JPEN. Journal of Parenteral and Enteral Nutrition

BACKGROUND: The aim of this study was to build and validate a risk prediction model for diarrhea in ICU patients with the enteral nutrition by identifying risk factors for diarrhea in ICU patients with the enteral nutrition. METHODS: The risk factors for diarrhea was analyzed to build a prediction model for enteral nutrition diarrhea in ICU patients based on the data collection of 302 ICU patients with the enteral nutrition. Subsequently, the model was validated by the area under the curve (AUC)...

Surgery and traumatic injury set off a cascade of metabolic changes that are becoming better understood. Recently, strategies and protocols have been developed for optimizing outcomes, and this has yielded beneficial results. This brief review evaluates three specific nutrition or metabolic interventions in the postoperative setting that attempt to optimize outcomes. We limited this to three subspecialty areas including oncologic surgery, orthopedic surgery, and cardiac surgery. These agents included fish oils, factors to prevent dysbiosis, and resistance exercise and its role in enhancing protein update...

BACKGROUND: We aimed to evaluate costs from transplant to discharge in children who had undergone intestine transplant. METHODS: We performed a cross-sectional observational study of pediatric intestine transplant recipients from 2004 through 2020 utilizing the Pediatric Health Information System® database. Standardized costs were applied to all charges and converted to 2021 US Dollars. We analyzed the association of cost from transplant to discharge with age, sex, race/ethnicity, length of stay, insurance type, transplant year, short bowel syndrome diagnosis, liver-containing graft, hospitalization status, and immunosuppressive regimen...

AIMS: This study aimed to assess the effect of zinc supplementation with or without other antioxidants and trace elements on clinical outcomes in patients with trauma. METHODS: A systematic review was conducted for adult patients with acute trauma who had been admitted to the hospital. Those who sustained burn injuries were excluded. Studies in PubMed, Web of Science, and Embase from 1990 to 2022 regarding the additional nutritional supplementation of zinc to patients, either in a single-agent or combined regimen, were included...

BACKGROUND: Cardiac surgery patients with prolonged stay in the intensive care unit (ICU) are at high-risk for acquired malnutrition. Medical nutrition therapy practices in cardiac surgery patients are unknown. The objective of this study is to describe current nutrition practices in critically ill cardiac surgery patients worldwide. METHODS: We conducted a prospective observational study in 13 international ICUs involving mechanically ventilated cardiac surgery patients with an ICU stay of at least 72 hours...

BACKGROUND: With data demonstrating benefit, the prevalence of Home Enteral Nutrition (HEN) has increased significantly over the last few decades. Despite this increase, there remains a paucity of data regarding real-world use of HEN including clinical outcomes and complications. METHODS: Descriptive analysis of the prospectively maintained database of our specialized HEN program was undertaken. Patients who received care in our program with HEN initiation date between January 1st, 2018, and December 31st, 2020, were included in the analysis...

Nutrition training is an essential part of the gastroenterology fellowship. We describe a method developed to guide physicians to perform a comprehensive, concise, and time-effective review of parenteral nutrition compositions. This article is protected by copyright. All rights reserved.

UNLABELLED:  : Patients with gastroparesis (Gp) not meeting nutritional needs orally, may need enteral nutrition (EN) or total parenteral nutrition (TPN). Among patients with gastroparesis, we aimed to: 1) Identify the frequency of EN and TPN use; and 2) Explore characteristics of patients with EN/TPN to those using oral nutrition (ON) including changes over 48 weeks. METHODS: Gp patients enrolled in NIDDK Gastroparesis Registries underwent history and physical examination, gastric emptying scintigraphy (GES), water load satiety testing (WLST), and questionnaires assessing gastrointestinal symptoms, and both general and Gp-related quality of life (QOL)...

UNLABELLED: Eicosapentaenoic (EPA) and docosahexaenoic (DHA) acids, naturally abundant in fish oil (FO), are known for their anti-inflammatory and potential antioxidant properties. AIM: To evaluate the effect of the infusion of a fish oil-containing parenteral lipid emulsion (FOLE) on markers of liver lipid peroxidation and oxidative stress in rats undergoing central venous catheterization (CVC). METHOD: After 5 days acclimatization, adult Lewis rats (n=42) receiving 20g/day AIN-93M oral diet were randomly subdivided into 4 groups: 1) Basal control (BC) (n=6): without CVC or LE infusion; 2) SHAM (n=12): with CVC, but without LE infusion; 3) SO/MCT (n=12): with CVC and receiving LE without FO (4...

