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Nutrition in Clinical Practice

Charles W Van Way
No abstract text is available yet for this article.
November 8, 2018: Nutrition in Clinical Practice
Kerstin Austin, Kelley Wilson, Sumona Saha
Nausea and vomiting of pregnancy affect the majority of pregnancies, while the most severe version, hyperemesis gravidarum (HG), affects a much smaller subset of women. Despite the prevalence of nausea and vomiting of pregnancy and the severe consequences of HG, the pathophysiology of these conditions is not fully understood. Currently, it is thought that a combination of hormonal factors accounts for their development. Multiple treatments have been described for nausea and vomiting of pregnancy and HG with varying levels of success...
October 18, 2018: Nutrition in Clinical Practice
Fauzia Shakeel, Melanie Newkirk, Taymeyah Altoubah, Denise Martinez, Ernest K Amankwah
BACKGROUND: We evaluated tolerance of hydrolyzed liquid protein (LP) supplement added to fortified human milk (HM) to optimize protein intake in preterm infants. METHODS: A prospective observational study of 31 subjects compared with 31 historic controls, receiving mothers own milk (MOM) and/or donor milk (DM) to assess LP tolerance, growth, and risk for morbidities was conducted. Milk was analyzed for nutrient content. Feeding intolerance, defined as cessation of feedings for ≥48 hours, abdominal distension and/or residuals, necrotizing enterocolitis (NEC), and metabolic acidosis were used to assess safety, while weight and head circumference (HC) were used to evaluate growth...
October 15, 2018: Nutrition in Clinical Practice
Patrícia Zamberlan, Rubens Feferbaum, Ulysses Doria Filho, Werther Brunow de Carvalho, Artur Figueiredo Delgado
BACKGROUND: Nutrition markers may be useful for diagnosis and monitoring and, also, as additional indicators of estimating death risk. We tested the association of body composition indicators (mid-upper arm circumference and phase angle) with pediatric intensive care unit (PICU) length of stay and mortality in critically ill pediatric patients. METHODS: Data from children aged 2 months-18 years were collected, and bioelectrical impedance was performed to obtain phase angle...
October 10, 2018: Nutrition in Clinical Practice
Karolina Brook, Tiffany M N Otero, D Dante Yeh, Cecilia Canales, Donna Belcher, Sadeq A Quraishi
BACKGROUND: Vitamin D status is associated with length of stay (LOS) and discharge destination in critically ill patients. To further understand this relationship, we investigated whether admission 25-hydroxyvitaminD (25OHD) levels are associated with discharge functional status in the intensive care unit (ICU). METHODS: In this retrospective study, data from 2 surgical ICUs at a large teaching hospital were analyzed. 25OHD levels were measured within 24 hours of ICU admission and Functional Status Score for the ICU (FSS-ICU) was calculated within 24 hours of ICU discharge for all patients...
October 7, 2018: Nutrition in Clinical Practice
Adam M Deane, Marianne J Chapman, Annika Reintam Blaser, Stephen A McClave, Anton Emmanuel
Gastrointestinal dysmotility causes delayed gastric emptying, enteral feed intolerance, and functional obstruction of the small and large intestine, the latter functional obstructions being frequently termed ileus and Ogilvie syndrome, respectively. In addition to meticulous supportive care, drug therapy may be appropriate in certain situations. There is, however, considerable variation among individuals regarding what gastric residual volume identifies gastric dysmotility and would encourage use of a promotility drug...
October 7, 2018: Nutrition in Clinical Practice
Molly Wong Vega, Stacey Beer, Marisa Juarez, Poyyapakkam R Srivaths
BACKGROUND: Underrecognition of pediatric malnutrition may affect nutrition interventions and outcomes. Pediatric malnutrition uses more specific etiology-based criteria but lacks clarity in implementation guidelines. Study goals were to identify malnutrition and risk among hospitalized patients, characterize malnutrition risk factors, and assess reliability of criteria against outcome measures. MATERIALS AND METHODS: All children 44 weeks postmenstrual age-18 years, admitted for 48 hours during a 16-day period, were included (n = 528)...
