -- it's Canadian, too -- for critical care dietitians and physicians. I discovered Critical Care Nutrition (CCN) by responding to a request to complete a survey.  I don't have a good excuse for my ignorance other than, from habit, I've always turned to A.S.P.E.N., and more recently, ESPEN for nutrition support practice guidelines.

Now that I've found CCN, I'll be adding the link to my Connotea library and sharing it here, with a brief introduction and description to guide your exploration of this site.

CCN's team consists of physicians and dietitians "dedicated to the improvement in nutrition therapies in intensive care units across the world." The site's resources include downloadable, adaptable:

• Evidence-based Canadian Clinical Practice Guidelines  in three formats: full-text Journal of Parenteral & Enteral Nutrition (JPEN) article (2003), protocol, and summary of recommendations.
• Tools & Training Kit (protocols, algorithms, flowcharts) consisting of (i) a Manual of Clinical Practice Guidelines for Nutrition Support in Mechanically-Ventilated, Adult Critically Ill Patients (ii) Glycemic Control for Adult Intensive Care Patients, (iii) Order Sets, and (iv) a Training Kit for an Interactive Workshop.

Another feature is a discussion forum, although its activity seems to be quite low at present.

CCN definitely is a site worth exploring if you are a dietitian looking after critically-ill patients.

Nutrition Support for Head Injury

I have uploaded another Cochrane review on nutrition for neurosciences patients. This one is Nutritional Support for Head-Injured Patients.

The reviewers concluded:

...[T]here have been few trials into nutritional support following head injury, which makes it hard for the clinician to make an evidence-based decision about nutritional support in head-injured patients. Overall the quality of the trials was poor (page 8).

Round-up of Stroke Resources

Today at a Stroke Care Improvement meeting I shared some of the stroke resources I've been gathering during the past two months. Now would be a good time to take stock and collect all the previously published links in one post. The list is a work-in-progress and will grow.

Although the resources are not nutrition-specific, they all contain some nutrition elements such as diet modifications to reduce stroke risk factors (primary and secondary prevention) or manage deficits (e.g, dysphagia) during acute stroke treatment and rehabilitation.

THE LIST:

Practices and Standards Working Group, The Canadian Stroke Strategy. Canadian Best Practice Recommendations for Stroke Care: 2006.

Best Practices and Standards Working Group, The Canadian Stroke Strategy. Best Practices and Standards Environmental Scan Report.

Heart and Stroke Foundation home page.

Heart and Stroke Foundation of Ontario, Ontario Stroke System. Best Practice Guidelines.

National Stroke Foundation, Australia. National Clinical Guidelines for Acute Stroke Management.

National Stroke Foundation, Australia. National Clinical Guidelines for Stroke Rehabilitation and Recovery.

National Stroke Foundation, Australia. Stroke Care Pathway: A Resource for Health Professionals.

Scottish Intercollegiate Guidelines Network. Management of patients with stroke: Identification and management of dysphagia. September 2004.

Scottish Intercollegiate Guidelines Network. Management of patients with stroke: Rehabilitation, prevention and management of complications, and discharge planning. November 2002.

Teasell R, Foley N. Evidence-based review of stroke rehabilitation: Managing the stroke rehabilitation triage process.