How to feed the patient in palliative care? A narrative review
DOI:
https://doi.org/10.35454/rncm.v4n2.243Keywords:
Nutrition, Parenteral nutrition, Palliative careAbstract
Malnutrition is a common condition in patients with incurable diseases who benefit from palliative care. Nutritional care, a fundamental component in the treatment of these patients, allows the adequate administration of oral, enteral, or parenteral nutritional therapy. In this context, nutritional therapy is indicated to increase survival and quality of life in some patients, such as those with neurological diseases or cancer. However, there is still a lot of controversy over its indications and potential benefits, particularly of home parenteral nutrition. Therefore, the aim of this review is to answer two questions: When should nutrition therapy be started and when should it be stopped? Does nutritional therapy improve the quality of life and prolong survival of palliative care patients? Scientific societies do not recommend the use of nutritional therapy in all cases of malnutrition, especially in patients with hypophagia whose life expectancy is less than 2 months. Parenteral nutrition may benefit some well identified patients by increasing survival. However, the impact on quality of life remains uncertain.
Decisions must be made individually, respecting the patient’s autonomy, and avoiding therapeutic viciousness. Research in this field must advance to determine with greater certainty the risk-benefit ratio of nutritional therapy.
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