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Appendix\t15\n).\nThe\tmanufacture\tand\tlabeling\tof\tenteral\tformulas\tare\tregulated\tby\tthe\tFood\tand\tDrug\tAdministration\n(FDA),\twhich\tclassifies\tenteral\tformulas\tas\tmedical\tfoods\t(a\tsubclassification\tof\tfoods\tfor\tspecial\tdietary\nuse).\tAs\tsuch,\tthese\tproducts\tare\texempt\tfrom\tspecific\tn... | [
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Federal\tRegulations.\tThe\tproducts\tmust\tbe\tlabeled\tas\t“intended\tto\tbe\tused\n\tunder\tmedical\tsupervision”\n(\nFDA,\t2014\n). | [
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Manufacturers\tare\tnot\tobligated\tto\tregister\tenteral\tproducts\twith\tthe\tFDA\tor\tobtain\tFDA\tapproval\tbefore\nplacing\tthem\ton\tthe\tmarket.\tMany\tEN\tformulas\tlack\trigorous\tscientific\tevidence\tto\tsupport\ttheir\tspecific\ncomposition,\tand\ttheir\tmarketing\tmaterials\tare\tnot\tsubject\tto\tthe\trig... | [
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drugs.\tEvaluation\tof\tthe\tefficacy\tof\tEN\n\tproducts\tand\tthe\tstatements\tmade\tin\tmarketing\tmaterials\tand\tby\ncompany\trepresentatives\trequires\tthe\tattention\tof\tqualified\tregistered\tdietitian\tnutritionists\t(RDNs).\tRDNs\nshould\tevaluate\tclaims\tof\tpharmacologic\teffects\tand\tother\tspecific\tbe... | [
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choosing\ta\tspecific\tproduct\tfor\ta\tformulary\tor\tfor\ta\tspecific\tpatient\t(\nBox\t12.2\n).\nBOX\t12.2\nFactors\tto\tConsider\tWhen\n\t\nChoosing\tan\tEnteral\tFormula\nAbility\tof\tthe\tformula\tto\tmeet\tthe\tpatient’s\tnutrient\trequirements\nCaloric\tand\tprotein\tdensity\tof\tthe\tformula\t(i.e.,\tkcal/mL,\... | [
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Gastrointestinal\tfunction\nSodium,\tpotassium,\tmagnesium,\tand\tphosphorus\tcontent\tof\tthe\tformula,\tespecially\tfor\tpatients\twith\ncardiopulmonary,\trenal,\tor\thepatic\tfailure\nForm\tand\tamount\tof\tprotein,\tfat,\tcarbohydrate,\n\tand\tfiber\tin\tthe\tformula\trelative\tto\tthe\tpatient’s\ndigestive\tand\ta... | [
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Cost\teffectiveness\tof\tformula\nPatient\tcompliance\nCost-to-benefit\tratio\nBlenderized\t(homemade)\ttube\tfeedings\nTube\tfeedings\tmade\tfrom\tcommon\tingredients\tsuch\tas\teggs,\tsugar,\tand\twine\thave\tbeen\tused\tsince\tthe\n1500s.\tBlenderized\ttube\tfeedings\t(BTFs)\twere\tcommonly\tused\tin\tthe\tUnited\tS... | [
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first\nhalf\tof\tthe\ttwentieth\tcentury\t(\nVassilyadi\tet\tal,\t2013\n).\tClinicians\toften\tare\tconcerned\tabout\tnutritional\nadequacy,\tfood\tsafety,\tand\tthe\tadditional\tburden\tpreparation\tof\tBTF\tplaces\ton\tthe\tcaregivers.\tAdvantages\nof\tBTF\tmay\tinclude\tcost\teffectiveness\t(because\tcommercial\tfor... | [
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health\tbenefits\tfrom\tusing\twhole\tfoods,\tand\tability\tto\ttailor\tthe\tformula\texactly\n\tto\tpatient\tneeds.\tThe\tsocial\nbond\tbetween\tthe\tcaregiver\twho\tprepares\tthe\tfeeding\t(possibly\tfrom\tfoods\tserved\tto\tthe\trest\tof\tthe\tfamily)\nand\tthe\tpatient\talso\tis\tcited\tas\ta\tstrong\tdriver\tfor\t... | [
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of\ta\tsmall\tsample\tof\thome\tEN\tpatients\tat\tthe\tMayo\tClinic\tin\tRochester,\tMN,\twanted\tto\tuse\tBTF\t(\nHurt\tet\tal,\n2015\n).\tIn\tthe\tlast\tseveral\tyears,\tseveral\tcommercially\n\tprepared\tBTF\thave\tappeared\ton\tthe\tmarket,\tsuch\tas\nLiquid\tHope™\tand\tReal\tFood\tBlends™.\tCompleat\n®\n\thas\tbe... | [
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®\n\thas\tbeen\tmarketed\tby\tNestle\tfor\ta\tnumber\tof\tyears,\tand\nAbbott\tNutrition\twill\tsoon\tmarket\ta\tBTF.\nHomemade\tBTFs\tare\tcontraindicated\tfor\tpatients\twho\tare\timmunocompromised\tand\tshould\tbe\thung\tfor\nno\tmore\tthan\t2\thours.\tAll\tBTF\tmay\tbe\tcontraindicated\tfor\tinfusion\tthrough\ttube... | [
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for\n\tcontinuous\tfeeding\t(unless\tthe\trecommended\tformula\thang\ttime\tis\tfollowed),\tif\ta\tfluid\trestriction\tof\tless\nthan\t900\tmL/day\tis\trequired,\tin\tcases\tof\tmultiple\tfood\tallergies,\tand\tif\ta\tjejunostomy\ttube\t(JT)\tis\tused\n(\nNovak\tet\tal,\t2009\n).\tSome\tstate\tregulations\tprohibit\tus... | [
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New\nDirections\n:\tPureed\tby\tGastrostomy\tTube—the\tPBGT\tDiet\n).\n\t\nNEW\tDIRECTIONS\nPureed\tby\tGastrostomy\tTube—the\tPBGT\tDiet\nThe\tPureed\tby\tGastrostomy\t(G)\tTube\t(PBGT)\tDiet\tis\ta\tspecialized,\tnutritionally\tbalanced\tblended\tfood\nfeeding\tgiven\tby\tG-tube.\tIt\twas\toriginally\tdesigned\tto\td... | [
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gagging\twhich\tcan\tbe\ta\tcomplication\tof\ta\tNissen\tFundoplication\tsurgery.\tIn\taddition\tto\timproving\ntolerance\tof\tbolus\tfeeds\tfor\tindividuals\n\twho\tare\tvolume\tsensitive,\tthe\tPBGT\tdiet\tis\talso\tused\tby\tfamilies\nseeking\tan\talternative\tto\tcommercial\tformulas.\nThe\tgoals\tof\tthe\tPBGT\tdi... | [
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The\tgoals\tof\tthe\tPBGT\tdiet\tare\tto:\n•\t\nDecrease\tfrequency\tof\tgastrostomy\ttube\tfeedings\tand\ttransition\tfrom\tdrip\tfeedings\n•\t\nMeet\tall\tnutritional\tand\tfluid\trequirements\n•\t\nImprove\tweight\tgain,\tgrowth,\tand\toverall\tnutritional\tstatus\n•\t\nEncourage\tincreased\topportunities\tfor\toral... | [
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•\t\nEncourage\tincreased\topportunities\tfor\toral\tintake\n•\t\nImprove\tand\tsustain\tquality\tof\tlife\tfor\tindividuals\tand\ttheir\tfamilies\nThe\tPBGT\tdiet\tis\tdifferent\tfrom\tthe\tusual\tblended\ttube\tfeeding\tin\tthat\tit\tis\tcalculated\tand\tformulated\nby\ta\tregistered\tdietitian\tnutritionist\t(RDN)\t... | [
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small,\tcalorie-dense\tgastrostomy\ttube\tboluses,\tthereby\teliminating\tthe\tneed\tand\tcost\tfor\ta\tfeeding\npump.\tIn\taddition\n\tto\tthe\teasier\tpreparation\tof\tthe\tPBGT,\tspecial\tattention\tis\talso\tgiven\tto\tthe\tvariety\tof\nfoods,\tnutrient\tcontent,\tcost,\tand\tease\tof\tthe\t5-\tto\t10-minute\tbolus... | [
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Pentiuk\tet\tal,\t2011\n).\nThe\tuse\tof\tStage\t2\tinfant\tfoods\tpromotes\tconsistency\tin\tthe\tviscosity\tof\tthe\tdiet,\tprovides\tavailability\nand\taffordability,\tand\teliminates\tthe\tneed\tfor\tan\texpensive\tblender.\tThey\tcan\tbe\tpremeasured\tand\nindividually\tsealed\tin\tcontainers\tthat\tcan\tbe\teasil... | [
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hospital\tpolicy.\tFamilies\tcan\tbe\teducated\ton\tthe\teasy\tpreparation\tmethod\tand\tproper\tstorage,\talong\nwith\tadditional\tfluid\tand\tvitamin\tand\tmineral\tsupplementation\tguidelines\t(\nO’Flaherty\tet\tal,\t2011\n;\nO’Flaherty,\t2015\n).\nTherese\tO’Flaherty\tMS,\tRDN,\tCSP,\tLD\nProtein | [
