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1
Turcan, Svetlana, and Liudmila Tofan-Scutaru. "Nutrition therapy in acute and chronic pancreatitis." Medicine and Pharmacy Reports 94, no. 3 (April 8, 2022): S51—S55. http://dx.doi.org/10.15386/mpr-2515.
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Pancreatitis is an inflammatory disease associated with disorders of nutrient assimilation and, as a result, with significant changes in the nutritional status.
All patients with acute pancreatitis should be considered at nutritional risk and should be screened using validated screening methods. The optimal nutritional treatment for acute pancreatitis has been debated for decades. The traditional approach was "nothing in the mouth", only parenteral nutrition until the acute symptoms disappear and the level of serum pancreatic enzymes decreases. However, this tactic can contribute to various complications, starting with malnutrition and ending with sepsis due to damage of the intestinal mucosa. Clinical trials and meta-analyses have shown that patients with acute pancreatitis can tolerate oral nutrition and that oral / enteral nutrition is associated with a shorter hospital stay and a lower rate of complications compared to solely parenteral. Therefore, early oral nutrition with a low-fat "soft food" is recommended. In case of oral feeding intolerance, enteral nutrition is preferable, but not parenteral supply. A combination of enteral and parenteral nutrition may be recommended in patients who do not tolerate a sufficient amount of enteral nutrition.
Malnutrition in chronic pancreatitis cannot be detected using BMI alone, and a detailed nutritional assessment is required, including assessment of symptoms and organic functions, anthropometry, and biochemical tests. Nutritional therapy in chronic pancreatitis should be multifactorial and based on abstinence from alcohol and nicotine, and diet modification. International guidelines no longer recommend severe dietary fat restriction; on the contrary, a physiological diet is recommended, but with adequate replacement of pancreatic enzymes. In case of intolerance to physiological nutrition, a low-fat diet with oral nutritional supplements is recommended to replenish energy and nutrients.
This is a review of recent studies and guidelines on nutrition in pancreatitis for physicians and medical trainees.
2
Hellerman Itzhaki, Moran, and Pierre Singer. "Advances in Medical Nutrition Therapy: Parenteral Nutrition." Nutrients 12, no. 3 (March 8, 2020): 717. http://dx.doi.org/10.3390/nu12030717.
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Parenteral nutrition has evolved tremendously, with parenteral formulas now safer and more accessible than ever. “All-in-one” admixtures are now available, which simplify parenteral nutrition usage and decrease line infection rates alongside other methods of infectious control. Recently published data on the benefits of parenteral nutrition versus enteral nutrition together with the widespread use of indirect calorimetry solve many safety issues that have emerged over the years. All these advances, alongside a better understanding of glycemic control and lipid and protein formulation improvements, make parenteral nutrition a safe alternative to enteral nutrition.
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Novakovic, Budimka, Jelena Jovicic, Ljiljana Pavlovic-Trajkovic, Maja Grujicic, Ljilja Torovic, and Dragana Balac. "Medical nutrition therapy planning." Medical review 63, no. 11-12 (2010): 816–21. http://dx.doi.org/10.2298/mpns1012816n.
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Introduction. Diet has vital, preventive and therapeutic functions. Medical nutrition therapy is a part of the Standardized Nutrition Care Process integrated in health care systems. Material and methods. An overview of the Nutrition Care Process model and the application of nutrition guidelines based on literature, reports, documents and programmes of international health, food and physical activity authorities was done. Results. The Nutrition Care Process model requires registered dieticians, standardized terminology as well as nutrition diagnosis categorization. It consists of four distinct, but interrelated and connected steps: (a) nutrition assessment, (b) nutrition diagnosis, (c) nutrition intervention, and (d) nutrition monitoring and evaluation. An individual approach is essential for successful medical nutrition therapy. Nutrition guidelines facilitate the process of understanding and application of medical nutrition therapy. Conclusion. The Nutrition Care process provides dietetic professionals information on high-quality client nutrition care. The success of medical nutrition therapy rests not only upon the advice of the dietician, but also upon the client?s compliance.
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Górska, Monika, and Ilona Kurnatowska. "Nutrition Disturbances and Metabolic Complications in Kidney Transplant Recipients: Etiology, Methods of Assessment and Prevention—A Review." Nutrients 14, no. 23 (November 24, 2022): 4996. http://dx.doi.org/10.3390/nu14234996.
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Nutrition disturbances occur at all stages of chronic kidney disease and progress with the decrease of the kidney filtration rate. Kidney transplantation (KTx) as the best form of kidney replacement therapy poses various nutritional challenges. Prior to transplantation, recipients often present with mild to advanced nutrition disturbances. A functioning allograft not only relieves uremia, acidosis, and electrolyte disturbances, but also resumes other kidney functions such as erythropoietin production and vitamin D3 metabolism. KTx recipients represent a whole spectrum of undernutrition and obesity. Since following transplantation, patients are relieved of most dietary restrictions and appetite disturbances; they resume old nutrition habits that result in weight gain. The immunosuppressive regimen often predisposes them to dyslipidemia, glucose intolerance, and hypertension. Moreover, most recipients present with chronic kidney graft disease at long-term follow-ups, usually in stages G2–G3T. Therefore, the nutritional status of KTx patients requires careful monitoring. Appropriate dietary and lifestyle habits prevent nutrition disturbances and may improve kidney graft function. Despite many nutritional guidelines and recommendations targeted at chronic kidney disease, there are few targeted at KTx recipients. We aimed to provide a brief review of nutrition disturbances and known nutritional recommendations for kidney transplant recipients based on the current literature and dietary trends.
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Sheean, Patricia M., Sarah J. Peterson, Weihan Zhao, David P. Gurka, and Carol A. Braunschweig. "Intensive Medical Nutrition Therapy: Methods to Improve Nutrition Provision in the Critical Care Setting." Journal of the Academy of Nutrition and Dietetics 112, no. 7 (July 2012): 1073–79. http://dx.doi.org/10.1016/j.jand.2012.02.007.
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Stawny, M., R. Olijarczyk, E. Jaroszkiewicz, and A. Jelińska. "Pharmaceutical Point of View on Parenteral Nutrition." Scientific World Journal 2013 (2013): 1–9. http://dx.doi.org/10.1155/2013/415310.
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Parenteral nutrition—a form of administering nutrients, electrolytes, trace elements, vitamins, and water—is a widely used mode of therapy applied in many diseases, in patients of different ages both at home and in hospital. The success of nutritional therapy depends chiefly on proper determination of the patient’s energetic and electrolytic needs as well as preparation and administration of a safe nutritional mixture. As a parenterally administered drug, it is expected to be microbiologically and physicochemically stable, with all of the components compatible with each other. It is very difficult to obtain a stable nutritional mixture due to the fact that it is a complex, two-phase drug. Also, the risk of incompatibility between mixture components and packaging should be taken into consideration and possibly eliminated. Since parenteral nutrition is a part of therapy, simultaneous use of drugs may cause pharmacokinetic and pharmacodynamic interactions as well as those with the pharmaceutical phase. The aim of this paper is to discuss such aspects of parenteral nutrition as mixture stability, methodology, and methods for determining the stability of nutritional mixtures and drugs added to them.
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Sonal, Viyas, Kumari Rinki, Tiwari Anamika, Shahi UP, and Singh GPI. "The Effect of Nutrition on Risk of Breast Cancer." Journal of Clinical Cases & Reports 3, no. 1 (January 31, 2020): 22–28. http://dx.doi.org/10.46619/joccr.2020.3-1056.
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Introduction: The nutritional status has been related to breast cancer risk factors as well as to cancer treatment morbid mortality. Thus, its assessment is important for developing strategies for the promotion of nutritional status and breast cancer outcome. Material and Methods: Several different methods used for nutritional assessment in breast cancer patients undergoing therapy were used, including subjective global assessment (SGA), body mass index (BMI), and biochemical analysis (BA). The occurrence of complications during breast cancer treatment versus the nutritional status was assessed. Results: We followed 86 women with age range 18-76 years. Most patients were considered malnourished (65%). A good number of patients experienced complications during breast cancer treatment, and associated with nutritional status. Conclusion: In breast cancer women undergoing therapy, the prevalence of under nutrition was high. There were the effects of poor nutrition or undernutrition on clinical outcomes of breast cancer.
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Mikhailova, Mikhailova N. A. "Methods of nutrition therapy of patients with chronic kidney disease." Nephrology 1_2023 (March 3, 2023): 70–78. http://dx.doi.org/10.18565/nephrology.2023.1.70-78.
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Aboshoushah, Enass, Jumanah Albarakati, Faisal Almajayishi, Fatimah AlHamar, Saeed Alghamdi, Jumanah Jarad, Salman Binladin, et al. "Identification, Prevention and Management of Malnutrition in the Critically Ill Patients." Journal of Healthcare Sciences 02, no. 10 (2022): 308–13. http://dx.doi.org/10.52533/johs.2022.21006.
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Proper nutrition is essential for enhancing healthcare outcomes. Elevated rates of malnutrition are present in hospitalized patients. Malnutrition and unmet nutritional needs increase morbidity and mortality, lower quality of life, lengthen the time spent on mechanical ventilation, and lengthen hospital stays, all of which raise the expense of medical treatment. Patients who are critically ill need specific care to minimize muscle wasting, avoid overfeeding, and prevent complications from nutritional therapy. The purpose of this research is to review the available information about identification, prevention, and management of malnutrition in the critically ill patients. To identify patients who are more likely to experience complications from malnutrition, nutritional status is evaluated. Various assessment methods and tools are present to identify malnutrition in critically ill patients. Effective targeting of appropriate nutrient levels, and prompt initiation of nutritional support, among other measures can reduce the risk of malnutrition. Ideally, enteral nutrition should be started after initial 24 to 48 hours. Parenteral nutrition may be employed if the nutritional need is not properly supplied by enteral nutrition even after seven days following intensive care admission. In patients receiving nutrition therapy, electrolytes should be carefully assessed. Even if 50% to 60% of nutritional requirements are not successfully met during 72 hours of oral nutrition support then tube feeding should be considered. Further clinical research can be beneficial in determining the effectiveness and outcomes of nutritional therapy in malnourished critically ill patients.
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Nakayama, Kento, Hiroyuki Koami, and Yuichiro Sakamoto. "Relationship between nutritional therapy and beneficial bacteria ratio in severe disease." Journal of Acute Disease 13, no. 1 (February 2024): 26–30. http://dx.doi.org/10.4103/jad.jad_121_23.