October 7, 2018: Nutrition in Clinical Practice
Tara McNicholl, Joel A Dubin, Lori Curtis, Marina Mourtzakis, Roseann Nasser, Manon Laporte, Heather Keller
BACKGROUND: Decreased physical functioning is associated with malnutrition and common in acute care patients; determining loss of function is often considered part of a comprehensive nutrition assessment. Handgrip strength (HGS) and 5-meter timed walk (5m) are functional measures used in a variety of settings. This analysis sought to determine which functional measure could be added to a hospital nutrition assessment, based on its feasibility and capacity to discriminate patient subgroups...
October 4, 2018: Nutrition in Clinical Practice
Kyuwan Lee, Nathalie Sami, Frank C Sweeney, Christina M Dieli-Conwright
BACKGROUND: Because obesity is an independent risk factor for breast cancer recurrence, assessment of body composition is crucial to guide weight management in breast cancer survivors (BCS). This study assessed whether dual-energy x-ray absorptiometry (DXA) and bioelectrical impedance analysis (BIA) yield similar results for body composition in BCS. METHODS: Body fat percentage, lean body mass, and fat mass were estimated using DXA and BIA under fasting conditions in 89 BCS...
September 25, 2018: Nutrition in Clinical Practice
Mohamad Hasif Jaafar, Sanjiv Mahadeva, Kit Mun Tan, Ai-Vyrn Chin, Shahrul B Kamaruzzaman, Hui Min Khor, Nor Izzati Saedon, Maw Pin Tan
BACKGROUND: A barrier to gastrostomy feeding exists among Asian clinicians and caregivers due to negative perceptions regarding complications. We compared clinical and nutrition outcomes in older dysphagic Asian patients with nasogastric (NG) or gastrostomy tube feeding using a pragmatic study design. METHODS: The choice of enteral tube access was determined by managing clinicians and patients/caregivers. Comparisons of tube feeding methods were made during a 4-month period, adjusting statistically for inherent confounders...
September 25, 2018: Nutrition in Clinical Practice
Anna Nakayama, Cecilia Canales, D Dante Yeh, Donna Belcher, Caitlin M McCarthy, Sadeq A Quraishi
BACKGROUND: The Patient- And Nutrition-Derived Outcome Risk Assessment (PANDORA) was recently validated for predicting mortality in hospitalized patients; however, its utility in the intensive care unit (ICU) remains unknown. METHODS: We investigated whether PANDORA is associated with 30, 90, and 180 day mortality in critically ill surgical patients by performing logistic regressions, controlling for age, sex, race, body mass index, macronutrient deficit, and length of stay...
September 12, 2018: Nutrition in Clinical Practice
Luis Alfonso Ortiz-Reyes, Yuchiao Chang, Sadeq A Quraishi, Liyang Yu, Haytham Kaafarani, Marc de Moya, David R King, Peter Fagenholz, George Velmahos, Daniel Dante Yeh
BACKGROUND: Neutrophil-lymphocyte ratio (NLR) is a measure of host inflammatory response; a higher NLR is associated with worse clinical outcomes. Enteral nutrition (EN) may mitigate inflammation through interaction with gut-associated lymphoid tissue. We hypothesized that early EN adequacy in critically ill surgical patients is associated with lower NLR and better clinical outcomes. METHODS: In this retrospective study, we analyzed data from adult surgical intensive care unit (ICU) patients receiving EN...
September 10, 2018: Nutrition in Clinical Practice
Jeanette M Hasse
No abstract text is available yet for this article.
December 2018: Nutrition in Clinical Practice
Selina M Parry, Lee-Anne S Chapple, Marina Mourtzakis
Muscle wasting occurs rapidly within days of an admission to the intensive care unit (ICU). Concomitant muscle weakness and impaired physical functioning can ensue, with lasting effects well after hospital discharge. Early physical rehabilitation is a promising intervention to minimize muscle weakness and physical dysfunction. However, there is an often a delay in commencing active functional exercises (such as sitting on the edge of bed, standing and mobilizing) due to sedation, patient alertness, and impaired ability to cooperate in the initial days of ICU admission...