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The\tamount\tof\tprotein\n\tin\tavailable\tcommercial\tenteral\tformulas\tvaries\tfrom\t6%\tto\t37%\tof\ttotal\tkilocalories.\nThe\tprotein\ttypically\tis\tderived\tfrom\tcasein,\twhey,\tor\tsoy\tprotein\tisolate.\tStandard\tformulas\tprovide\tintact\nprotein;\telemental\tformulas\tcontain\tdi-\tand\ttripeptides\tand\t... | [
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Specialized\tformulas\t(that\tare\tmarketed\tfor\thepatic\tor\tsevere\trenal\tfailure\tor\tfor\tcases\tof\tmultiple,\n\tsevere\nallergies)\tusually\tinclude\tcrystalline\tamino\tacids.\nSpecific\tamino\tacids\tmay\tbe\tadded\tto\tsome\tenteral\tformulas.\tBranched\tchain\tamino\tacids\thave\tbeen | [
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used\tin\tformulas\tfor\tpatients\twith\tsevere\thepatic\tdisease,\tand\targinine\thas\tbeen\tadded\tto\tformulas\nmarketed\tfor\tcritically\till\tpatients.\tStrong\tevidence\tto\tsupport\tthese\tadditions\tis\tnot\tavailable.\t(See\nChapter\t37\n\tfor\tfurther\tdiscussion.)\nCarbohydrate | [
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Chapter\t37\n\tfor\tfurther\tdiscussion.)\nCarbohydrate\nCarbohydrate\tcontent\tin\tenteral\tformulas\tvaries\tfrom\t30%\tto\t85%\tof\tkilocalories.\tCorn\tsyrup\tsolids\ntypically\tare\tused\tin\tstandard\tformulas.\tSucrose\tis\tadded\tto\tflavored\tformulas\tthat\tare\tmeant\tfor\toral\nconsumption.\tHydrolyzed\tfor... | [
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Carbohydrate\tor\tfiber\tthat\tcannot\tbe\tprocessed\tby\thuman\tdigestive\tenzymes\tis\tadded\tfrequently\n\tto\nenteral\tformulas.\tFibers\tare\tclassified\tas\twater\tsoluble\t(pectins\tand\tgums)\tor\twater\tinsoluble\t(cellulose\tor\nhemicellulose).\tThe\teffectiveness\tof\tdifferent\tfibers\tadded\tto\tenteral\tf... | [
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critically\till\tpatients\tis\tcontroversial.\tThe\tAdult\tCritical\tIllness\tguidelines,\tin\tthe\tEvidence\tAnalysis\tLibrary\nof\tthe\tAcademy\tof\tNutrition\tand\tDietetics\t(\nAND\tand\tEAL,\t2012\n),\n\tsuggests\tthat\tthe\tRDN\t“consider\tusing\nsoluble\tfiber\tto\tprevent\tand/or\tmanage\tdiarrhea.” | [
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soluble\tfiber\tto\tprevent\tand/or\tmanage\tdiarrhea.”\nFructooligosaccharides\t(FOS),\twhich\tare\tprebiotics,\thave\tbeen\tadded\tto\tenteral\tformulas,\toften\tin\ncombination\twith\ta\tsource\tof\tdietary\tfiber,\tfor\tmore\tthan\t15\tyears.\tMore\trecently\tinulin,\tanother | [
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0.06509958952665329,
-0.0020736821461468935,
0.02186805009841919,
0.1361193209886551,
-0.05479094758629799,
0.023276466876268387,
0.0704... |
fermentable\toligosaccharide,\thas\tbeen\tadded\tto\tsome\tenteral\tformulas.\tBoth\tFOS\tand\tinulin\tare\tassociated\nwith\tfermentable\n\toligosaccharides,\tdisaccharides,\tmonosaccharides,\tand\tpolyols\t(FODMAPs),\twhich\tare\npoorly\tabsorbed\tshort-chain\tcarbohydrates\t(\nEscuro\tand\tHummell,\t2016\n). | [
-0.02009308524429798,
-0.060280073434114456,
0.010924541391432285,
0.03133147582411766,
-0.05161622539162636,
0.03261247277259827,
0.07367769628763199,
0.013385300524532795,
0.01185163389891386,
0.08259677141904831,
0.08056855946779251,
-0.04809994623064995,
-0.008650737814605236,
0.023820... |
Escuro\tand\tHummell,\t2016\n).\nFOS\thave\tbeen\tshown\tto\tstimulate\tthe\tproduction\tof\tbeneficial\tbifidobacteria,\tand\twhen\tcombined\twith\ndietary\tfiber\tmay\tproduce\tbeneficial\tchanges\tin\tcolonic\tpH,\tfecal\tmicrobiota,\tand\tshort-chain\tfatty\tacid\nconcentrations.\tAnimal\tmodels\tprovide\n\tevidenc... | [
0.005918279755860567,
-0.020401889458298683,
0.058228977024555206,
-0.03774169832468033,
-0.02803833782672882,
0.037059031426906586,
0.04385054484009743,
0.007106511853635311,
0.006790250539779663,
0.0709039717912674,
0.12655380368232727,
-0.07284391671419144,
0.028088584542274475,
0.02768... |
against\t\nClostridium\tdifficile\n.\tUse\tof\tformulas\twith\ta\thigh\tFODMAPs\tcontent\tmay\texacerbate\tand\tplay\ta\trole\nin\tdiarrhea,\tespecially\tin\tindividuals\twho\treceive\tantibiotics\tthat\taffect\tthe\tintestinal\tmicrobiome\t(\nEscuro\nand\tHummell,\t2016\n).\nThe\tSociety\tof\tCritical\tCare\tMedicine\... | [
0.006464178673923016,
-0.04639935493469238,
0.03255234658718109,
-0.00607785489410162,
-0.05584860220551491,
0.0016428256640210748,
0.018724588677287102,
0.08897700160741806,
-0.010673231445252895,
0.05620938539505005,
0.07101328670978546,
0.01774642989039421,
0.010808832943439484,
0.03254... |
be\tused\troutinely”\tin\tadult\tcritically\till\tpatients\t“to\tpromote\tregularity\tor\tprevent\tdiarrhea”\tand\talso\t“to\nconsider\ta\tfermentable\tsoluble\tfiber\tadditive\t(FOS,\tinulin)\tfor\troutine\tuse\tin\tall\tstable\tMICU/SICU\tpatients\nplaced\ton\tstandard\tenteral\tformulations\tif\tthere\tis\tevidence\... | [
-0.004047973081469536,
-0.023013107478618622,
0.049561068415641785,
-0.054713282734155655,
-0.11396432667970657,
0.016704799607396126,
0.07085694372653961,
0.037596166133880615,
-0.008100863546133041,
0.020595142617821693,
0.09524339437484741,
-0.014838183298707008,
0.02056962437927723,
0.... |
McClave\tet\tal,\t2016\n).\nAll\tcommercially\tavailable\tenteral\tformulas\tare\tlactose\tfree,\tbecause\tlactase\tinsufficiency\n\tmay\tbe\nencountered\tin\tacutely\till\tpatients.\t(Atkinson\tand\tWorthley,\t2003).\nLipid\nLipid\tcontent\tof\tenteral\tformulas\tvaries\tfrom\t1.5%\tto\t55%\tof\tthe\ttotal\tkilocalori... | [
-0.0035991433542221785,
-0.07106693834066391,
0.008197659626603127,
-0.012928543612360954,
-0.12532983720302582,
0.054623812437057495,
0.06574656814336777,
0.060811400413513184,
0.03188705816864967,
-0.00814867950975895,
0.09862703830003738,
-0.033784572035074234,
-0.01478771772235632,
0.0... |
lipid\tas\t(typically)\tcanola,\tsoybean,\tand/or\tsafflower\toil\tprovides\tbetween\t15%\tand\t30%\tof\tthe\ttotal\nkilocalories.\tElemental\tformulas\tcontain\tminimal\tamounts\tof\tfat,\ttypically\tin\tthe\tform\tof\tmedium-chain\ntriglycerides\t(MCTs)\trather\tthan\tlong-chain\ttriglycerides\t(LCTs). | [
-0.021294759586453438,
-0.09690501540899277,
0.004181417636573315,
-0.007120400667190552,
-0.0763038769364357,
-0.02890787273645401,
0.02677183598279953,
0.05623588338494301,
0.002803321462124586,
-0.022054893895983696,
0.10187821835279465,
-0.04145226627588272,
-0.04585687443614006,
-0.02... |
triglycerides\t(MCTs)\trather\tthan\tlong-chain\ttriglycerides\t(LCTs).\nMost\tof\tthe\tlipid\tin\tstandard\tenteral\tformulas\tis\tin\tthe\tform\tof\tLCTs\tand\tMCTs.\tSome\tformulas\tcontain\n“structured\tlipids,”\twhich\tare\ta\tmix\tof\tLCTs\tand\tMCTs\tand\tcontain\tproperties\tof\tboth.\tMost\tof\tthe\tLCTs | [
-0.020299943163990974,
-0.04677669331431389,
-0.0021086116321384907,
