nutrition_enterale

Does the nutritional composition and category of administered enteral nutrition affect the nutritional status of patients receiving home nutritional therapy?

Sat, 21 May 2022 08:18:53 +0000

Author Names: Xavier de Melo V.,Mezzomo T.R.,Aristides Dall'igna A.L.,de Araujo Marques Dengo V.,Stangarlin-Fiori L.,Madalozzo Schieferdecker M.E.,Rodrigues Ferreira S.M.

Database Source: Embase Weekly Updates

Journal Title: Clinical Nutrition ESPEN,Clinical Nutrition ESPEN

Article Title: Does the nutritional composition and category of administered enteral nutrition affect the nutritional status of patients receiving home nutritional therapy?

Year: 2022

Issue:

Volume:

Abstract: Background & aims: Home enteral nutrition is a nutritional intervention that can help in the recovery of health after hospital discharge. The objectives of this study were to evaluate the nutritional composition of different categories of enteral nutrition administered to patients at home, the relationship with their nutritional status, and to compare the nutritional recommendations to the nutritional content provided by the different categories of enteral nutrition. Method(s): 111 samples of homemade enteral preparations (HEP), blended enteral preparations (BEP) and commercial enteral formulas (CEF) were collected from patients' homes. Physicochemical analyses were performed on the enteral formulations, and anthropometric and body composition evaluations were performed on the patients. Comparisons between the infused and prescribed nutritional content were performed. Shapiro-Wilk, Wilcoxon, and Kruskal-Wallis tests with post hoc DMS were conducted. Result(s): The enteral nutrition categories demonstrated adequacy in relation to the physical analyses. The energy content was similar among the evaluated categories. The BEP and CEF presented higher levels of total solids, proteins, lipids, caloric density and non-protein calories; they also had a lower volume of infused/day content, and both were classified as normocaloric. The HEP were classified as hypocaloric. Regarding the infused content in relation to the recommended content, the HEP presented lower levels of protein and lipids; the CEF showed lower lipid and carbohydrate content, and the BEP presented adequacy in all nutrients. Most of the evaluated anthropometric parameters did not differ between the enteral nutrition categories. The anthropometric indicator of arm circumference (cm and %) was higher in patients receiving CEF and BEP, and the triceps skin fold (mm) was higher in patients receiving CEF and HEP. Conclusion(s): It is recommended to review the macronutrient content in nutritional prescriptions, regardless of the enteral nutrition category used. Most anthropometric parameters did not differ between the categories of enteral nutrition administered, especially those that were indicative of lean body mass. Copyright © 2022 European Society for Clinical Nutrition and Metabolism

Nutritional status in patients with advanced-stage multiple sclerosis

Sat, 21 May 2022 08:18:53 +0000

Author Names: Teng M.,Bensmail D.,Hanachi M.,Haddad R.,Hugeron C.,Lansaman T.,Levy J.

Database Source: Embase Weekly Updates

Journal Title: European Journal of Neurology,European Journal of Neurology

Article Title: Nutritional status in patients with advanced-stage multiple sclerosis

