{"id":51818,"date":"2021-12-20T00:10:55","date_gmt":"2021-12-20T03:10:55","guid":{"rendered":"https:\/\/nutritotal.com.br\/pro\/?p=51818"},"modified":"2023-05-31T16:53:19","modified_gmt":"2023-05-31T19:53:19","slug":"exames-laboratoriais-na-terapia-nutricional","status":"publish","type":"post","link":"https:\/\/nutritotal.com.br\/pro\/exames-laboratoriais-na-terapia-nutricional\/","title":{"rendered":"Quais exames devem acompanhar de pacientes com nutri\u00e7\u00e3o enteral e parenteral?"},"content":{"rendered":"<div id=\"ez-toc-container\" class=\"ez-toc-v2_0_75 counter-hierarchy ez-toc-counter ez-toc-grey ez-toc-container-direction\">\n<div class=\"ez-toc-title-container\">\n<p class=\"ez-toc-title\" style=\"cursor:inherit\">Conte\u00fado<\/p>\n<span class=\"ez-toc-title-toggle\"><a href=\"#\" class=\"ez-toc-pull-right ez-toc-btn ez-toc-btn-xs ez-toc-btn-default ez-toc-toggle\" aria-label=\"Alternar tabela de conte\u00fado\"><span class=\"ez-toc-js-icon-con\"><span class=\"\"><span class=\"eztoc-hide\" style=\"display:none;\">Toggle<\/span><span class=\"ez-toc-icon-toggle-span\"><svg style=\"fill: #999;color:#999\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" class=\"list-377408\" width=\"20px\" height=\"20px\" viewBox=\"0 0 24 24\" fill=\"none\"><path d=\"M6 6H4v2h2V6zm14 0H8v2h12V6zM4 11h2v2H4v-2zm16 0H8v2h12v-2zM4 16h2v2H4v-2zm16 0H8v2h12v-2z\" fill=\"currentColor\"><\/path><\/svg><svg style=\"fill: #999;color:#999\" class=\"arrow-unsorted-368013\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"10px\" height=\"10px\" viewBox=\"0 0 24 24\" version=\"1.2\" baseProfile=\"tiny\"><path d=\"M18.2 9.3l-6.2-6.3-6.2 6.3c-.2.2-.3.4-.3.7s.1.5.3.7c.2.2.4.3.7.3h11c.3 0 .5-.1.7-.3.2-.2.3-.5.3-.7s-.1-.5-.3-.7zM5.8 14.7l6.2 6.3 6.2-6.3c.2-.2.3-.5.3-.7s-.1-.5-.3-.7c-.2-.2-.4-.3-.7-.3h-11c-.3 0-.5.1-.7.3-.2.2-.3.5-.3.7s.1.5.3.7z\"\/><\/svg><\/span><\/span><\/span><\/a><\/span><\/div>\n<nav><ul class='ez-toc-list ez-toc-list-level-1 ' ><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-1\" href=\"https:\/\/nutritotal.com.br\/pro\/exames-laboratoriais-na-terapia-nutricional\/#Mas_quais_exames_laboratoriais_devem_ser_monitorados_para_pacientes_em_terapia_nutricional\" >Mas quais exames laboratoriais devem ser monitorados para pacientes em terapia nutricional?<\/a><ul class='ez-toc-list-level-3' ><li class='ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-2\" href=\"https:\/\/nutritotal.com.br\/pro\/exames-laboratoriais-na-terapia-nutricional\/#E_com_qual_frequencia_devemos_avaliar_esses_exames\" >E com qual frequ\u00eancia devemos avaliar esses exames?<\/a><\/li><\/ul><\/li><\/ul><\/nav><\/div>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone wp-image-51820 size-full\" src=\"https:\/\/nutritotal.com.br\/pro\/wp-content\/uploads\/2021\/12\/Parenteral_site.png\" alt=\"Exames laboratoriais na Terapia Nutricional\" width=\"1142\" height=\"460\" srcset=\"https:\/\/nutritotal.com.br\/pro\/wp-content\/uploads\/2021\/12\/Parenteral_site.png 1142w, https:\/\/nutritotal.com.br\/pro\/wp-content\/uploads\/2021\/12\/Parenteral_site-300x121.png 300w, https:\/\/nutritotal.com.br\/pro\/wp-content\/uploads\/2021\/12\/Parenteral_site-1024x412.png 1024w, https:\/\/nutritotal.com.br\/pro\/wp-content\/uploads\/2021\/12\/Parenteral_site-768x309.png 768w\" sizes=\"(max-width: 1142px) 100vw, 1142px\" \/><\/p>\n<p>Em algumas condi\u00e7\u00f5es cl\u00ednicas, quando o paciente n\u00e3o pode se alimentar atrav\u00e9s da via oral, considera-se a utiliza\u00e7\u00e3o da Terapia Nutricional Enteral (TNE) e\/ou Parenteral (TNP) para um melhor aporte nutricional e consequentemente otimiza\u00e7\u00e3o de sua recupera\u00e7\u00e3o.