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been\tdiagnosed\twith\taspiration\tpneumonia,\tantibiotic\ttherapy\tshould\n\tinclude\tcoverage\tfor\tanaerobic\npathogens\tbecause\tthey\tmay\tcause\tsignificant\tdisease\twhen\tpresent\t(\nAllen\tet\tal,\t2013\n).\nMedical\tnutrition\ttherapy\nPatients\twith\taspiration\tpneumonia\tmay\thave\tdysphagia\tso\ta\tswallow\tevaluation\tby\ta\tspeech | [
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pathologist\twill\tbe\tneeded\tbefore\tallowing\toral\tintake.\tDiet\ttextures\tand\tliquid\tviscosities\tmay\tneed\nmodification\tto\tprevent\tfurther\taspiration.\tDysphagia\tdiets\n\tare\tdescribed\tin\t\nChapter\t39\n\tand\nAppendix\t20\n.\nIf\tthe\tpatient\thas\tdysphagia\tand\tmust\thave\tnothing\tby\tmouth,\tthen\tenteral\tnutrition\twill\tbe\tthe | [
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•\t\nUse\tprokinetic\tagents\n•\t\nMinimize\tuse\tof\tsedatives\n•\t\nOptimize\toral\thygiene\tusing\tchlorhexidine\tmouthwash\nGastric\tresiduals\n\tvolumes\thave\tbeen\tfound\tnot\tto\tcorrelate\twith\tincidences\tof\taspiration.\tAlso\ncoloring\tagents,\tincluding\tblue\tfood\tcoloring,\tshould\tnot\tbe\tused\tas\tmarkers\tof\taspiration\tdue\tto\ntheir\tpotential\ttoxicity.\nLung\ttransplantation | [
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their\tpotential\ttoxicity.\nLung\ttransplantation\nLung\ttransplantation\twas\tdone\tfor\tthe\tfirst\ttime\tin\t1963\twith\tgood\tpulmonary\tresults\tbut\tthe\tpatient\ndied\t18\tdays\tafter\ttransplant\tdue\tto\tcomorbidities\tand\tmalnutrition.\n\tSubsequently,\tmultiple\tlung\ntransplants\twere\tdone\twithout\tevaluating\toutcomes\tcompared\twith\tother\tsolid\torgan\ttransplants.\tIn | [
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the\tpast,\tone\tof\tthe\tmain\tobstacles\tassociated\twith\tlung\ttransplantation\twas\tthe\ttype\tof\nimmunosuppression\trequired\twith\tthe\thigh\tdose\tof\tsteroids\tthat\tcan\taffect\tairway\tanastomosis\nhealing.\tOver\tthe\tlast\t20\tyears,\tthe\tnumber\tof\tlung\ttransplants\tperformed\tincreased\trapidly\n\twith | [
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with\n4122\tlung\ttransplants\tdone\tin\t2015.\tOutcomes\thave\timproved\twith\tbetter\tdonor\tand\trecipient\nselection,\tsurgical\ttechniques,\tand\tmedical\ttherapy.\tThe\tcurrent\tmedian\tsurvival\tfor\tlung\ttransplant\npatients\tis\tabout\t5.5\tyears\twith\tchronic\trejection\tbeing\tthe\tmost\tcommon\tcomplication.\nMajor\tindications\tfor\tlung\ttransplant\tare\tthe\tfollowing:\n•\t\nCOPD | [
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Major\tindications\tfor\tlung\ttransplant\tare\tthe\tfollowing:\n•\t\nCOPD\n•\t\nIdiopathic\tinterstitial\tpneumonia\t(most\n\tcommonly\tIPF)\n•\t\nCF\n•\t\nPulmonary\tarterial\thypertension\n•\t\nAlpha-1\tantitrypsin\tdeficiency\nMultiple\tfactors\tare\tconsidered\twhen\ta\tpatient\tis\tbeing\tevaluated\tfor\tlung\ttransplantation; | [
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2\n)\tare\trelatively\ncontraindicated\twhile\tthose\twith\tclass\tII\tobesity\t(BMI:\t>35\tkg/m\n2\n)\tare\tabsolutely\tcontraindicated.\tA\nlow\tBMI\thas\tnot\tbeen\ta\trisk\tfactor\tfor\tmortality\tafter\tlung\ttransplantation\t(\nWeill\tet\tal,\t2015\n).\nHowever,\tmultiple\tstudies\thave\tshown\tthat\tmalnutrition\tor\ta\tlow\tBMI\t<18\tkg/m\n2\n\tcan\tbe\tassociated\nwith\tworse\toutcomes\t( | [
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2\n\tcan\tbe\tassociated\nwith\tworse\toutcomes\t(\nChristie\tet\tal,\t2012\n;\t\nLederer\tet\tal,\t2009\n).\nMedical\tnutrition\ttherapy\nAs\tstated\tabove,\tnutritional\tstatus\tplays\ta\tcrucial\trole\tin\ta\tpatient’s\thospital\tcourse\tand\tsurvival\tafter\nlung\ttransplantation.\tThe\tpretransplant\tassessment\tby\tthe\tRDN\twill\tdetermine\tthe\tpresence\tof | [
