1. Greenwald, Beverly PhD, RN, CNS, CGRN

Article Content

Practical Nutritional Support Techniques is a nutritional support reference for infant, pediatric, and adult patients and will be a useful resource to physicians, nurses, dietitians, and pharmacists. Both authors are physicians and faculty in Chicago, Illinois. Alan Buchman, MD, an adult gastroenterologist, is faculty at the Feinberg School of Medicine of Northwestern University. Timothy Sentongo, MD, is a pediatric gastroenterologist and faculty at the University of Chicago. Their goal was to provide a practical practice guide for the delivery of nutritional support, in a cost-effective manner, with minimal therapy-related complications.


The chapters are easy to read and cover a variety of practical topics, from assessment to nutritional support. The nutritional assessment chapter covers anthropometric and laboratory data and the history and physical examination. The appendix supplements this chapter with numerous charts and tables to assist with a nutritional assessment.


The nutritional requirements highlighted include fluid, caloric, protein, fat, vitamin, electrolyte, and trace elements. The evaluation of patients may identify a need for nutritional supplementation; therefore, the authors cover the indications, contraindications, and complications of parenteral nutrition, and its components, methods of delivery, and details to monitor. Also included are enteral nutrition, indications, contraindications, routes, formulas, and details to monitor. The table of enteral nutrition supplements is especially useful for comparisons. Details specific to the home care of the parenterally and enterally fed patients are provided.


Pediatric nutritional support is a separate chapter that includes special assessments and interpretations regarding chronic illness and impaired growth. Numerous growth and nutritional assessment tables and charts appear in this chapter and in the appendices, and these can be useful to evaluate the pediatric population. Modifications of parenteral and enteral feeding specific to the pediatric population are discussed.


Nutritional support during pregnancy to ensure proper fetal development and maternal health include the topics of hyperemesis gravidarum, active Crohn disease, restricted oral intake, anorexia, pancreatitis, and cystic fibrosis. Expected weight gains and laboratory changes during pregnancy are provided. Metabolic changes and nutritional requirements of pregnancy are discussed.


Appropriate follow-up for each patient includes the evaluation of established nutritional goals, which should be reevaluated at appropriate intervals. Also included are key points to assessing the efficacy of nutritional therapy. The authors review disease specific nutrition information regarding common medical conditions. The conditions discussed are as follows: acute renal-, chronic renal-, respiratory-, and hepatic-failure, short bowel syndrome, and inflammatory bowel disease.


Practical Nutritional Support Techniques will be a useful guide for physicians, nurses, dietitians, and pharmacists. Their patients will benefit through improved quality of care and an improved quality of life.