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Objective: To evaluate relationship between changes in the beneficial bacteria in intensive care unit (ICU) patients and nutritional therapy type. Methods: Ten patients aged ≥18 years admitted to the ICU between January and December 2020, were included. Good enteral nutrition was defined as early achievement of target calorie intake through enteral feeding. The ratio of beneficial bacteria at the first and second bowel movements after each patient's admission was calculated and the patients were classified into the increase or decrease group. Among all patients, five each were in the increase and decrease groups. We investigated patient background, changes in sequential organ failure assessment (SOFA) and acute physiology and chronic health evaluation (APACHE) II scores, nutritional doses or methods, and clinical outcomes. Results: No relationship was found between changes in the ratio of beneficial bacteria and changes in SOFA/APACHE II scores at the time of admission. The rate of good enteral nutrition was significantly higher in the increase group than in the decrease group (4/5 vs. 0/5, P=0.01). Conclusions: An increase in beneficial bacteria may be significantly related to the early establishment of enteral nutrition. In the future, accumulating cases may make it possible to establish a new nutritional strategy for critically ill patients from an intestinal microbiota perspective.
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Zakirova, A. M., R. A. Faizullina, A. G. Kadriev, D. Т. Shayapova, L. Yu Palmova, E. L. Rashitova, I. R. Zaripov, A. A. Kadriev, and R. P. Kiselеv. "Nutritional support for different conditions accompanied with protein and energy insufficiency in children." Meditsinskiy sovet = Medical Council, no. 1 (March 13, 2023): 96–109. http://dx.doi.org/10.21518/ms2022-019.
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Introduction. Malnutrition in children manifests itself in the form of general metabolic disorders and leads to impaired cellular differentiation of tissues. The state of nutritional status is an important success factor in the treatment of any disease, therefore, the development of methodological approaches to optimize the nutritional status of children with protein-energy malnutrition is an urgent task.Aim. To study the efficacy and safety of nutritional support in various conditions accompanied by protein-energy malnutrition in children.Materials and methods. 62 cases were analyzed: including 29 with antibiotic-associated diarrhea, 8 with celiac disease, 14 with gastrointestinal allergy (allergic enteropathy), 11 with hypostature against the background of low gestational age with birth. Age – 1–10 years. All patients were divided into groups identical in age, nosology, gender, duration of the pathological condition, degree of malnutrition. In the main group (31 children), the main treatment included a low-microbial diet, sips, parenteral nutrition with glucose-salt solutions (7–10 days), enteral nutrition. The control group consisted of 31 children, in whose therapy there was no enteral nutrition. Anthropometry, clinical, laboratory and instrumental examination were used to assess the nutritional status.Results and discussion. The main syndromes during treatment are: underweight, loss of appetite, intestinal dyspepsia and malabsorption. Analysis of the diet indicated the monotony of the set of products. The course of nutritional support was 15 days. The survey was conducted on the 1st, 5th, 10th, 15th days of the study. The effect of using enteral nutrition in terms of physical development, clinical and laboratory parameters was more significant in the main group compared to conventional methods of nutrition optimization.Conclusions. The use of enteral nutrition in combination with drug therapy shows more significant effectiveness compared to conventional methods of nutrition optimization.
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Kanno, Yoshihiko, Eiichiro Kanda, and Akihiko Kato. "Methods and Nutritional Interventions to Improve the Nutritional Status of Dialysis Patients in JAPAN—A Narrative Review." Nutrients 13, no. 5 (April 21, 2021): 1390. http://dx.doi.org/10.3390/nu13051390.
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Patients receiving dialysis therapy often have frailty, protein energy wasting, and sarcopenia. However, medical staff in Japan, except for registered dietitians, do not receive training in nutritional management at school or on the job. Moreover, registered dietitians work separately from patients and medical staff even inside a hospital, and there are many medical institutions that do not have registered dietitians. In such institutions, medical staff are required to manage patients’ nutritional disorders without assistance from a specialist. Recent studies have shown that salt intake should not be restricted under conditions of low nutrition in frail subjects or those undergoing dialysis, and protein consumption should be targeted at 0.9 to 1.2 g/kg/day. The Japanese Society of Dialysis Therapy suggests that the Nutritional Risk Index-Japanese Hemodialysis (NRI-JH) is a useful tool to screen for older patients with malnutrition.
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Cunha, Sofia, Susiane Santiago, Camyla Guedine, Cláudia Pádua, and Patrícia Prado. "Terapia nutricional em pacientes adultos com COVID-19: revisão de escopo." BRASPEN Journal 36, no. 1 (2021): 93–100. http://dx.doi.org/10.37111/braspenj.2021.36.1.12.
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Introduction: Nutrition is a key determinant for health, being a fundamental part of the treatment of chronic and acute diseases, and the adequate activity of the immune system as well. COVID-19 emerged in China, on December 2019, where many cases of pneumonia were reported. Considering that nutrition therapy is one of the main treatments applied to COVID-19 patients, this paper aims to identify the nutrition therapy recommendations for intensive care patients affected with this disease. Methods: This is a scope review. The data search occurred between December 2019 and September 3rd, 2020. The inclusion criteria were: articles published in English, Portuguese or Spanish, full text, that agree with the aim of this study. PubMed and Virtual Health Library were the databases selected. Results: 633 publications potentially eligible were identified, and the final sample was composed by 3 articles. Nutrition screening, feeding route, indications of calories, protein and micronutrients intake were summarized. Conclusion: It is recommended the offer of a high protein diet, and the use of macro and micronutrient supplements to COVID-19 patients in nutritional risk, as well as preferring the oral or enteral feeding rout when possible, use of nutritional screening tools and following the guidelines from nutrition and dietetics societies. We suggest the conduction of prospective randomized controlled trials to evaluate nutrition therapy, aiming to identify the best nutritional care practices for adult patients with COVID-19.
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Tashiro, Mitsuru, Suguru Yamada, Tsutomu Fujii, Norifumi Hattori, Hideki Takami, Masaya Suenaga, Yukiko Niwa, et al. "Clinical implication of nutrition for neoadjuvant therapy and impact of nutritional support in pancreatic cancer." Journal of Clinical Oncology 36, no. 4_suppl (February 1, 2018): 416. http://dx.doi.org/10.1200/jco.2018.36.4_suppl.416.
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416 Background: Several studies have shown that nutritional support is important to reduce chemotherapy-related toxicities and improve tolerance to chemotherapy, but little is known about the nutritional influence of neoadjuvant therapy (NAT) for pancreatic cancer. The aim of this study was to assess the influence of NAT on nutritional status and the effectiveness of postoperative nutritional support in patients with NAT for pancreatic cancer. Methods: Between 2010 and 2017, 169 consecutive patients who underwent pancreatoduodenectomy of pancreatic cancer were enrolled, and divided into the neoadjuvant group (NAG, n = 70) and the control group (CG, n = 99). We assessed the change of nutritional index (body weight, albumin and rapid turnover proteins; retinol binding protein, prealbumin and transferrin), inflammatory index, and inflammation-based prognostic scores during NAT. Perioperative change of rapid turnover proteins at the point of pre-operation, postoperative day (POD) 5, POD12 and POD21, and perioperative and oncological outcomes between NAG and CG were evaluated. Finally, we divided NAG into nutrition group (n = 27) who received postoperative enteral immunonutrition from POD 1 to POD 21 and without nutrition group (n = 41), and compared perioperative change of rapid turnover proteins between two groups. Results: After NAT, the retinol binding protein, prealbumin, neutrophil to lymphocyte ratio, platelet to lymphocyte ratio and prognostic nutrition index significantly got worse in NAG (P < 0.05). The recovery of rapid turnover proteins after POD5 was significantly worse in NAG compared to CG (P < 0.05). There was no significant difference in the incidence of postoperative complications and time to adjuvant therapy between two groups. The recovery of retinol binding protein and prealbumin after POD12 was significantly better in nutrition group compared to without nutrition group (P < 0.05). Conclusions: NAT for pancreatic cancer could decrease nutritional status and its postoperative recovery. Postoperative enteral nutrition could be effective in patients with NAT for pancreatic cancer. Based on these results, we plan to perform the nutritional support at earlier stage of therapy.
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Zheng, Huijun, Yingchun Huang, Yongmei Shi, Wei Chen, Jianchun Yu, and Xinying Wang. "Nutrition Status, Nutrition Support Therapy, and Food Intake are Related to Prolonged Hospital Stays in China: Results from the NutritionDay 2015 Survey." Annals of Nutrition and Metabolism 69, no. 3-4 (2016): 215–25. http://dx.doi.org/10.1159/000451063.
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Background and Aims: Malnutrition is a common and critical problem that greatly influences the clinical outcomes of hospitalized patients. Nutrition support therapy and food intake, in addition to disease-related factors, are also important to maintain the nutrition status of patients. In light of this, we aimed to examine the risk factors associated with malnutrition in 3 hospitals in China. Methods: This project was part of the NutritionDay audit, an international daylong cross-sectional audit investigating the nutritional intervention profiles of hospitalized patients. Seven standardized questionnaires were used, and malnutrition was defined as a body mass index <18.5 kg/m2 or unintentional weight loss >5% in last 3 months. Results: A total of 842 hospitalized patients from 9 units in 3 Chinese hospitals participated in the project on November 19, 2015. Among them, 825 were included in the analyses. Malnutrition was identified in 29.3% of the patients and oral nutrition was the primary nutrition support therapy administered (n = 623, 75.6%). Age, nutrition support, and food intake during the past week were independent risk factors for malnutrition. Furthermore, nutrition status, nutrition support therapy, and food intake during the past week were associated with prolonged length of stay. Conclusions: The prevalence of malnutrition in Chinese hospitals was similar to that in European hospitals. Nutrition status was associated with age, nutrition support, and food intake, which was closely related to patients' clinical outcome, such as prolonged hospital stays as confirmed in this study. More studies are needed to determine why nutrition intake is often inadequate and to determine efficient methods for correcting the nutrition status of patients.
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Imamura, Teruhiko, Hayato Fujioka, Nikhil Narang, and Koichiro Kinugawa. "Impact of Sodium Zirconium Cyclosilicate Therapy on Nutrition Status in Patients with Hyperkalemia." Journal of Clinical Medicine 12, no. 1 (December 22, 2022): 83. http://dx.doi.org/10.3390/jcm12010083.
