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Nutrition in Clinical Practice

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https://www.readbyqxmd.com/read/28208022/protein-requirements-for-critically-ill-patients-with-renal-and-liver-failure
#1
Jayshil J Patel, Craig J McClain, Menaka Sarav, Jill Hamilton-Reeves, Ryan T Hurt
Diseases leading to critical illness induce proteolysis resulting in muscle wasting and negative nitrogen balance. Muscle wasting has been associated with poor intensive care unit (ICU)-related outcomes, including an increased risk for mortality. Acute kidney injury (AKI) represents a common organ dysfunction associated with ICU-related disorders, such as sepsis, trauma, and respiratory failure. AKI and renal replacement therapy lead to amino acid loss. Decompensated liver cirrhosis (DLC) and acute liver failure (ALF) represent more severe forms of liver dysfunction leading to ICU admission...
February 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28199797/nutritional-risk-screening-2002-short-nutritional-assessment-questionnaire-malnutrition-screening-tool-and-malnutrition-universal-screening-tool-are-good-predictors-of-nutrition-risk-in-an-emergency-service
#2
Estela Iraci Rabito, Aline Marcadenti, Jaqueline da Silva Fink, Luciane Figueira, Flávia Moraes Silva
BACKGROUND: There is an international consensus that nutrition screening be performed at the hospital; however, there is no "best tool" for screening of malnutrition risk in hospitalized patients. OBJECTIVE: To evaluate (1) the accuracy of the MUST (Malnutrition Universal Screening Tool), MST (Malnutrition Screening Tool), and SNAQ (Short Nutritional Assessment Questionnaire) in comparison with the NRS-2002 (Nutritional Risk Screening 2002) to identify patients at risk of malnutrition and (2) the ability of these nutrition screening tools to predict morbidity and mortality...
February 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28166447/nutrition-support-for-persistent-inflammation-immunosuppression-and-catabolism-syndrome
#3
Frederick A Moore, Stuart Phillips, Craig McClain, Jayshil J Patel, Robert Martindale
Despite tremendous advances in critical care, multiple-organ failure continues to be a significant problem. However, in recent years, far fewer patients with multiple-organ failure die early, but many experience ongoing immune dysregulation and are developing persistent inflammation, immunosuppression, and catabolism syndrome (PICS). Most PICS patients are discharged to nonhome destinations, fail to rehabilitate, and succumb to indolent death. From a nutrition perspective, patients with PICS experience persistent inflammation-induced cachexia despite evidenced-based recommended intensive care unit nutrition support...
February 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28145792/from-evidence-to-clinical-practice
#4
Tina Munk, Nina Bruun, Michael A Nielsen, Thordis Thomsen
BACKGROUND: The aim of this study was to investigate if a protein-enriched menu in conjunction with individualized dietary counseling would increase energy and protein intake in hospitalized patients at nutrition risk compared with providing the protein-enriched menu as a stand-alone intervention. METHOD: Data from medical and surgical hospitalized patients were prospectively collected and compared with a historical intervention group (HIG). Primary outcome was the number of patients achieving >75% of energy and protein requirements...
January 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28135431/retrospective-dual-center-study-of-parenteral-nutrition-associated-cholestasis-in-premature-neonates
#5
Weihui Yan, Li Hong, Ying Wang, Yi Feng, Lina Lu, Yijing Tao, Jiang Wu, Huijuan Ruan, Qingya Tang, Wei Cai
BACKGROUND: The pathogenesis of parenteral nutrition-associated cholestasis (PNAC) has not been clarified. The objective of this study was to explore the incidence of PNAC in premature infants without surgery and to identify associated risk factors. MATERIALS AND METHODS: Premature neonates who received parenteral nutrition (PN) at least 14 days were included in a retrospective, dual-center study. Cholestasis was diagnosed as conjugated bilirubin ≥2 mg/dL. Infants with metabolic liver disease, cyanotic congenital heart disease, congenital syphilis, hepadnaviridae infection, and those who underwent surgery were excluded...