Year: 2022

Issue: 6

Volume: 29

Abstract: Introduction: Motor and swallowing dysfunctions in multiple sclerosis (MS) unbalance calorie intake and energy expenditure, modifying nutritional status. Only one study has described nutritional status in MS patients at early disease stages (median Expanded Disability Status Scale [EDSS] = 3), but this has never been assessed in the most severe cases. The goal of the present study was to describe nutritional status in advanced-stage MS. Method(s): The study was a non-interventional retrospective analysis of a prospective registry. We reviewed medical files of consecutive MS patients admitted for annual follow-up in a physical and rehabilitation medicine unit between May 2016 and October 2018. Malnutrition for frail people, according to the French Health Authority (Haute Autorite de Sante [HAS]) definition, was our composite primary outcome criterion: body mass index (BMI) <21 kg/m2 and/or albumin<35 g/L. First, we performed a descriptive analysis of the nutritional status. Second, we studied the association between malnutrition and MS characteristics in univariate and multivariate analyses. Result(s): A total of 163 patients with median EDSS = 8 [7; 8.5] were included. Ninety-three patients (57%) met HAS malnutrition criteria (36% with albumin <35 g/L, 31% with BMI <21 kg/m2 and 10% with both). Malnutrition was associated in univariate analysis with MS severity (EDSS >=8.5, p = 0.0003), primary progressive type of MS (p = 0.01) and swallowing disorders (p = 0.002). Multivariate analysis showed that low disability status (EDSS <7) was the only independent (protective) factor associated with malnutrition (OR = 0.2, p = 0.03). Conclusion(s): Malnutrition is frequent in advanced stages of MS and is probably a key point for therapeutics, which has never been demonstrated previously. A standardized evaluation should be developed to improve nutritional therapeutic strategies in this population. Copyright © 2022 European Academy of Neurology.

Safety and efficacy of continuous or intermittent enteral nutrition in patients in the intensive care unit: Systematic review of clinical evidence

Sat, 21 May 2022 08:18:53 +0000

Author Names: De Lazzaro F.,Alessandri F.,Tarsitano M.G.,Bilotta F.,Pugliese F.

Database Source: Embase Weekly Updates

Journal Title: Journal of Parenteral and Enteral Nutrition,Journal of Parenteral and Enteral Nutrition

Article Title: Safety and efficacy of continuous or intermittent enteral nutrition in patients in the intensive care unit: Systematic review of clinical evidence

Year: 2022

Issue: 3

Volume: 46

Abstract: The best mode of delivering enteral nutrition (EN) in the intensive care unit (ICU) is still debated: several consensus guidelines (American Society for Parenteral and Enteral Nutrition [ASPEN] and the European Society for Parental and Enteral Nutrition [ESPEN]) suggest that EN in ICU should be preferably delivered continuously rather intermittently, but some authors highlight that the first is unphysiological. The aim of this systematic review (SR) is to summarize available clinical evidence related to safety and efficacy of continuous EN (C-EN) or intermittent EN (I-EN) in patients in the ICU, in relation to appropriated supply on nutrition status, gastrointestinal symptoms or tolerance, and risks on respiratory tract infections. A literature search of PubMed, EMBASE, and Google Scholar was performed comparing C-EN vs I-EN, and 4196 published studies were screened. Nineteen studies were selected for this SR reporting types of ICU, nutrition protocols, and study period. Effects of C-EN vs I-EN were presented according to the impact on nutrition status, digestive tract, and respiratory tract. The contrasting results confirmed that the optimal delivering mode of EN remains controversial. Future studies dedicated to identifying the benefits and limitations of C-EN or I-EN should be realized. Copyright © 2022 American Society for Parenteral and Enteral Nutrition.

Learning to live with COVID and looking to the future.

Thu, 07 Apr 2022 04:00:00 +0000

British Journal of Nursing; 04/07/2022
(AN 156215951); ISSN: 09660461
CINAHL Complete

A Qualitative Exploration of Nutrition Screening, Assessment and Oral Support Used in Patients Undergoing Cancer Surgery in Low- and Middle-Income Countries.

Fri, 01 Apr 2022 04:00:00 +0000

Nutrients; 04/01/2022
(AN 155521209); ISSN: 20726643
CINAHL Complete

From the Editor's Desk.

Fri, 01 Apr 2022 04:00:00 +0000

Topics in Clinical Nutrition; 04/01/2022
(AN 155996216); ISSN: 08835691
CINAHL Complete

早期肠内营养支持对老年胃癌术后病人康复、营养状况及生活质量的影响

Fri, 25 Mar 2022 04:00:00 +0000

Chinese General Practice Nursing; 03/25/2022
(AN 156066334); ISSN: 16744748
CINAHL Complete

Clinical Application of Enteral Nutrition Combined with Microbial Preparation for Intestinal Preparation in Elderly Patients with Colorectal Cancer

Mon, 21 Mar 2022 00:00:00 +0000

Med Sci Monit. 2022 Mar 21;28:e935366. doi: 10.12659/MSM.935366.