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Background: Restriction of oral potassium intake is a necessary dietary intervention for managing chronic hyperkalemia. These dietary changes may have negative impacts on nutrition status, particularly in geriatric cohorts with multiple comorbidities. Sodium zirconium cyclosilicate (SZC) is a newly introduced potassium binder intended for patients with hyperkalemia. We aimed to investigate whether the improvements in hyperkalemia with SZC therapy and the liberation of potassium intake restriction may improve nutrition status in a primarily geriatric patient cohort with chronic hyperkalemia. Methods: Patients who were maintained on SZC therapy for at least 3 months were retrospectively studied. Following the initiation of SZC and improvement in hyperkalemia, instructions on the restriction of potassium intake were loosened according to the institutional protocol. The change in nutrition status during the 3 month therapeutic period using SZC was investigated by referencing the prognostic nutritional index score (PNI), geriatric nutritional risk index score (GNRI), and controlling nutritional status (CONUT) scores. Results: A total of 24 patients (median age 78 years, 58% men, median estimated glomerular filtration rate 29.8 mL/min//1.73 m2) were included. Serum potassium level decreased significantly from 5.4 (5.1, 5.9) to 4.4 (4.2, 4.9) mEq/L without any drug-related adverse events, including hypokalemia. Nutrition-related scores, including the PNI score, the GNRI score, and the CONUT score, improved significantly following 3 months of SZC therapy (p < 0.05 for all). Psoas muscle volume and average days for one movement also improved significantly during the therapeutic period (p < 0.05 for both). Conclusions: Mid-term SZC therapy and liberation of potassium intake restriction might improve nutrition status in geriatric patients with chronic hyperkalemia.
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Yang, Weihong. "Effect of Individualized Nutritional Therapy Combined with Low-intensity Continuous Exercise on Pregnancy Outcomes in Patients with Gestational Diabetes." Journal of Clinical Medicine Research 4, no. 4 (December 6, 2023): 119. http://dx.doi.org/10.32629/jcmr.v4i4.1423.
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Objective: To study the effect of individualized nutrition therapy combined with low intensity continuous exercise on gestational diabetes mellitus (GDM) control and pregnancy outcome. Methods: A total of 72 GDM patients diagnosed and treated in our hospital from October 2022 to October 2023 were randomly divided into an observation group and a control group. Individualized nutritional therapy combined with low-intensity continuous exercise therapy and conventional therapy were given, respectively. The blood glucose level, biochemical indexes, depression score, anxiety score and pregnancy outcome of the patients were observed and compared. Results: After individualized nutrition therapy combined with low-intensity continuous exercise, compared with the control group, the levels of fasting blood glucose, 2h postprandional blood glucose, glycated protein, albumin, total cholesterol, and triacylglycerol of the patients in the observation group were significantly reduced, and the depression and anxiety of the patients in the observation group were significantly alleviated, and the pregnancy complications were significantly reduced. Conclusion: Individualized nutrition therapy combined with low-intensity continuous exercise can effectively control gestational diabetes and improve pregnancy outcomes.
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Davanov, Sh, and L. Musina. "NUTRITIONAL SUPPORT FOR CANCER PATIENTS IN THE EARLY POSTOPERATIVE PERIOD." Oncologia i radiologia Kazakhstana 69, no. 3 (September 30, 2023): 47–52. http://dx.doi.org/10.52532/2521-6414-2023-3-69-47-52.
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Relevance: The modern medicine, evaluating patients’ nutritional status is a priority for many specialists. The incidence of nutritional
deficiency in cancer pathology increases annually by 65-85%. The nutritional status of patients is represented by a decrease in life expectancy,
deterioration of immediate and long-term treatment results, a decrease in the tolerability of therapy, and a decrease in the quality of life. Early
detection of nutritional insufficiency and evaluation of the patient’s nutritional status makes it possible for early provision of nutritional therapy
and has a positive effect before the operation, during and after the operating period, reduces postoperative complications, and reduces the duration
of stay in the hospital. This article reflects on the features of evaluating the nutritional status and methods of correction of clinical nutrition.
The study aimed to analyze the effectiveness of cancer patients’ nutrition in the early postoperative period and determine the optimal method
of its implementation.
Methods: We compared the clinical effectiveness of enteral and parenteral nutrition methods in the complex of postoperative therapeutic
measures on the hepato-pancreatic-duodenal zone.
Results: On Days 10-12 after surgery, 12 out of 17 control group patients had normal nutritional status judging by their Subjective Global
Assessment (SGA) and Nutritional Risk Index (NRI), and five had moderate malnutrition. After enteral nutrition was added (on Days 13-15), no
malnutrition cases in this group were detected. The total blood protein in the subjects showed a significant difference between the average values
of indicators in clinical groups for the entire study period (p<0.05). The average total blood protein by Day 8 after surgery was 62.5±10.0 g/L in
the leading group and 57.5±10.1 g/L in the control group. The change in the blood biochemical composition was due to the volume, duration, and
nature of the surgical intervention.
Conclusion: When using nutritional therapy in cancer patients operated on for tumors of the hepato-pancreatic-duodenal zone in the early
postoperative period, the enteral route of administration of nutrient mixtures is preferred, provided there is no pronounced intestinal paresis and
purulent discharge from the stomach.
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Davanov, Sh, and L. Musina. "NUTRITIONAL SUPPORT FOR CANCER PATIENTS IN THE EARLY POSTOPERATIVE PERIOD." Oncologia i radiologia Kazakhstana 69, no. 3 (October 10, 2023): 47–52. http://dx.doi.org/10.52532/2663-4864-2023-3-69-47-52.
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Relevance: The modern medicine, evaluating patients’ nutritional status is a priority for many specialists. The incidence of nutritional deficiency in cancer pathology increases annually by 65-85%. The nutritional status of patients is represented by a decrease in life expectancy, deterioration of immediate and long-term treatment results, a decrease in the tolerability of therapy, and a decrease in the quality of life. Early detection of nutritional insufficiency and evaluation of the patient’s nutritional status makes it possible for early provision of nutritional therapy and has a positive effect before the operation, during and after the operating period, reduces postoperative complications, and reduces the duration of stay in the hospital. This article reflects on the features of evaluating the nutritional status and methods of correction of clinical nutrition.
The study aimed to analyze the effectiveness of cancer patients’ nutrition in the early postoperative period and determine the optimal method of its implementation.
Methods: We compared the clinical effectiveness of enteral and parenteral nutrition methods in the complex of postoperative therapeutic measures on the hepato-pancreatic-duodenal zone.
Results: On Days 10-12 after surgery, 12 out of 17 control group patients had normal nutritional status judging by their Subjective Global Assessment (SGA) and Nutritional Risk Index (NRI), and five had moderate malnutrition. After enteral nutrition was added (on Days 13-15), no malnutrition cases in this group were detected. The total blood protein in the subjects showed a significant difference between the average values of indicators in clinical groups for the entire study period (p<0.05). The average total blood protein by Day 8 after surgery was 62.5±10.0 g/L in the leading group and 57.5±10.1 g/L in the control group. The change in the blood biochemical composition was due to the volume, duration, and nature of the surgical intervention.
Conclusion: When using nutritional therapy in cancer patients operated on for tumors of the hepato-pancreatic-duodenal zone in the early postoperative period, the enteral route of administration of nutrient mixtures is preferred, provided there is no pronounced intestinal paresis and purulent discharge from the stomach.
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Simões Covello, Luís Henrique, Marcella Giovana Gava-Brandolis, Melina Gouveia Castro, Martins Fidelis Dos Santos Netos, William Manzanares, and Diogo Oliveira Toledo. "Vasopressors and Nutrition Therapy: Safe Dose for the Outset of Enteral Nutrition?" Critical Care Research and Practice 2020 (February 10, 2020): 1–7. http://dx.doi.org/10.1155/2020/1095693.
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Background and Aims. Patients with hemodynamic instability need to receive intensive treatment as fluid replacement and vasoactive drugs. In the meantime, it is supposed to initiate nutritional therapy within 24 to 48 hours after admission to the intensive care unit (ICU), as an essential part of patient’s intensive care and better outcomes. However, there are many controversies tangential to the prescription of enteral nutrition (EN) concomitant to the use of vasopressor and its doses. In this way, the present study aimed to identify what the literature presents of evidence to guide the clinical practice concerning the safe dose of vasopressors for the initiation of nutritional therapy in critically ill patients. Methods. This review was carried out in PubMed, ProQuest, Web of Science, and Medline databases. The descriptors were used to perform the search strategy: Critical Care, Intensive Care Units, Vasoconstrictor Agents, and Enteral Nutrition. Inclusion criteria were patients of both genders, over 18 years of age, using vasoactive drugs, with the possibility of receiving EN therapy, and articles written in English, Portuguese, and Spanish. In addition, exclusion criteria were case reports, non-papers, and repeated papers. Results. 10 articles met our inclusion criteria. Conclusion. It was observed that there are many controversies about the supply of EN in critically ill patients using vasopressor, especially about the safe dose, and it was not possible to identify a cutoff value for the beginning therapy. Despite the drug doses, clinical signs are still the most important parameters in the evaluation of EN tolerance.
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Lew, Charles Chin Han, Puay Shi Ng, Kok Wah Wong, Ser Hon Puah, Cassandra Duan Qi Lim, Geetha Kayambu, Andrew Yunkai Li, Chee Hong Toh, Jonathen Venkatachalam, and Amartya Mukhopadhyay. "Nutrition support practices for critically ill patients with severe acute respiratory syndrome coronavirus-2: A multicentre observational study in Singapore." Annals of the Academy of Medicine, Singapore 51, no. 6 (June 28, 2022): 329–40. http://dx.doi.org/10.47102/annals-acadmedsg.202231.
