nutrition_parenterale

Bedside post-pyloric tube placement using direct visualisation in mechanically ventilated patients: A single centre case series.

Wed, 01 Jun 2022 04:00:00 +0000

Intensive & Critical Care Nursing; 06/01/2022
(AN 156673718); ISSN: 09643397
CINAHL Complete

An Infant With a Hemorrhagic Rash and Cardiomyopathy.

Wed, 01 Jun 2022 04:00:00 +0000

Clinical Pediatrics; 06/01/2022
(AN 156614047); ISSN: 00099228
CINAHL Complete

Parenteral Nutrition in Advanced Cancer: The Healthcare Providers' Perspective.

Wed, 01 Jun 2022 04:00:00 +0000

Oncology & Therapy; 06/01/2022
(AN 156839574); ISSN: 23661070
CINAHL Complete

Outcomes of the First 54 Pediatric Patients on Long Term Home Parenteral Nutrition From a Single Brazilian Center

Sat, 21 May 2022 08:22:37 +0000

Author Names: Goldani H.A.S.,Ceza M.R.,Godoy L.L.,Giesta J.M.,Beier S.,Oliveira J.G.,Nunes D.L.,Feldens L.,Lucena I.R.S.,Taniguchi A.N.R.,Hallberg S.C.M.,Durant D.,Boettcher S.,Schneider M.A.,Mello P.P.,Riberg M.G.L.,Signorini A.V.,Miller C.,Santos B.L.,Silveira C.O.,Morais M.C.M.,Laggazio T.V.,Costa C.C.,Kieling C.O.

Database Source: Embase Daily Updates

Journal Title: Journal of pediatric gastroenterology and nutrition

Article Title: Outcomes of the First 54 Pediatric Patients on Long Term Home Parenteral Nutrition From a Single Brazilian Center

Year: 2022

Issue:

Volume:

Abstract: OBJECTIVES: Data on multidisciplinary programs dedicated to home parenteral nutrition (HPN) in Latin America are limited. This study describes the results of the first multidisciplinary pediatric intestinal rehabilitation program for HPN at a public tertiary hospital in Brazil. METHOD(S): We retrospectively reviewed patients ages 0-18 years with intestinal failure (IF) who required parenteral nutrition (PN) for >60 days between January 2014 and December 2020. RESULT(S): Fifty-four patients were discharged on HPN (15 achieved enteral autonomy, 34 continued on HPN at the end of the study, one underwent intestinal transplantation, and four died). The median (interquartile range) age at the study endpoint of patients who achieved enteral autonomy was 14.1(9.7-19) versus 34.7(20.4-53.9) months in those who did not achieve enteral autonomy. Overall prevalence of catheter-related thrombosis was 66.7% and catheter-related bloodstream infection rate was 0.39/1000 catheter-days. Intestinal failure-associated liver disease (IFALD) was present in 24% of all patients; none of the patients who achieved enteral autonomy had IFALD. All patients showed significant improvement in anthropometric parameters during the HPN period. The sociodemographic characteristics of the patients' family members were mothers less than 20 years old (7.5%), schooling time more than 10 years (55.5%), and household income between one and three times the minimum wage (64.8%). The 5-year survival rate for HPN is 90%, and 27.7% of patients achieve enteral autonomy. CONCLUSION(S): The treatment of pediatric patients with IF followed by a multidisciplinary pediatric intestinal rehabilitation program with HPN is feasible and safe in the Brazilian public health system. Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition.

Parenteral Nutrition in Advanced Cancer: The Healthcare Providers' Perspective

Sat, 21 May 2022 08:22:37 +0000

Author Names: Balstad T.R.,Lohre E.T.,Thoresen L.,Thronaes M.,Skjelvan L.S.,Helgas R.G.,Solheim T.S.,Sand K.

Database Source: Embase Weekly Updates

Journal Title: Oncology and Therapy

Article Title: Parenteral Nutrition in Advanced Cancer: The Healthcare Providers' Perspective

Year: 2022

Issue: 1

Volume: 10

Abstract: Introduction: The evidence base for parenteral nutrition (PN) in advanced cancer patients is limited. We studied healthcare providers' (HCPs') experiences with PN in cancer patients, focusing on perceived treatment benefits and challenges. Method(s): An 18-item online survey was emailed to HCPs attending one of three regional palliative care seminars held within a 6-month period. The survey included single-response items, multiple-response items, and free text boxes concerning PN. Descriptive statistics and qualitative thematic content analysis were applied. Result(s): One hundred and two seminar participants completed the survey. Ninety-three percent were female, 86% were nurses/oncological nurses, and 80% worked in primary care. Respondents reported a well-functioning collaboration across levels of care. They perceived that PN may increase the patients' level of energy, improve the general condition, and reduce eating-related distress. On the downside, HCPs observed burdensome side effects, that the treatment was resource-demanding, and that decisions on PN withdrawal were difficult. Conclusion(s): The study results are based on the perspectives of more than 100 HCPs with comprehensive clinical experience with PN. Their knowledge represents an important experience base for improvement of healthcare services and advanced care planning. Copyright © 2022, The Author(s).

