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Sommacal HM, Gazal CH, Jochims AM, Beghetto M, Paz A, Silla LM, Mello ED
Rev Bras Hematol Hemoter. 2012;34(5):334-8
Figure 1 - Flow chart of the study design
TUBE (lactose free infusion pump,
caloric density of 1 to 1.5 kcal/mL)
*contraindicated if mucositis and/or
low platet count
ORAL
(boiled and cooked/supplements)
< 60% total caloric
index or > 60% total
caloric index + 5-day
malnourished =
parenteral nutrition
> 60% total caloric index or
> 80% total caloric index +
2-day malnourished = stop
parenteral nutrition
ENTERAL
NUTRITION
YES
PARENTERAL
NUTRITION
NO
FOLLOW UP (daily weight, intake
assessment 3x/week, gastrointestinal
symptoms, complications,
diet acceptance, blood panel
laboratorials)
funcionaL
GASTROINTESTINAL
TRACT?
ADMINISTRATION
ROUTE
SET
NUTRITIONAL
GOALS
NUTRITIONAL
DIAGNOSIS
ANAMNESIS
• % WEIGHT LOSS
• ANTHROPOMETRY (weight, height, skinfold
thickness, body mass index)
• PHISICAL EXAMINATION
NUTRITIONAL
ASSESSMENT
HOSPITALIZATION
WATER INTAKE:
20-30 mL/kg/day
(decrease in renal failure)
VITAMINS:
trace elements 1 a 2x RDA
CARBOHYDRATE INTAKE:
50-55% total caloric index (assess
glycosuria/borderline glucose tolerance)
FAT INTAKE:
20-30% total caloric index
(decrease if triglycerides > 400; platelet
< 5000; hypoxia; hyperbilirubinemia)
PROTEIN INTAKE:
1.5 g/kg/day
(decrease in renal failure)
CALORIC INTAKE:
average between Harris Benedict
and hand pocket formula
HEMATOPOIETIC
STEM CELL
TRANSPLANTATION
UNIT ROUTINES