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Introduction: To improve the nutritional care and resource allocation of critically ill patients with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), we described their characteristics, treatment modalities and clinical outcomes, and compared their nutrition interventions against the American Society for Parenteral and Enteral Nutrition (ASPEN) recommendations. Methods: This was a retrospective observational study conducted in 5 tertiary hospitals in Singapore. Characteristics, treatment modalities, clinical outcomes and nutrition interventions of critically ill patients with SARS-CoV-2 who received enteral and parenteral nutrition were collected between January and May 2020. Results: Among the 83 critically ill patients with SARS-CoV-2, 22 (28%) were obese, 45 (54%) had hypertension, and 21 (25%) had diabetes. Neuromuscular blockade, prone therapy and dialysis were applied in 70% (58), 47% (39) and 35% (29) of the patients, respectively. Refeeding hypophosphataemia and hospital mortality occurred respectively in 6% (5) and 18% (15) of the critically ill patients with SARS-CoV-2. Late enteral nutrition and cardiovascular comorbidities were associated with higher hospital mortality (adjusted relative risk 9.00, 95% confidence interval [CI] 2.25–35.99; 6.30, 95% CI 1.15–34.40, respectively). Prone therapy was not associated with a higher incidence of high gastric residual volume (≥250mL). The minimum caloric (15kcal/kg) and protein (1.2g/kg) recommendations of ASPEN were achieved in 54% (39) and 0% of the patients, respectively. Conclusion: The high obesity prevalence and frequent usage of neuromuscular blockade, prone therapy, and dialysis had considerable implications for the nutritional care of critically ill patients with SARS-CoV-2. They also did not receive adequate calories and protein. More audits should be conducted to refine nutritional interventions and guidelines for this ever-evolving disease. Keywords: COVID-19, critical illness, energy intake, enteral nutrition, nutrition support, protein intake
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Cunha, Haroldo. "Autophagy, critical illness and nutrition therapy: a narrative review for non-specialists." BRASPEN Journal 36, no. 4 (2021): 415–19. http://dx.doi.org/10.37111/braspenj.2021.36.4.13.
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Introduction: In recent years, the concept of autophagy has been incorporated on the lexicon of intensive care unit (ICU) nutrition therapy. Macroautophagy, or simply, autophagy, is a continuous homeostatic process, through which degradation of cytoplasmic components (i.e., damaged organelles, toxic, senescent, or defective protein aggregates) occurs. Methods: Narrative review. Results: The article presents an overview of the topic focusing the interplay among autophagy, nutrition therapy and critical care illness. Conclusions: Although further studies on the interface between autophagy and nutrient supply are needed, nutritional therapy professionals can now reinforce their understanding of their own specialty, considering that their intervention is not limited to the mere supply of fuel for the metabolism, but extends for the induction of biochemical stimuli and signals capable of interfering with critical cellular processes in health and disease.
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Molnár, Andrea, Ágnes Anna Csontos, Sarolta Dakó, Rita Hencz, Dániel Áron Anton, Erzsébet Pálfi, and Pál Miheller. "A táplálásterápia hatékonyságának vizsgálata gyulladásos bélbetegségben szenvedők gondozása során." Orvosi Hetilap 158, no. 19 (May 2017): 731–39. http://dx.doi.org/10.1556/650.2017.30719.
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Abstract: Introduction: Inflammatory bowel diseases can cause malnutrition (due to inflammatory cytokine production, catabolic states after surgery, restricted diet), which is difficult to treat by nutritional therapy. Aim: Investigating the efficacy of nutrition therapy. Method: Combined malnutrition risk screening (questionnaires and body composition analysis), at the beginning of the research and after a 1 year period. Results: 205 patients were screened, 82 were malnourished. A total of 44 received nutritional intervention for 1 year, for 45% dietary management was satisfactory, 50% needed oral nutritional supplements and 5% received home parenteral nutrition. These interventions reduced the number of patients considered by both measuring methods in high risk from 31 to 21, increased the body weight and fat-free mass in 8 and 9 cases significantly (i.e., with more than 10%), and improved the indices as well (ΔBMI: +1.3 kg/m2, p = 0.035 s., ΔFFMI: +0.5 kg/m2, p = 0.296 n.s.). The main limitations of our research are the relatively low number of cases and the mono-centric involvement. Conclusions: We recommend combined malnutrition risk screening for all patients with inflammatory bowel disease due to the high risk of malnutrition, and follow-up of the malnourished patients to monitor the efficacy of their nutrition therapy. Orv Hetil. 2017; 158(19): 731–739.
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Satvaldieva, Elmira, Gulchekhra Ashurova, and Fuat Kurbanov. "Nutritional therapy in children with sepsis and septic shock: unresolved questions and the need for an individualized approach." ScienceRise: Medical Science, no. 2(53) (March 31, 2023): 4–11. http://dx.doi.org/10.15587/2519-4798.2023.281226.
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The aim. This review provides a meta-analysis of current guidelines on nutrition in critically ill patients, including SCCM–ASPEN (2017), SSC (2012, 2021), ESPNIC (2020), and SSC (2020) pediatric sepsis guidelines. While the ESPNIC (2020) guidance complements the existing ASPEN (2017) guidelines for critical paediatrics, the Children's SSC (2020) did not find sufficient direct evidence to develop strong nutritional recommendations for children with sepsis/septic shock.
Materials and methods. Looking for publications on nutritional assessment and nutritional support in children with sepsis have been keywords sepsis in children, nutrition, and critical conditions. Literature searched and analyzed from PubMed, Google Scholar and ScienceDirect databases. Revealed under-a sufficient amount of work on pediatric sepsis (an exception is neonatal sepsis), there are no protocols for assessing nutritional status and its correction in children diagnosed with sepsis/SS.
Results. Despite ongoing research in this area, many questions remain unresolved and require systematic study. While some small and large pediatric studies have recommended nutritional therapy, the heterogeneity of children's ICUs in terms of age, pathology, disease severity, comorbidities, and nutritional status precludes a one-size-fits-all approach to nutrition in critically ill children. Therefore, an individualized approach to nutrition is necessary, considering the patient's unique circumstances and the risk/benefit ratio of different nutritional therapies.
Conclusions. An extensive literature review did not reveal strong nutritional recommendations for children with sepsis/SS, underscoring the need for future research on the assessment and correction of protein-energy malnutrition in this population. Overall, this review highlights the importance of tailoring nutritional therapy to the individual needs of critically ill children with sepsis/ septic shock to optimize outcomes
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Maksimycheva, T. Yu, E. I. Kondratyeva, and V. V. Shadrina. "Pharmacoeconomic aspects of complex therapy including clinical nutrition in children with cystic fibrosis." Voprosy detskoj dietologii 20, no. 6 (2022): 14–20. http://dx.doi.org/10.20953/1727-5784-2022-6-14-20.
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Objective. To estimate the annual cost of antibiotic therapy for cystic fibrosis exacerbations in children depending on nutritional status and the comparative cost of enteral nutrition products of two manufacturing companies. Patients and methods. This study included 50 male and female patients with cystic fibrosis aged 7 to 17 years (mean age 13 ± 4 years). All patients were divided into two age groups. Group 1 consisted of 26 children aged 7 to 10 years and group 2 consisted of 24 children aged 11 to 17 years. Each age group was subdivided depending on the body mass index (BMI): subgroup 1: ≤10th percentile, subgroup 2: 50th percentile. According to the 2019 registry, we calculated the number of courses and doses of antibiotic therapy per year, the annual cost of antibiotic therapy in each subgroup and per patient, and the cost of nutritional status correction with supplementary feeding. Results. In groups of patients with different nutritional status, it was shown that the average annual cost of antibiotic therapy in children aged 7–10 years with BMI ≥50th percentile was 600 thousand rubles (11%) lower than in children with BMI ≤10th percentile. In the age group of 11–17 years, cost savings amounted to 2.9 million rubles (58%). When calculating the cost of enteral nutrition, it was found that the use of domestic products to correct the nutritional status is economically more feasible. Cost savings ranged between 484,080 and 608,880 rubles (25–30%) in each age group. Conclusion. The decline in nutritional status should be corrected as early as possible. Maintaining optimal rates of physical development may lead to significant cost savings. The results obtained may be used for future economic assessments and cost projections for the treatment of patients with pathology accompanied by poor nutritional status. Key words: cystic fibrosis, children, enteral nutrition, protein-energy malnutrition, malnutrition
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LeBrett, Wendi, Jenny Sauk, and Berkeley Limketkai. "11 ENTERAL NUTRITION THERAPY IS ASSOCIATED WITH FEWER READMISSIONS AND DEATHS AMONG MALNOURISHED INPATIENTS WITH INFLAMMATORY BOWEL DISEASE." Inflammatory Bowel Diseases 26, Supplement_1 (January 2020): S43—S44. http://dx.doi.org/10.1093/ibd/zaa010.113.
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Abstract Background Malnutrition is a common complication observed in hospitalized patients with inflammatory bowel disease (IBD). Enteral nutrition therapy can be used to support the nutritional needs of inpatients with IBD. However, evidence on the impact of inpatient enteral nutrition on clinical outcomes is equivocal. This study assesses post-hospitalization outcomes associated with enteral nutrition therapy amongst inpatients with IBD in a large nationwide database. Methods We conducted a retrospective propensity score-matched study among IBD inpatients diagnosed with protein-calorie malnutrition using the Nationwide Readmissions Database from 2010–2015. ICD9 codes associated with each admission were used to identify patients who received enteral nutrition. Using propensity score matching, patients who received inpatient enteral nutrition were matched with patients who did not receive enteral nutrition based on the following variables: age, sex, elective admission, patient income, teaching hospital, and hospital urban or rural locality. Primary endpoints included 30-day readmissions, 90-day readmissions, 30-day mortality and 90-day mortality. Results Among the 1,588 IBD patients (822 Crohn’s disease, 755 ulcerative colitis, 11 unclassified IBD) with protein-calorie malnutrition, patients who received enteral nutrition (n=794) had fewer 30-day readmissions (OR 0.73; 95% CI 0.55 – 0.96) and 90-day readmissions (OR 0.77; 95% CI 0.61 – 0.97). None of the patients (0%) in the enteral nutrition group died on a subsequent admission within 30 days of discharge, compared to 6 patients (0.8%) in the control group (p=0.027). Inpatient mortality within 90 days of discharge did not differ significantly between the two groups (0.8%, enteral nutrition vs. 1.6%, control; p=0.086). Discussion Enteral nutrition therapy among IBD inpatients with malnutrition was associated with lower odds of readmission and 30-day mortality, but not 90-day mortality. The findings of our study support the use of enteral nutrition in IBD inpatients and motivate the need for prospective studies assessing the impact of enteral nutritional support in IBD inpatients.
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Booth, M. L., E. Denney-Wilson, A. D. Okely, and L. L. Hardy. "Methods of the NSW Schools Physical Activity and Nutrition Survey (SPANS)." Journal of Science and Medicine in Sport 8, no. 3 (August 2005): 284–93. http://dx.doi.org/10.1016/s1440-2440(05)80039-8.