Recommendations for specialized nutritional-metabolic management of the critical patient: introduction, methodology and list of recommendations. Metabolism and Nutrition Working Group of the Spanish Society of Intensive and Critical Care Medicine and Coro

Sat, 21 May 2022 08:22:37 +0000

Author Names: Bordeje Laguna L.,Fernandez-Ortega J.F.,Garcia de Lorenzo y Mateos A.,Montejo Gonzalez J.C.,Acosta Escribano J.A.,Bordeje Laguna M.L.,Fernandez Ortega J.F.,Grau Carmona T.,Herrero Meseguer J.I.,Jimenez Jimenez F.J.,Jorda Minana A.,Juan Diaz M.,Lopez Delgado J.C.,Marquez Vacaro J.A.,Martinez Carmona J.F.,Martinez de Lagran Zurbano I.,Mesejo Arizmendi A.,Perez Quesada S.,Ortiz Leyba C.,Ruiz-Santana S.,Vaquerizo Alonso C.,Blesa Malpica A.L.,Bonet Saris A.,Cervera Montes M.,de la Fuente O'Connor E.,Alcazar Espin M.N.,Flordelis Lasierra J.L.,Garcia Martinez M.A.,Gastaldo Simeon R.M.,Gonzalez Iglesias C.,Zamora Elson M.,Leon Cinto C.,Lorencio Cardenas C.,Martinez de la Gandara A.,Martinez Garcia P.,Martinez-Lozano Aranaga F.,Sanchez Alvarez C.,Martinez Quintana M.E.,Macaya Redin L.,Mateu Campos M.L.,Moreno Clari E.,Martin Luengo A.I.,Navas Moya E.,Portugal Rodriguez E.,Robles Gonzalez A.,Sanchez Alonso S.,Sanchez Miralles A.,Seron Arbeloa C.,Servia Goixart L.,Vila Garcia B.,Valenzuela Sanchez F.,Yebenes Reyes J.C.

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Journal Title: Medicina Intensiva,Medicina Intensiva

Article Title: Recommendations for specialized nutritional-metabolic management of the critical patient: introduction, methodology and list of recommendations. Metabolism and Nutrition Working Group of the Spanish Society of Intensive and Critical Care Medicine and Coronary Units (SEMICYUC),Recomendaciones para el tratamiento nutrometabolico especializado del paciente critico: introduccion, metodologia y listado de recomendaciones. Grupo de Trabajo de Metabolismo y Nutricion de la Sociedad Espanola de Medicina Intensiva, Critica y Unidades Coronarias (SEMICYUC)

Year: 2020

Issue: Supplement 1

Volume: 44

Abstract: The Metabolism and Nutrition Working Group of the Spanish Society of Intensive and Critical Care Medicine and Coronary Units (SEMICYUC) has reviewed and updated the recommendations for specialized nutritional and metabolic support in critically ill patients published by the Group in 2011, with the primary aim of helping decision making in daily clinical practice. The recommendations have been formulated by an expert panel with broad experience in nutritional and metabolic support in critically ill patients, and were drafted between March 2016 and February 2019. A level of evidence has been provided for each of the recommendations, based on the GRADE methodology (Grading of Recommendations Assessment, Development and Evaluation Working Group). A grade of recommendation has also been produced, taking into account the clinical impact of the recommendation, regardless of the level of evidence established by the GRADE scale. Copyright © 2020

Effects of EN combined with PN enriched with n-3 polyunsaturated fatty acids on immune related indicators and early rehabilitation of patients with gastric cancer: A randomized controlled trial

Sat, 21 May 2022 08:22:37 +0000

Author Names: Yang J.,Zhang X.,Li K.,Zhou Y.,Hu Y.,Chen X.,Liang S.,Jiang L.