ABSTRACT

BACKGROUND The purpose of this study was to determine the safety and efficacy of enteral nutrition in combination with microbial preparations for bowel preparation in elderly patients with colorectal cancer. MATERIAL AND METHODS Were divided 160 patients diagnosed with colorectal cancer into a control group (n=80) and an experimental group (n=80) by random number table method. The control group took the traditional intestinal preparation, and the experimental group took oral enteral nutrition combined with microbial preparations. Both groups were treated by the same medical team. The postoperative recovery, complications, nutritional status, inflammation, and other indicators of the 2 groups were compared. RESULTS The nutritional status of the experimental group was significantly better than that of the control group, the incidence of tissue inflammation and postoperative complications was significantly lower than that of the control group, and the stool test results of patients with postoperative diarrhea were better than those of the control group, and the difference between groups was statistically significant. CONCLUSIONS The intestinal preparation using enteral nutrition combined with microbial preparations can alleviate the systemic inflammatory response in elderly patients, improve the nutritional status, reduce the occurrence of postoperative complications, and facilitate rapid postoperative recovery.

PMID:35307727 | PMC:PMC8951595 | DOI:10.12659/MSM.935366

Efficacy of the Nutritional Risk Index, Geriatric Nutritional Risk Index, BMI, and GLIM-Defined Malnutrition in Predicting Survival of Patients with Head and Neck Cancer Patients Qualified for Home Enteral Nutrition.

Tue, 15 Mar 2022 04:00:00 +0000

Nutrients; 03/15/2022
(AN 156072323); ISSN: 20726643
CINAHL Complete

Nutrition Interventions for Children with Cerebral Palsy in Low- and Middle-Income Countries: A Scoping Review.

Tue, 15 Mar 2022 04:00:00 +0000

Nutrients; 03/15/2022
(AN 156072266); ISSN: 20726643
CINAHL Complete

Nutritional status in patients of mandibular osteoradionecrosis: A single‐institution experience.

Tue, 01 Mar 2022 05:00:00 +0000

Oral Diseases; 03/01/2022
(AN 155324420); ISSN: 1354523X
CINAHL Complete

MNT FOR CRITICALLY ILL COVID-19 PATIENTS.

Tue, 01 Mar 2022 05:00:00 +0000

Today's Dietitian; 03/01/2022
(AN 155316517); ISSN: 15404269
CINAHL Complete

Ten top tips: nutrition and wound healing.

Tue, 01 Mar 2022 05:00:00 +0000

Wounds International; 03/01/2022
(AN 155735900); ISSN: 20440057
CINAHL Complete

Estado nutricional y su asociación con eventos cardíacos adversos mayores intrahospitalarios en pacientes con insuficiencia cardíaca grave: un estudio prospectivo.

Tue, 01 Mar 2022 05:00:00 +0000

Nutricion Hospitalaria; 03/01/2022
(AN 156015280); ISSN: 02121611
CINAHL Complete

Nurses' assessment of nutrition awareness in the critical patient.

Tue, 01 Mar 2022 05:00:00 +0000

Journal of Surgery & Medicine (JOSAM); 03/01/2022
(AN 156307675)
CINAHL Complete

Early postoperative feeding following surgery for upper gastrointestinal cancer: A systematic review.

Tue, 01 Feb 2022 05:00:00 +0000

Journal of Human Nutrition & Dietetics; 02/01/2022
(AN 154716197); ISSN: 09523871
CINAHL Complete

Editor's Note.