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Arykan, N. G., E. A. Evdokimov, V. V. Stets, V. A. Zyryanov, A. G. Zhuravlev, and A. E. Shestopalov. "Enteral nutrition in perioperative nutritional support and rehabilitation during surgical treatment of oncological diseases." Russian Medical Inquiry 5, no. 3 (2021): 137–44. http://dx.doi.org/10.32364/2587-6821-2021-5-3-137-144.
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Aim: to evaluate the efficacy of metabolic disorders perioperative correction and the completeness of providing macronutrients in cancer patients when standard and specialized sterilized mixtures for enteral nutrition are included in the nutritional support program. Patients and Methods: the analysis of the enteral nutrition clinical efficacy during the perioperative period in cancer patients using Nutrien line liquid sterilized mixtures was carried out. The treatment results of 89 patients with GIT neoplasms who were treated in the surgical department and ICU of the Main Military Clinical Hospital named after N.N. Burdenko and the F.I. Inozemtsev City Clinical Hospital were analyzed. Personalized metabolic and nutritional support was provided before and after surgery. The effectiveness of metabolic disorders correction after surgery was evaluated on the basis of specialized examination methods. Results: after preoperative nutritional support, there was a significant increase (average group values) in total protein — 67.3±1.2 g/L, albumin — 33.5±2.3 g/L, transferrin — 1.5±0.11 g/L (p<0.05), and the absolute WBC count — 969±39 109/L (p≤0.05). Group 2 showed a decrease in the number of patients with grade 2 nutritional deficiency (by 8.3±1.71%, p<0.05); group 3 — the number of patients with positive dynamics of nutritional deficiency resolution was less (by 4.5±1.1%, p<0.05). In the postoperative period, in patients with diabetes mellitus, respiratory insufficiency, purulent-septic complications, who required personalized nutritional therapy with specialized mixtures, normalization of metabolic parameters was achieved by the 7–10 days of the postoperative period, which was confirmed by normalization of biochemical parameters and a decrease in nutritive demand. Conclusion: the study results on the use of enteral nutrition mixtures in the complex of perioperative nutritional support in cancer patients showed high clinical efficacy and provided the possibility of choosing a mixture based on a specific clinical situation, taking into account a personalized nutritional support program. KEYWORDS: nutritional support, pharmaconutrients, enteral nutrition, liquid mixtures. FOR CITATION: Arykan N.G., Evdokimov E.A., Stets V.V. et al. Enteral nutrition in perioperative nutritional support and rehabilitation during surgical treatment of oncological diseases. Russian Medical Inquiry. 2021;5(3):138–144. DOI: 10.32364/2587-6821-2021-5-3-138-144.
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Emanuel, Aline, Julia Krampitz, Friederike Rosenberger, Sabine Kind, and Ingeborg Rötzer. "Nutritional Interventions in Pancreatic Cancer: A Systematic Review." Cancers 14, no. 9 (April 28, 2022): 2212. http://dx.doi.org/10.3390/cancers14092212.
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(1) Background: Pancreatic cancer (PaCa) is directly related to malnutrition, cachexia and weight loss. Nutritional interventions (NI) are used in addition to standard therapy. The aim of this systematic review is to provide an overview of the types of NI and their effects. (2) Methods: We included RCTs with at least one intervention group receiving an NI and compared them with a control group with no NI, placebo or alternative treatment on cachexia, malnutrition or weight loss in patients with PaCa. Any available literature until 12 August 2021 was searched in the Pubmed and Cochrane databases. RCTs were sorted according to NI (parenteral nutrition, enteral nutrition, dietary supplements and mixed or special forms). (3) Results: Finally, 26 studies with a total of 2720 patients were included. The potential for bias was mostly moderate to high. Parenteral nutrition is associated with a higher incidence of complications. Enteral nutrition is associated with shorter length of stay in hospital, lower rate and development of complications, positive effects on cytokine rates and lower weight loss. Dietary supplements enriched with omega-3 fatty acids lead to higher body weight and lean body mass. (4) Conclusions: Enteral nutrition and dietary supplements with omega-3 fatty acids should be preferred in nutritional therapy of PaCa patients.
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Baumgartner, Scott, Vinay Rao, Ali Khan, and Marie Borum. "P018 INTERNET DIETS: ONLINE INFORMATION REGARDING NUTRITIONAL TREATMENTS FOR IBD." Inflammatory Bowel Diseases 26, Supplement_1 (January 2020): S53—S54. http://dx.doi.org/10.1093/ibd/zaa010.135.
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Abstract Background Nutrition is a vital component in the management of IBD and can be an effective primary therapy for many patients. Certain types of diets, including the Western diet, have been speculated to be associated with increased IBD risk or exacerbations. There are currently no specific dietary recommendations for IBD risk reduction. However, online resources may offer nutritional guidance to patients seeking information. This study evaluated specific nutritional and dietary treatment information for IBD on the Internet. Methods Google search engine was used to query “nutrition and inflammatory bowel disease” to obtain the first 100 websites. Websites that were non-accessible, duplicates, videos without transcripts, or evaluated animal models were excluded. Websites were categorized as informational or academic/professional. Websites were reviewed for discussion of specific nutritional treatments, acknowledgement of areas of uncertainty and references. Statistical analysis was performed using a two-tailed Fisher’s Exact Test with a significance value set at p <0.05. Results 89 (50 informational, 39 academic) met the inclusion criteria. No websites were commercial or personal. 49 (55%) websites discussed nutrition as a treatment modality. Enteral nutrition was discussed in 38 (77.6%), probiotics in 22 (44.9%), parenteral nutrition in 21 (42.9%), elimination diet in 19 (38.8%), and low FODMAP diet in 15 (30.6%). Academic resources discussed specific nutritional therapy more often than informational resources (82.1% and 45.0%, respectively; p=0.003) (Figure 1). Academic resources acknowledged areas of uncertainty more frequently than informational resources (64.1% and 30.0%, respectively; p=0.024). Academic resources cited references significantly more often than informational resources (80.9% and 10.6%, respectively; p<0.0001). Discussion This study shows that the most commonly discussed nutritional therapy was enteral feedings (77.6%), followed by probiotics (44.9%), parenteral feeding (42.9%), elimination diet (38.8%), and the low FODMAP diet (30.6%). Academic websites discussed dietary options significantly more than informational websites. These results suggest that there is a paucity in consumer-oriented literature regarding nutrition in IBD. Academic websites are the primary online resources for information about nutrition in IBD, discuss areas of uncertainty, and offer references. As patients with IBD are increasingly utilizing the Internet for recommendations regarding disease management, it is important that both academic and informational online IBD resources provide comprehensive nutritional information to enhance patient education. Reference
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Glebova, E. S., and V. G. Amcheslavskiy. "Nutrition therapy in children with pancreatic trauma in pediatric Intensive Care Unit." Russian Journal of Pediatric Surgery 27, no. 1 (April 6, 2023): 34–40. http://dx.doi.org/10.55308/1560-9510-2023-27-1-34-40.
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Introduction. Pancreatic injury is a leading cause of acute pancreatitis in children. The prescribed conservative therapy (nutrition therapy) excludes the pancreas from the process of digestion.Purpose. The aim of the study was to find an optimal algorithm of nutrition therapy for patients with pancreatic injury in a pediatric intensive care unit.Material and methods. Nutrition therapy protocols applied in 20 children with pancreatic injury were analyzed.Results. In pancreatic injury, the enteral feeding via an intestinal tube seems to be the most preferable nutrition strategy; in case of necessity, it can be combined with parenteral nutrition. The nutrition therapy program should be designed using objective techniques for assessing energy and protein needs.Conclusion. All patients with pancreatic injury should receive the enteral feeding via an intestinal tube since the first day of their stay in the hospital.
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Schneeweiss-Gleixner, Mathias, Bernhard Scheiner, Georg Semmler, Mathias Maleczek, Daniel Laxar, Marlene Hintersteininger, Martina Hermann, et al. "Inadequate Energy Delivery Is Frequent among COVID-19 Patients Requiring ECMO Support and Associated with Increased ICU Mortality." Nutrients 15, no. 9 (April 27, 2023): 2098. http://dx.doi.org/10.3390/nu15092098.
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Background: Patients receiving extracorporeal membrane oxygenation (ECMO) support are at high risk for malnutrition. There are currently no general nutrition guidelines for coronavirus disease 2019 (COVID-19) patients during ECMO therapy. Methods: We conducted a retrospective analysis of COVID-19 patients requiring venovenous ECMO support at a large tertiary hospital center. Nutrition goals were calculated using 25 kcal/kg body weight (BW)/day. Associations between nutrition support and outcome were evaluated using Kaplan–Meier and multivariable Cox regression analyses. Results: Overall, 102 patients accounted for a total of 2344 nutrition support days during ECMO therapy. On 40.6% of these days, nutrition goals were met. Undernutrition was found in 40.8%. Mean daily calorie delivery was 73.7% of calculated requirements, mean daily protein delivery was 0.7 g/kg BW/d. Mean energy intake of ≥70% of calculated targets was associated with significantly lower ICU mortality independently of age, disease severity at ECMO start and body mass index (adjusted hazard ratio: 0.372, p = 0.007). Conclusions: Patients with a mean energy delivery of ≥70% of calculated targets during ECMO therapy had a better ICU survival compared to patients with unmet energy goals. These results indicate that adequate nutritional support needs to be a major priority in the treatment of COVID-19 patients requiring ECMO support.
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Adamina, Michel, Konstantinos Gerasimidis, Rotem Sigall-Boneh, Oded Zmora, Anthony de Buck van Overstraeten, Marjo Campmans-Kuijpers, Pierre Ellul, et al. "Perioperative Dietary Therapy in Inflammatory Bowel Disease." Journal of Crohn's and Colitis 14, no. 4 (September 24, 2019): 431–44. http://dx.doi.org/10.1093/ecco-jcc/jjz160.