-0.04317004606127739,
-0.08265095949172974,
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0.04298382252454758,
0.08032910525798798,
0.04503786191344261,
0.0022039106115698814,
0.10478361696004868,
-0.010382834821939468,
-0.011685783974826336,
0.... |
found\tin\tstructured\tlipids\tare\tomega-3\tfatty\tacids\t(such\tas\teicosapentaenoic\tacid\tand\tdocosahexanoic\nacid);\tthese\tomega-3\tfatty\n\tacids\tmay\thave\tantiinflammatory\teffects\t(see\t\nChapter\t7\n).\nMCTs\tdo\tnot\trequire\tbile\tsalts\tor\tpancreatic\tlipase\tfor\tdigestion\tand\tare\tabsorbed\tdirect... | [
-0.027690015733242035,
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0.011322379112243652,
0.005273823626339436,
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0.07759378105401993,
0.009416394867002964,
0.02726742997765541,
0.03949028253555298,
0.12444167584180832,
-0.06868990510702133,
0.0012793063651770353,
0.015... |
circulation.\tThe\tpercentage\tof\tfat\tas\tMCT\tin\tenteral\tformulas\tvaries\tfrom\t0%\tto\t85%.\tAbout\t2%\tto\t4%\tof\ndaily\tenergy\tintake\tfrom\tlinoleic\tand\tlinolenic\tacid\tis\tnecessary\tto\tprevent\t\nessential\tfatty\tacid\tdeficiency\n(EFAD)\n.\tMCTs\tdo\tnot\n\tprovide\tlinoleic\tor\tlinolenic\tacids;\t... | [
0.01871391385793686,
-0.035804688930511475,
0.026655927300453186,
-0.029800692573189735,
-0.10405176877975464,
-0.02867363765835762,
0.07143890857696533,
0.07243712991476059,
-0.007594341412186623,
0.002441402990370989,
0.13277088105678558,
-0.03134177625179291,
0.058580853044986725,
0.051... |
receive\thigh\tMCT\tenteral\tformulas\treceive\tlinoleic\tand\tlinolenic\tacids\tfrom\tother\tsources.\nVitamins,\tminerals,\tand\telectrolytes\nMost,\tbut\tnot\tall,\tavailable\tformulas\tprovide\tthe\tdietary\treference\tintakes\t(DRIs)\tfor\tvitamins\tand\tminerals\nin\ta\tvolume\tthat\tmay\tbe\tadministered\tto\tmo... | [
-0.0071878014132380486,
-0.046853721141815186,
0.04576471820473671,
-0.043054211884737015,
-0.12226693332195282,
-0.034684937447309494,
0.09798955917358398,
0.07881852239370346,
-0.026492981240153313,
0.012308277189731598,
0.09503088146448135,
0.0051302253268659115,
0.036736860871315,
0.02... |
intended\tfor\thealthy\npopulations,\tnot\tspecifically\tfor\tindividuals\t(whether\thealthy\tor\tacutely\tor\tchronically\till),\tit\tis\tdifficult\tto\nknow\tfor\tcertain\twhether\tthe\tvitamin\tand\tmineral\tprovision\tfrom\tthese\tformulas\tis\tadequate.\tFormulas\nintended\tfor\tpatients\twith\trenal\tor\thepatic\... | [
0.01110606174916029,
0.0025598208885639906,
0.04885042831301689,
-0.06385067105293274,
-0.08316073566675186,
-0.01906409114599228,
0.049926359206438065,
0.047415755689144135,
0.01187505666166544,
0.03651147708296776,
0.09350641071796417,
-0.012101341970264912,
0.052415236830711365,
0.05971... |
potassium.\tConversely,\tdisease-specific\tformulas\toften\n\tare\tsupplemented\twith\tantioxidant\tvitamins\tand\nminerals\tand\tmarketed\tto\tsuggest\tthat\tthese\tadditions\timprove\timmune\tfunction\tor\taccelerate\twound\nhealing.\tDefinitive\tstudies\tdemonstrating\tthese\teffects\tare\tnot\tavailable. | [
0.009577229619026184,
-0.09618469327688217,
0.06589297950267792,
-0.004742592107504606,
-0.0918351337313652,
0.03709835931658745,
0.11478173732757568,
0.01580171473324299,
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0.046204134821891785,
0.05076435208320618,
-0.05843045935034752,
0.010641280561685562,
-0.01723... |
Electrolyte\tcontent\tof\tenteral\tformulas\tis\ttypically\tmodest\tcompared\twith\tthe\toral\tdiet.\tPatients\twho\nexperience\tlarge\telectrolyte\tlosses\t(e.g.,\tbecause\tof\tdiarrhea,\tfistula,\n\temesis)\tlikely\twill\trequire\telectrolyte\nsupplementation.\tSalt\tmust\tbe\tadded\tto\thome-prepared\tBTFs\tin\torde... | [
-0.0006713191396556795,
-0.05938432738184929,
0.06751585751771927,
-0.010852999053895473,
-0.11792752146720886,
-0.04417959228157997,
0.12090691924095154,
0.0446883924305439,
0.0000014937547803128837,
0.019315026700496674,
0.11349727213382721,
0.003380423877388239,
0.03813490644097328,
0.0... |
intake.\nFluid\nAdult\tfluid\tneeds\toften\tare\testimated\tat\t1\tmL\tof\twater\tper\tkilocalorie\tconsumed,\tor\t30\tto\t35\tmL/kg\tof\tusual\nbody\tweight.\tPatients\tfed\texclusively\tby\tEN,\tespecially\tif\tit\tis\ta\tconcentrated\tformula,\tmay\treceive\ninsufficient\tfluid\t(water)\tto\tmeet\n\ttheir\tneeds.\tI... | [
0.0015329614980146289,
-0.07732198387384415,
0.04133705049753189,
-0.002864768961444497,
-0.07254043221473694,
-0.08428783714771271,
0.046655911952257156,
0.06361380964517593,
-0.04724075272679329,
-0.03300485759973526,
0.0380156934261322,
-0.04306155443191528,
0.027374541386961937,
0.0097... |
product\tcan\tlead\tto\tundesirable\tconsequences,\tincluding\tinadequate\turine\toutput,\tconstipation,\tand\nformation\tof\ta\tfiber\tbezoar\t(a\thard\tball\tof\tfiber\tthat\tmay\tdevelop\twithin\tthe\thuman\tstomach).\tAll\tsources\tof\nfluid,\tincluding\tfeeding\ttube\tflushes,\tmedications,\tand\tintravenous\tflui... | [
-0.019101912155747414,
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0.04287545382976532,
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0.10979350656270981,
0.04232931137084961,
0.039537813514471054,
0.013944492675364017,
0.08880174905061722,
-0.007752740755677223,
0.07487224787473679,
0.02... |
assessing\ta\tpatient’s\n\tfluid\tintake\trelative\tto\tindividual\tneeds.\nStandard\t(1\tkcal/mL)\tformulas\tcontain\tabout\t85%\twater\tby\tvolume;\tconcentrated\t(2\tkcal/mL)\tformulas\ncontain\tonly\tabout\t70%\twater\tby\tvolume.\tAdditional\twater\t(as\tflushes\tand\tfor\tadditional\thydration)\tare\noften\tneces... | [
0.0165712870657444,
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0.024200372397899628,
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0.030112367123365402,
0.06278812140226364,
0.036696359515190125,
-0.014545504935085773,
0.050236813724040985,
-0.04933341592550278,
0.04852452501654625,
0.06... |
Administration\nEN\tmay\tbe\tadministered\tas\ta\tbolus,\tor\tas\tan\tintermittent\tor\tcontinuous\n\tfeeding.\tAdministration\tmethod\nselection\tshould\taccommodate\tthe\tpatient’s\tclinical\tstatus,\tliving\tsituation,\tand\tquality-of-life\nconsiderations.\tOne\tmethod\tmay\tserve\tas\ta\ttransition\tto\tanother\tm... | [
0.03103778325021267,
-0.01870865561068058,
0.0411418117582798,
-0.01360673550516367,
-0.12324695289134979,
-0.002508187899366021,
0.0680423453450203,
-0.007254227064549923,
0.005397926550358534,
0.030215119943022728,
0.13164696097373962,
-0.018230238929390907,
0.04157484322786331,
0.031817... |
In\ta\t\nclosed\tenteral\tsystem\n,\tthe\tcontainer\tor\tbag\tis\tprefilled\twith\tsterile\tliquid\tformula\tby\tthe\nmanufacturer\tand\tis\t“ready\tto\tfeed”\tafter\tconnecting\tto\tthe\tpatient’s\n\tfeeding\taccess.\tIn\tan\t\nopen\tenteral\nsystem\n,\tthe\tcontents\tof\tformula\tcans\tor\tpackages\tare\tpoured\tinto... | [
0.02254355326294899,