Database Source: Embase Weekly Updates

Journal Title: Clinical Nutrition,Clinical Nutrition

Article Title: Effects of EN combined with PN enriched with n-3 polyunsaturated fatty acids on immune related indicators and early rehabilitation of patients with gastric cancer: A randomized controlled trial

Year: 2022

Issue: 6

Volume: 41

Abstract: Background & aims: Patients who undergo gastrectomy often have a high risk of postoperative complications. This study aimed to investigate the effects of n-3 polyunsaturated fatty acids (PUFAs) on immune function, the inflammatory response, nutritional status, and rehabilitation of patients with gastric cancer. Method(s): A total of 120 patients with gastric cancer who underwent elective radical gastrectomy in the Department of Gastrointestinal Surgery, West China Hospital, Sichuan University from September 2019 to December 2020 were randomly divided into the n-3 PUFAs group (n = 60) and control group (n = 60). Patients in N-3 PUFAs group were treated with enteral nutrition (EN) combined with parenteral nutrition (PN) enriched with n-3 PUFAs from postoperative Day 1 to Day 5, whereas patients in the control group were administered EN combined with PN without n-3 PUFAs. Immune parameters (lymphocyte count [LYM], CD3+, CD4+, CD8+, CD4+/CD8+), inflammatory indicators (white blood cell [WBC], C-reactive protein [CRP], interleukin 6 [IL-6], tumor necrosis factor alpha [TNF-alpha]), nutrition parameters (hemoglobin [Hb], total protein [TP], albumin [Alb], prealbumin [PAB], transferrin [TRF]), the incidence of postoperative complications and rehabilitation parameters were compared between the two groups. Result(s): The immune parameters (LYM, CD3+, CD4+, CD4+/CD8+) and nutritional parameters (TP, Alb, PAB) of the n-3 PUFAs group were significantly increased compared with the control group, and inflammatory indicators (CRP, IL-6, TNF-alpha) were lower compared with the control group. The rate of postoperative complications in the n-3 PUFAs group (7%) was significantly lower than that in the control group (20%), and the time to first aerofluxus and defecation were earlier in the n-3 PUFAs group. No differences in postoperative length of stay, unplanned 30-day readmission or reoperation after surgery were noted. Conclusion(s): The study shows that n-3 PUFAs contribute to the recovery of immune function, inflammatory response, and early rehabilitations of patients with gastric cancer undergoing gastrectomy. N-3 PUFAs were safe and effective in promoting the rehabilitation of patients with gastrectomy in our study. More high-quality and large sample studies are needed. Registration number of Clinical Trial: ChiCTR1900028381. Copyright © 2022 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism

El impacto de la implantacion de una unidad de nutricion clinica en un hospital: estudio observacional retrospectivo

Wed, 18 May 2022 08:20:40 +0000

Author Names: Quarenghi M.,Turri Quarenghi R.,Villa L.,Forni Ogna V.

Database Source: Embase Daily Updates

Journal Title: Nutricion hospitalaria

Article Title: El impacto de la implantacion de una unidad de nutricion clinica en un hospital: estudio observacional retrospectivo,The impact of the introduction of a clinical nutrition unit in a hospital: a retrospective observational study

Year: 2022

Issue:

Volume:

Abstract:

Management of home parenteral nutrition catheter related blood stream infections in hospitals outside of a specialised intestinal failure centre

Wed, 18 May 2022 08:20:40 +0000

Author Names: Bond A.,Conley T.,Teubner A.,Taylor M.,Abraham A.,Romero Salazar F.,Mallawaarachchi P.,Lal S.

Database Source: Embase Daily Updates

Journal Title: JPEN. Journal of parenteral and enteral nutrition

Article Title: Management of home parenteral nutrition catheter related blood stream infections in hospitals outside of a specialised intestinal failure centre

Year: 2022

Issue:

Volume:

