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 Table of Contents  
LETTER TO EDITOR
Year : 2022  |  Volume : 11  |  Issue : 1  |  Page : 85

Malnutrition in intensive care unit patients requiring noninvasive ventilation: Lesson pending to resolve


1 Department of Respiratory Care, Symbiosis Institute of Health Sciences, Symbiosis International University, Pune, Maharashtra, India
2 Staff Physician, Intensive Care Unit, International School of Non Invasive Mechanical Ventilation; Staff Physician, Intensive Care Unit, International College of Experts in Non Invasive Ventilation; Staff Physician, Intensive Care Unit, International Association of Non Invasive Ventilation; Staff Physician, Intensive Care Unit, Intensive Care Unit, Hospital Morales Meseguer, Murcia, Spain
3 Centro de Investigaciones Clínicas, Fundación Valle del Lili, Cali, Colombia

Date of Submission20-Oct-2021
Date of Decision08-Nov-2021
Date of Acceptance09-Nov-2021
Date of Web Publication04-Jan-2022

Correspondence Address:
Mr. O Oscar Iván Quintero
Centro de Investigaciones Clínicas, Fundación Valle del Lili, Cali
Colombia
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijrc.ijrc_129_21

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How to cite this article:
Selvan T, Esquinas AM, Quintero O O. Malnutrition in intensive care unit patients requiring noninvasive ventilation: Lesson pending to resolve. Indian J Respir Care 2022;11:85

How to cite this URL:
Selvan T, Esquinas AM, Quintero O O. Malnutrition in intensive care unit patients requiring noninvasive ventilation: Lesson pending to resolve. Indian J Respir Care [serial online] 2022 [cited 2022 Jan 16];11:85. Available from: http://www.ijrc.in/text.asp?2022/11/1/85/334813



Sir,

We have read with great interest Sharma et al.'s study on the existence of significant malnutrition in patients receiving noninvasive mechanical ventilation (NIMV) and its impact.[1] We agree that the implementation of nutrition in these patients continues to be a matter of controversy due to the beneficial effects or complications that the use of a nasogastric (NG) tube may entail. The authors consider that it is important to take into account the effects of the association of NG feeding and NIMV.

At this point, we want to highlight that technically, this difficulty can be controlled (level of asynchronies, leaks, etc.) with the use of devices recently developed and published. We consider that the author should consider them as a recommendation. Quintero et al.[2] developed a tube adapter for NIMV (TA-NIMV) responding to the need for a device that allowed NIMV and nutritional support without altering the mask's traditional design. This device allows the use of up to two tubes concomitantly, one for nutritional support and the other for gastric decompression, avoiding gastric insufflation and controlling residual gastric volume. TA-NIMV allows proper ventilation with enteric nutritional support either continuous or intermittent, while reducing the risk of tube collapse and diminishing the risk of air leakage through the oronasal mask. Moreover, other initiatives such as the double-purpose tubes,[3],[4] used in conjunction with the TA-NIMV, could reduce complications and improve patients' nutritional status while contributing to adequate respiratory management.

We agree with the authors that more studies are needed to validate previous observations and study further outcomes in this population.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Sharma G, Venkataraman R, Rajagopal S, Ramakrishnan N, Abraham BK, Savio RD. Nutrition therapy in patients requiring noninvasive ventilation in the Intensive Care Unit: Feasibility, tolerance, and complications. Indian J Respir Care 2021;10:289-93.  Back to cited text no. 1
  [Full text]  
2.
Quintero OI, Sanchez AI, Chavarro PA, Casas IC, Ospina Tascón GA. Impact of using a novel gastric feeding tube adaptor on patient's comfort and air leaks during non-invasive mechanical ventilation. Arch Bronconeumol (Engl Ed) 2020;56:353-9.  Back to cited text no. 2
    
3.
Silk DB, Quinn DG. Dual-purpose gastric decompression and enteral feeding tubes rationale and design of novel nasogastric and nasogastrojejunal tubes. JPEN J Parenter Enteral Nutr 2015;39:531-43.  Back to cited text no. 3
    
4.
Toh Yoon EW, Nishihara K, Murata H. Maintaining enteral nutrition in the severely Ill using a newly developed nasojejunal feeding tube with gastric decompression function. Intern Med 2016;55:2945-50.  Back to cited text no. 4
    




 

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