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Nutritional status and radiation therapy

Preparation

Subjective Global Assessment (SGA)

Subjective Global Assessment (SGA) is a scheme for classifying the patient's nutritional status.

Based on information about weight, food intake, symptoms and physical function, the patient is classifed as well-nourished, somewhat undernourished, or seriously malnourished. This categorization as shown to correlate well with more objective goals for nutritional status as well as morbidity, death, and quality of life. 

Other tables that are frequently used are Malnutrition Universal Screening Tool (MUST), Mini Nutritional Assessment (MNA) and Nutrition Risk Score (NRS). In principle, these schemes are prepared in the same way as SGA, but they are not validated for patients with cancer.

Actions include offerring the patient a diet that is appropriate for their symptoms and nutritional status. The patient should be offered nutritionally-rich food, snacks, nutritional beverages, tube feeding, and intravenous nutrition.

Tube feeding

The end of the tube is often inserted into the stomach. In the event of poor gastric function, total gastrectomy or pancreatic resection, the feeding tube should be inserted in the duodenum or jejunum. The position of the feeding tube is vital for the choice of tube feeding solution and mode of administration.

The most common method is to insert the tube nasogastrically, but it can also be done through the abdominal wall (PEG).

Parenteral ernæring

Peripheral veins can be used for short-term parenteral nutrition. In this case, a large vein on the forearm is used and a small needle. Nutrition is then given as more diluted solutions.

Central veins must be used for TPN with high osmolality.

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