Abstract: INTRODUCTION: Catheter-related blood stream infections (CRBSIs) remain the commonest complication associated with home parenteral nutrition (HPN). While the management outcomes of CRBSIs have been extensively reported by specialised intestinal failure (IF) centres, there are minimal data reporting CRBSI outcomes for HPN-dependent patients admitted to non-specialised hospitals. METHOD(S): Observational study from a prospectively-maintained database of CRBSIs in HPN-dependent patients managed outside of a specialised IF centre. RESULT(S): Three-hundred and six patients from a total cohort of 1066 HPN-dependent patients suffered from 489 CRBSI events from 2003-2021; after 2017, 71 of these events were managed at the patient's local, non-specialised hospital and the remainder at the specialised IF centre. From 2017 to 2021, salvage of the central venous catheter (CVC) with antimicrobial therapy was attempted in 32/71 (45.1%) patients admitted to the non-specialised hospital, with successful salvage recorded in 23 (71.8%) cases. Notably, CVC salvage was attempted more commonly (77/103 (74.8%); p=0.004 vs. non-specialised hospital), with a better salvage success rate (64/77 (83.1%) p=0.01 vs. non-specialised hospital) in patients who were admitted to the specialised IF centre. CONCLUSION(S): In some instances CRBSIs can be effectively managed when patients presenting to anon-specialised hospital, however overall salvage is more likely to be successful in the specialised setting. Further development of clinical and educational networks between IF centres and patients' local hospitals aimed at standardising care may lead to improved CRBSI outcomes. This article is protected by copyright. All rights reserved.

Medical nutrition therapy and clinical outcomes in critically ill adults: a European multinational, prospective observational cohort study (EuroPN).

Wed, 18 May 2022 04:00:00 +0000

Critical Care; 05/18/2022
(AN 156934407); ISSN: 13648535
CINAHL Complete

Medical nutrition therapy and clinical outcomes in critically ill adults: a European multinational, prospective observational cohort study (EuroPN)

Wed, 18 May 2022 00:00:00 +0000

Crit Care. 2022 May 18;26(1):143. doi: 10.1186/s13054-022-03997-z.

ABSTRACT

BACKGROUND: Medical nutrition therapy may be associated with clinical outcomes in critically ill patients with prolonged intensive care unit (ICU) stay. We wanted to assess nutrition practices in European intensive care units (ICU) and their importance for clinical outcomes.

METHODS: Prospective multinational cohort study in patients staying in ICU ≥ 5 days with outcome recorded until day 90. Macronutrient intake from enteral and parenteral nutrition and non-nutritional sources during the first 15 days after ICU admission was compared with targets recommended by ESPEN guidelines. We modeled associations between three categories of daily calorie and protein intake (low: < 10 kcal/kg, < 0.8 g/kg; moderate: 10-20 kcal/kg, 0.8-1.2 g/kg, high: > 20 kcal/kg; > 1.2 g/kg) and the time-varying hazard rates of 90-day mortality or successful weaning from invasive mechanical ventilation (IMV).

RESULTS: A total of 1172 patients with median [Q1;Q3] APACHE II score of 18.5 [13.0;26.0] were included, and 24% died within 90 days. Median length of ICU stay was 10.0 [7.0;16.0] days, and 74% of patients could be weaned from invasive mechanical ventilation. Patients reached on average 83% [59;107] and 65% [41;91] of ESPEN calorie and protein recommended targets, respectively. Whereas specific reasons for ICU admission (especially respiratory diseases requiring IMV) were associated with higher intakes (estimate 2.43 [95% CI: 1.60;3.25] for calorie intake, 0.14 [0.09;0.20] for protein intake), a lack of nutrition on the preceding day was associated with lower calorie and protein intakes (- 2.74 [- 3.28; - 2.21] and - 0.12 [- 0.15; - 0.09], respectively). Compared to a lower intake, a daily moderate intake was associated with higher probability of successful weaning (for calories: maximum HR 4.59 [95% CI: 1.5;14.09] on day 12; for protein: maximum HR 2.60 [1.09;6.23] on day 12), and with a lower hazard of death (for calories only: minimum HR 0.15, [0.05;0.39] on day 19). There was no evidence that a high calorie or protein intake was associated with further outcome improvements.

CONCLUSIONS: Calorie intake was mainly provided according to the targets recommended by the active ESPEN guideline, but protein intake was lower. In patients staying in ICU ≥ 5 days, early moderate daily calorie and protein intakes were associated with improved clinical outcomes. Trial registration NCT04143503 , registered on October 25, 2019.

PMID:35585554 | PMC:PMC9115983 | DOI:10.1186/s13054-022-03997-z

ASHP Guidelines on the Safe Use of Automated Compounding Devices for the Preparation of Parenteral Nutrition Admixtures.

Sun, 15 May 2022 04:00:00 +0000

American Journal of Health-System Pharmacy; 05/15/2022
(AN 156739307); ISSN: 10792082
CINAHL Complete

Chronic Intestinal Failure in Children: An International Multicenter Cross-Sectional Survey

Sat, 14 May 2022 00:00:00 +0000

Nutrients. 2022 Apr 30;14(9):1889. doi: 10.3390/nu14091889.