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Abstract Background and Aims The incidence of inflammatory bowel disease [IBD] is rising worldwide and no cure is available. Many patients require surgery and they often present with nutritional deficiencies. Although randomised controlled trials of dietary therapy are lacking, expert IBD centres have long-established interdisciplinary care, including tailored nutritional therapy, to optimise clinical outcomes and resource utilisation. This topical review aims to share expertise and offers current practice recommendations to optimise outcomes of IBD patients who undergo surgery. Methods A consensus expert panel consisting of dietitians, surgeons, and gastroenterologists, convened by the European Crohn’s and Colitis Organisation, performed a systematic literature review. Nutritional evaluation and dietary needs, perioperative optimis ation, surgical complications, long-term needs, and special situations were critically appraised. Statements were developed using a Delphi methodology incorporating three successive rounds. Current practice positions were set when ≥80% of participants agreed on a recommendation. Results A total of 26 current practice positions were formulated which address the needs of IBD patients perioperatively and in the long term following surgery. Routine screening, perioperative optimisation by oral, enteral, or parenteral nutrition, dietary fibre, and supplements were reviewed. IBD-specific situations, including management of patients with a restorative proctocolectomy, an ostomy, strictures, or short-bowel syndrome, were addressed. Conclusions Perioperative dietary therapy improves the outcomes of IBD patients who undergo a surgical procedure. This topical review shares interdisciplinary expertise and provides guidance to optimise the outcomes of patients with Crohn’s disease and ulcerative colitis. taking advantage of contemporary nutrition science.
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Adamina, M., K. Gerasimidis, R. Sigall-Boneh, O. Zmora, A. de Buck van Overstraeten, M. Campmans-Kuijpers, P. Ellul, et al. "DOP05 Perioperative Dietary Therapy in inflammatory bowel disease." Journal of Crohn's and Colitis 14, Supplement_1 (January 2020): S044. http://dx.doi.org/10.1093/ecco-jcc/jjz203.044.
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Abstract Background The incidence of inflammatory bowel disease [IBD] is rising worldwide and no cure is available. Many patients require surgery and they often present with nutritional deficiencies. Although randomised controlled trials of dietary therapy are lacking, expert IBD centres have long-established interdisciplinary care, including tailored nutritional therapy, to optimise clinical outcomes and resource utilisation. This topical review aims to share expertise and offers current practice recommendations to optimise outcomes of IBD patients who undergo surgery. Methods A consensus expert panel consisting of dietitians, surgeons, and gastroenterologists, convened by the European Crohn’s and Colitis Organisation, performed a systematic literature review. Nutritional evaluation and dietary needs, perioperative optimisation, surgical complications, long-term needs, and special situations were critically appraised. Statements were developed using a Delphi methodology incorporating three successive rounds. Current practice positions were set when ≥80% of participants agreed on a recommendation. Results A total of 26 current practice positions were formulated which address the needs of IBD patients perioperatively and in the long term following surgery. Routine screening, perioperative optimisation by oral, enteral, or parenteral nutrition, dietary fibre, and supplements were reviewed. IBD-specific situations, including management of patients with a restorative proctocolectomy, an ostomy, strictures, or short-bowel syndrome, were addressed. Conclusion Perioperative dietary therapy improves the outcomes of IBD patients who undergo a surgical procedure. This topical review shares interdisciplinary expertise and provides guidance to optimise the outcomes of patients with Crohn’s disease and ulcerative colitis. taking advantage of contemporary nutrition science.
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Vega Díaz, Evelin Nataly, Aida Adriana Miranda Barros, Monica Alexandra Castelo Reyna, Dennys Tenelanda López, and Irvin Tubon. "Negative Outcomes Associated with Medication in Neonates on Parenteral Nutrition Therapy." Pediatric Reports 15, no. 2 (June 6, 2023): 360–72. http://dx.doi.org/10.3390/pediatric15020032.
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Objective: In Ecuador, studies on clinical daily practice problems focused on parenteral nutrition in neonates are scarce. Therefore, this research aimed to identify negative results associated with medications (NRAM) in neonates with parenteral nutrition (PN) in a third-level hospital in Ecuador. Material and methods: An observational, prospective, descriptive study was designed in the neonatology area of a tertiary-level public hospital, where, for over four months, the medical records, PN prescriptions, and pharmacy-managed databases of 78 patients were analyzed. Drug-related problems (DRPs) as possible causes of NRAM were classified through administrative, physicochemical, and clinical validation. Results: DRPs classified as follows were found: 78.81% by physicochemical, 17.62% by clinical, and 3.57% by administrative validation. The NRAM were 72% quantitatively uncertain, 16% needed, and 11% quantitatively ineffective. Conclusion: The NRAM associated with DRPs were statistically related to prematurity condition, APGAR score, PN time, and the number of medications administered, which suggests the need to create a nutritional therapy committee at the health facility.
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Pivi, Glaucia Akiko Kamikado, Paulo Henrique Ferreira Bertolucci, and Rodrigo Rizek Schultz. "Nutrition in Severe Dementia." Current Gerontology and Geriatrics Research 2012 (2012): 1–7. http://dx.doi.org/10.1155/2012/983056.
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An increasing proportion of older adults with Alzheimer's disease or other dementias are now surviving to more advanced stages of the illness. Advanced dementia is associated with feeding problems, including difficulty in swallowing and respiratory diseases. Patients become incompetent to make decisions. As a result, complex situations may arise in which physicians and families decide whether artificial nutrition and hydration (ANH) is likely to be beneficial for the patient. The objective of this paper is to present methods for evaluating the nutritional status of patients with severe dementia as well as measures for the treatment of nutritional disorders, the use of vitamin and mineral supplementation, and indications for ANH and pharmacological therapy.
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Taye, Abdi Gudeta, Dessalegn Wase Mola, and Md Hamidur Rahman. "Analyzing the Nutritional Awareness, Dietary Practices, Attitudes, and Performance of U-17 Football Players in Ethiopia." Physical Education Theory and Methodology 24, no. 1 (February 29, 2024): 110–17. http://dx.doi.org/10.17309/tmfv.2024.1.14.
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Background. Adequate nutrition knowledge is crucial for developing proper eating habits, especially among athletes, as it has a significant impact on sports performance. This underscores the consensus in sports nutrition education among professionals working with athletes. Study purpose. The study aimed to assess the nutritional knowledge, attitudes, and dietary practices of under-17 football club players in Ethiopia. Materials and methods. A descriptive survey research method was used, and standardized questionnaires were randomly distributed to 26 footballers to assess participants’ knowledge, attitudes, and dietary practices regarding nutrition. Data were analyzed using the t-test, Pearson coefficient, and one-way ANOVA (p <0.05). Reliability analysis showed a Cronbach’s alpha value of 0.83 for the scales measuring attitudes towards eating habits and nutrition knowledge (0.79 and 0.78, respectively). Results. No statistically significant differences (p >0.5) were observed in the data related to eating habits, age, or nutritional understanding. Significant variations in educational backgrounds were noted (p <0.05). Although gender and source were not recognized as correlates of nutritional knowledge, but age and education were. Conclusions. In summary, the study revealed no significant differences (p > 0.05) in nutrition knowledge scores for age, education, and source of information. However, a significant difference (p<0.05) was found between male and female athletes. Gender correlated with dietary habits, while age, education, and source of information did not. The key factor is to encourage ongoing future vision within sports organizations, nutritionists, and educational institutions to continuously refine and enhance nutrition knowledge, attitudes, and practice programs for U-17 players. It is also important to ensure sustainable relevance and effectiveness in the evolving landscape of sports and nutrition.
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Ribeiro, Amanda Coelho, Diana Borges Dock-Nascimento, João Manoel Silva Jr., Cervantes Caporossi, and José Eduardo de Aguilar-Nascimento. "Hypophosphatemia and risk of refeeding syndrome in critically ill patients before and after nutritional therapy." Revista da Associação Médica Brasileira 66, no. 9 (September 2020): 1241–46. http://dx.doi.org/10.1590/1806-9282.66.9.1241.
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Summary OBJECTIVE: To investigate the prevalence of hypophosphatemia as a marker of refeeding syndrome (RFS) before and after the start of nutritional therapy (NT) in critically ill patients. METHODS: Retrospective cohort study including 917 adult patients admitted at the intensive care unit (ICU) of a tertiary hospital in Cuiabá-MT/Brasil. We assessed the frequency of hypophosphatemia (phosphorus <2.5mg/dl) as a risk marker for RFS. Serum phosphorus levels were measured and compared at admission (P1) and after the start of NT (P2). RESULTS: We observed a significant increase (36.3%) of hypophosphatemia and, consequently, a greater risk of RFS from P1 to P2 (25.6 vs 34.9%; p<0.001). After the start of NT, malnourished patients had a greater fall of serum phosphorus. Patients receiving NT had an approximately 1.5 times greater risk of developing RFS (OR= 1.44 95%CI 1.10-1,89; p= 0.01) when compared to those who received an oral diet. Parenteral nutrition was more associated with hypophosphatemia than either enteral nutrition (p=0,001) or parenteral nutrition supplemented with enteral nutrition (p=0,002). CONCLUSION: The frequency of critically ill patients with hypophosphatemia and at risk for RFS on admission is high and this risk increases after the start of NT, especially in malnourished patients and those receiving parenteral nutrition.
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Osowiecka, Karolina, Damian Skrypnik, and Joanna Myszkowska-Ryciak. "Assessment of the Impact of Nutritional Intervention with the Probiotic Lactiplantibacillus plantarum 299v on Nutritional Status and Quality of Life of Hashimoto’s Thyroiditis Patients—A Randomized Double-Blind Study Protocol." Journal of Personalized Medicine 13, no. 12 (November 28, 2023): 1659. http://dx.doi.org/10.3390/jpm13121659.
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The current treatment for the autoimmune disease of hypothyroidism (AIDH) is based on pharmacotherapy with levothyroxine. A non-pharmacological supplementary element of therapy could be the implementation of an individualized balanced diet and probiotics. Lactiplantibacillus plantarum 299v (Lp299v), with its anti-inflammatory effects, may also support the therapy. However, the number of studies on personalized dietary interventions with probiotics in AIDH is limited, and no clear conclusions can be drawn from the results so far. Therefore, this trial will analyze the effect of Lp299v supplementation in conjunction with nutrition education on the quality of life and nutritional status of patients with Hashimoto’s. Methods: This double-blind, 12-week intervention study will include 100 female patients with AIDH. They will be divided into two groups: (1) individual personalized nutrition education + Lp299v and (2) individual personalized nutrition education + placebo. Before and after the education intervention, selected elements in the diet, eating behavior, quality of life, nutritional status (anthropometric parameters, body composition), blood pressure, and anti-TPO (antibodies against thyroid peroxidase) titer will be assessed. Hypothesis: It is expected that this study will provide deeper knowledge on the validity of using proper nutritional principles and Lp299v in AIDH. Specifically, the impact on the subjective assessment of the quality of life, selected elements in the diet, and the state of nutrition and health will be assessed.