January 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28129045/emerging-clinical-benefits-of-new-generation-fat-emulsions-in-preterm-neonates
#6
Gregory Guthrie, Muralidhar Premkumar, Douglas G Burrin
Soybean oil-based intravenous fat emulsions (IVFEs) have been the predominant parenteral nutrition IVFE used in the United States for neonates over the past 45 years. Even though this emulsion has proven useful in supplying infants with energy for growth and essential fatty acids, there have been concerns over its composition in the development of several morbidities, ranging from sepsis to liver disease, bronchopulmonary dysplasia, and impaired neurodevelopment and growth. The exact mechanisms that drive these morbidities in preterm infants are multifactorial, but potential contributors include high omega-6 (n-6) fatty acid composition, low docosahexaenoic acid and antioxidant supplementation, and the presence of potentially harmful nonnutritive components (eg, phytosterols)...
January 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28107096/implementation-of-an-aggressive-enteral-nutrition-protocol-and-the-effect-on-clinical-outcomes
#7
Daniel Dante Yeh, Catrina Cropano, Sadeq A Quraishi, Eva Fuentes, Haytham M A Kaafarani, Jarone Lee, Yuchiao Chang, George Velmahos
BACKGROUND: Macronutrient deficiency in critical illness is associated with worse outcomes. We hypothesized that an aggressive enteral nutrition (EN) protocol would result in higher macronutrient delivery and fewer late infections. METHODS: We enrolled adult surgical intensive care unit (ICU) patients receiving >72 hours of EN from July 2012 to June 2014. Our intervention consisted of increasing protein prescription (2.0-2.5 vs 1.5-2.0 g/kg/d) and compensatory feeds for EN interruption...
January 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28124948/comparing-steady-state-to-time-interval-and-non-steady-state-measurements-of-resting-metabolic-rate
#8
Chelsea Jayne Irving, Dennis L Eggett, Susan Fullmer
The 2 most common methods to determine resting metabolic rate (RMR) with indirect calorimetry are steady state (SS) and time intervals. Studies have suggested SS more accurately reflects RMR, but further research is needed. Our objective was to compare the bias, precision, and accuracy of SS to time intervals and non-SS measurements in a healthy adult population. Seventy-seven participants were measured for 45 minutes using a Quark RMR. Inclusion criteria included healthy participants aged 18-65 years. Pregnant and lactating women were excluded...
February 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28124947/differentiating-sarcopenia-and-cachexia-among-patients-with-cancer
#9
Sarah J Peterson, Marisa Mozer
Patients with cancer are at an increased risk for muscle loss via 2 distinct mechanisms: sarcopenia, defined as the age-associated decrease in muscle mass related to changes in muscle synthesis signaling pathways, and/or cachexia, defined as cytokine-mediated degradation of muscle and adipose depots. Both wasting disorders are prevalent; among patients with cancer, 15%-50% are sarcopenic and 25%-80% are cachectic. Muscle mass may be difficult to quantify in overweight/obese individuals. Often, overweight/obese patients with cancer are assumed to be normally nourished when in fact severe muscle depletion may be present...
February 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28124946/editor-s-note
#10
Jeanette M Hasse
No abstract text is available yet for this article.
February 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28124945/reviewer-acknowledgments
#11
(no author information available yet)
No abstract text is available yet for this article.
February 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/27879465/why-is-diagnosing-pediatric-malnutrition-important
#12
Mark R Corkins
The literature indicates that pediatric malnutrition is more common than the number of times it is actually diagnosed. A new pediatric malnutrition definition is now available with criteria to make the diagnosis. If pediatric malnutrition is present, it should be diagnosed for financial, educational, and research purposes as well as the effects on patient development and mortality. These reasons extend beyond the health of an individual patient to potential impacts on society as a whole. When all of these reasons are examined and added, making the diagnosis of pediatric malnutrition becomes an obligation of the pediatric caregiver...
February 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/27765878/diagnosing-pediatric-malnutrition
#13
Sandra Bouma
The publication of the landmark paper "Defining Pediatric Malnutrition: A Paradigm Shift Toward Etiology-Related Definitions" launched a new era in diagnosing pediatric malnutrition. This work introduced the paradigm shift of etiology-related definitions-nonillness and illness related-and the use of anthropometric z scores to help identify and describe children with malnutrition (undernutrition) in the developed world. Putting the new definition into practice resulted in some interesting observations: (1) Etiology-related definitions result in etiology-related interventions...