A diet that is low in fermentable This article is protected by copyright. All rights reserved.

BACKGROUND: Drug administration through feeding tubes presents many challenges to the healthcare provider. There is little information available on medications than can be delivered safely when crushed and what efforts can be implemented to minimize clogging the feeding tube. Our institution requested a comprehensive examination of all oral medications for the feeding tube route. MATERIALS AND METHODS: This report is a synopsis of the physical evaluation of 323 different oral medications for their appropriateness for feeding tube administration with distal site in either the stomach or jejunum...

OBJECTIVE: Infants receiving parenteral nutrition (PN) are at increased risk of PN associated liver disease (PNALD), which can lead to hepatic fibrosis. While congenital heart disease (CHD) represents a risk factor for hepatic fibrosis, this study sought to better understand if infants with CHD were at elevated risk of PNALD when receiving long-term PN. STUDY DESIGN: A retrospective cohort of infants at a Level IV NICU from 2010 to 2020 who received long-term PN during the first 8 weeks of life...

BACKGROUND: Intestinal failure associated liver disease (IFALD) occurs in up to 50% of neonates treated with prolonged parenteral nutrition. Preventative strategies for IFALD include soybean-oil lipid emulsion (SOLE) minimization and use of mixed-oil intravenous lipid emulsions (ILE). We conducted a pilot study prospectively comparing these two ILE strategies in the prevention of IFALD in neonates who required abdominal surgery. METHODS: We randomized eligible neonates to SOLE at 1 g/kg/day (SOLE Min) or mixed-oil ILE containing fish oil (MOLE) at 3 g/kg/day...

OBJECTIVE: We aimed to describe enteral nutrition (EN) delivery in patients receiving post-pyloric EN (PPEN) versus gastric EN (GEN). METHODS: Single-center, retrospective study including patients <21 years of age, admitted to an ICU in a pediatric quaternary care hospital for ≧48 hours and who received PPEN or GEN as a first approach, as guided by a nutrition algorithm. PPEN patients were 1:1 propensity-score matched to GEN patients for demographics, clinical characteristics, and disease severity...

BACKGROUND: Skeletal muscle wasting is a determinant of physical disability in survivors of critical illness. Intramuscular bioenergetic failure, altered substrate metabolim, and inflammation are likely underpinning mechanisms. We examined the effect of pioglitazone, a peroxisome proliferator-activated receptor γ agonist, on muscle-related outcomes in adults. METHODS: We included randomized controlled trials in which pioglitazone was administered (no dose/dosage restrictions) and muscle-related outcomes were reported...

BACKGROUND: Most data on anemia in children with intestinal failure (IF) have been obtained from studies in which the data were collected at a single point in time. We aimed to identify the frequency of anemia and factors associated with hemoglobin levels in children with IF during their course of home parenteral nutrition. METHODS: This prospective cohort study included patients with IF followed up at a pediatric intestinal rehabilitation center. Outcome variables were hemoglobin levels and prevalence of anemia during the follow-up period...

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BACKGROUND: Considering that the validation of the Global Leadership Initiative on Malnutrition (GLIM) remains unclear in patients with colorectal cancer, the present study aimed to assess the agreement, accuracy, sensitivity, specificity, and the prognostic effect of the GLIM on survival when compared with the patient-generated subjective global assessment (PG-SGA). METHODS: Patients with colorectal cancer who were scheduled to undergo a routine abdominal computed tomography (CT) scan were recruited...

BACKGROUND: Refeeding syndrome (RS) is a condition characterized by electrolyte derangements, thiamine deficiency, and organ dysfunction following provision of nutrition to an individual who had been deprived of nutrients. Published guidelines outlining the recognition and definition of RS exist in adult and children, but there are limited newborn-specific guidelines due to a paucity of available literature and variation in reporting. CASE: We describe a small for gestational age, full-term newborn with neonatal encephalopathy who underwent therapeutic hypothermia...

The time couldn't be riper for the field of nutrition as it moves into the forefront being recognized as a major influencer in the prevention and management of many diseases. The approach to nutrition support therapy, which includes oral diet and enteral and parenteral nutrition, has historically involved approaching patients in the same "one size fits all" manner. However, as research methodologies have advanced over the past decade, data suggest that although people may be grouped into having a particular disease or condition, their nutritional therapeutic intervention may be optimized if it is personalized...