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GABRIEL, Beatriz Diniz, Cristiano Tulio ALBUQUERQUE, Marcella Lobato Dias CONSOLI, Patrícia Amaral Fulgêncio da Cunha MENEZES, and Janice Sepúlveda REIS. "Training adolescents with type 1 diabetes to carbohydrate counting without parents' help." Revista de Nutrição 29, no. 1 (February 2016): 77–84. http://dx.doi.org/10.1590/1678-98652016000100008.
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ABSTRACT Objective: To develop and evaluate the effectiveness of a nutrition education program to enable adolescents with type 1 diabetes to count carbohydrates without the parents' help. Methods: Nineteen adolescents with type 1 diabetes from a diabetes center participated in four fortnightly meetings of one hour, with lectures and discussions about healthy nutrition, importance of nutrients for blood glucose, portion sizes, food replacements, and carbohydrate counting therapy. All meetings ended with exercises to check the learning. Adolescents were followed for one year after the intervention. Results: All participants were 100% successful in all the steps of the program and started carbohydrate counting in the main meals. Nutritional status and total daily insulin doses before and after the study did not differ. After 12 months, 68% of the adolescents counted carbohydrates at all times, 16% did so in extra snacks, and 16% were suspended from the new therapy. Eighty percent of the parents were satisfied with the program, believing teenagers were trained in the new therapy. Conclusion: A short nutrition education program successfully trained adolescents to count carbohydrates without the parents' help.
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Aldubayan, Khalid, Alhanouf S. Alsamani, Alanoud Aladel, and Yara Almuhtadi. "Physicians’ Knowledge of Clinical Nutrition Discipline in Riyadh Saudi Arabia." Healthcare 9, no. 12 (December 13, 2021): 1721. http://dx.doi.org/10.3390/healthcare9121721.
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Background: Nutrition plays a major role in the prevention and management of diet-related disease. With the absence of clinical nutrition dietitians, physicians are considered responsible for prescribing nutritional support. Identifying weaknesses in nutritional knowledge among Saudi physicians may provide guidance to improve their nutritional knowledge. Methods: A cross-sectional study that used an anonymous electronic questionnaire to investigate physicians’ knowledge of the clinical nutrition discipline. In addition to demographics, the questionnaire consisted of 15 questions covering six areas in the clinical nutrition discipline (macro- and micronutrients, nutrition and chronic diseases, nutrition and metabolic diseases, nutrition care process, nutrition support therapy, and research). For continuous variables, independent t-tests and one-way ANOVA were used. Results: A total of 332 had completed the questionnaire and were included in the study. Most of the physicians were Saudi (87%), male (73.5%), aged between 26 and 35 years (63.3%), and without health problems (56.3%). The mean score of the physicians’ knowledge was 5.3 ± 1.97 out of 15. Physicians who reported that they received some sort of nutritional training or course (M = 5.57, SD = 2.08) scored significantly more than physicians who did not (M = 5.10, SD = 1.86); t(330) = −2.174, p = 0.30. Conclusions: Nutrition should be reinforced as an important component of continuing medical education. There is a need for hiring more dietitians in health care settings in Saudi Arabia as an integral part of a multidisciplinary team delivering medical care services.
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laavanya, Sai, and Silambu selvi Kumbamoorthy. "A Comprehensive Analysis of Sports Nutrition Knowledge and Diet Diversity Among South Indian Athletes." Physical rehabilitation and recreational health technologies 9, no. 2 (March 30, 2024): 52–60. http://dx.doi.org/10.15391/prrht.2024-9(2).02.
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Purpose. Athletes can benefit greatly from having knowledge about sports nutrition. However, there are limited studies on athletes' nutritional knowledge and dietary habits in South India. This study aims to assess the athletes' sports nutrition knowledge, analyse their dietary practices and attitudes, and the dietary diversity score. Material & Methods. A descriptive cross sectional study was conducted in selected areas of Chengalpattu district in Tamil Nadu. Eighty-five athletes aged 10-18 training in different sports academies were interviewed individually using a validated questionnaire to analyse their sports nutrition knowledge, attitude and dietary practices. Results. The results showed that only 4.7% of the athletes had adequate nutritional knowledge of over 60%. The mean overall knowledge score was 40.2%, with athletes being most knowledgeable about protein and its sources (mean score of 67.9%), but less aware of carbohydrate and fat sources and recommendations (mean score of 15.08% and 14.01%, respectively). The mean score for attitude and dietary practices were 64.4 and 59.5 respectively. A strong and positive correlation was found between the level of nutritional knowledge and attitude (p=0.0001). Additionally, we found that the occupation of parents and the monthly income of the family were significantly associated with the athletes' nutritional knowledge. Majority of athletes (74.1%) of the athletes had an adequate dietary diversity score (DDS) of ≥ 5, and 25.9% of the athletes had a DDS of ≤ 4. Conclusions. Nutritional educational interventions at the grass root level can potentially improve athletes' knowledge, dietary practices and sports performance in the future. It is crucial to identify and address knowledge gaps, and use technology to monitor and motivate athletes towards consistency in implementing their knowledge.
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Kazzi, Marcel, Jan Bieniasz, Konrad Dendys, Michał Puła, and Marta Wychota. "Role of nutrition management in the treatment of acute pancreatitis – comprehensive review." Journal of Education, Health and Sport 17, no. 1 (September 10, 2023): 242–54. http://dx.doi.org/10.12775/jehs.2023.17.01.020.
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Introduction and purpose
The treatment of acute pancreatitis remains a clinically significant problem worldwide, as well as in Poland, where the incidence of the condition is nearly twice as high as in the global population. The aim of this study is to present the latest available guidelines regarding conservative management of patients diagnosed with acute pancreatitis, focusing on nutritional management and treatment methods.
Materials and methods:
The literature available in PubMed, Scopus, Google Scholar databases, and guidelines from the European Society for Clinical Nutrition and Metabolism (ESPEN) was reviewed using the following keywords: "acute pancreatitis," "AP treatment," "nutritional treatment of acute pancreatitis," "enteral nutrition," "parenteral nutrition."
Description of the state of knowledge:
The approach to conservative treatment for acute pancreatitis has evolved over the years. Previously, the preferred route of feeding was parenteral with limited lipid content, aimed at reducing the stress on the pancreas. Current guidelines emphasize the superiority of enteral nutrition using a complete nutritional composition.
Conclusions:
The latest guidelines highlight the advantage of enteral nutrition over parenteral nutrition, with implementation within 48 hours of diagnosis. This approach reduces mortality, the risk of complications, and the duration of hospital stay for patients. The appropriate caloric intake should be adjusted to the individual needs of the patient, considering the severity of the disease and coexisting conditions. Meeting the patient's energy requirements, along with the choice of administration method and precise composition of nutritional formulas, play a crucial role in therapy.
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Kim, Nahan, Kwang-Seok Hong, and In-Kyung Jung. "Nutrition Quotient and Dietary Self-efficacy according to the Transtheoretical Model in Adolescent Athletes." Exercise Science 31, no. 4 (November 30, 2022): 499–510. http://dx.doi.org/10.15857/ksep.2022.00416.
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PURPOSE: This study aimed to explore the direction of nutrition management and education for adolescent athletes based on the transtheoretical model (TTM).METHODS: This cross-sectional study was conducted on 205 male adolescent athletes using questionnaires in Seoul and Gyeonggi provinces. Differences in nutritional indices, dietary behaviors, and dietary self-efficacies were compared according to the stage of dietary behavior change, and significance was verified using analysis of variance and chi-square tests.RESULTS: According to the stage of change in dietary behavior, a significant difference was observed in the grade and score of the nutrition quotient (NQ), and the nutritional status and quality of meals were extremely poor in the precontemplation and contemplation groups. Dietary self-efficacy differed significantly according to the stage of change in dietary behavior. Compared to the pre-contemplation and contemplation stage groups, the action and maintenance stage groups had a higher willingness to practice desirable dietary behaviors and overcome barriers.CONCLUSIONS: In this study, we demonstrated that individualized nutritional intervention based on TTM was an effective strategy for healthy dietary behavior and had a positive impact on adolescent athletes’ sports performance. Furthermore, nutrition education should include content that enhances students’ dietary self-efficacy.
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Tsuei, Betty J., Timothy M. Clifford, Barbara L. Magnuson, and Paul A. Kearney. "The Open Abdomen: Enteral Access Results in Cost Savings." Hospital Pharmacy 40, no. 3 (March 2005): 240–46. http://dx.doi.org/10.1177/001857870504000307.
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Purpose To evaluate the cost savings of using enteral access for drug and nutrition delivery in patients requiring open peritoneal cavity management (laparosotomy). Methods A review of 14 patients who required laparostomy and received at least 4 consecutive days of enteral nutrition treated at our tertiary care facility between January 1999 and May 2001. Data collected included age, sex, reason for laparostomy, enteral formulation, medications, and side effects (diarrhea and gastric reflux). Cost savings were calculated as the difference between the cost of intravenous (IV) and enteral nutritional formulation and drug dosage costs. Results Patients were fed via nasojejunal feeding tube. Average duration of enteral nutrition (EN) was 19.1 ± 12.3 days. Gastric reflux and diarrhea occurred in five (36%) and six (42%) patients, respectively. These were easily treated and did not require conversion to IV nutrition or medications. Drug and electrolyte levels were therapeutic at appropriate enteral doses. A total of 267 days of EN were utilized in these 14 patients. The cost difference between the parenteral nutrition that would have been used during that time and the actual enteral formula utilized was $25,373. The use of enteral rather than IV medications also resulted in a cost savings of $7,058. Thus, the combined cost savings of enteral medication and nutrition therapy for the 14 patients was $32,431. Conclusion EN and drug therapy can be utilized in patients requiring open peritoneal cavity management. The resultant cost savings can be substantial, and these methods of cost reduction can also be applied to other patients.
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Jain, Kapila, and Vibha Bhatnagar. "Impact of Dietary Module on Nutritional Knowledge and Consumption Pattern of Type 2 Diabetic Patients at Risk of Cardiac Diseases." Indian Journal of Nutrition and Dietetics 53, no. 4 (December 1, 2016): 433. http://dx.doi.org/10.21048/ijnd.2016.53.4.8401.