-0.008964728564023972,
0.05296473577618599,
-0.009352035820484161,
-0.11287888884544373,
-0.0008525943267159164,
0.08178357034921646,
-0.007046834100037813,
0.04162570461630821,
0.02210012637078762,
0.10774416476488113,
-0.00515513913705945,
0.05949031934142113,
0.0462... |
then\tconnected\tto\tthe\tfeeding\taccess.\nHang\ttime\n\tis\tthe\tlength\tof\ttime\tan\tenteral\tformula\thanging\tat\troom\ttemperature\tis\tconsidered\tsafe\tfor\ndelivery\tto\tthe\tpatient.\tMost\tfacilities\tallow\ta\t4-hour\thang\ttime\tfor\ta\tproduct\tin\tan\topen\tsystem\tand\t24\tto\n48\thours\n\tfor\tproduct... | [
0.019463686272501945,
-0.0019627949222922325,
0.08104555308818817,
-0.028841672465205193,
-0.0890735313296318,
-0.021977121010422707,
0.09128663688898087,
0.03488603234291077,
0.003834335831925273,
0.00957026332616806,
0.10284920036792755,
-0.02383599430322647,
0.06964723020792007,
0.04120... |
Bolus\nSyringe\t\nbolus\tenteral\tfeedings\n\tcan\tbe\tsuitable\tfor\tpatients\twith\tadequate\tgastric\temptying\twho\tare\nclinically\tstable\t(see\t\nFig.\t12.4\n).\tAdministered\tover\t5\tto\t20\tminutes,\tthese\tfeedings\tare\tmore\tconvenient\tand\nless\texpensive\tthan\tpump\tor\tgravity\tbolus\tfeedings\tand\ts... | [
0.010773246176540852,
-0.04145162180066109,
0.060739342123270035,
0.0057440828531980515,
-0.10400404781103134,
-0.016176516190171242,
0.07875928282737732,
0.06483758985996246,
-0.020494874566793442,
-0.016005273908376694,
0.08434899896383286,
-0.020816756412386894,
0.036837317049503326,
0.... |
60-mL\nsyringe\tmay\tbe\tused\tto\tinfuse\tthe\tformula.\tIf\tbloating\tor\tabdominal\tdiscomfort\tdevelops,\tthe\tpatient\tshould\nwait\t10\tto\t15\tminutes\tbefore\tinfusing\tthe\tremainder\tof\tformula\tallocated\tfor\tthat\tfeeding.\tPatients\twith\nnormal\tgastric\tfunction\tgenerally\ttolerate\t500\tmL\tor\tmore\... | [
0.014134755358099937,
-0.04882735386490822,
0.02459256537258625,
-0.04154287651181221,
-0.1192084401845932,
0.005029317457228899,
0.026595233008265495,
0.07384493201971054,
-0.007099469192326069,
-0.010296754539012909,
0.09795498102903366,
0.01690274477005005,
0.0418553464114666,
0.0281116... |
bolus\tfeedings\tper\tday\ttypically\tprovide\ttheir\tdaily\tnutritional\trequirements.\n\tSome\tindividuals,\tespecially\tif\nelderly,\tmay\tnot\ttolerate\tlarger\tboluses\tand\trequire\tsmaller,\tmore\tfrequent\tfeedings.\tFormula\tat\troom\ntemperature\tis\tbetter\ttolerated\tthan\tcold\tformula;\thowever,\tfood\tsa... | [
0.046590954065322876,
-0.07785560935735703,
0.064815953373909,
-0.03749782219529152,
-0.1347067803144455,
-0.01936216838657856,
0.08852966874837875,
0.0005186542985029519,
0.014067214913666248,
0.05096796154975891,
0.13047365844249725,
-0.039589717984199524,
0.03359802067279816,
0.00208403... |
Follow\tlabel\tdirections\tfor\tstoring\tpartially\tused\tcans\tof\tformula.\nIntermittent\tand\tcyclic\nQuality-of-life\tissues\tare\toften\tthe\treason\tfor\tthe\tinitiation\n\tof\t\nintermittent\tenteral\tfeedings\n.\tCyclic\nregimens\tallow\tmobile\tpatients\tan\timproved\tquality\tof\tlife\tby\toffering\ttime\t“of... | [
0.00890055950731039,
-0.015342476777732372,
0.07219601422548294,
-0.03490345552563667,
-0.0811273381114006,
0.02598980814218521,
0.06294688582420349,
0.03266897797584534,
-0.00517247524112463,
0.058662693947553635,
0.12304533272981644,
0.001080100191757083,
0.02620203234255314,
0.076213769... |
autonomy.\tThey\tare\tinitiated\tto\tallow\ttime\tfor\ttreatments,\ttherapies,\tand\tactivities.\tIntermittent\tfeedings\ncan\tbe\tgiven\tby\tpump\tor\tgravity\tdrip.\tGravity\tfeeding\tis\taccomplished\tby\tpouring\tformula\tinto\ta\tfeeding\nbag\tthat\tis\tequipped\twith\ta\troller\tclamp.\tThe\n\tclamp\tis\tadjusted... | [
0.03498617187142372,
-0.07342075556516647,
0.06435999274253845,
-0.00917578674852848,
-0.1288776993751526,
-0.016400953754782677,
0.08091536909341812,
-0.014433510601520538,
0.009230376221239567,
0.07532826066017151,
0.11223696172237396,
-0.022808486595749855,
0.02111434005200863,
0.042527... |
clamp\tis\tadjusted\tto\tthe\tdesired\tdrips\tper\tminute.\tA\ttypical\ndaily\tfeeding\tschedule\tis\tfour\tto\tsix\tfeedings,\teach\tadministered\tover\t20\tto\t60\tminutes.\tFormula\nadministration\tis\tinitiated\tat\t100\tto\t150\tmL\tper\tfeeding\tand\tincreased\tincrementally\tas\ttolerated.\tPatients | [
0.015766797587275505,
-0.031689807772636414,
0.054647695273160934,
-0.04799307510256767,
-0.18060608208179474,
-0.022176198661327362,
0.059672463685274124,
0.07811013609170914,
0.0015362832928076386,
0.00268855644389987,
0.10613778978586197,
-0.015810417011380196,
0.019055483862757683,
0.0... |
who\tmost\toften\tsucceed\twith\tthis\tregimen\tare\tmotivated,\torganized,\talert,\tand\tmobile.\tCyclic\tfeeding\talso\nallows\tfor\ttime\taway\tfrom\n\ttube\tfeeding.\tThis\tfeeding\tregimen\tis\ta\tgood\tchoice\tfor\tpatients\twho\tare\nreceiving\tphysical\ttherapy\tor\tparticipate\tin\tother\tactivities\tthat\treq... | [
-0.0033617860171943903,
-0.03071892075240612,
0.05457368865609169,
-0.0023887380957603455,
-0.11854413151741028,
-0.006506731268018484,
0.079893097281456,
-0.005666994024068117,
-0.024176454171538353,
0.05108368769288063,
0.11519373953342438,
-0.02341127209365368,
0.029457975178956985,
0.0... |
schedule\tis\t90\tto\t150\tmL\tper\thour\tof\tformula\tadministered\tover\t18\tto\t20\thours.\tThis\tregimen,\toften\tstarted\nat\tnight,\tcan\tbe\tused\tto\ttransition\tto\tan\toral\tdiet.\nContinuous\nContinuous\tinfusion\tof\tEN\trequires\ta\tpump.\n\tThis\tmethod\tis\tappropriate\tfor\tpatients\twho\tdo\tnot\ttoler... | [
-0.03900209069252014,
-0.0030093712266534567,
0.02791227027773857,
-0.02745828777551651,
-0.11477718502283096,
0.0389237217605114,
0.05271567404270172,
0.01762012019753456,
-0.0011712689884006977,
-0.027185264974832535,
0.07882874459028244,
0.00989576056599617,
0.0250666793435812,
0.018816... |
This\tmethod\tis\tappropriate\tfor\tpatients\twho\tdo\tnot\ttolerate\tthe\nvolume\tof\tinfusion\tused\twith\tthe\tbolus,\tcyclical,\tor\tintermittent\tmethods.\tPatients\twith\tcompromised\ngastrointestinal\tfunction\tbecause\tof\tdisease,\tsurgery,\tcancer\ttherapy,\tor\tother\tphysiologic\timpediments\tare | [
-0.013650188222527504,
-0.015064077451825142,
0.039002321660518646,
-0.03578353673219681,
-0.10517603158950806,
0.009144342504441738,
0.09255849570035934,
0.0670735239982605,
0.04254934936761856,
0.015495332889258862,
0.0751831978559494,
-0.01270911656320095,
0.033045172691345215,
0.066927... |
candidates\tfor\tcontinuous\tfeedings.\tPatients\twith\ta\tfeeding\ttube\ttip\tin\tthe\tsmall\tintestine\tshould\tbe\tfed\nonly\tby\tcontinuous\n\tor\tcyclic\tinfusion.\t(Use\tof\tbolus\tor\tgravity\tfeeding\tin\tthese\tpatients\tis\tstrongly\ndiscouraged,\talthough\tanecdotal\tverbal\treports\tof\tuse\tof\tboth\thave\... | [
-0.00007029351399978623,
-0.06169327720999718,
0.040301643311977386,
-0.0329861044883728,
-0.09548666328191757,