February 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/27913774/gravity-flow-in-proposed-enteral-tube-small-bore-connectors
#14
Ryan T Hurt, Lisa M Epp, Adele K Pattinson, Wanda M Duellman, Stephen M Corner, Manpreet S Mundi
BACKGROUND: Enteral nutrition (EN) misconnections have been identified as a serious and potential deadly problem. An international effort led by EN industry leaders has developed a small-bore enteral connector (ENFit) that in theory will reduce the frequency of misconnections. Despite the potential benefit of preventing misconnections, the full impact of adoption of the ENFit connector is unknown. To assess the impact of transitioning to ENFit on our home EN (HEN) patients, the current study evaluated gravity feeding comparing 2 proposed small-bore connectors to the legacy (current connector) using various commercial formulas...
December 2, 2016: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/27913773/pediatric-nutrition-assessment-anthropometrics-to-zinc
#15
Kelly Green Corkins, Erin E Teague
Pediatric patients with chronic illnesses or diseases or who require long-term nutrition support are most vulnerable to nutrition-related issues. Malnutrition in a pediatric patient may negatively affect long-term growth and development. Children also become malnourished much more quickly than adults. A comprehensive nutrition assessment that includes food and nutrition-related history, anthropometric measurements, biochemical data, medical tests and procedures, nutrition-focused physical findings, and patient history should be completed on these patients as no one parameter is a comprehensive indicator of nutrition status...
December 2, 2016: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/27756849/enfit-enteral-nutrition-connectors
#16
REVIEW
Peggi Guenter, Beth Lyman
New enteral connectors are now available based on the development of standards using the International Organization of Standardization process to prevent misconnections between systems that should not connect. Enteral devices with the new patient access connectors, called ENFit, are being now introduced for the purpose of improving patient safety. Transitioning to these new connectors poses benefits and challenges for facilities or agencies implementing these new devices. Information from appropriate resources should be sought by clinicians who need to partner with their suppliers and clinical organizations to see how best to meet these challenges...
December 2016: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/27895228/differences-in-durability-dislodgement-and-other-complications-with-use-of-low-profile-nonballoon-gastrostomy-tubes-in-children
#17
Temara Hajjat, Riad M Rahhal
BACKGROUND: Nonballoon low-profile gastrostomy tubes (GTs) are used for enteral nutrition support in a subset of pediatric patients with feeding difficulties when use of balloon GTs is problematic. Different nonballoon low-profile tube types are available, but comparative studies are lacking. MATERIALS AND METHODS: This was a retrospective cohort study comparing complications and outcomes between different low-profile nonballoon GTs at a pediatric tertiary care center over 10 years...
November 28, 2016: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/27881807/sarcopenia-is-highly-prevalent-in-older-medical-patients-with-mobility-limitation-comparisons-according-to-ambulatory-status
#18
Keisuke Maeda, Hiroshi Shamoto, Hidetaka Wakabayashi, Junji Akagi
BACKGROUND: The association of sarcopenia with disability with ambulatory status is uncertain because most studies have targeted people who could walk independently. This study explored the prevalence of sarcopenia regardless of ambulatory status and the impact of ambulatory status on sarcopenia. MATERIALS AND METHODS: In total, 778 consecutive patients, aged ≥65 years and admitted to a hospital, were enrolled. Ambulatory status was divided into 4 grades according to mobility as described in the Barthel index...
November 23, 2016: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/27856693/construction-of-lambda-mu-sigma-values-for-determining-mid-upper-arm-circumference-z-scores-in-u-s-children-aged-2-months-through-18-years
#19
Susan M Abdel-Rahman, Charlie Bi, Kristi Thaete
BACKGROUND: Mid-upper arm circumference (MUAC) has proven highly predictive of morbidity and mortality associated with malnutrition better, in some cases, than other growth indicators, including body mass index (BMI) z scores and weight-for-height z scores. A recent consensus statement recommended the inclusion of MUAC and MUAC z scores in the nutrition assessment of children in the United States; however, the requisite data to permit z score calculations for children aged >5 years have not been published...
November 17, 2016: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/27834282/the-use-of-technology-for-estimating-body-composition-strengths-and-weaknesses-of-common-modalities-in-a-clinical-setting
#20
Levi M Teigen, Adam J Kuchnia, Marina Mourtzakis, Carrie P Earthman
Assessment of body composition, both at single time points and longitudinally, is particularly important in clinical nutrition practice. It provides a means for the clinician to characterize nutrition status at a single time point, aiding in the identification and diagnosis of malnutrition, and to monitor changes over time by providing real-time information on the adequacy of nutrition interventions. Objective body composition measurement tools are available clinically but are often underused in nutrition care, particularly in the United States...
November 9, 2016: Nutrition in Clinical Practice
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