Tue, 01 Feb 2022 05:00:00 +0000

Nutrition in Clinical Practice; 02/01/2022
(AN 154961299); ISSN: 08845336
CINAHL Complete

Key approaches to diagnosing malnutrition in adults.

Tue, 01 Feb 2022 05:00:00 +0000

Nutrition in Clinical Practice; 02/01/2022
(AN 154961293); ISSN: 08845336
CINAHL Complete

Role of the nutrition‐focused physical examination in identifying malnutrition and its effectiveness.

Tue, 01 Feb 2022 05:00:00 +0000

Nutrition in Clinical Practice; 02/01/2022
(AN 154961290); ISSN: 08845336
CINAHL Complete

Vitamin D status in very low birth weight infants and response to vitamin D intake during their NICU stays: a prospective cohort study.

Tue, 01 Feb 2022 05:00:00 +0000

Journal of Perinatology; 02/01/2022
(AN 155105468); ISSN: 07438346
CINAHL Complete

Efficacy of early enteral nutrition versus total parenteral nutrition for patients with gastric cancer complicated with diabetes mellitus: A systematic review and meta‐analysis.

Tue, 01 Feb 2022 05:00:00 +0000

Nutrition & Dietetics; 02/01/2022
(AN 155519020); ISSN: 14466368
CINAHL Complete

Nutritional status and its association with in-hospital major adverse cardiac events in patients with severe heart failure: a prospective study

Tue, 25 Jan 2022 00:00:00 +0000

Nutr Hosp. 2022 Mar 29;39(2):256-265. doi: 10.20960/nh.03846.

ABSTRACT

Objectives: this study aimed to evaluate the relationship of Nutritional Risk Screening 2002 (NRS2002) and in-hospital major adverse cardiac events (MACE) in patients with severe heart failure. Methods: an observational study was conducted at the emergency intensive care units (EICU) of Shandong University Qilu Hospital from January 2017 to December 2019. Nutritional screening and assessment were performed at the time of admission to hospital with the NRS2002. Results: of the 209 patients included, 16 cases (7.66 %) were not at nutritional risk, and 193 cases (92.34 %) were at risk. Among them, 12 cases (5.74 %) were malnourished, 38 cases (18.18 %) were at high nutritional risk, and 115 cases (55.02 %) were overweight and obese. The differences in prealbumin (PA) and N-terminal B-type natriuretic peptide precursor (NT-proBNP) between the 2 groups were statistically significant (p < 0.05). A total of 134 cases (64.12 %) received nutrition treatment support, of which 39 cases (29.10 %) received enteral nutrition (EN), 77 cases (57.46 %) parenteral nutrition, and 18 cases (13.43 %) enteral nutrition combined with parenteral nutrition (EN + SPN) support treatment. In all, 31 cases (54.39 %) reached 100 % of the target dose. Patients in the EN and EN + SPN groups had 37 MACE (64.91 %) and 31 enteral nutrition complications (54.39 %), with differences between the 3 groups being statistically significant (p < 0.05). Conclusion: the nutritional risk of patients with severe heart failure is high, and age and heart function are positively correlated with nutritional risk. The complications rate of patients with high nutritional risk is significantly higher than in those with low risk; the higher the nutritional risk, the higher the hospital mortality rate - that is, nutritional risk affects disease outcome.

PMID:35075911 | DOI:10.20960/nh.03846

Evaluation of Nutritional Practices in the Critical Care patient (The ENPIC study): Does nutrition really affect ICU mortality?

Sat, 22 Jan 2022 00:00:00 +0000

Clin Nutr ESPEN. 2022 Feb;47:325-332. doi: 10.1016/j.clnesp.2021.11.018. Epub 2021 Nov 16.

ABSTRACT

BACKGROUND & AIMS: The importance of artificial nutritional therapy is underrecognized, typically being considered an adjunctive rather than a primary therapy. We aimed to evaluate the influence of nutritional therapy on mortality in critically ill patients.