<\/p>\n<p>Devido a v\u00e1rios fatores, como a doen\u00e7a base e risco de complica\u00e7\u00f5es, deve haver um monitoramento continuo e constante, quanto a toler\u00e2ncia da TN, poss\u00edveis intera\u00e7\u00f5es medicamentosas, altera\u00e7\u00f5es antropom\u00e9tricas e controle bioqu\u00edmico por meio de exames laboratoriais.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"Mas_quais_exames_laboratoriais_devem_ser_monitorados_para_pacientes_em_terapia_nutricional\"><\/span>Mas quais exames laboratoriais devem ser monitorados para pacientes em terapia nutricional?<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Para pacientes em TNE, os seguintes exames devem ser monitorados frequentemente:<\/p>\n<ul>\n<li>Glicemia;<\/li>\n<li>S\u00f3dio e pot\u00e1ssio;<\/li>\n<li>C\u00e1lcio, magn\u00e9sio e fosforo;<\/li>\n<li>Triglicer\u00eddeo<\/li>\n<li>Colesterol<\/li>\n<li>Alanina aminotransferase (ALT)<\/li>\n<li>Aspartato Aminotransferase (AST)<\/li>\n<li>Gama glutamil transferase (GGT)<\/li>\n<li>Pr\u00e9-albumina<\/li>\n<li>Albumina<\/li>\n<li>Ureia\/Creatinina<\/li>\n<\/ul>\n<p>Al\u00e9m disso, podemos monitorar a glicemia capilar e, sempre que poss\u00edvel, os n\u00edveis de elementos tra\u00e7o e vitaminas.<\/p>\n<p>J\u00e1 pacientes em TNP, o controle requer maior aten\u00e7\u00e3o, pois o uso da solu\u00e7\u00e3o parenteral pode aumentar o risco de altera\u00e7\u00f5es metab\u00f3licas importantes.<\/p>\n<p>Sendo assim, al\u00e9m dos j\u00e1 monitorados na terapia enteral, podemos adicionar o exame de PCR (prote\u00edna C-reativa), bilirrubina total, fosfatase alcalina, glicemia capilar e tempo de protrombina.<\/p>\n<h3><span class=\"ez-toc-section\" id=\"E_com_qual_frequencia_devemos_avaliar_esses_exames\"><\/span>E com qual frequ\u00eancia devemos avaliar esses exames?<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>A frequ\u00eancia de monitoramento desses exames pode depender de alguns fatores, como tempo de administra\u00e7\u00e3o da terapia, estado cl\u00ednico do paciente e a progress\u00e3o da doen\u00e7a.<\/p>\n<p>Abaixo podemos ver qual a frequ\u00eancia dos exames em cada uma das terapias:<\/p>\n<p><strong>Exames bioqu\u00edmicos e frequ\u00eancia de monitoramento na TNE <\/strong><\/p>\n<table>\n<tbody>\n<tr>\n<td width=\"204\"><strong>Exames<\/strong><\/td>\n<td width=\"227\"><strong>Frequ\u00eancia<\/strong><\/td>\n<\/tr>\n<tr>\n<td width=\"204\">Glicemia<\/td>\n<td width=\"227\">Diariamente<\/td>\n<\/tr>\n<tr>\n<td width=\"204\">S\u00f3dio e pot\u00e1ssio<\/td>\n<td width=\"227\">Diariamente<\/td>\n<\/tr>\n<tr>\n<td width=\"204\">C\u00e1lcio, magn\u00e9sio e f\u00f3sforo<\/td>\n<td width=\"227\">Diariamente<\/td>\n<\/tr>\n<tr>\n<td width=\"204\">Triglicer\u00eddeo<\/td>\n<td width=\"227\">Inicio