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As diabetes is a disease which continues for a lifetime, the proper therapy methods should be applied in order to control the disease, remove or relief the symptoms, prevent and delay the complications. Patients have a major role in the control and treatment of T2DM. So knowledge of different aspects of this disease especially diet therapy is very important for these patients. The aim of the study was to determine the effect of nutrition education on diabetic patient's nutritional knowledge and food consumption habits. To provide nutrition education, an evaluated dietary module with the help of 16 panel members was developed. Further in this study, diabetic subjects were divided into two groups, experimental (50 subjects) and control (50 subjects). Nutrition education with the help of module was provided to the experimental group and not to the control group. In order to determine the nutritional knowledge, 30 questions related to general facts and management information about disease were presented to the patients. "24 hour recall method" for three consecutive days was used to determine the food intake. Further daily intake of energy and other nutrients were determined using computer software. At the end of nutrition education, significant differences were detected in experimental group regarding nutritional knowledge, dietary and nutrient intake and a higher percentage change was also observed in experimental group as compared to control group. The efficacy of the dietary module in improving nutritional knowledge, dietary intake was confirmed in the present study because obtained results indicated that education was effective in changing their consumption habits.
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Kadim, Muzal, and William Cheng. "The role of nutrition and pancreatic enzyme replacement therapy in children with cystic fibrosis." World Nutrition Journal 4, no. 2 (August 27, 2021): 84–93. http://dx.doi.org/10.25220/wnj.v04.i2.0011.
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Background Cystic fibrosis (CF) is an inherited genetic disorder with high mortality and morbidity. CF is strongly correlated with malnutrition due to higher energy losses, pancreatic insufficiency, chronic inflammation, higher resting energy expenditure, and feeding problems. Malnutrition in CF patients associated with worse survival. Thus, appropriate and prompt nutritional intervention should be addressed to reduced malnutrition in CF patients.
Methods The literature search was performed on 9 August 2021 in four major databases such as MEDLINE, EBSCOhost, Cochrane Reviews, and Web of Sciences to find the role of nutrition and pancreatic enzyme replacement therapy in pediatrics population with cystic fibrosis.
Recent findings In recent decades, early nutritional management and pancreatic enzyme replacement therapy (PERT) have been shown to improve CF patient’s outcomes. Nutrition should be given in higher calories compared to healthy individuals with close and regular nutritional status monitoring. High protein and fat diets are essential for CF patient’s overall survival. Adequate level of micronutrients should be ensured to avoid morbidity caused by micronutrients deficiency. Regular pancreatic insufficiency screening should be done annually in order to start PERT early. Further research focusing on body composition, growth chart, protein intake, and PERT are needed to further improve the management of CF patient.
Conclusion Nutritional intervention and PERT play an important role in prolonging CF patient survival. Both treatments should be initiated early with nutritional status close monitoring and tailored to each individual. Collaboration with parents and children is critical to warrant that CF patients followed the dietary advice.
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Heyland, Daren, Luis A. Ortiz, Alexis F. Turgeon, Lucy Wibbenmeyer, Jonathan Pollack, Samuel P. Mandell, Niknam Eshraghi, and Andrew G. Day. "88 Validation of the Modified NUTrition Risk Score (mNUTRIC) in Burn Victims: Evidence from a Multi-centre, Multi-national, Double-blind, Controlled Randomized Clinical Trial." Journal of Burn Care & Research 41, Supplement_1 (March 2020): S58—S59. http://dx.doi.org/10.1093/jbcr/iraa024.092.
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Abstract Introduction Nutrition is an essential therapy in burn victims. However, whether nutrition therapy provide benefits equally to all burn victims is unknown. The NUTRIC score identifies patients who may not benefit more from aggressive nutrition therapy (score < 5) and those who may benefit more from aggressive nutrition (High score ≥ 5). It can be estimated from age, SOFA, APACHE scores, comorbidities, and IL-6. If the latter is not available, the modified NUTRIC score (mNUTRIC) can be computed. The mNUTRIC score has been validated in ICU settings. In burn victims, the association between mNUTRIC score, nutritional intake, and clinical outcomes is unknown. We hypothesize that a higher mNUTRIC score will be associated with worst clinical outcomes and that greater nutritional adequacy will be associated with better clinical outcomes in nutritionally high-risk burn victims. Methods In the context of a double-blind, placebo-active, multi-centre RCT of adult burn patients, we evaluated the association between mNUTRIC score, nutritional adequacy, and clinical outcomes. Patients with deep second and/or third-degree burns with a total body surface area percentage (TBSA%) ≥10 were enrolled in the RCT. Patients demographics, type of burn, %TBSA, nutrition intake, hospital length of stay (LOS), Burn Unit (BU) LOS, and hospital mortality were collected. The nutritional adequacy was calculated from all sources, except intravenous glucose and oral intake. Descriptive and inferential analyses for quantitative data were performed. Results Six hundred and sixty patients were included. The majority were Caucasian (78%) males (74%) with a BMI between 25–35 (53%), median age of 50 ±18 years and severely ill (Apache Score II; 14 ±8, SOFA score; 2.9 ±3). The most common type of burn was fire (87%), with %TBSA of 31 ±16, Table 1. EN alone was provided to 79% of the patients and the daily average energy and protein adequacy was 73% and 76%, accordingly. Table 2. Compared to low mNUTRIC, the high mNUTRIC group had less ventilator free days (11 [6–19] vs. 28 [11–28] days), worse survival (52% vs. 9.5%), and longer hospital LOS (181 [81–181] vs. 34 [20–68] days), Table 3. Compared to the low mNUTRIC, the high mNUTRIC group had better clinical outcomes with increasing energy (by 20% of goal), interaction for energy, mNUTRIC, and mortality was p=0.11 and for time-discharge-alive was < p=0.0001. Similarly, more protein tended towards better outcomes in the high mNUTRIC group but not the low NUTRIC group (interaction for protein, mNUTRIC, mortality was p=0.20; time-to-discharge alive was p=0.08, Table 4. Conclusions A high mNUTRIC score identifies high risk burn victims and may identify those who may benefit more from an aggressive nutrition therapy. Applicability of Research to Practice Nutrition therapy in burns can be more efficient.
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Welian-Polus, Iwona, Michał Leśniewski, Karolina Maliszewska, Izabela Oleksak, Joanna Ziółkowska, Bartosz Mazur, Karolina Gendek, Mikołaj Smach, Magdalena Mazur, and Wiktoria Wilanowska. "Role of nutrition in cerebral palsy treatment – comprehensive literature review." Journal of Education, Health and Sport 70 (May 20, 2024): 49419. http://dx.doi.org/10.12775/jehs.2024.70.49419.
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Introduction and purpose: A collection of symptoms known as cerebral palsy first manifest in early childhood and result in profound physical impairment. Cerebral palsy is thought to affect 1 in 500 live births, or roughly 17 million people worldwide. The type of cerebral palsy determines the clinical symptoms. Movement coordination disorders, epilepsy, muscle weakness, and feeding difficulties are the most common symptoms. The purpose of this article is to familiarize readers with the options for nutritional therapy for cerebral palsy patients. Material and methods The following review was based on articles from the PubMed and Google Scholar databases. Key search terms included cerebral palsy; nutrition; treatment; gut microbiota.. State of knowledge Early identification of malnutrition symptoms and appropriate interventions, such as the implantation of a percutaneous endoscopic gastrostomy tube in patients who are unable to swallow food, are the cornerstones of nutritional therapy for cerebral palsy patients. Dysphagia is a major problem in the population of patients with cerebral palsy, and multidisciplinary therapy is necessary for them. Patients' serum vitamin D levels are also influenced by their diet; 50% of those with cerebral palsy have a deficiency in this nutrient. Conclusions For people with cerebral palsy, nutrition is very important. Premature death may arise from malnutrition brought on by the disease's advancement. As a result, individuals with cerebral palsy need to receive specialized care
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Mangiwa, Ingrid, and Agussalim Bukhari. "Postoperative Medical Nutrition Therapy in Patient With Ascending Colon Adenocarcinoma With Severe Malnutrition: A Case Report." Current Developments in Nutrition 6, Supplement_1 (June 2022): 748. http://dx.doi.org/10.1093/cdn/nzac062.017.
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Abstract Objectives Colorectal cancer is one of the cancers with the highest cause of death in the world. Indonesia as a developing country is also reported an increased incidence of colorectal cancer together with the increase in the economy, industrialization, and westernization lifestyle. Due to the inflammatory process, colorectal cancer patients are in a hypermetabolic state leading to increased nutritional requirements and failure to meet these requirements will result in malnutrition. Colorectal cancer with severe malnutrition requires special nutrition therapy, tailored to each patient based on their nutritional status and clinical condition. Methods A 36 year old male patient with severe malnutrition (subjective global assessment score C) diagnosed with post exploratory laparotomy, adhesiolysis, segmentectomy, end ileostomy due to adenocarcinoma of the ascending colon. Oral intake is decreased due to loss of appetite and abdominal pain. The patient shows pallor conjunctiva, loss of subcutaneous fat, and wasting of the extremities. Laboratory findings were anemia (10.4 g/dL), leukocytosis (20,100 mm3), total lymphocyte count (582.9/µL), hypoalbuminemia (1.8 gr/dL), hyponatremia (132 mmol/L), elevated enzymes transaminases (SGOT 232 U/L, SGPT 88 U/L). Results Medical nutrition therapy was initially given 450 kcal and gradually increased to 2300 kcal, protein 1–1.8 g/kilogram ideal body weight/day using a high protein formula and Branched Chain Amino Acid (BCAA) parenteral nutrition. We administered supplementations which were zinc, vitamin A, B, C, D, curcuma, and snakehead fish extract. The patient was discharged after 12 days with clinical and functional improvement assessed with handgrip strength dynamometer from 11.4 to 16.3 kg. Laboratory improvement were leukocytes 10,000 mm3, total lymphocyte count 1,310/µL, albumin 2.7 gr/dL, sodium 133 mmo/L, SGOT 40 U/L, SGPT 31 U/L. Conclusions Malnourished colorectal cancer patient had a higher risk of poor clinical outcome. Specific nutritional therapy is needed to reduce inflammation or hypermetabolic, and to treat postoperative complications, proper monitoring and nutritional education results in a good outcome for patient. Funding Sources Institutions from Department of Nutrition, Faculty of Medicine, Hasanuddin University.