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implications\tthat\twill\tneed\tattention,\tincluding\tthe\tneed\tfor\teducation\tabut\tfood\tsafety.\nBronchopulmonary\tdysplasia\nBronchopulmonary\tdysplasia\t(BPD)\n\tis\ta\tchronic\tlung\tdisease\tmost\tcommonly\tseen\tin\tpremature\ninfants\twho\trequire\tmechanical\tventilation\n\tand\toxygen\ttherapy\tfor\tacute\trespiratory\tdistress.\tBPD | [
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and\toxygen\ttherapy\tfor\tacute\trespiratory\tdistress.\tBPD\noccurs\tin\t40%\tof\tpreterm\tneonates\tless\tthan\tor\tequal\tto\t28\tweeks\tgestational\tage\t(\nDavidson\tet\tal,\n2017\n).\tBPD\tis\ta\tlung\tdevelopment\tdisorder\tcharacterized\tby\timpairment\tof\talveolarization.\tThis\tleads\nto\tpulmonary\tand\tvascular\thypoplasia\twith\tless\tinterstitial\tcellularity\tand\tfibrosis\t( | [
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Jobe,\t2011\n).\nCommon\tinterventions\thave\tlittle\timpact\ton\n\tlong-term\toutcomes,\twith\trespiratory\tcare\tremaining\nsupportive.\tDecreased\tlung\tcompliance\tand\tincreased\tneed\tfor\trespiratory\tsupport\texists\tin\tthese\npatients\t(\nDani\tand\tPoggi,\t2012\n).\nMedical\tmanagement | [
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Management\tshould\tminimize\tany\tfurther\tinjuries,\twhile\tproviding\tan\toptimal\tenvironment\tfor\ngrowth\tand\trecovery\t(\nAdams\tand\tStark,\t2014\n).\nOngoing\tpulse\toximetry\tis\tused\tto\tmonitor\toxygenation,\n\twhereas\tintermittent\tblood\tgas\tsampling\nmonitors\tpH\tand\tPaco\n2\n.\tPeriodic\tattempts\tare\tmade\tto\tprogressively\twean\tinfants\tfrom\tventilator | [
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support.\tProlonged\tventilation\tis\tassociated\twith\tlaryngeal\tinjury\tand\tsubglottic\tstenosis,\tespecially\nwith\tinfants\twho\trequire\tmultiple\tintubations.\tSuctioning\tshould\tbe\tlimited\tto\tonly\twhen\tneeded\nbecause\tit\tis\tassociated\twith\ttracheal\tand\tbronchial\tinjury\t(\nAdams\tand\tStark,\t2014\n). | [
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Adams\tand\tStark,\t2014\n).\nThe\tuse\tof\tsupplemental\toxygen\tis\tchallenging\tin\tpatients\twith\tBPD\tbecause\tof\tthe\tneed\tto\ttreat\nhypoxemia\ton\tone\thand,\tand\ton\tthe\tother,\tto\tavoid\texposure\tto\texcess\toxygen.\tIncreasing\tthe\tinhaled\noxygen\tconcentrations\tcould\thave\ta\tnegative\taffect\tby\tincreasing\tthe\trisk\tof\tretinopathy,\tpulmonary\nedema,\tor\tinflammation. | [
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edema,\tor\tinflammation.\nMost\tinfants\tare\tmanaged\twith\ta\tmodest\tfluid\trestriction\tof\t140\tto\t150\tmL/kg\n\tper\tday.\tAlthough\ndiuretic\ttherapy\tmay\timprove\tshort-term\tpulmonary\tstatus,\tthere\tis\tno\tevidence\tthat\tit\timproves\nclinical\toutcomes.\tUse\tof\tdiuretics\tleads\tto\tserum\telectrolyte\tabnormalities\tsuch\tas\thyponatremia\nand\thypokalemia\t( | [
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and\thypokalemia\t(\nAdams\tand\tStark,\t2014\n).\nMedical\tnutrition\ttherapy\nUsing\tthe\tcriteria\tin\t\nBox\t33.4\n,\tassessment\tof\tthe\tinfant\twith\tBPD\tbegins\twith\tMNT.\tEnergy\tneeds\tof\ninfants\twith\tBPD\n\tare\t15%\tto\t20%\thigher\tthan\tthose\tof\thealthy\tinfants,\tand\tthey\tbenefit\tfrom\t140\tto\n150\tkcal/kg/day\tduring\tactive\tstages\tof\tthe\tdisease\t(\nDani\tand\tPoggi,\t2012 | [
