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JPEN. Journal of Parenteral and Enteral Nutrition

(no author information available yet)
Mundi MS, Nystrom EM, Hurley DL, McMahon MM. Management of parenteral nutrition in hospitalized adult patients [published online September 1, 2016]. JPEN J Parenter Enteral Nutr. (Original DOI: 10.1177/0148607116667060).
October 13, 2016: JPEN. Journal of Parenteral and Enteral Nutrition
David F Driscoll
The first clinically successful lipid injectable emulsion was marketed in 1961, consisting of soybean oil triglycerides in sterile water for injection. Since that time, numerous products have entered the market, with the main difference being changes in the oil composition with triglycerides of plant and marine oil origin. With this change, the fatty acid profiles are unique, coming from medium- and long-chain triglycerides. The fatty acids can be saturated or unsaturated, having different pharmaceutical and metabolic activities that affect the safety and efficacy of these unique pharmaceutical dosage forms...
October 13, 2016: JPEN. Journal of Parenteral and Enteral Nutrition
Pilar Anton-Martin, Michael Papacostas, Elisabeth Lee, Paul A Nakonezny, Michael L Green
BACKGROUND: Malnutrition is associated with an increased risk of mortality in patients admitted to the intensive care unit. Children requiring extracorporeal membrane oxygenation (ECMO) support represent an extremely ill subset of this population. There is a lack of data on the impact of nutrition state on survival in this cohort. We examined the association between being underweight and in-hospital mortality among children supported with ECMO. MATERIALS AND METHODS: This article reports on an observational retrospective cohort study performed among neonatal and pediatric patients supported with ECMO in a tertiary children's hospital from May 1996 through June 2013...
October 13, 2016: JPEN. Journal of Parenteral and Enteral Nutrition
Amber Smith, Mary Beth Feuling, Catherine Larson-Nath, Catherine Karls, Megan Van Hoorn, Cassandra L S Walia, Carly Leon, Elaine Danner, Pam Opichka, Lori Duesing, Alfonso Martinez, Praveen S Goday
BACKGROUND: The primary hypothesis of this article is that a team approach in creating a protocolized laboratory monitoring schedule for home parenteral nutrition (PN) patients improves patient safety by decreasing the occurrence of nutrition deficiencies and is cost-effective. METHODS: In this prospective cohort study of home PN patients, each patient followed an established protocol of laboratory monitoring and weekly review by an interdisciplinary team of dietitians, nurses, and physicians...
October 11, 2016: JPEN. Journal of Parenteral and Enteral Nutrition
Derek Fleming, Jennifer Kesey, Kendra Rumbaugh, Sharmila Dissanaike
BACKGROUND: Probiotics are widely used in healthy and nonhealthy individuals to maintain a favorable gut microbiome and inhibit pathogen takeover. Currently, there are many varieties of probiotic delivery vehicles on the market, with no real research indicating which is the most effective at allowing for colon colonization. In this study, we sought to determine if probiotic preparation influences the ability of Lactobacillus species, one of the most common genera of probiotic bacteria, to survive gastric acidity...
September 29, 2016: JPEN. Journal of Parenteral and Enteral Nutrition
Kathleen M Gura, Andrew E Mulberg, Paul D Mitchell, John Yap, Clara Y Kim, Minjun Chen, Alexis Potemkin, Mark Puder
BACKGROUND: Intestinal failure-associated liver disease (IFALD) is complex and diagnosed by concurrent use of parenteral nutrition, clinical presentation, and alterations in hepatic biomarkers exclusive of other causes of liver disease. In comparison with individual measures, composite biomarkers may provide a more effective means for assessing disease progression and response to treatment than single parameters. Since IFALD is considered by some to be a type of drug-induced liver injury (DILI), those diagnostic criteria could potentially be used in this population...
September 28, 2016: JPEN. Journal of Parenteral and Enteral Nutrition
Adam J Kuchnia, Levi M Teigen, Abigail J Cole, Urvashi Mulasi, M Cristina Gonzalez, Steven B Heymsfield, David M Vock, Carrie P Earthman
BACKGROUND: Raw bioimpedance parameters (eg, 50-kHz phase angle [PA] and 200-kHz/5-kHz impedance ratio [IR]) have been investigated as predictors of nutrition status and/or clinical outcomes. However, their validity as prognostic measures depends on the availability of appropriate reference data. Using a large and ethnically diverse data set, we aimed to determine if ethnicity influences these measures and provide expanded bioimpedance reference data for the U.S. POPULATION: HASH(0x3fe0c78) METHODS: The National Health and Nutrition Examination Survey (NHANES) is an ongoing compilation of studies conducted by the U...