December 2018: Nutrition in Clinical Practice
Bethany J Farr, Samuel E Rice-Townsend, Nilesh M Mehta
Providing adequate nutrition to critically ill pediatric patients is essential and positively impacts outcomes. Critically ill infants and children receiving extracorporeal membrane oxygenation (ECMO) therapy are nutritionally vulnerable, yet there are challenges to reliable assessment of nutrition requirements and to the delivery of optimal nutrition in this cohort. In this review of the relevant literature, we present the current evidence and guidelines for the optimal prescription and delivery of nutrition for pediatric patients receiving ECMO...
December 2018: Nutrition in Clinical Practice
Erin M Nystrom, Andrea M Nei
Continuous renal replacement therapy (CRRT) is the modality of choice in critically ill patients with hemodynamic instability requiring renal replacement therapy. The goal of this review is to discuss an overview of CRRT types, components, and important considerations for nutrition support provision. Evidence basis for guidelines and our recommendations are reviewed. Nutrition support-related implications include the possibility of calorie gain with citrate-based anticoagulation, calorie loss with glucose-free replacement fluids and dialysate, and significant amino acid losses in effluent...
December 2018: Nutrition in Clinical Practice
Danielle E Bear, Elizabeth Smith, Nicholas A Barrett
The use of extracorporeal membrane oxygenation (ECMO) for both severe respiratory and cardiac failure is increasing. Because these patients are some of the sickest in the intensive care unit, a multidisciplinary approach to their treatment, including appropriate nutrition therapy, is warranted. Currently, limited data exist on the optimal timing, type, and amount of nutrition to be provided. This review focuses on describing the current nutrition practices in patients receiving ECMO, details research that is currently being undertaken, and lists important research questions that require exploration in this field...
December 2018: Nutrition in Clinical Practice
Andrew Ukleja, Karen Gilbert, Kris M Mogensen, Renee Walker, Ceressa T Ward, Joe Ybarra, Beverly Holcombe
The American Society for Parenteral and Enteral Nutrition defines standards as benchmarks representing a range of performance of competent care that should be provided to assure safe and efficacious nutrition care in most circumstances. Standards are documents that define the structure needed to provide competent care. These Standards for Nutrition Support for Adult Hospitalized Patients are an update of the 2010 Standards. These practice-based standards are intended for use by healthcare professionals charged with the care of adult hospitalized patients receiving nutrition support therapy in any hospital with or without a formal nutrition support service or team...
December 2018: Nutrition in Clinical Practice
Menaka Sarav, Allon N Friedman
Intradialytic parenteral nutrition (IDPN) is a form of supplemental nutrition used to treat patients with malnutrition who receive hemodialysis. Once the diagnosis of malnutrition is made in such patients, encouragement of oral intake is the first-line treatment. If this fails, then enteral or parenteral nutrition may be needed. This review examines the literature on the use of IDPN and summarizes the current recommendations. There is considerable controversy over indications and benefits of IDPN, and well-controlled, long-term studies are needed to help tease out these issues...
December 2018: Nutrition in Clinical Practice
Sharon Y Irving, Gina Rempel, Beth Lyman, Wednesday Marie A Sevilla, LaDonna Northington, Peggi Guenter
The placement of a nasogastric tube (NGT) in a pediatric patient is a common practice that is generally perceived as a benign bedside procedure. There is potential risk for NGT misplacement with each insertion. A misplaced NGT compromises patient safety, increasing the risk for serious and even fatal complications. There is no standardized method for verification of the initial NGT placement or reverification assessment of NGT location prior to use. Measurement of the acidity or pH of the gastric aspirate is the most frequently used evidence-based method to verify NGT placement...
December 2018: Nutrition in Clinical Practice
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