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0.024134190753102303,
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0.033193498849868774,
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0.0294022373855114,
0.02917369268834591,
0.046056024730205536,
-0.008831608109176159
] |
Dani\tand\tPoggi,\t2012\n).\tInadequate\tcaloric\tintake\nleads\tto\ta\tcatabolic\tstate\tand\tmuscle\tfatigue\tof\tthe\tdiaphragm.\tAdequate\tnutrition\tis\tessential\tfor\nlung\tgrowth,\talveolar\tdevelopment,\tsurfactant\tproduction,\tand\tprotection\tagainst\tinfections.\nBOX\t33.4\nComponents\n\t\nof\tNutrition\tAssessment\tfor\tInfants\twith\nBronchopulmonary\tDysplasia\nHistory | [
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0.029795492067933083,
0.06915092468261719,
0.0899527445435524,
0.03948361426591873
] |
Bronchopulmonary\tDysplasia\nHistory\nBirthweight\nGestational\tage\nMedical\thistory\nNutrition\thistory\nPrevious\tgrowth\tpattern\nMedical\tstatus\nRespiratory\tstatus\nOxygen\tsaturation\nUse\tof\tmedications\nEmesis\nStool\tpattern\nUrine\toutput\nUrine\tspecific\tgravity\nVentilator\tdependency\nNutrition-biochemical\tmeasures\nAnthropometrics\nWeight\nLength | [
0.05942366272211075,
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0.01777167059481144,
0.025227349251508713,
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Environmental\tconcerns\nParent-child\tinteraction\nHome\tfacilities\nAccess\tto\tsafe\tfood\tsupply\nCommunity\tresources\nEconomic\tresources\nAccess\tto\tadequate\tfood\tand\tnutrients\nInfants\twith\tBPD\thave\tdecreased\tLBM,\tindicating\tan\tinadequate\tprotein\tintake.\tTreatment\twith | [
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] |
30\tweeks\t(\nDani\tand\tPoggi,\n2012\n)\t(see\t\nChapter\t41\n).\nAlthough\tlipids\tremain\ta\tvital\tcomponent\tin\tproviding\tessential\tfatty\tacids\tand\tmeeting\tenergy\ngoals,\tthe\trole\tof\tlipid\tadministration\tremains\tcontroversial.\tLipids\tare\theld\tor\tadministered\tin\tsmall | [
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respiration\tin\tadults,\tinfants\twho\treceive\thigh-fat\tformulas\texhibit\tdecreased\tCO\n2\n\tproduction\tand\nimproved\trespiration\t(\nDani\tand\tPoggi,\t2012\n).\tFurther\tinvestigation\tis\trequired\tto\tdetermine\tthe\noptimal\tlipid\tintake\tfor\tinfants\twith\tBPD.\tThe\tEuropean\tSociety\tof\tPediatric\n\tGastroenterology, | [
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Gastroenterology,\nHepatology\tand\tNutrition\t(ESPGHAN)\trecommends\ta\treasonable\trange\tof\t4.4\tto\t6.0\tg\tof\tfat/100\tkcal\nor\t40%\tto\t55%\tof\tcaloric\tintake.\nSodium\tand\tpotassium\tdepletion\tare\tseen\tin\tinfants\twith\tBPD\twho\tare\ttreated\twith\tdiuretics.\nBecause\tsodium\tadministration\tcounteracts\tthe\taction\tof\tdiuretics,\tmild\tdeficiencies\tin\tsodium\tand | [
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chloride\tare\tanticipated\t(\nDani\tand\tPoggi,\t2012\n).\nDecreased\n\tbone\tmineralization\tis\tseen\tin\tinfants\twith\tBPD.\tUrinary\tloss\tof\tcalcium\tis\tincreased\nwith\tthe\tadministration\tof\tcorticosteroids\tand\tdiuretics.\tOsteopenia\tof\tprematurity\tis\tcommon\tin\ninfants\twith\tBPD\tresulting\tfrom\tnutritional\tdeficiencies\tof\tcalcium\tand\tphosphorus.\tEnteral\tfeeds\tare | [
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not\tuseful\tin\tproviding\tadequate\tamounts\tof\tcalcium\tand\tphosphorus,\twhereas\tparenteral\tfeeds\nrestrict\tthe\tintake\n\tbecause\tof\tlimited\tsolubility\tof\tcalcium\tand\tphosphorus.\nInfants\twith\tBPD\tare\tmonitored\tevery\t1\tto\t2\tweeks\tfor\tcalcium\tand\tphosphorus\tand\tit\tis\nrecommended\tto\tsupplement\twith\tvitamin\tD\t(\nDani\tand\tPoggi,\t2012\n)\tand\tmilk\tfortifiers\t(see | [
