Biography
Biography: Andreas H. Leischker
Abstract
Nutrition is of upmost importance in patients with acute stroke. Delivery of nutrition as well as withholding nutrition may seriously harm patients with acute stroke. In contrast to many other diseases, there were no clinical guidelines on nutrition in acute stroke.. In clinical practice, nursing staff, speech-language therapists, nutritionists and physicians are often unassertive how to deliver nutritional support for patients with acute stroke. Key questions include the timing of enteral nutrition, screening and assessment for dysphagia, indication and timing of placement of nasogastric tube versus PEG for stroke patients, swallowing training during in patients with nasogastric tubes, oral nutritional supplements, and texture modification/thickening of fluids. The author (AL) was asked by the steering committees of the German Society for Neurology, the German Society for Nutritional Medicine and the German Geriatric Society to develop evidence based guideline on nutrition for patients with acute stroke. This guideline was published 2007. To our knowledge, this was the first clinical guideline on this topic. Implementation of the guideline in Germany changed clinical practice significantly: For example it was clinical practice to place a PEG tube in patients with severe dysphagia early, after implementation the placement of nasogastric tubes was state of the art. The guideline was updated starting 2010 and finally published in English language 2013. Currently, a European ESPEN guideline on this topic is in progress