0.01477098185569048,
0.07176519185304642,
0.019528556615114212,
0.01529796700924635,
0.02240060083568096,
0.07132402807474136,
-0.016918407753109932,
0.056856900453567505,
0.0894... |
feeding\trate\tgoal,\tin\tmilliliters\tper\thour,\tis\tset\tby\tdividing\tthe\ttotal\tdaily\tvolume\tby\tthe\tnumber\tof\thours\nper\tday\tof\tadministration.\tFull\tstrength\tfeeding\tis\tstarted\tat\tone\tquarter\tto\tone\thalf\tof\tthe\thourly\tgoal\n\trate\nand\tadvanced\tevery\t8\tto\t12\thours\tto\tthe\tfinal\tvo... | [
0.02648518979549408,
-0.08358468115329742,
0.02951744943857193,
-0.0499720461666584,
-0.17079050838947296,
-0.007774943485856056,
0.033281244337558746,
-0.039716687053442,
-0.022581232711672783,
0.05669394135475159,
0.0938103049993515,
-0.016892852261662483,
0.0634501501917839,
0.033442053... |
underfeeding.\tHigh\tosmolality\tformulas\tmay\trequire\tmore\ttime\tto\tachieve\ttolerance\tand\tshould\tbe\nadvanced\tconservatively.\nOne\tpossible\tdrawback\tto\tcontinuous\tfeedings\toccurs\tif\tthe\tpatient\trequires\tmedication\tthat\tmust\tbe\nadministered\ton\tan\tempty\tstomach.\tFor\texample,\twhen\tadminist... | [
0.03884938731789589,
-0.034005071967840195,
0.07581369578838348,
-0.016992831602692604,
-0.10825946182012558,
-0.011231929995119572,
0.07298757880926132,
0.02377656288444996,
-0.008851565420627594,
0.003068616846576333,
0.09760159999132156,
0.013533737510442734,
0.05717114359140396,
0.0150... |
phenytoin\t(Dilantin)\tit\tis\nrecommended\tthat\ttube\tfeedings\tbe\tstopped\tbefore\tand\tafter\tadministration.\tThe\ttimes\tvary\tby\tsituation\nand\tmedication.\nEnteral\tpumps\tfor\thome\tuse\tare\tsmall\tand\teasy\tto\thandle.\tMany\tpumps\trun\tfor\tup\tto\t8\thours\ton\tbattery | [
0.02881067991256714,
-0.07173594832420349,
0.0940903052687645,
-0.049433041363954544,
-0.09035679697990417,
-0.00022093416191637516,
0.08556196093559265,
0.020655032247304916,
0.03179405257105827,
0.05372593551874161,
0.09034312516450882,
-0.021676383912563324,
0.01326682697981596,
0.01677... |
power,\twith\ta\t“plug-in”\toption,\tallowing\tflexibility\tand\tmobility\tfor\tthe\tpatient.\tPump\tsets\ttypically\tinclude\nbags\tand\ttubing\tcompatible\twith\tproper\n\tpump\toperation.\tFeeding\tbags\tshould\tbe\tlabeled\tin\taccordance\nwith\tthe\tASPEN\tEnteral\tNutrition\tPractice\tGuidelines\tand\tshould\tinc... | [
0.006357827689498663,
0.006401247810572386,
0.04025078937411308,
-0.02487156167626381,
-0.10968714952468872,
-0.0015081509482115507,
0.09099724888801575,
-0.00713361194357276,
0.002032872289419174,
0.03990233317017555,
0.0947222113609314,
-0.01255771704018116,
0.057463280856609344,
0.01988... |
concentration,\tthe\tdate\tand\ttime\tthe\tbag\twas\tfilled,\tand\tthe\tinitials\tof\tthe\thealth\tcare\tprovider\twho\thung\nthe\tfeeding.\nMonitoring\tand\tevaluation\nMonitoring\tfor\tcomplications\nBox\t12.3\n\tprovides\ta\tcomprehensive\tlist\tof\tcomplications\n\tassociated\twith\tEN.\tMany\tcomplications\tcan\tb... | [
0.06763744354248047,
-0.026399314403533936,
0.030656417831778526,
-0.04271057993173599,
-0.09734516590833664,
0.03468163311481476,
0.1265360414981842,
0.0282108373939991,
0.010424304753541946,
0.027646690607070923,
0.09993782639503479,
-0.009562931954860687,
0.0391029417514801,
0.047890305... |
prevented\tor\tmanaged\twith\tcareful\tpatient\tmonitoring.\nBOX\t12.3\nComplications\tof\tEnteral\tNutrition\nAccess\nLeakage\tfrom\tostomy/stoma\tsite\nPressure\tnecrosis/ulceration/stenosis\nTissue\terosion\nTube\tdisplacement/migration | [
0.0033748133573681116,
0.03708117455244064,
0.017957523465156555,
-0.030367238447070122,
-0.028307870030403137,
0.06585439294576645,
0.027473093941807747,
0.005991270765662193,
-0.04255840182304382,
0.017746970057487488,
0.08989126235246658,
0.07732854783535004,
-0.015887342393398285,
0.01... |
Tube\tobstruction/occlusion\nAdministration\nMicrobial\tcontamination\nEnteral\tmisconnections\tor\tmisplacement\tof\ttube,\n\tcausing\tinfection,\taspiration\tpneumonia,\nperitonitis,\tpulmonary\tor\tvenous\tinfusion\nRegurgitation\nInadequate\tdelivery\tfor\tone\tor\tmore\treasons\nGastrointestinal\nConstipation\nDel... | [
0.025339344516396523,
-0.06323888152837753,
0.04027636721730232,
-0.031519658863544464,
-0.08046255260705948,
-0.0013423823984339833,
0.027672644704580307,
0.0768510177731514,
-0.066522017121315,
0.055834539234638214,
0.07741987705230713,
-0.005595650989562273,
0.058325428515672684,
0.0864... |
Delayed\tgastric\temptying/elevated\tgastric\tresidual\tvolume\nDiarrhea\nOsmotic\tdiarrhea,\tespecially\tif\tsorbitol\tis\tpresent\tin\tliquid\tdrug\tpreparations\nSecretory\nDistention/bloating/cramping\nFormula\tchoice/rate\n\tof\tadministration\nIntolerance\tof\tnutrient\tcomponents\nMaldigestion/malabsorption\nNau... | [
0.026470299810171127,
-0.11581651121377945,
0.006206807680428028,
0.018280040472745895,
-0.08684086799621582,
0.006093607284128666,
0.025637660175561905,
0.10371227562427521,
-0.012900911271572113,
-0.010195830836892128,
0.044707681983709335,
-0.007667813450098038,
0.09874022006988525,
0.0... |
Nausea/vomiting\nMetabolic\nDrug-nutrient\tinteractions\nGlucose\tintolerance/hyperglycemia/hypoglycemia\nDehydration/overhydration\nHypernatremia/hyponatremia\nHyperkalemia/hypokalemia\nHyperphosphatemia/hypophosphatemia\nMicronutrient\tdeficiencies\t(notably\tthiamin)\nRefeeding\tsyndrome\nData\tfrom\tRussell\tM: | [
0.059509530663490295,
-0.037066105753183365,
0.01708948239684105,
-0.002343184780329466,
-0.030714618042111397,
-0.048098690807819366,
0.07619825750589371,
0.10985241830348969,
-0.06985776126384735,
-0.01171315647661686,
0.019174892455339432,
-0.042272187769412994,
0.0738615095615387,
-0.0... |
Refeeding\tsyndrome\nData\tfrom\tRussell\tM:\n\tComplications\tof\tenteral\tfeedings.\tIn\tCharney\tP,\tMalone\tA\t(eds):\t\nPocket\tguide\tto\tenteral\nnutrition\n,\ted\t2,\tChicago,\t2013,\tAcademy\tof\tNutrition\tand\tDietetics,\tp\t170.\nAspiration,\ta\tcommon\tconcern\tfor\tpatients\treceiving\tEN,\tis\ta\tcontrov... | [
-0.03137730434536934,
-0.03420587629079819,
0.02668624557554722,
-0.013350481167435646,
-0.07313302904367447,
-0.006407568231225014,
0.050046682357788086,
0.09566754847764969,
-0.004111771006137133,
-0.005555079318583012,
0.08462541550397873,
0.039066385477781296,
0.00019297449034638703,
0... |
that\taspiration\tof\tthroat\tcontents\tand\tsaliva\tis\tas\tmuch\tas\tor\tmore\timportant\tthan\taspiration\tof\tformula.\tTo\nminimize\n\tthe\trisk\tof\taspiration,\tpatients\tshould\tbe\tpositioned\twith\ttheir\theads\tand\tshoulders\tabove\ttheir\nchests\tduring\tand\timmediately\tafter\tfeeding\t(\nBankhead\tet\ta... | [
0.032847024500370026,
-0.014243257232010365,
0.1026575043797493,
-0.0444570854306221,
-0.06985592842102051,
0.04384000599384308,
0.09406924247741699,
-0.004846511408686638,
-0.023818377405405045,
0.048666082322597504,
0.11362512409687042,
-0.05176449567079544,
0.05078456550836563,
0.032460... |