ABSTRACT

BACKGROUND: The European Society for Clinical Nutrition and Metabolism database for chronic intestinal failure (CIF) was analyzed to investigate factors associated with nutritional status and the intravenous supplementation (IVS) dependency in children.

METHODS: Data collected: demographics, CIF mechanism, home parenteral nutrition program, z-scores of weight-for-age (WFA), length or height-for-age (LFA/HFA), and body mass index-for-age (BMI-FA). IVS dependency was calculated as the ratio of daily total IVS energy over estimated resting energy expenditure (%IVSE/REE).

RESULTS: Five hundred and fifty-eight patients were included, 57.2% of whom were male. CIF mechanisms at age 1-4 and 14-18 years, respectively: SBS 63.3%, 37.9%; dysmotility or mucosal disease: 36.7%, 62.1%. One-third had WFA and/or LFA/HFA z-scores < -2. One-third had %IVSE/REE > 125%. Multivariate analysis showed that mechanism of CIF was associated with WFA and/or LFA/HFA z-scores (negatively with mucosal disease) and %IVSE/REE (higher for dysmotility and lower in SBS with colon in continuity), while z-scores were negatively associated with %IVSE/REE.

CONCLUSIONS: The main mechanism of CIF at young age was short bowel syndrome (SBS), whereas most patients facing adulthood had intestinal dysmotility or mucosal disease. One-third were underweight or stunted and had high IVS dependency. Considering that IVS dependency was associated with both CIF mechanisms and nutritional status, IVS dependency is suggested as a potential marker for CIF severity in children.

PMID:35565856 | PMC:PMC9103944 | DOI:10.3390/nu14091889

Advances in Trace Element Supplementation for Parenteral Nutrition

Sat, 14 May 2022 00:00:00 +0000

Nutrients. 2022 Apr 23;14(9):1770. doi: 10.3390/nu14091770.

ABSTRACT

Parenteral nutrition (PN) provides support for patients lacking sufficient intestinal absorption of nutrients. Historically, the need for trace element (TE) supplementation was poorly appreciated, and multi-TE products were not initially subjected to rigorous oversight by the United States Food and Drug Administration (FDA). Subsequently, the American Society for Parenteral and Enteral Nutrition (ASPEN) issued dosage recommendations for PN, which are updated periodically. The FDA has implemented review and approval processes to ensure access to safer and more effective TE products. The development of a multi-TE product meeting ASPEN recommendations and FDA requirements is the result of a partnership between the FDA, industry, and clinicians with expertise in PN. This article examines the rationale for the development of TRALEMENT^® (Trace Elements Injection 4*) and the FDA's rigorous requirements leading to its review and approval. This combination product contains copper, manganese, selenium, and zinc and is indicated for use in adults and pediatric patients weighing ≥10 kg. Comprehensive management of PN therapy requires consideration of many factors when prescribing, reviewing, preparing, and administering PN, as well as monitoring the nutritional status of patients receiving PN. Understanding patients' TE requirements and incorporating them into PN is an important part of contemporary PN therapy.

PMID:35565737 | PMC:PMC9105959 | DOI:10.3390/nu14091770

Impact of critical illness and withholding of early parenteral nutrition in the pediatric intensive care unit on long-term physical performance of children: a 4-year follow-up of the PEPaNIC randomized controlled trial.

Thu, 12 May 2022 04:00:00 +0000

Critical Care; 05/12/2022
(AN 156892075); ISSN: 13648535
CINAHL Complete

Efficacy of Donated Milk in Early Nutrition of Preterm Infants: A Meta-Analysis.

Thu, 05 May 2022 04:00:00 +0000

Nutrients; 05/05/2022
(AN 156874026); ISSN: 20726643
CINAHL Complete

Advances in Trace Element Supplementation for Parenteral Nutrition.

Thu, 05 May 2022 04:00:00 +0000

Nutrients; 05/05/2022
(AN 156874072); ISSN: 20726643
CINAHL Complete

PN Administration in Critically Ill Children in Different Phases of the Stress Response.

Thu, 05 May 2022 04:00:00 +0000

Nutrients; 05/05/2022
(AN 156874121); ISSN: 20726643
CINAHL Complete

Chronic Intestinal Failure in Children: An International Multicenter Cross-Sectional Survey.

Thu, 05 May 2022 04:00:00 +0000

Nutrients; 05/05/2022
(AN 156874191); ISSN: 20726643
CINAHL Complete

Metabolic Bone Disease in Children with Intestinal Failure and Long-Term Parenteral Nutrition: A Systematic Review.