Nutritional support practices in hematopoietic stem cell transplantation centers: A nationwide comparison

Autor: Annic Baumgartner, Urs Schanz, Panagiotis Samaras, Jakob Passweg, Urs Hess, Claude Pichard, Zeno Stanga, Luciano Wannesson, Thomas Pabst, Mario Bargetzi, Beat Mueller, Annika Bargetzi, Philipp Schuetz, Micheal Medinger, Yves Chalandon, Michel A. Duchosal, Alessandro Luigi Limonta, Noemi Zueger
Přispěvatelé: University of Zurich, Schuetz, Philipp
Jazyk: angličtina
Rok vydání: 2017
Předmět:
Pediatrics
medicine.medical_specialty
Allogeneic transplantation
Endocrinology
Diabetes and Metabolism
medicine.medical_treatment
education
610 Medicine & health
Hematopoietic stem cell transplantation
Qualitative survey
Transplantation
Autologous
Nutrition Policy
03 medical and health sciences
Nutritional Support/methods/standards
0302 clinical medicine
Surveys and Questionnaires
Medicine
Autologous transplantation
Humans
Medical nutrition therapy
Intensive care medicine
ddc:616
Nutrition and Dietetics
Nutritional Support
business.industry
Malnutrition
Hematopoietic Stem Cell Transplantation
medicine.disease
3. Good health
Diet
Transplantation
2712 Endocrinology
Diabetes and Metabolism
Parenteral nutrition
Nutrition Assessment
Evaluation Studies as Topic
030220 oncology & carcinogenesis
10032 Clinic for Oncology and Hematology
2916 Nutrition and Dietetics
Patient Compliance
business
Malnutrition/diagnosis
Switzerland
030215 immunology
Zdroj: Nutrition, Vol. 35 (2017) pp. 43-50
Nutrition (Burbank Los Angeles County Calif.)
ISSN: 0899-9007
Popis: Objective In 2009, international nutritional societies published practice guidelines on screening and nutritional support for patients undergoing stem cell transplantation. Little is known about how these guidelines are implemented in clinical practice. We performed a nationwide survey with the aim of understanding current practice patterns, differences between clinical practice, and international recommendations as well as barriers to the use of nutritional therapy. Methods We performed a qualitative survey including all centers across Switzerland offering allogeneic (n = 3) or autologous (n = 7) stem cell transplantation. We focused on in-house protocols pertaining to malnutrition screening, indications for nutritional support, types of nutritional therapy available and provided, and recommendations regarding neutropenic diets. Results All centers offering allogeneic, and most of the centers offering autologous transplantation, had a malnutrition screening tool, mainly the nutritional risk score (NRS 2002) method. Only one center does not provide nutritional support. There is wide variation regarding start and stop of nutritional therapy as well as route of delivery, with five centers recommending parenteral nutrition and five centers recommending enteral nutrition as a first step. Although all centers offering allogeneic transplantation, and approximately every other autologous transplant center, used a neutropenic diet, specific recommendations regarding the type of food and food handling showed significant variation. Conclusion This Swiss survey found wide variation in the use of nutritional therapy in patients undergoing stem cell transplantation, with low adherence overall to current practice guidelines. Understanding and reducing barriers to guideline implementation in clinical practice may improve clinical outcomes. Close collaboration of centers will facilitate future research needed to improve current practice and ensure high quality of treatment.
Databáze: OpenAIRE
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