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Dani\tand\tPoggi,\t2012\n)\tand\tmilk\tfortifiers\t(see\t\nChapter\n41\n).\nThe\tuse\tof\tvitamin\tA,\tcorticosteroids,\tand\tcaffeine\thave\tbeen\tshown\tto\treduce\tBPD\tat\t36\tweeks\tof\nage.\t5000\tIU\tof\tvitamin\tA\twas\tadministered\tintramuscularly\n\tthree\ttimes\ta\tweek\tfor\ta\tmonth\tto\tshow\na\tsignificant\treduction\tin\tBPD\tand\tdeath\tin\tthose\tinfants\treceiving\tthe\tsupplementation\t( | [
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Ehrenkranz,\n2014\n).\nParenteral\tnutrition\tis\tcontinued\talong\twith\tenteral\tfeeds\ttill\tthe\tfeeding\tvolume\treaches\t100\nmL/kg/day.\tStarting\tenteral\tfeeds\tearlier\tinduces\tgastric\tmotility\tand\tpromotes\tprogression\tto\tfull\nenteral\tfeedings.\tBetter\tneurologic\tdevelopment\tin\tpreterm\n\tinfants\twith\tBPD\tcan\tbe\taccomplished | [
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infants\twith\tBPD\tcan\tbe\taccomplished\nwith\tearly\tnutrition\tsupport,\tappropriate\tenteral\tfeeds,\tand\tparenteral\tfeed\tselection\t(\nDani\tand\nPoggi,\t2012\n).\tSee\t\nChapter\t41\n\tfor\tfurther\tdiscussion\ton\tfeeding\tthe\tlow\tbirth\tweight\tinfant.\nComplementary\tand\tintegrative\tapproaches\tfor\tpulmonary\tdisease | [
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Complementary\tand\tintegrative\tapproaches\tfor\tpulmonary\tdisease\nComplementary\tand\tintegrative\tapproaches\tfor\tpulmonary\tdisease\tusually\tfocus\ton\tproviding\nsupport\tfor\tthe\n\tunderlying\tpathology,\twhether\tit\tis\tinflammation\tand\tfibrosis\tor\texcess\tmucous\nproduction.\tIt\talso\tfocuses\ton\texacerbating\tfactors\tsuch\tas\tstress\tand\tenvironmental\texposures\t(such | [
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as\tchemicals\tand\tpollution).\t\nChapter\t7\n\tand\t\nappendix\t22\n\tprovide\ta\treview\tof\tnutrition\tsupport\tfor\ninflammation.\tVitamin\tD\tand\tOmega-3\tfatty\tacids\thave\tshown\tbenefit\tfor\treducing\tinflammation,\nfibrosis\tand\texacerbations\n\tin\tasthma\tand\tCOPD\tand\tfurther\tstudy\tis\tunderway\ton\tthe\tlong\tterm\nbenefit\tof\tthese\tsupplements\t(\nGold,\t2016 | [
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benefit\tof\tthese\tsupplements\t(\nGold,\t2016\n).\tA\trecent\treview\ton\tdiet\tand\tasthma\tconcluded\tthat\tstudy\nresults\tare\tcontradictory\tfor\tsingle\tnutrient\tinterventions\tand\tthe\tauthors\trecommend\ta\twhole\tdiet\napproach\t(\nHan,\t2015\n).\tMind\tbody\ttherapies\tsuch\tmeditation,\tyoga,\ttai\tchi,\tand\tmindfulness\tbased\nstress\treduction\tmay\tbe\thelpful\tfor | [
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degree\tof\theterogenicity\tin\tstudy\tparticipants\tand\tdesign,\tthus\tmaking\tthe\tconclusions\tless\tcertain\n(\nPoole,\t2019\n).\tContradictions\tin\tresearch\ton\tintegrative\tapproaches\tmay\tcome\tfrom\tthe\tneed\tfor\nindividualized\tassessment.\tFor\texample,\tpeople\twho\n\tare\tnot\tnutrient\tdeficient\twill\tnot\trespond\tto | [
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are\tnot\tnutrient\tdeficient\twill\tnot\trespond\tto\nsupplementation\tor\tdietary\tinterventions\tto\tboost\tintake\tof\tthat\tnutrient.\tAdditionally,\tsingle\tnutrient\ninterventions,\tincluding\tantioxidant\tvitamins,\tare\ttypically\tinadequate\tfor\ttreating\tcomplex\nconditions.\tFor\tthis\treason,\tintegrative\tinterventions\tare\tusually\tmulti-modal,\tincluding\twhole\tdiet, | [
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