Bankhead\tet\tal,\t2009\n;\t\nMcClave\tet\tal,\t2016\n).\nSignificant\tdisagreement\texists\tabout\tthe\tvalue\tof\t\ngastric\tresidual\tvolumes\t(GRV)\n\tas\tan\tindicator\tof\nEN\ttolerance.\tGRV\tprocedures\tare\tnot\tstandardized\tand\tchecking\tGRV\tdoes\tnot\tprotect\tpatients\tfrom\naspiration. | [
-0.014130673371255398,
0.007370127364993095,
0.01056237705051899,
-0.0419149175286293,
-0.062000080943107605,
0.02493872120976448,
0.0994604304432869,
0.026265190914273262,
-0.011020728386938572,
-0.02816656231880188,
0.08989514410495758,
-0.03516841307282448,
-0.01094739232212305,
-0.0101... |
aspiration.\n\tGRV\tdoes\tnot\thave\tto\tbe\tchecked\tregularly\tin\tpatients\twho\tare\tstable\ton\ta\tfeeding\tregimen\tand\nthose\twho\thave\ta\tlong\thistory\ton\ttube\tfeedings.\tIn\tcritically\till\ttube-fed\tpatients\tthe\tbest\tmethods\tfor\nreducing\tthe\trisk\tof\taspiration\tinclude\televation\tof\tthe\thead... | [
0.014872630126774311,
-0.049259960651397705,
0.05047869309782982,
-0.0009395177476108074,
-0.13291019201278687,
-0.009006683714687824,
0.05728314816951752,
0.010999541729688644,
-0.0023044671397656202,
0.03442194312810898,
0.11386249214410782,
-0.031494975090026855,
0.06616567075252533,
0.... |
and\toral\tdecontamination\t(\nBankhead\tet\tal,\t2009\n;\t\nMcClave\tet\tal,\t2016\n).\nIn\tthe\tpresence\tof\n\tgastroparesis,\tdoses\tof\ta\tpromotility\tdrug\t(like\tmetoclopramide)\tmay\tincrease\ngastrointestinal\ttransit,\timprove\tEN\tdelivery,\tand\timprove\tfeeding\ttolerance\t(\nMcClave\tet\tal,\t2016\n). | [
-0.016339464113116264,
-0.04491228982806206,
0.0018675163155421615,
-0.023524604737758636,
-0.08375474065542221,
0.060903772711753845,
0.010802962817251682,
0.07525978982448578,
0.016174007207155228,
0.05645139887928963,
0.13962091505527496,
0.0008077913662418723,
-0.0005527901812456548,
0... |
McClave\tet\tal,\t2016\n).\nDiarrhea\tis\ta\tcommon\tEN\tcomplication,\toften\trelated\tto\tthe\tantibiotic\ttherapy,\tcolonic\tbacterial\novergrowth,\tand\tgastrointestinal\tmotility\tdisorders\tassociated\twith\tacute\tand\tcritical\tillness.\tHyperosmolar\nmedications\n\tsuch\tas\tmagnesium-containing\tantacids,\tso... | [
-0.015745824202895164,
-0.07039275020360947,
0.004427071660757065,
-0.0239744670689106,
-0.030671607702970505,
0.02724892646074295,
0.0604587122797966,
0.07232750207185745,
-0.005358907859772444,
0.040944069623947144,
0.11001046001911163,
-0.02378040924668312,
0.005640666000545025,
0.08358... |
supplements\talso\tcontribute\tto\tdiarrhea.\tAdjustment\tof\tmedications\tor\tadministration\tmethods\tmay\treduce\nor\teliminate\tthe\tdiarrhea.\tFOS,\tpectin,\tguar\tgum,\tbulking\tagents,\tand\tantidiarrheal\tmedications\talso\tcan\nbe\tbeneficial.\t(Use\tcare\tto\tavoid\tclogging\tthe\tfeeding\ttube\twhen\tusing\t... | [
-0.0071073719300329685,
-0.049487121403217316,
0.01938593201339245,
-0.0189170204102993,
-0.07736442238092422,
-0.023491935804486275,
0.10066533833742142,
0.0603402778506279,
0.01645749993622303,
-0.01112566888332367,
0.08221964538097382,
0.010905280709266663,
0.07864198833703995,
0.055309... |
predigested\n\tformula\tis\trarely\tthe\tbest\t“first\tline”\toption,\tbecause\tthe\tformula\tis\ttypically\tnot\tthe\tcause\tof\nthe\tdiarrhea.\nConstipation\tis\ta\tconcern\twith\tEN,\tparticularly\tamong\tbed-bound\tpatients\twho\treceive\tlong-term\nfeedings.\tFiber-containing\tformulas\tor\tstool-bulking\tmedicati... | [
0.010411273688077927,
-0.05280335247516632,
0.053024642169475555,
-0.035132698714733124,
-0.13106779754161835,
0.01285570114850998,
0.03152037411928177,
0.04090446978807449,
0.049877699464559555,
0.02884718030691147,
0.10994928330183029,
0.01770077459514141,
0.051331762224435806,
0.0213825... |
fluid\tis\timportant.\tNarcotic\tpain\trelievers\tslow\tGIT\tactivity;\tiron\tsupplements\n\tcan\tcause\tconstipation.\nDiarrhea\tmay\tcoexist\twith\tconstipation\tbecause\tliquid\tstool\tcan\tpass\ta\tfecal\timpaction.\nMonitoring\tfor\ttolerance\tand\tnutrient\tintake\tgoals\nMonitoring\tthe\tpatient’s\t\nactual\n\t(... | [
0.03531469777226448,
-0.053198277950286865,
0.06955277174711227,
0.022234244272112846,
-0.10367466509342194,
0.004444651771336794,
0.10874472558498383,
0.04937697574496269,
0.0029795696027576923,
-0.017321178689599037,
0.07749172300100327,
-0.039662592113018036,
0.047407396137714386,
0.090... |
nutrition\tgoals\tare\tachieved\tand\tmaintained.\tMonitoring\tof\tmetabolic\tand\tgastrointestinal\ttolerance,\nhydration\tstatus,\tweight,\n\tand\tlean\tbody\tmass\tis\textremely\timportant\t(\nBox\t12.4\n).\tPractice\tguidelines,\ninstitutional\tprotocols,\tand\tstandardized\tordering\tprocedures\tshould\tbe\tdevelo... | [
-0.00349236186593771,
-0.017444336786866188,
0.049828656017780304,
0.0021656756289303303,
-0.058085884898900986,
0.011047678999602795,
0.0866369977593422,
0.06381399929523468,
-0.07001623511314392,
0.014379985630512238,
0.08411679416894913,
0.003969361074268818,
-0.0002770109858829528,
-0.... |
optimal,\tsafe\tmonitoring\tof\tEN\t(\nMcClave\tet\tal,\t2016\n).\nBOX\t12.4\nMonitoring\tthe\tPatient\tReceiving\tEnteral\tNutrition\nAbdominal\tdistention\tand\tdiscomfort | [
0.026230303570628166,
0.013752639293670654,
-0.020832357928156853,
-0.07100541889667511,
-0.10867802053689957,
0.056691087782382965,
0.0023593096993863583,
0.1350361406803131,
-0.0035659181885421276,
0.0156786497682333,
0.03532711789011955,
0.06818240880966187,
0.004418206866830587,
0.1112... |
Confirm\tproper\ttube\tplacement\tand\tmaintain\thead\tof\tbed\t>30\n\tdegrees\t(daily)\nChange\tfeeding\tdelivery\tcontainer\tand\ttubing\t(daily)\nFluid\tintake\tand\toutput\t(daily)\nGastric\tresidual\tvolume\tif\tappropriate\t(not\tfor\tjejunal\ttubes)\nSigns\tand\tsymptoms\tof\tedema\tor\tdehydration\t(daily)\nSto... | [
-0.01961487904191017,
-0.005499185994267464,
0.055953189730644226,
0.016453711315989494,
-0.023933084681630135,
-0.03993579372763634,
0.12381254136562347,
0.014444183558225632,
0.021480076014995575,
0.018138157203793526,
0.11099354922771454,
-0.04858348146080971,
0.051862508058547974,
0.02... |
Stool\tfrequency,\tvolume,\tand\tconsistency\t(daily)\nWeight\t(at\tleast\tthree\ttimes/wk)\nNutritional\tintake\tadequacy\t(daily)\nClinical\tstatus\t(daily)\nNutrition\tfocused\tphysical\texam\n\t(daily)\nSerum\telectrolytes,\tblood\turea\tnitrogen,\tcreatinine,\t(daily\tuntil\tstable,\tthen\ttwo\tto\tthree\ttimes/wk... | [
0.0278086606413126,
-0.09637925028800964,
0.06240127608180046,
0.05419951304793358,
-0.09560584276914597,
-0.0532945841550827,
0.0772397518157959,
0.03546473756432533,
0.00009947020589606836,
-0.007224985398352146,
0.08929845690727234,
-0.023085132241249084,
0.018923582509160042,
0.0325051... |
Serum\tglucose,\tcalcium,\tmagnesium,\tphosphorus\t(daily\tuntil\tstable,\tthen\tweekly)\nData\tfrom\tMcClave\tSA\tet\tal:\tGuidelines\tfor\tthe\tprovision\tand\tassessment\tof\tnutrition\tsupport\ttherapy\tin\tthe\nadult\tcritically\till\tpatient,\t\nJ\tParenter\tEnteral\tNutr\n\t40:159-211,\t2016.\nShelton\tM:\tMonit... | [