METHODS: This multicenter prospective observational study included adult patients needing artificial nutritional therapy for >48 h if they stayed in one of 38 participating intensive care units for ≥72 h between April and July 2018. Demographic data, comorbidities, diagnoses, nutritional status and therapy (type and details for ≤14 days), and outcomes were registered in a database. Confounders such as disease severity, patient type (e.g., medical, surgical or trauma), and type and duration of nutritional therapy were also included in a multivariate analysis, and hazard ratios (HRs) and 95% confidence intervals (95%CIs) were reported.

RESULTS: We included 639 patients among whom 448 (70.1%) and 191 (29.9%) received enteral and parenteral nutrition, respectively. Mortality was 25.6%, with non-survivors having the following characteristics: older age; more comorbidities; higher Sequential Organ Failure Assessment (SOFA) scores (6.6 ± 3.3 vs 8.4 ± 3.7; P < 0.001); greater nutritional risk (Nutrition Risk in the Critically Ill [NUTRIC] score: 3.8 ± 2.1 vs 5.2 ± 1.7; P < 0.001); more vasopressor requirements (70.4% vs 83.5%; P=0.001); and more renal replacement therapy (12.2% vs 23.2%; P=0.001). Multivariate analysis showed that older age (HR: 1.023; 95% CI: 1.008-1.038; P=0.003), higher SOFA score (HR: 1.096; 95% CI: 1.036-1.160; P=0.001), higher NUTRIC score (HR: 1.136; 95% CI: 1.025-1.259; P=0.015), requiring parenteral nutrition after starting enteral nutrition (HR: 2.368; 95% CI: 1.168-4.798; P=0.017), and a higher mean Kcal/Kg/day intake (HR: 1.057; 95% CI: 1.015-1.101; P=0.008) were associated with mortality. By contrast, a higher mean protein intake protected against mortality (HR: 0.507; 95% CI: 0.263-0.977; P=0.042).

CONCLUSIONS: Old age, higher organ failure scores, and greater nutritional risk appear to be associated with higher mortality. Patients who need parenteral nutrition after starting enteral nutrition may represent a high-risk subgroup for mortality due to illness severity and problems receiving appropriate nutritional therapy. Mean calorie and protein delivery also appeared to influence outcomes.

TRIAL REGISTRATION: ClinicaTrials.gov NCT: 03634943.

PMID:35063222 | DOI:10.1016/j.clnesp.2021.11.018

Nutritional Factors Associated with Late-Onset Sepsis in Very Low Birth Weight Newborns.

Sat, 01 Jan 2022 05:00:00 +0000

Nutrients; 01/01/2022
(AN 154583356); ISSN: 20726643
CINAHL Complete

Nutrition and Medical Practices for Optimizing Glycemic Control in Hospitalized Adult Nutrition Support Patients.

Sat, 01 Jan 2022 05:00:00 +0000

Support Line; 01/01/2022
(AN 154851915); ISSN: 10673768
CINAHL Complete

Pre-operative nutrition assessments do not improve outcomes in cerebral palsy patients undergoing varus derotational osteotomy

Wed, 29 Dec 2021 00:00:00 +0000

Medicine (Baltimore). 2021 Nov 24;100(47):e27776. doi: 10.1097/MD.0000000000027776.