da TN<\/td>\n<\/tr>\n<tr>\n<td width=\"204\">Colesterol<\/td>\n<td width=\"227\">Inicio da TN<\/td>\n<\/tr>\n<tr>\n<td width=\"204\">ALT<\/td>\n<td width=\"227\">Diariamente<\/td>\n<\/tr>\n<tr>\n<td width=\"204\">AST<\/td>\n<td width=\"227\">Semanalmente<\/td>\n<\/tr>\n<tr>\n<td width=\"204\">GGT<\/td>\n<td width=\"227\">Semanalmente<\/td>\n<\/tr>\n<tr>\n<td width=\"204\">Pr\u00e9-albumina<\/td>\n<td width=\"227\">Semanalmente<\/td>\n<\/tr>\n<tr>\n<td width=\"204\">Albumina<\/td>\n<td width=\"227\">No inicio e a cada 21 dias<\/td>\n<\/tr>\n<tr>\n<td width=\"204\">Ureia\/creatinina<\/td>\n<td width=\"227\">Diariamente<\/td>\n<\/tr>\n<tr>\n<td width=\"204\">&nbsp;<\/p>\n<p>Glicemia capilar<\/td>\n<td width=\"227\">6\/6 em hora do primeiro dia, 8\/8 horas no segundo dia, 12\/12 horas no quinto dia, ap\u00f3s isso diariamente.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p><strong>Fonte: adaptado de Manual de processos de trabalho equipe multidisciplinar em terapia nutricional, 2011.<\/strong><strong>\u00a0<\/strong><\/p>\n<p><strong>Exames bioqu\u00edmicos e frequ\u00eancia de monitoramento na TNP <\/strong><\/p>\n<table>\n<tbody>\n<tr>\n<td width=\"236\"><strong>Exames<\/strong><\/td>\n<td width=\"247\"><strong>Frequ\u00eancia<\/strong><\/td>\n<\/tr>\n<tr>\n<td width=\"236\">PCR\/Albumina<\/p>\n<p><strong>\u00a0<\/strong><\/td>\n<td width=\"247\">1x\/dia no in\u00edcio, paciente cr\u00edtico: semanalmente; paciente est\u00e1vel: mensalmente;<\/td>\n<\/tr>\n<tr>\n<td width=\"236\">Bilirrubina total<\/td>\n<td width=\"247\">Semanalmente<\/td>\n<\/tr>\n<tr>\n<td width=\"236\">Fosfatase alcalina<\/td>\n<td width=\"247\">Semanalmente<\/td>\n<\/tr>\n<tr>\n<td width=\"236\">Glicemia capilar<\/p>\n<p>&nbsp;<\/td>\n<td width=\"247\">Paciente cr\u00edtico: 3x\/dia; paciente est\u00e1vel: se necess\u00e1rio;<\/td>\n<\/tr>\n<tr>\n<td width=\"236\">Tempo de protrombina<\/td>\n<td width=\"247\">Semanalmente<\/td>\n<\/tr>\n<tr>\n<td width=\"236\">S\u00f3dio, pot\u00e1ssio, cloro<\/td>\n<td width=\"247\">Inicio: 3x\/dia; paciente cr\u00edtico: diariamente; paciente est\u00e1vel: 1 a 2x semana<\/td>\n<\/tr>\n<tr>\n<td width=\"236\">C\u00e1lcio, magn\u00e9sio e f\u00f3sforo<\/td>\n<td width=\"247\">Inicio: 1x\/dia; paciente cr\u00edtico: se necess\u00e1rio; paciente est\u00e1vel: semanalmente<\/td>\n<\/tr>\n<tr>\n<td width=\"236\">Ureia\/creatinina<\/td>\n<td width=\"247\">Inicio: 3x\/dia; paciente cr\u00edtico: diariamente; paciente est\u00e1vel: 1 a 2x semana<\/td>\n<\/tr>\n<tr>\n<td width=\"236\">Triglicer\u00eddeo<\/td>\n<td width=\"247\">Apenas no in\u00edcio e se necess\u00e1rio<\/td>\n<\/tr>\n<tr>\n<td width=\"236\">ALT, AST e GGT<\/td>\n<td width=\"247\">Inicio: 1x\/dia; paciente cr\u00edtico: semanalmente; paciente est\u00e1vel: mensal<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p><strong>Fonte: Adaptado de Protocolo de terapia nutricional enteral e parenteral da comiss\u00e3o de suporte nutricional, 2014. <\/strong><\/p>\n<p>Veja tamb\u00e9m: <strong><a href=\"https:\/\/nutritotal.com.br\/pro\/material\/posicionamento-aspen-uso-de-albumina-serica-e-a-pre-albumina-como-marcadores-nutricionais\/\" target=\"_blank\" rel=\"noopener\">Posicionamento ASPEN: Uso de albumina s\u00e9rica e a pr\u00e9-albumina como marcadores nutricionais<\/a><\/strong><\/p>\n<p><strong>Refer\u00eancia <\/strong><\/p>\n<p>Gosty\u0144ska A, Stawny M, Dettlaff K, Jeli\u0144ska A. