Acompanhamento nutricional de pacientes submetidos à transplante de medula óssea

Abstract

BMT (Bone Marrow Transplantation) is a therapeutic modality that aims to perform a reconstruction of the hematopoietic system through an infusion of healthy hematopoietic stem cells. After BMT, the receiver goes through a phase of toxicity due to previously administered chemotherapy/radiotherapy, which can last from 10 to 15 days. The most common symptoms present at this stage are nausea, vomiting, diarrhea and mucositis. OM can range from mild to severe, and occurs in approximately 47% to 100% of patients. The associated clinical alterations lead to changes in food intake, due to a decrease in intake and an increase in metabolic needs, which affect the nutritional status of the patient. LTBI (Low-Level Laser Therapy) is a nonpharmacological method that is safe, painless, little invasive, inexpensive and has a quick and safe application, with studies proving its effectiveness in the prophylaxis and treatment of OM. It can provide significant improvements in nutritional management, thus reducing chances of malnutrition and improving quality of life. This study aimed to evaluate nutritional care for the implementation of a follow-up protocol for patients undergoing bone marrow transplantation. It comprises an experimental research, carried out with seven patients submitted to BMT at the Bone Marrow Transplant Center of the University Hospital of Santa Maria, during five months. A nutritional follow-up protocol was created, covering the pre- and post-BMT phases, monitoring the symptoms caused by side effects during hospitalization, highlighting the most frequent symptoms. The curative/preventive TLBI was applied by the dentist. As a result, nausea, lack of appetite, mucositis and diarrhea were the symptoms that most interfered with food acceptance. No patient had their average food consumption above the minimum values of nutritional recommendation, both for calories and protein. The data found show that, even moderately, oral health interferes with food. The LTBI and dental follow-up proved to be of great importance in the prevention and treatment of OM, a symptom that has a great negative impact on the nutritional status. The nutritional protocol proved to be an easy-to-use tool for monitoring patients during all phases of BMT, helping to facilitate routine nutritional care, highlighting the most frequent symptoms and enabling the search for the best treatments, aimed at maintaining the nutritional status.