Discover and read the best of Twitter Threads about #dietitian
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#Endocrinology #Endotwitter @RpratleyMD @ethanjweiss @parthaskar @SaifiTaban @AlbalawiZaina @drkevinfernando @drricardocorrea @CMichaelGibson @cpcannon @Sonia_ButaliaMD @mmamas1973 @SABOURETCardio FOLLOW us here for accredited programs at the speed of Twitter!
1) Welcome to a tweetorial on #insulinhesitancy in contemporary #T2D management. This serialized program is accredited for 0.5h by @academiccme: #physicians, #nurses, #pharmacists! I am @AliceYYCheng . . . 
. . . and this educational activity is intended for healthcare providers and is supported by grants from AstraZeneca, Bayer, Chiesi, and NovoNordisk.
Top 10 key expert opinion recommendations for nutrition support for the critically ill patient with #COVID19 via @ASPENWEB.
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These recs are based on indirect evidence (2016 SCCM/ASPEN and 2019 EPSEN Guidelines), direct evidence from limited COVID19 trials, and expert opinion. 2/
Key Rec #1:
-Use wt based equations to determine energy & protein needs
-15-20 kcals/kg/d; 1.2-2 g protein/kg
-Do not use indirect calorimeter as this increases contamination risk
-Monitor for refeeding syndrome (monitor phos, mag, potassium)
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-Use wt based equations to determine energy & protein needs
-15-20 kcals/kg/d; 1.2-2 g protein/kg
-Do not use indirect calorimeter as this increases contamination risk
-Monitor for refeeding syndrome (monitor phos, mag, potassium)
3/
Lots of talk happening on different enteral feeding methods. Here is a thread to describe each and their ideal usages. #RDChat #WhatRDsDl 1/
Continuous (pump assisted): requires feeding bag (feed&flush bag or RTH allows both to be given via pump) & pump. Typically used for ICU, j-tubes or G who🙅🏻♀️ tolerate bolus. Rate ordered is infused over the full hour (eg 60mL/hr infused 60mL over 1 hour) 2/ #WhatRDsDo #RDChat
Keep in mind that any volume of formula via pump is given over the entire hour, whereas a flush via pump is usually given in one quick bolus. This can sometimes lead to cramping, dumping esp in j tube patients. Smaller, more frequent flushes are helpful. 3/#WhatRDsDo #RDChat
🚨📢 #Tweetorial on #ICU nutritional management in #COVID19 – disclaimer this is from my own insights having worked as an ICU #dietitian & working as a #juniordoctor #Hammersmith ICU resources will be tagged at the end - WARNING it’s long - so grab a ☕️ 1/13
Calculating requirements (Energy)
▪️If BMI>25 therefore opt for AIBW/IBW
▪️Many with single organ failure, ventilated & febrile +
▪️Equations to help – PENN STATE & Mifflin St Jeor – factors temp/vent settings OR if in doubt or time limits ASPEN BMI>30 11-14kcal/kg/ABW/day 2/13
▪️If BMI>25 therefore opt for AIBW/IBW
▪️Many with single organ failure, ventilated & febrile +
▪️Equations to help – PENN STATE & Mifflin St Jeor – factors temp/vent settings OR if in doubt or time limits ASPEN BMI>30 11-14kcal/kg/ABW/day 2/13
Calculating requirements (Energy)
▪️We anticipate most pt’s will receive only 70% of feed due to variety of issues (proning, aspiration risk/placement delays)
▪️Don’t despair but prioritise tolerance and build up feed and ⬆️ protein provision 3/13
▪️We anticipate most pt’s will receive only 70% of feed due to variety of issues (proning, aspiration risk/placement delays)
▪️Don’t despair but prioritise tolerance and build up feed and ⬆️ protein provision 3/13
Here’s Evanna our Gastrointestinal Surgery Dietitian in MDT Pre-Op clinic. Dietetic advice is key to help prepare a patient for better surgical outcomes incl. reducing the chance of stoma formation and reducing hospital stay for patients with #CrohnsDisease #Gisurgerydietitian
Evanna is involved in surgical prehabilitation for gastrointestinal surgeries.
Here's more on the importance of the role of nutrition and exercise: anesthesiology.theclinics.com/article/S1932-…
Here's more on the importance of the role of nutrition and exercise: anesthesiology.theclinics.com/article/S1932-…
Nutrition is a modifiable risk factor for post-operative outcomes. We must identify ‘at-risk’ patients early to help prevent malnutrition @StGDietitians
#WhatDietitiansDo #NutritionScreening #MUST #PreOp #Patientflow
#WhatDietitiansDo #NutritionScreening #MUST #PreOp #Patientflow