-0.009640847332775593,
-0.041734930127859116,
0.01887362450361252,
-0.02937200665473938,
-0.07215713709592819,
-0.022995829582214355,
0.0716816857457161,
0.11801066994667053,
-0.05252813547849655,
-0.041948288679122925,
0.0677323266863823,
-0.02103644609451294,
0.016411976888775826,
0.0569... |
evaluation\tof\tenteral\tfeedings.\tIn\tCharney\tP,\tMalone\tA:\t\nPocket\tguide\tto\tenteral\nnutrition\n,\ted\t2,\tChicago,\t2013,\tAND,\tp.\t153.\nTime\tis\toften\tlost\tfrom\tthe\tprescribed\tfeeding\tschedule\tbecause\tof\tissues\tsuch\tas\tNPO\t(nothing\tby\nmouth)\tstatus\tfor\tmedical\tprocedures,\tclogged\ttub... | [
-0.01676967926323414,
-0.007435406092554331,
0.04325443506240845,
0.0025297654792666435,
-0.04185401648283005,
-0.00269512040540576,
0.06784413009881973,
0.06173282116651535,
-0.012488773092627525,
0.026100536808371544,
0.07256228476762772,
0.02459760569036007,
0.015761541202664375,
0.0759... |
actual\tgastrointestinal\tintolerance.\tThe\tresult\tof\t“held”\tfeedings\n\tis\talways\tinadequate\tnutrition\twith\tthe\nrisk\tof\tonset,\tor\tworsening,\tof\tmalnutrition.\tAdjustment\tin\tthe\ttube\tfeeding\tregimen\tmust\tbe\tmade.\tFor\nexample,\tif\ttube\tfeedings\tare\tbeing\tturned\toff\tfor\t2\thours\tevery\t... | [
0.008446436375379562,
-0.08364897221326828,
0.06671922653913498,
-0.005734422709792852,
-0.1276433765888214,
-0.003034894587472081,
0.06693711876869202,
0.002489629667252302,
0.012128057889640331,
0.0533086434006691,
0.09695349633693695,
-0.01600780338048935,
0.040086887776851654,
0.015348... |
rate\ton\tthe\tfeeding\tshould\tbe\tincreased\tand\tthe\tfeeding\ttime\tdecreased\tto\taccommodate\tthe\ttherapy\nschedule.\nParenteral\tnutrition\nPN\tprovides\n\tnutrients\tdirectly\tinto\tthe\tbloodstream\tintravenously.\tPN\tis\tindicated\twhen\tthe\tpatient\tor\nindividual\tis\tunable\tto\ttake\tadequate\tnutrient... | [
0.012160074897110462,
-0.027362680062651634,
0.043936800211668015,
-0.01713104173541069,
-0.11935735493898392,
0.021124910563230515,
0.08644209057092667,
0.010839336551725864,
-0.020394926890730858,
0.02675762213766575,
0.1348443478345871,
-0.03458280861377716,
0.035555191338062286,
0.0496... |
EN\tto\tmeet\tnutrient\tneeds\t(\nMundi\tet\tal,\t2017\n;\t\nDerenski\tet\tal,\t2016\n).\tAlternatively,\tPN\tmay\tbe\tthe\tsole\nsource\tof\tnutrition\tduring\trecovery\tfrom\tillness\tor\tinjury\tor\tmay\tbe\ta\tlife-sustaining\ttherapy\n\tfor\tpatients\nwho\thave\tlost\tthe\tfunction\tof\ttheir\tintestine\tfor\tnutr... | [
-0.020528476685285568,
-0.004076229874044657,
0.014913931488990784,
-0.04379405826330185,
-0.08464789390563965,
0.021046416833996773,
0.08962056785821915,
0.003912245389074087,
-0.013260268606245518,
0.006039151921868324,
0.13191120326519012,
-0.0006623193039558828,
0.06194932758808136,
0.... |
than\toral\tis\tinvasive,\tit\tis\timportant\tto\tevaluate\tethical\tissues\tif\tthe\tpatient\tis\tterminal\tor\thas\ta\tshort\tlife\nexpectancy\t(\nSchwartz\tet\tal,\t2016\n).\nGetting\tstarted\twith\tparenteral\tnutrition\nAfter\tthe\tpatient\thas\tbeen\tdeemed\tto\trequire\tnutrition\tsupport\tvia\tthe\tparenteral\n... | [
0.013502843677997589,
-0.03447628393769264,
0.06350063532590866,
-0.06010667607188225,
-0.16064666211605072,
-0.023067282512784004,
0.037414927035570145,
0.012993910349905491,
-0.021701544523239136,
0.047975458204746246,
0.14658333361148834,
-0.02952239103615284,
0.038519278168678284,
0.05... |
choose\tbetween\tcentral\tand\tperipheral\taccess.\t\nCentral\taccess\n\trefers\tto\tcatheter\ttip\tplacement\tin\ta\tlarge,\nhigh-blood-flow\tvein\tsuch\tas\tthe\tsuperior\tvena\tcava;\tthis\tis\t\ncentral\tparenteral\tnutrition\t(CPN)\n.\nPeripheral\tparenteral\tnutrition\t(PPN)\n\trefers\tto\tcatheter\ttip\tplacemen... | [
-0.001246697036549449,
-0.08337459713220596,
0.053436197340488434,
-0.04728693887591362,
-0.146005779504776,
0.011466939933598042,
0.08381042629480362,
0.028548195958137512,
0.050798200070858,
0.040145643055438995,
0.12550634145736694,
-0.029529862105846405,
-0.0038311192765831947,
0.05622... |
hand\tor\tforearm.\nThe\tosmolarity\tof\tthe\tPN\tsolution\tdictates\tthe\n\tlocation\tof\tthe\tcatheter;\tcentral\tcatheter\tplacement\tallows\nfor\tthe\thigher\tcaloric\tPN\tformulation\tand\ttherefore\tgreater\tosmolarity\t(\nTable\t12.2\n).\tThe\tuse\tof\tPPN\tis\nlimited:\tit\tis\tshort-term\ttherapy\tand\ttherefo... | [
0.029381077736616135,
-0.03582609072327614,
0.06344425678253174,
-0.05569424852728844,
-0.1505936086177826,
-0.0022762559819966555,
0.08856043219566345,
0.012065166607499123,
0.016540834680199623,
0.06153114140033722,
0.10896995663642883,
0.01087878830730915,
0.03074457123875618,
0.0365609... |
and\tamount\tof\tfluids\tthat\tcan\tbe\tprovided\tperipherally\tare\tlimited\tand\tmost\toften\tdo\tnot\tfully\tmeet\nnutrition\trequirements.\tVolume-sensitive\n\tpatients\tsuch\tas\tthose\twith\tcardiopulmonary,\trenal,\tor\thepatic\nfailure\tare\tnot\tgood\tcandidates\tfor\tPPN.\tPPN\tmay\tbe\tappropriate\twhen\tuse... | [
0.010636460967361927,
-0.03966711461544037,
0.035477906465530396,
-0.03005998209118843,
-0.08118651807308197,
-0.007384453434497118,
0.08074340224266052,
0.06161007657647133,
-0.002390683861449361,
0.02137395553290844,
0.09544982761144638,
-0.013145715929567814,
0.061321232467889786,
0.051... |
in\ttransition\tto\tenteral\tor\toral\tfeeding,\tor\tas\ta\ttemporary\tmethod\tto\tbegin\tfeeding\twhen\tcentral\taccess\thas\nnot\tbeen\tinitiated.\tCalculation\tof\tthe\tosmolarity\tof\ta\tparenteral\tsolution\tis\timportant\tto\tensure\tvenous\ntolerance.\n\t\nOsmolarity\n,\tor\tmOsm/mL,\tis\tused\tto\tcalculate\tIV... | [
0.019550945609807968,
-0.1124679297208786,
0.0162606630474329,
-0.044235777109861374,
-0.07647257298231125,
-0.02783980779349804,
0.04123730957508087,
0.030090652406215668,
0.004951925948262215,
0.04293596372008324,
0.10492987185716629,
-0.02845686860382557,
0.049374599009752274,
0.0426670... |
body\tfluids.\nTABLE\t12.2\nOsmolarity\tof\tNutrients\tin\tPN\tSolutions\nNutrient\nOsmolarity\t(mOsm/mL)\nSample\tCalculations\nDextrose\t5%\n0.25\n500\tmL\t=\t125\tmOsm\nDextrose\t10%\n0.505\n500\tmL\t=\t252\tmOsm\nDextrose\t50%\n2.52\n500\tmL\t=\t1260\tmOsm\nDextrose\t70%\n3.53\n500\tmL\t=\t1765\tmOsm\nAmino\tacids\... | [
-0.018544400110840797,
-0.05940505117177963,
-0.057535991072654724,
-0.018357232213020325,
-0.02424607425928116,
-0.08419374376535416,
0.03385232016444206,
0.10295610129833221,
-0.061967670917510986,
-0.01757567748427391,
0.0724269300699234,
-0.050605762749910355,
0.023112492635846138,
0.0... |
0.81\n1000\tmL\t=\t810\tmOsm\nAmino\tacids\t10%\n0.998\n1000\tmL\t=\t998\tmOsm\nLipids\t10%\n0.6\n500\tmL\t=\t300\tmOsm\nLipids\t20%\n0.7\n500\tmL\t=\t350\tmOsm\nElectrolytes\nVaries\tby\tadditive\nMultitrace\telements\n0.36\n5\tmL\t=\t1.8\tmOsm\nMultivitamin\tconcentrate\n4.11\n10\tmL\t=\t41\tmOsm\nData\tfrom\tRxKinet... | [
