lais tab. 초기/유지요법 (라이스 정 초기/유지 ... · 4 강동경희대학교병원...
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1 2013 7
2013 7
CONTENTS ........ 1 Special Issue . 3 ... 7 ... 9 ..... 9
Lais tab. / ( /) 1.
2.
Dermatophagoides MIX ( )
300AU 1,000AU
3.
4.
IgE
5.
, ,
6.
1 1 ,
2
(300AU) : 1 1
4 1, 2, 3, 4
(1,000AU) :
, 2, 1 1
7.
: , , ,
:
: ,
: , ,
: ,
: ,
8.
(,
) ,
9.
,
,
,
10.
6
11.
1 1
2
.
, 1 1 , ,
2 .
30 ,
.
, , ,
,
.
2 2013 7
Lais tab./ Staloral 300 /
300AU (), 1000AU () 10 IR/ml ( ), 300 IR/ml ( )
/ Lofarma/ STALLERGENS S.A/
IgE
, ,
1 1
2
:
300 AU 1T
300 AU 2T
300 AU 3T
300 AU 4T
:
1 1(1,000 AU)
2
1 5T
1 1
1 2
:
1
(10IR/ml)
*1 = 1 IR
1
2 2
3 4
4 6
5 8
6 10
7
(300IR/ml)
*1 = 30 IR
1
8 2
9 4
10 6
11 8
:
( )
3
- : 1 4
- 3 : 1 8
Allergoid
: Allergen
,
Allergen
Reference
: ()
3 2013 7
Special Issue
Nutrition Support ( ) 1.
1) :
2)
65% malnutrition risk , malnutrition mortality morbidity
malnutrition malabsorption outcome
,
3) :
2. (Parenteral Nutrition, PN)
1)
(oral intake)
metabolic level , , 3 ,
,
2)
,
GI tract
,
3)
GI tract
5 PN
PN
4)
Peripheral PN Central PN
PN 2 2
(900mOsm/L )
Dextrose < 12~13% 12~13%
2
48~72
tapering 1~2 tapering
4 2013 7
5)
(1) (Mechanical)
(Pneumothorax), (hemothorax), (hydrothorax)
Subclavian vein thrombosis
Air embolism
Phlebitis
(2) (Metabolic)
Refeeding syndrome
: malnutrition ,
K, P, Mg , ,
:
: insulin K, P, Mg K, P, Mg
: PN , ,
: Nonfasting blood glucose > 180mg/dL
:
5 2013 7
(3) commercial
IFCOM IFCOMPR IFPNP2 IFCOML IFCOMLP IFOLCN7 IFOLCN4 IFNULU IFNULP
2
Dextrose(g) 250 120 75 232 130 160 120 225 80
Protein(g) 50 21 28 58 45 40 33 72 40
Lipid(g) 0 0 0 58 68 40 30 75 50
Na(mEq) 53.4 37.3 35 40.6 43 32 31.5 75 50
K(mEq) 40 22.7 30 34.8 32 24 24 52.5 30
Mg(mEq) 6.3 4.5 5 5.8 10.6 4.4 6.6 12 6
Ca(mEq) 5.6 4.5 4.6 5.22 5.4 4 6 12 6
Cl(mEq) 43.8 31.8 40 46.4 62 48 49.5 67.5 48
phophate(mM) 15 6.8 15 17.4 14 10 12.8 22.5 7.5
acetate(mEq) 50 87 52 57 45 67.5 40
Zn(mmol) 0.045 0.03
Dex (%) 25 10.9 7.5 16 9.3 16 8.8 12 6.4
(%) 5.2 1.9 2.8 4 3.3 4 2.2 3.84 3.2
volume(ml) 1000 1100 1000 1450 1920 1000 1500 1875 1250
total calorie(Kcal) 1200 563 410 1740 1400 1200 915 1900 955
NPC/N 120.3 140 67 158 167 162 153 140 124
(mOsm) 1985 878 845 1470 750 1450 750 1540 920
19,883 12,601 14,172 33,625 38,765 40,658 40,284 40,569 28,022
6 2013 7
3. (Enteral nutrition, EN)
1) :
2)
pH
3)
, ,
4) :
, ,
,
,
5) : ,
(3 ): ,
(4-8 ) : (Percutaneous endoscopic gastrostomy, PEG),
(Percutaneous endoscopic jejunostomy, PEJ)
6)
volume
(g) (g) (g) (g) (ml) (kcal)
[ LD] 200 200 7.5 6 32 3
[ TF] 200 200 8 4.5 34 3
[ DM] 200 200 10 8 25 5
[ ] 200 200 8 10.5 27.5 3
[ ] 200 200 10 9 22 5
[ 1.5] 200 300 13 11 38 3
[ 1.5] 200 300 12 9 43 2.6
[ KD] 200 400 6 14 64 4
[ KD+] 200 400 15 17 49 4
[ ] 200 200 8 7 28 2.8
[ ] 200 200 13 6 25 0
RTH [ RTH] 500 500 23 15 70 7
200ml 200 200 9.6 6 27 2
500ml 500 500 24 15 67.5 5
4. Nutrition support team (NST)
1) ( NST) : , , ,
7 2013 7
2) NST
,
,
, , ,
4) NST : NST / NST
1. KCl mix ? ( )
Y-site(3-way) .
, .
Regular insulin(RI), multivitamin .
.
2. Compounding PN ?
7 30, 12.
3. ?
6 .
Reference
1. ASPEN 2nd 2005 NS Practice Mannual
2.
: ()
(, : HH837)
1. : () () () ()[]
() () () () []
() () () ()
() () () () ()
2. : ,
3. : (), (), ()
8 2013 7
4. : , , , , ,
, ,
5.
()
() .
. .
,
. .
( ; )
() () .
() . () .
.
() (), (), ()
() , ()
. () (:
, ) .
(), (), () . (: )
() (: ) , .
6.
, , , ,
, , , ,
, , , , , , ,
, , , ,
,
, , , ,
7. : 1 2.5g, 1 3
8.
1 1g , ,
, , , ( )
: , , ,
: , , , ,
9. : 36
10. :
Reference
1., (:,), , 2005 766,779
2. 11, , , 2002 1297
3., , ,2005 169
: ()
9 2013 7
50% ( : 2013.6.5) 1.
IIMAG Masi inj. 50%/20mL[!](Mg sulfate) 50%()
2. : , , (), ()
3.
FDA, 5~7
5~7
A D
,
(Hydroxyethylstarch) ( : 2013.6.26) 1.
2. :
3.
FDA , ,
,
,
/ 6975
/ 6983
6988
6988
6999
6978
6987
NST/TDM 6978
: : , , , , , , ,
134-090 892
- -
TEL. 02-440-6977 / 02-440-6992 () FAX. 02-440-6984
http://www.khnmc.or.kr E-mail: rosa78@khnmc.or.kr
IFPEN []Pentaspan inj.10%/500mL 500ML ()
IFHEX []Hextend inj. 500mL 500ML (CJ)
IIVOLU []Volulyte inj. 6% 500mL 6% 500ML ()
6994
6995
6992
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