Formulating Diet for Transitional Feeding in Tuberculous Meningitis Patient after a Period of Home Healthcare

Background/Aims: Nutritional management and transitional feeding are known to play an important role in immobilized patient to prevent malnutrition. Unfortunately, long-term using tube feeding will impaired normal process of recovery major disease and risk to secondary infection. Adequate intake of...

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Bibliographic Details
Published in:Annals of nutrition and metabolism 2019-01, Vol.75, p.53
Main Authors: Rahardjo, Franciska, Mardiana, Taslim, Nurpudji A
Format: Article
Language:English
Subjects:
Albumin
Albumins
Anemia
Choline
Cognitive ability
Cough
Depletion
Dermatitis
Diet
Enteral nutrition
Feeding
Fever
Fish oils
Health care
Health risks
Home health care
Hyperlipidemia
Hyponatremia
Immune system
Lymphocytes
Malnutrition
Meningitis
Micronutrients
Morbidity
Mortality
Nutrient solutions
Nutrition
Nutrition therapy
Paralysis
Patients
Physical therapy
Pressure ulcers
Quality of care
Rehabilitation
Secondary infection
Tuberculosis
Wound healing
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Summary:Background/Aims: Nutritional management and transitional feeding are known to play an important role in immobilized patient to prevent malnutrition. Unfortunately, long-term using tube feeding will impaired normal process of recovery major disease and risk to secondary infection. Adequate intake of macronutrients and micronutrients before, during, and after rehabilitation can affect morbidity, mortality, and improving immune system, cognitive and functional capacity. Methods: We present a case of a 25-year-woman was consulted by a neurologist with tuberculous meningitis and decubitus ulcer. The chief complaint was no intake since last 9 days because of loss consciousness. There was fever and seldomly cough. From physical examination, we found sign of anemia, dermatitis in neck, armpit and back, decubitus ulcer and limb paralysis. From laboratory examination, there were normocytic normochromic anemia, immune depletion, hypoalbuminemia, hyponatremia, hyperlipidemia and elevated liver transaminase. Nutritional therapy, by giving enteral nutrition to reach the calorie target, contained of high protein and choline ONS (oral nutritional supplement), blenderized diet. vitamin A, B complex, C, D, zinc, and cork fish extract as the source of albumin, immunonutrient such as fish oil as supplementation were given. Results: After 35-day treatment, there were increased of plasma albumin and lymphocyte level, accelerated wound healing, dermatitis, and functional capacity. Home healthcare visit for about 1-month and physiotherapy to support oral feeding from liquid to blenderized diet until porridge and improve cognitive and functional capacity. Conclusion: Optimal nutritional support with transitional feeding to enhance adequate intake can accelerate wound healing, decrease morbidity and mortality rate in tuberculous meningitis patient.
ISSN:0250-6807
1421-9697
DOI:10.1159/000501751