-0.014873332343995571,
-0.03924696519970894,
-0.006008744705468416,
-0.01417820155620575,
-0.022238604724407196,
-0.11446744203567505,
0.05838058888912201,
0.08648829907178879,
-0.04532720148563385,
0.004325200337916613,
0.10409396141767502,
-0.060106322169303894,
0.037084709852933884,
0.0... |
Calculating\tOsmolarity\tof\tan\tIV\tAdmixture\n\t(website):\t\nhttp://www.rxkinetics.com/iv_osmolarity.html\n. | [
0.01484451163560152,
-0.029848240315914154,
-0.007930798456072807,
-0.010099045932292938,
-0.04064663127064705,
-0.05235463008284569,
0.03869738429784775,
0.1125282272696495,
-0.06562443822622299,
0.024487724527716637,
0.08449429273605347,
-0.028619371354579926,
0.010577232576906681,
0.085... |
Access\nPeripheral\taccess\nPPN\tsolutions\tshould\tbe\thypoosmolar,\tthat\tis,\tnot\tmore\tthan\t800\tto\t900\tmOsm/kg\tto\tallow\tinfusion\tthrough\na\tperipheral,\tmidline,\tor\tmidclavicular\tintravenous\tcatheter.\tClear\tcriteria\tmust\tbe\tidentified\tto\tdetermine\nwhen\tit\tis\tappropriate\tto\tuse\tPPN,\tas\t... | [
-0.0203385129570961,
-0.010677292011678219,
0.028171654790639877,
-0.05959659069776535,
-0.13048842549324036,
-0.0093312356621027,
0.08149460703134537,
0.03569686412811279,
0.015547963790595531,
0.04612993076443672,
0.10104378312826157,
-0.05070577561855316,
0.08528143167495728,
0.00726125... |
PPN\tis\tused\tas\ta\t“bridge”\tto\teither\treturn\tto\tEN\tor\tCPN.\nShort-term\tcentral\taccess\nCatheters\tused\tfor\tCPN\tideally\tconsist\tof\ta\tsingle\tlumen.\tIf\tcentral\taccess\tis\tneeded\tfor\tother\treasons,\tsuch\nas\themodynamic\tmonitoring,\tdrawing\tblood\tsamples,\tor\tgiving\tmedications,\tmultiple-l... | [
-0.07159507274627686,
-0.03433812037110329,
0.04218452051281929,
-0.06517479568719864,
-0.1019890159368515,
0.02237549237906933,
0.1044260710477829,
-0.005562511272728443,
0.047893647104501724,
0.04929058253765106,
0.09049715846776962,
0.016595270484685898,
0.06273283809423447,
0.027193577... |
available\t(\nDerenski\tet\tal,\t2016\n).\tTo\treduce\tthe\trisk\tof\tinfection,\tthe\tcatheter\tlumen\tused\tto\tinfuse\tCPN\nshould\tbe\treserved\tfor\tthat\tpurpose\tonly.\tCatheters\tare\n\tinserted\tmost\tcommonly\tinto\tthe\tsubclavian\tvein\nand\tadvanced\tuntil\tthe\tcatheter\ttip\tis\tin\tthe\tsuperior\tvena\t... | [
-0.011935137212276459,
-0.00881187617778778,
0.05805180221796036,
-0.07241404801607132,
-0.13996164500713348,
0.03301488608121872,
0.06484711170196533,
0.002338527701795101,
0.016042834147810936,
0.044404275715351105,
0.10029783844947815,
-0.05677662789821625,
0.032786957919597626,
0.00023... |
Alternatively,\tan\tinternal\tor\texternal\tjugular\tvein\tcatheter\tcan\tbe\tused\twith\tthe\tsame\tcatheter\ttip\nplacement.\tHowever,\tthe\tmotion\tof\tthe\tneck\tmakes\tthis\tsite\tmuch\tmore\tdifficult\tfor\tmaintaining\tthe\nsterility\tof\ta\tdressing.\tRadiologic\tverification\tof\tthe\n\ttip\tsite\tis\tnecessar... | [
0.044514525681734085,
-0.06382419914007187,
0.058775343000888824,
-0.048388294875621796,
-0.10810185223817825,
0.01887727901339531,
0.0854460597038269,
-0.062076665461063385,
0.0335690975189209,
0.06109565496444702,
0.12228072434663773,
-0.0347006656229496,
0.055503107607364655,
0.05545260... |
tip\tsite\tis\tnecessary\tbefore\tinfusion\tof\tnutrients\tcan\nbegin.\tStrict\tinfection\tcontrol\tprotocols\tshould\tbe\tused\tfor\tcatheter\tplacement\tand\tmaintenance.\t\nFig.\t12.6\nshows\talternative\tvenous\taccess\tsites\tfor\tCPN;\tfemoral\tplacement\tis\talso\tpossible.\nFIG.\t12.6\nVenous\tsites\tfrom\twhic... | [
0.002801273250952363,
-0.03769934922456741,
0.06876766681671143,
-0.03806396946310997,
-0.05925360321998596,
0.030209578573703766,
0.12164288759231567,
-0.006570839788764715,
-0.02207585610449314,
0.04889335110783577,
0.13894495368003845,
-0.023752771317958832,
-0.001911414903588593,
0.000... |
Venous\tsites\tfrom\twhich\tthe\tsuperior\tvena\tcava\tmay\tbe\taccessed.\nA\t\nperipherally\tinserted\tcentral\tcatheter\t(PICC)\n\tmay\tbe\tused\tfor\tshort-\tor\tmoderate-term\tinfusion\tin\nthe\thospital\tor\tin\tthe\thome.\tThis\tcatheter\tis\tinserted\tinto\ta\tvein\tin\tthe\tantecubital\tarea\tof\tthe\tarm\tand | [
-0.0019144993275403976,
-0.004380113445222378,
0.057764749974012375,
-0.03648807853460312,
-0.09752856940031052,
0.005915809888392687,
0.09936994314193726,
0.017651550471782684,
0.021305100992321968,
0.05214235931634903,
0.07720614969730377,
-0.03520223870873451,
0.012856804765760899,
0.05... |
threaded\tinto\tthe\tsubclavian\tvein\twith\tthe\tcatheter\ttip\tplaced\tin\tthe\tsuperior\tvena\tcava.\tTrained\nnonphysicians\n\tcan\tinsert\ta\tPICC,\twhereas\tplacement\tof\ta\ttunneled\tcatheter\tis\ta\tsurgical\tprocedure.\tAll\ncatheters\tmust\thave\tradiologic\tconfirmation\tof\tthe\tplacement\tof\tthe\tcathete... | [
-0.012532067485153675,
-0.04388047754764557,
0.05917444825172424,
-0.049987584352493286,
-0.17829284071922302,
-0.008862726390361786,
0.044226501137018204,
-0.02462846226990223,
0.019789107143878937,
0.04080751910805702,
0.09578920155763626,
-0.048373837023973465,
0.018894247710704803,
0.0... |
infusion.\nLong-term\tcentral\taccess\nA\tcommonly\tused\tlong-term\tcatheter\tis\ta\t“tunneled”\tcatheter.\tThis\tsingle-\tor\tmultiple-lumen\tcatheter\tis\nplaced\tin\tthe\tcephalic,\tsubclavian,\tor\tinternal\tjugular\tvein\n\tand\tfed\tinto\tthe\tsuperior\tvena\tcava\t(\nOpilla,\n2016 | [
-0.06497599929571152,
-0.0263439379632473,
0.059921931475400925,
-0.04238060116767883,
-0.14271032810211182,
0.005989996716380119,
0.04945547506213188,
0.00590802077203989,
0.020869944244623184,
0.018768176436424255,
0.06491055339574814,
-0.07415426522493362,
-0.002888938644900918,
0.02557... |
and\tfed\tinto\tthe\tsuperior\tvena\tcava\t(\nOpilla,\n2016\n).\tA\tsubcutaneous\ttunnel\tis\tcreated\tso\tthat\tthe\tcatheter\texits\tthe\tskin\tseveral\tinches\tfrom\tits\tvenous\nentry\tsite.\tThis\tallows\tthe\tpatient\tto\tcare\tfor\tthe\tcatheter\tmore\teasily\tas\tis\tnecessary\tfor\tlong-term | [
0.0006974319112487137,
0.009479847736656666,
0.07789742946624756,
-0.04075969383120537,
-0.14230559766292572,
-0.0007403679192066193,
0.07366085797548294,
0.009343142621219158,
0.007745647802948952,
0.012271696701645851,
0.10387478768825531,
-0.013327240943908691,
0.02905975840985775,
0.04... |
infusion.\tAnother\ttype\tof\tlong-term\tcatheter\tis\ta\tsurgically\timplanted\tport\tunder\tthe\tskin\twhere\tthe\ncatheter\tnormally\twould\texit\tat\tthe\tend\n\tof\tthe\tsubcutaneous\ttunnel.\tA\tspecial\tneedle\tmust\taccess\tthe\nentrance\tport.\tPorts\tcan\tbe\tsingle\tor\tdouble;\tan\tindividual\tport\tis\tequ... | [
-0.0004195145738776773,
-0.05829785019159317,
0.08504863828420639,
-0.027307147160172462,
-0.10900560021400452,
-0.0028707124292850494,
0.06166674569249153,
0.01662801206111908,
0.011790597811341286,
0.0377998910844326,
0.09781297296285629,
-0.025890441611409187,
0.025192374363541603,
0.06... |
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