September 26, 2016: JPEN. Journal of Parenteral and Enteral Nutrition
David W Lim, Abdoulaye Diané, Mitsuru Muto, Donna F Vine, Patrick N Nation, Pamela R Wizzard, David L Sigalet, David L Bigam, Paul B Pencharz, Justine M Turner, Paul W Wales
BACKGROUND: We aim to study the efficacy of exogenously administered glucagon-like peptide 2 (GLP-2) on intestinal adaptation in 2 preclinical models of neonatal short bowel syndrome (SBS) according to remnant intestinal anatomy, with and without ileum. Furthermore, we aim to determine if this adaptive effect was potentiated with enteral nutrition (EN). METHODS: Neonatal piglets were block-randomized to 75% mid-intestinal (JI group, retains ileum) or distal-intestinal (JC group, has no ileum) resection or no resection (sham control) and GLP-2 treatment (11 nmol/kg/d) or saline control for 7 days...
September 22, 2016: JPEN. Journal of Parenteral and Enteral Nutrition
Joseph A Carcillo, J Michael Dean, Richard Holubkov, John Berger, Kathleen L Meert, Kanwaljeet J S Anand, Jerry J Zimmerman, Christopher J L Newth, Rick Harrison, Jeri Burr, Douglas F Willson, Carol Nicholson, Michael J Bell, Robert A Berg, Thomas P Shanley, Sabrina M Heidemann, Heidi Dalton, Tammara L Jenkins, Allan Doctor, Angie Webster, Robert F Tamburro
BACKGROUND AND AIMS: The pediatric Critical Illness Stress-induced Immune Suppression (CRISIS) trial compared the effectiveness of 2 nutraceutical supplementation strategies and found no difference in the development of nosocomial infection and sepsis in the overall population. We performed an exploratory post hoc analysis of interaction between nutraceutical treatments and host immune status related to the development of nosocomial infection/sepsis. METHODS: Children from the CRISIS trial were analyzed according to 3 admission immune status categories marked by decreasing immune competence: immune competent without lymphopenia, immune competent with lymphopenia, and previously immunocompromised...
September 22, 2016: JPEN. Journal of Parenteral and Enteral Nutrition
Jianbo Yang, Chao Ding, Xujie Dai, Tengfei Lv, Tingbing Xie, Tenghui Zhang, Wen Gao, Jianfeng Gong, Weiming Zhu, Ning Li, Jieshou Li
BACKGROUND: Intestinal fibrosis is a late complication of pelvic radiotherapy. Epithelial-to-mesenchymal transition (EMT) plays an important role in tissue fibrosis. The aim of this study was to examine the effect of soluble dietary fiber on radiation-induced intestinal EMT and fibrosis in a mouse model. MATERIALS AND METHODS: Apple pectin (4% wt/wt in drinking water) was administered to wild-type and pVillin-Cre-EGFP transgenic mice with intestinal fibrosis induced by a single dose of abdominal irradiation of 10 Gy...
September 22, 2016: JPEN. Journal of Parenteral and Enteral Nutrition
Syed Tariq Khalil, Michael R Uhing, Lori Duesing, Alexis Visotcky, Sergey Tarima, T Hang Nghiem-Rao
BACKGROUND: The aim of this study was to determine the tube-related complications and feeding outcomes of infants discharged home from the neonatal intensive care unit (NICU) with nasogastric (NG) tube feeding or gastrostomy (G-tube) feeding. MATERIALS AND METHODS: We performed a chart review of 335 infants discharged from our NICU with home NG tube or G-tube feeding between January 2009 and December 2013. The primary outcome was the incidence of feeding tube-related complications requiring emergency department (ED) visits, hospitalizations, or deaths...
September 19, 2016: JPEN. Journal of Parenteral and Enteral Nutrition
(no author information available yet)
McClave SA, Taylor BE, Martindale RG, et al. Guidelines for the provision and assessment of nutrition support therapy in the adult critically ill patient: Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.). J Parenter Enteral Nutr. 2016;40(2):159-211. (Original DOI: 10.1177/0148607115621863).
September 15, 2016: JPEN. Journal of Parenteral and Enteral Nutrition
Lynn D Hiller, Robert F Shaw, Peter J Fabri
BACKGROUND: Previous studies have demonstrated an association between malnutrition and poor outcomes. The primary objective of this study was to explore the difference in the composite end point of readmission rate or mortality rate between hospitalized veterans with and without malnutrition. MATERIALS AND METHODS: This was a retrospective chart review comparing veterans with malnutrition based on a modified version of the Academy of Nutrition and Dietetics/American Society for Parenteral and Enteral Nutrition consensus characteristics that used 5 of the 6 clinical characteristics to a matched control group of nonmalnourished veterans based on age, admitting service, and date of admission who were admitted between August 1, 2012, and December 1, 2014...
September 8, 2016: JPEN. Journal of Parenteral and Enteral Nutrition
Manpreet S Mundi, Erin M Nystrom, Daniel L Hurley, M Molly McMahon
Despite the high prevalence of malnutrition in adult hospitalized patients, surveys continue to report that many clinicians are undertrained in clinical nutrition, making targeted nutrition education for clinicians essential for best patient care. Clinical practice models also continue to evolve, with more disciplines prescribing parenteral nutrition (PN) or managing the cases of patients who are receiving it, further adding to the need for proficiency in general PN skills. This tutorial focuses on the daily management of adult hospitalized patients already receiving PN and reviews the following topics: (1) PN basics, including the determination of energy and volume requirements; (2) PN macronutrient content (protein, dextrose, and intravenous fat emulsion); (3) PN micronutrient content (electrolytes, minerals, vitamins, and trace elements); (4) alteration of PN for special situations, such as obesity, hyperglycemia, hypertriglyceridemia, refeeding, and hepatic/renal disease; (5) daily monitoring and adjustment of PN formula; and (6) PN-related complications (PN-associated liver disease and catheter-related complications)...
