MEDICAL NUTRITION

THERAPY FOR
HYPERMETABOLIC
CONDITIONS
WILMAR JUN O. ELOPRE, RND
2 FEVER

● Pyrexia
○ Above Normal (98.6 deg. F) - 99.6 deg. F orally, 100
deg. F rectally, or 99 deg. F axillary
○ Low-grade fever - >37.1 deg C < 38.2 deg. C
○ High-grade fever - 38.2 deg. C and higher
○ Hyperpyrexia/Hyperthermia - >40 deg.
● Sepsis
● Febrile conditions
3 FEVER: METABOLIC EFFECTS

● Increased BMR: 7% increase in every deg. F rise or 13 %

for every deg. C rise
● Increased tissue catabolism
● Increased loss of water and electrolytes
● Decreased GI activity
● Anorexia
● General weakness and prostration
4 INFECTION: CLASSIFICATION

● Acute
● Chronic
● Recurrent
 GOALS OF MNT FOR FEBRILE, INFECTIOUS
5 CONDITIONS

● Counteract water and electrolyte loss

● Counteract tissue catabolism
● Increase antioxidant and anti-inflammatory
nutrients/food components
● Counteract anorexia and altered GI activity
● Address micronutrient deficiencies, if any
 COMPONENTS OF MNT FOR FEBRILE,
6 INFECTIOUS CONDITIONS
● Energy
○ 7% BMR increase for every deg. C rise; additional
10% for tissue catabolism; additional 10-13% more
if the patient is restless
● Proteins
○ Up to 2 g/kgBW/day (100% increase)
● Water and Electrolytes
● Immune-enhancing, anti-inflammatory, antioxidant
nutrients
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Respiratory
System
 UPPER RESPIRATORY TRACT INFECTION
8 (URTI): Common Cold
● Common cold
● Viral (rhinovirus - most common cause)
● Role of zinc and vitamin C
● Symptoms
○ sore throat
○ runny nose
○ coughing
○ sneezing
○ headaches
○ body aches
 UPPER RESPIRATORY TRACT INFECTION
9 (URTI): Flu
● Influenza viruses
● Droplet and fomite modes of transmission
● Seasonal
● H1N1 (Swine Flu), Avian Flu (Bird Flu) - Influenza A subtypes
● Nutrition Therapy:
○ Modification of texture
○ SFF
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 UPPER RESPIRATORY TRACT INFECTION
12 (URTI): MEASLES
● Morbillivirus
● Hyperpyrexia with diarrhea
● The classic symptoms include a four-day fever (the 4 D's) and
the three C's—cough, coryza (head cold, fever, sneezing), and
conjunctivitis (red eyes)—along with a maculopapular rash
● Airborne
● Prevented by MMR vaccine
● Two doses (200 000 IU) of vitamin A was shown to reduce
mortality for measles in children younger than two years of age
● 10% mortality in people with malnutrition
● Use of ORS
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15 MUMPS
● Viral parotitis - orthorubulavirus
● Prevented by MMR vaccine
● Droplet/aerosol transmission - most contagious 5 days after
onset
● MNT similar with fever
16 Dengue Fever
● Virus carried by Aedes aegypti
● Prevented by mosquito control and Dengvaxia vaccine
● Supportive treatment
● Paracetamol instead of NSAIDs
● Oral rehydration therapy for those with mild condition
● ICU admission for severe
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21 For your own reading...
● Diphtheria
● Pertussis (Whooping coungh)
● Typhoid fever
● Cholera
● Poliomyelitis
● Rheumatic fever
● Malaria