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ADIME for COPD (Diagnosis (Malnutrition, Underweight, Inadequate protein…
ADIME for COPD
Assessment
Diagnosis
Malnutrition
Underweight
Inadequate protein intake
Unintended wt loss
Inadequate energy intake
Food and nut-related knowledge deficit
Inadequate oral intake
Intervention
Protein Requirements
1.2-1.5g/kg/day
May be higher in severe states
Energy Requirements
125-145kJ/kg/day
May be higher
Moderately hyper during IECOPD
Nutrition support options
Enteral Nutrition
Oral supplements
Low volume, high energy/pro oral ONS
Food fortification and energy conservation strategies
Small frequent meals and snacks
Make every mouthful count
Rest before meals
Eat slowly and chew foods well
Softer foods may be better tolerated
Eat meals when symptoms are best controlled eg if mornings feel lousy, eat small then more as u feel better
Consider a home delivery service
If prescribed O2 use this while u eat
Treatment Goals
Acute Exacerbation (inpatient)
Minimise effects on nut status
Stable COPD (outpatient)
Improve nut status if post IECOPD
Maintain nut status
Mechanical ventilation (ICU
Minimise effects on nut status while avoiding complications of re-feeding syndrome
Monitoring and Evaluation
Intake
Wt
Who
NGO DTN
Community DTN
GP