September 1, 2016: JPEN. Journal of Parenteral and Enteral Nutrition
Weisheng Chen, Cheng Sun, Ru Wei, Yanlin Zhang, Heng Ye, Ruibin Chi, Yichen Zhang, Bei Hu, Bo Lv, Lifang Chen, Xiunong Zhang, Huilan Lan, Chunbo Chen
BACKGROUND: Despite the use of prokinetic agents, the overall success rate for postpyloric placement via a self-propelled spiral nasoenteric tube is quite low. METHODS: This retrospective study was conducted in the intensive care units of 11 university hospitals from 2006 to 2016 among adult patients who underwent self-propelled spiral nasoenteric tube insertion. Success was defined as postpyloric nasoenteric tube placement confirmed by abdominal x-ray scan 24 hours after tube insertion...
August 31, 2016: JPEN. Journal of Parenteral and Enteral Nutrition
Ryu Yanagisawa, Kouichi Takeuchi, Kazutoshi Komori, Ikuko Fujihara, Yoshihiko Hidaka, Daisuke Morita, Akiko Futatsugi, Takako Ono, Eiko Hidaka, Kazuo Sakashita, Masaaki Shiohara
BACKGROUND: Parenteral nutrition (PN) is required with pediatric procedures such as hematopoietic stem cell transplantation (HSCT). However, risks associated with temporary PN infusion interruption remain unclear. MATERIALS AND METHODS: We retrospectively analyzed in 22 children undergoing HSCT receiving PN with the same daily routine: temporary PN infusion interruption before breakfast for administering a saline-diluted acyclovir drip. After correcting patients' glucose levels, we examined minimum blood glucose levels between preparative regimen initiation and post-HSCT day 30...
August 23, 2016: JPEN. Journal of Parenteral and Enteral Nutrition
Malki Miller, Keyur Donda, Alok Bhutada, Deepa Rastogi, Shantanu Rastogi
BACKGROUND: Growth in preterm infants is compromised during the transition phase of nutrition, when parenteral nutrition (PN) volumes are weaned with advancing enteral nutrition (EN) feeds, likely due to suboptimal nutrient intakes during this time. We implemented new PN guidelines designed to maintain optimal nutrient intakes during the transition phase and compared growth outcomes of this cohort with a control group. MATERIALS AND METHODS: A chart review was conducted on infants born <32 weeks' gestation, before (control group) and after (study group) a new transition PN protocol was implemented in the neonatal intensive care unit...
August 18, 2016: JPEN. Journal of Parenteral and Enteral Nutrition
Hiren Vallabh, Denise Konrad, Robert DeChicco, Gail Cresci, Rocio Lopez, Ezra Steiger, Donald F Kirby
BACKGROUND: Reducing hospital readmissions decreases healthcare costs and improves quality of care. There are no published studies examining the rate of, and risk factors for, 30-day readmissions for patients discharged with home parenteral support (HPS). OBJECTIVE: Determine the rate of 30-day readmissions for patients discharged with HPS and whether malnutrition and other demographic or clinical factors increase the risk. MATERIALS AND METHODS: Retrospective review of patients discharged with HPS from the Cleveland Clinic between July 1, 2013, and June 30, 2014, and followed by the Cleveland Clinic Home Nutrition Support Service...
August 18, 2016: JPEN. Journal of Parenteral and Enteral Nutrition
Rena Gale, Julia Namestnic, Pierre Singer, Ilya Kagan
BACKGROUND AND OBJECTIVE: Israeli law mandates chronic ventilator support for children and adolescents who are severely brain impaired and show minimal responses. Feeding protocols in these cases have been based on the caloric requirements of healthy children, deducting calories for lack of activity as well as an individual adjustment according to the cerebral palsy growth curves. However, patients are still inclined to gain excessive weight. Our objective was to determine the caloric requirements of these patients...
August 15, 2016: JPEN. Journal of Parenteral and Enteral Nutrition
Ken Fujioka, Khursheed Jeejeebhoy, Ulrich-Frank Pape, Benjamin Li, Nader N Youssef, Stéphane M Schneider
BACKGROUND: Narcotic agents are frequently administered to manage increased intestinal motility in patients with short bowel syndrome, but long-term use is associated with gastrointestinal (GI) complaints. This analysis evaluated the incidence of narcotic use and abdominal adverse events among patients with short bowel syndrome receiving teduglutide. MATERIALS AND METHODS: Pooled data from patients who received ≥1 dose of teduglutide 0.05 mg/kg/d (n = 77) or placebo (n = 59) in either of 2 randomized, double-blind, phase III studies were analyzed...
August 9, 2016: JPEN. Journal of Parenteral and Enteral Nutrition
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