21
Figure 1. ONS Usage
One or more high risk factors, including but not limited to:
• Heavy exudates
• Diarrhea
• Vacuum assisted closure therapy
• Prealbumin <15
• Poor appetite
• C-reactive protein >3 mg/L
• Recent surgery or infection
• Malnutrition
Step 1: Hydrate
STEP 1: HYDRATE
STEP 2: INCREASE CALORIC INTAKE
STEP 3: PROVIDE TARGETED
NUTRITIONAL THERAPY
STEP 4: FOLLOW UP
• Hydrate — meet fluid needs first
• Optimize caloric intake
• Meet protein needs
• Provide targeted nutritional therapy
(e.g., Juven
®
)
Continue to follow up every 7–14 days
until needs are met
If no improvement:
• Increase protein
• Increase calories in patients with mid
to low BMI
• Continue targeted nutritional therapy
• Consider enteral or parenteral
nutrition supplementation
