Artificial Nutrition

Code:

OPT4_04

Acronym:

NA

Keywords
Classification	Keyword
OFICIAL	Medicine

Instance: 2021/2022 - 2S (of 28-02-2022 to 09-06-2022)

Active?	Yes
Responsible unit:	Medical Teaching
Course/CS Responsible:	Integrated Masters Degree in Medicine

Cycles of Study/Courses

Acronym	No. of Students	Study Plan	Curricular Years	Credits UCN	Credits ECTS	Contact hours	Total Time
MIM	28	Official Study Plan	4	-	3	32	81

Teaching language

Portuguese

Objectives

Maintaining an adequate nutritional status in patients in whom it's not possible to resort to the normal physiologicals means is recognized as an essential factor in medical training. It is essential for students to know the importance of how to provide an adequate nutritional support to patients. The learning objectives are : to integrate how each organ and systems works, alone and as parts of the whole organism in the healthy individual and in patological situations, and realize what are the limitations that influence an adequate nutritional in each clinical conditions . In this class the student will start his apprenticeship on the study of food, and the mechanisms by which the organism ingests , assimilates and uses the nutrients that provide us with the energy needed for our survival .

Learning outcomes and competences

By the end of the internship the student will be able to :

1 ) To evaluate the nutritional status of the patient

2 ) To establish adequate nutritional support

3 )To be aware of the limitations for the different types of nutritional support which    may be used.

Working method

Presencial

Program

- In this module students will gain further knowledge in the following areas:

1) How to evaluate the nutritional status of patients

2) How to assess the nutrition requirements of the inpatient.

3) How to provide artificial nutrition support by enteral route

4) How to tackle complications associated with enteral route and is limitations

5) How to provide artificial nutrition support by parenteral route

6) How to tackle complications associated with parenteral route and is limitations

 

• Besides gaining knowledge in the field of nutritional support in hospitalized patient, as the lessons take place in intermediate care and intensive care environment, the students can also further their knowledge of critically ill patients, including how to monitor in a comprehensive manner these patients , how to proceed with hemodynamic and respiratory resuscitation. They will also be able to assist in the implementation of different invasive techniques and have the opportunity to participate in doctor´s rounds and attend meetings.

Mandatory literature

Ayers P, Adams S, Boullata J, et al.; A.S.P.E.N. parenteral nutrition safety consensus recommendations. , JPEN J Parenter Enteral Nutr; ; 38:296, 2014
Mehanna HM, Moledina J, Travis J.; Refeeding syndrome: what it is, and how to prevent and treat it. , BMJ; 336:1495, 2008
National Heart, Lung, and Blood Institute Acute Respiratory Distress Syndrome (ARDS) Clinical Trials Network, Rice TW, Wheeler AP, et al. ; Initial trophic vs full enteral feeding in patients with acute lung injury: the EDEN randomized trial. , JAMA 2012; 307:795., 2012
Montejo JC, Miñambres E, Bordejé L, et al. ; Gastric residual volume during enteral nutrition in ICU patients: the REGANE study. . ISBN: Intensive Care Med 2010; 36:1386.
Costa NA; Marinho AD; Cansado LR. ; Necessidades nutricionais do doente crítico. , Rev. bras. ter. intensiva, São Paulo , 2012 ; 24: 270-277.
Marinho A. ; Suporte Nutricional no Doente Crítico.Manual de Medicina Intensiva, 2015: cap 29

Teaching methods and learning activities

Theoretical and theoretical-practical classes : with the presentation of program of the discipline in the first class. The class can't have more than 4-6 students. All classes will be in an environment of acute patients , in an intensive care or intermediate care unit, which allows the students to view a great variety of conditions and the implementation of several monitoring and therapeutic approaches. This weekly stay in the infirmary will allow them to continually update the clinical and nutritional status of the patients.

In the context of the COVID-19 pandemic, teaching / learning methodologies will depend on the existing epidemiological situation and we can have one of the 3 scenarios:

A. Face-to-face - classes will take place in the usual manner

B. Blended format for contact hours:

. Theoretical classes will be held with presence of some students or totally remotely via Zoom in a synchronous way.

. TP classes will be held with presence of some students or totally remotely via Zoom in a synchronous way with discussion of clinical cases.

. Practical classes: the groups will be divided into two parts, half should have contact with the real patient and the other half with the virtual patient or perform another activity indicated by the teacher, alternating the following week.

C. Distance learning - this model will only be applied if the conditions for semi-face-to-face teaching are impossible due to pandemic and will be done entirely with the use of virtual patients and digital platforms.

Evaluation Type

Distributed evaluation without final exam

Assessment Components

Designation	Weight (%)
Participação presencial	50,00
Trabalho de campo	50,00
Total:	100,00

Amount of time allocated to each course unit

Designation	Time (hours)
Estudo autónomo	49,00
Frequência das aulas	32,00
Total:	81,00

Eligibility for exams

In accordance with the legislation in force

Calculation formula of final grade

The final evaluation will take into account the student’s attendance, their participation throughout the two weeks of classes (50%) and a final evaluation via a practical test (50%).

Pratical test - On the last day of the internship, each student will be asked to make a nutritional assessment of an admitted patient, to create a plan for an adequate caloric intake to be provided to that patient or to assess the caloric load that is being provided to a particular patient and judge its suitability for the said patient.

 

 

 

Special assessment (TE, DA, ...)

Oral Exam

Classification improvement

Oral Exam