Impacto da nutrição enteral em pacientes pós-avc: uma revisão integrativa

Abstract

Introduction: Stroke is one of the biggest causes of death in the world, being the first in Brazil. It affects the brain by interrupting its blood flow or by rupturing a cerebral vessel, which can lead to various neurological consequences. The loss of autonomy to perform day-to-day functions causes changes in the individual's quality of life, making them dependent on other people or specialized care such as the use of enteral nutrition (EN) so that there is an adequate supply of metabolic demands. With the use of this type of nutrition, there are pros and cons that will also impact the patient's quality of life. Methodology: this is an integrative review to evaluate the impact of enteral nutrition in post-stroke patients. A search was carried out in three databases using the key words and the Boolean connectives “and” and “or”. Results: after the searches, 2426 studies were found. After reading the title and abstract, 2413 studies were discarded because they were outside the proposed topic, with 13 articles being read in full. Then, 9 were discarded because they were not consistent with the guiding question and 4 were used for the review. Discussion: the occurrence of a stroke can cause several sequelae and impact the patient's life. Some factors such as malnutrition, advanced age, poor care and pneumonia are associated with poor prognoses. The use of EN is necessary in some cases, therefore, one can compare the use of NGT with oral feeding and see that EN guarantees better results, reducing mortality and infections. Malnutrition is undoubtedly a critical factor for clinical deterioration in post-stroke patients, making EN a great ally in this process, but there are some factors that impact quality of life, such as diarrhea, dry mouth, dependence from other people, discomfort due to the use of the probe, difficulty with hygiene, nausea, swelling, among others. Conclusion: EN through NGT is better in relation to infection rates, mortality and presents better neurological performance, and guarantees the lowest rate of malnutrition. In relation to continuous and intermittent NGT, continuous NGT stands out with lower rates of diarrhea and less total intolerance, contributing to the reduction of recurrent diarrheal episodes. There is a need for more randomized clinical studies that can point out advantages, disadvantages and indications for the use of EN in post-stroke patients.