LB016-SUN TELEDYSPHAGIA FOR ACUTE STROKE PATIENTS USING A STANDARDIZED EXAMINATION KIT IN A TELESTROKE NETWORK

LATE BREAKING ABSTRACTS I LB016-SUN TELEDYSPHAGIA FOR ACUTE STROKE PATIENTS USING A STANDARDIZED EXAMINATION KIT IN A TELESTROKE NETWORK J. H¨ ohlig1 , A. Czekanska1 , C. H¨ ohlig1 , H.J. Koch2 , 3 H. Reichmann , G.W. Ickenstein1 , on behalf of TELE-DIAS study group. 1 Department of Neurology, 2 Department of Psychiatry, Helios General Hospital Aue, Technical University Dresden, Aue, 3 Department of Neurology, Carl Gustav Carus University Hospital, Dresden, Germany Rationale: Since 2006, the Teleneuromedicine Stroke Network in Southwest Saxony was established to implement a fast access to stroke thrombolysis. Nowadays, this mission is nearly completed and thrombolysis rates reached a more acceptable level. The focus of our technical approach is now to bridge a telesupervised dysphagia concept to the satellite partner hospitals in the telenetwork to early detect aspiration signs and establish a safer nutrition. Methods: Our TELE-DIAS study included acute stroke patients with signs of aspiration in the modified swallowing assessment. They were observed with a telemedicine approach using a standardized protocol for the clinical swallowing examination (CSE) and a flexible transnasal swallowing examination (FEES). During the CSE and the FEES, a standardized examination kit with ready-to use products of different viscosities were used to detect aspiration signs and to find a suitable texture modified diet (TMD). Results: Acute stroke patients (n = 34) were examined with CSE and in addition with FEES. In 68% the swallowing therapist suspected signs of aspiration in the CSE. After tele-FEES was performed by a medical doctor, this suspicion was confirmed only in 43% of the patients. The medical doctor recommended a nasogastric tube for 33% of severe dysphagic patients while for the others, a therapeutic feeding protocol with TMD could be initiated. Conclusion: CSE has a high sensitivity but a low specificity to detect patients with aspiration. Consequently, the combination of CSE and FEES can be highly recommended even in a new teledysphagia approach using standardized examination kits. A tele-supervised FEES supports the medical doctor in a satellite partner hospital in the decision for or against nasogastric tube feeding. Within a telestroke network, the dysphagia expert is able to observe the pathological findings and assist with a standardized protocol to find the suitable TMD. Disclosure of Interest: None Declared

LB017-SUN PREVENTION OF MALNUTRITION IN THE ELDERLY C. Hillger1 , D. Pippel1 , K. Strempel2 , B. Wegener3 , A. Weimann4 , W. Kirch1 . 1 Forschungsverbund Public Health, Medizinische Fakult¨ at der Technischen Universit¨ at Dresden, Dresden, 2 Verein zur F¨ orderung der Gesundheitswirtschaft in der Region Leipzig e.V., Leipzig, 3 Referat Gemeinschaftsverpflegung und Qualit¨ atssicherung, Deutsche Gesellschaft f¨ ur Ern¨ ahrung e.V., Bonn, 4 Klinik f¨ ur Allgemein- und Visceralchirurgie, Klinikum St. Georg gGmbH, Leipzig, Germany Rationale: Aim is the improvement of the nutrition related health status of the elder population with the main focus on

S229 elderly living in their domestic environment in rural regions of Saxony. Methods: Main objectives are focused upon: (1) the improvement of the nutrition related health status of the elder population in rural regions, an increase of the health related quality of life, (2) the networking of regional, national stakeholders of the health care sector, aiming at a greater bundling of competencies, (3) the scientific evaluation of implemented preventive measures, network activities and the scientific presentation of the project results. Results: Anticipated results are among others (1) an improvement of the health related life quality, (2) and the curative treatment, rehabilitation, (3) reduction of length of stay in hospital, (4) decrease of risk of secondary complication through malnutrition, lethality and morbidity rate, (5) reduction of nutrition related disease duration, (6) cost reduction for the health care system. An innovative concept for health promotion will be implemented by integrating stationary, ambulant key actors and other regional stakeholders into a competence network. Hence, the health network will be developed for an sustainable establishment in Saxony and for serving as a good practice that might inspire other regions. The project is planned to start in 2014. Conclusion: The project will make a contribution to the sustainable networking of regional inpatient and outpatient sectors. The risk of malnutrition among the elder population shall be reduced in the long-term, the health related life quality shall be increased by implementing individual preventional measures. Objectives will be realised by a close cooperation of regional health actors in the rural areas of Saxony, by supraregional knowledge transfer and by implementing measures for raising awareness on malnutrition among the population. Funded by the Federal Ministry of Education and Research Disclosure of Interest: None Declared

LB018-SUN EFFECTS OF LOW-CARBOHYDRATE ENTERAL NUTRITION ON STABILIZATION OF BLOOD SUGAR LEVELS AFTER ESOPHAGEAL SURGERY: A RANDOMIZED CONTROLLED TRIAL T. Nakano1 , G. Miyata1 , T. Kamei1 , K. Naoshima1 , S. Abe1 , K. Katsura1 , Y. Taniyama1 , J. Teshima1 , N. Ohuchi1 . 1 Division of Advanced Surgical Science and Technology, Tohoku University School of Medicine, Sendai Miyagi, Japan Rationale: Intensive insulin therapy for patients in the intensive care unit reportedly contributes to decreased complication and mortality rates. This study aimed to evaluate the effects of enteral nutrition with different lipid carbohydrate ratios on stabilization of blood sugar levels and nitrogen balance after esophagectomy. Methods: Forty-six patients who underwent esophagectomy for esophageal cancer were randomly assigned to receive enteral nutrition with low (LC: n = 23) or high-carbohydrate content (HC: n = 23). The primary endpoint was blood glucose levels, the amount of insulin administered, and nitrogen balance. Secondary endpoints were the incidence of complications and adverse events related to surgery and enteral nutrition. Results: Although blood glucose levels after enteral nutrition administration and the amount of insulin administered for