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/31810303\/\">Clinical Nutrition of Critically Ill Patients in the Context of the Latest ESPEN Guidelines<\/a>. <strong>Medicina (Kaunas)<\/strong>. 2019 Dec 2;55(12):770.<\/p>\n<p>CUPPARI, Lilian. <strong>Nutri\u00e7\u00e3o<\/strong>: cl\u00ednica no adulto. 3. ed. Barueri, Sp: Manole, 2014. 599 p. (Guias de Medicina Ambulatorial e Hospitalar da EPM-UNIFESP).<\/p>\n<p>GIROLDI, Maiara; BOSCAINI, Camile. <a href=\"http:\/\/www.braspen.com.br\/home\/wp-content\/uploads\/2016\/11\/13-Perfil-nutricional.pdf\">Perfil nutricional e bioqu\u00edmico de pacientes internados em uso de terapia nutricional enteral<\/a>. <strong>Revista Brasileira de Nutri\u00e7\u00e3o Cl\u00ednica<\/strong>, S\u00e3o Paulo, v. 1, n. 31, p. 65-69, jan. 2016.<\/p>\n<p>FORA, Hospital Universitario da Universidade Federal de Juiz de. <a href=\"https:\/\/www.gov.br\/ebserh\/pt-br\/hospitais-universitarios\/regiao-sudeste\/hu-ufjf\/saude\/vigilancia-em-saude-e-seguranca-do-paciente\/nqh-nucleo-de-qualidade-hospitalar\/POP.UNC.EMTN.034Solicitaoemonitoramentdeexameslaboratoriaisemterapianutricionalparenteral.pdf\">SOLICITA\u00c7\u00c3O E MONITORAMENTO DE EXAMES LABORATORIAIS EM TERAPIA NUTRICIONAL PARENTERAL<\/a>. Juiz de Fora, MG: SUS, 2021. 2 p.<\/p>\n<p>UNICAMP. <a href=\"https:\/\/intranet.hc.unicamp.br\/manuais\/emtn.pdf\">Manual de processos de trabalho equipe multidisciplinar em terapia nutricional<\/a>: grupo de apoio nutricional. Campinas: Unicamp, 2011. 107 p. (S\u00e9rie manual do Hospital de Cl\u00ednicas da UNICAMP).<\/p>\n<p><a href=\"https:\/\/www.gov.br\/ebserh\/pt-br\/hospitais-universitarios\/regiao-centro-oeste\/hc-ufg\/governanca\/comissoes-e-comites\/6aManualdeNutricaoParenteraleEnteral.pdf\">PROTOCOLO DE TERAPIA NUTRICIONAL ENTERAL E PARENTERAL DA COMISS\u00c3O DE SUPORTE NUTRICIONAL<\/a>. Goi\u00e2nia: Hospital das Cl\u00ednicas da Universidade Federal de Goi\u00e1s, 2014, 162 p.<\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Em algumas condi\u00e7\u00f5es cl\u00ednicas, quando o paciente n\u00e3o pode se alimentar atrav\u00e9s da via oral, considera-se a utiliza\u00e7\u00e3o da Terapia Nutricional Enteral (TNE) e\/ou Parenteral (TNP) para um melhor aporte nutricional e consequentemente otimiza\u00e7\u00e3o de sua recupera\u00e7\u00e3o. Devido a v\u00e1rios fatores, como a doen\u00e7a base e risco de complica\u00e7\u00f5es, deve haver um monitoramento continuo e [&hellip;]<\/p>\n","protected":false},"author":15,"featured_media":51821,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[576,577],"tags":[194,98,185],"divisao":[2185,2192,3327],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v23.5 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Quais exames devem acompanhar de pacientes com nutri\u00e7\u00e3o enteral e parenteral?<\/title>\n<meta name=\"description\" content=\"Pacientes em terapia nutricional devem ter seus exames laboratoriais monitorados frequentemente. 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