ABSTRACT

Pre-operative nutritional assessments have been used as a "cornerstone" to help optimize nutritional status and weight in children with cerebral palsy (CP) to lower the risk of postoperative complications. However, the potential value of nutritional assessments on surgical outcomes in patients with CP undergoing major orthopedic surgery remains unproven.Do pre-operative nutritional assessments reduce complication rates of varus derotational osteotomy surgery in children with CP? Are complication rates higher in patients with a gastrostomy tube (G-tube) and can they be decreased by pre-operative nutritional assessment?One-hundred fifty-five patients with CP who underwent varus derotational osteotomy from January 1, 2012 through December 31, 2017 at a tertiary pediatric hospital with minimum 6 months follow-up were retrospectively identified. One-hundred-ten (71%) were categorized as "non-ambulatory" (Gross Motor Function Classification System [GMFCS] IV-V), and 45 (29%) as "ambulatory" (GMFCS I-III). Variables assessed included age, GMFCS level, G-tube, body mass index (BMI) percentile, complications, and if patients underwent pre-operative nutritional assessment.One-hundred-eleven patients (71.6%) underwent pre-operative nutritional assessment. Sixty-two of 155 patients (40.0%) had G-tubes. In non-ambulatory patients with G-tubes, BMI percentile changes were not significantly different between patients with a pre-operative nutritional assessment compared to those without at 1 (P = .58), 3 (P = .61), 6 (P = .28), and 12 months (P = .21) postoperatively. In non-ambulatory patients who underwent pre-operative nutritional assessment, BMI percentile changes were not significantly different between those with and without G-tubes at 1 (P = .61), 3 (P = .71), 6 (P = .19), and 12 months (P = .10). Pulmonary complication rates were significantly higher in non-ambulatory patients with G-tubes than in non-ambulatory patients without G-tubes (20% vs 4%, P = .03). Pre-operative nutritional assessments did not influence postoperative complication rates for non-ambulatory patients with or without a G-tube (P = .12 and P = .16, respectively). No differences were found in postoperative complications between ambulatory patients with and without G-tubes (P = .45) or between ambulatory patients with or without nutritional assessments (P = .99).Nutritional assessments, which may improve long term patient nutrition, should not delay hip surgery in patients with CP and progressive lower extremity deformity. Patients and their families are unlikely to derive any short-term nutritional improvement using routine pre-operative evaluation and surgical outcomes are unlikely to be improved.Level of Evidence: III, retrospective comparative.

PMID:34964739 | PMC:PMC8615376 | DOI:10.1097/MD.0000000000027776

Key approaches to diagnosing malnutrition in adults

Wed, 22 Dec 2021 00:00:00 +0000

Nutr Clin Pract. 2022 Feb;37(1):23-34. doi: 10.1002/ncp.10810. Epub 2021 Dec 22.

ABSTRACT

Nutrition assessment is used to describe nutrition status-related nutrition problems and their causes, one of which includes malnutrition. Four malnutrition diagnostic tools are currently in use today in adults: Subjective Global Assessment, the Mini Nutritional Assessment, the Academy of Nutrition and Dietetics/American Society for Parenteral and Enteral Nutrition malnutrition consensus characteristics, and the Global Leadership Initiative on Malnutrition criteria. The aim of this article is to provide sufficient background of these methodologies to assist clinicians in choosing their approach in diagnosing malnutrition. There is substantial overlap between the criteria included in these malnutrition diagnostic approaches. A desired goal is to identify a core data set in order to evaluate malnutrition prevalence globally and to assess the impact of nutrition interventions on nutrition and clinical outcomes.

PMID:34936131 | DOI:10.1002/ncp.10810

12th "Jesús Culebras" Lesson. Feeding and nutrition in patients with head and neck cancer - A permanent challenge

Thu, 09 Dec 2021 00:00:00 +0000

Nutr Hosp. 2022 Feb 9;39(1):217-222. doi: 10.20960/nh.03963.

ABSTRACT

Head and neck cancer patients are a population at permanent nutritional risk. In addition to the presence of the tumour, the reason for this is the tumour's location, which affects all structures involved in the swallowing process. The side effects of the oncological treatments they must receive during the course of their illness-surgery, chemo-radiotherapy, etc.-only further burden an already precarious nutritional status. For all these reasons, it is essential that, from the diagnosis of their disease, a multidisciplinary team including specialists in dietetics and nutrition supervises them.

PMID:34881636 | DOI:10.20960/nh.03963

Nutrition screening tools: Still no consensus 40 years on.