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Complications of parenteral nutrition

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https://www.readbyqxmd.com/read/29444733/medically-attended-catheter-complications-are-common-in-patients-with-outpatient-central-venous-catheters
#1
Steven S Spires, Peter F Rebeiro, Mickie Miller, Katie Koss, Patty W Wright, Thomas R Talbot
OBJECTIVE Outpatient central venous catheters (CVCs) are being used more frequently; however, data describing mechanical complications and central-line-associated bloodstream infections (CLABSI) in the outpatient setting are limited. We performed a retrospective observational cohort study to understand the burden of these complications to elucidate their impact on the healthcare system. METHODS Data were retrospectively collected on patients discharged from Vanderbilt University Medical Center with a CVC in place and admitted into the care of Vanderbilt Home Care Services...
February 15, 2018: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/29443394/catheter-related-bloodstream-infections-in-adults-receiving-home-parenteral-nutrition-substantial-differences-in-incidence-comparing-a-strict-microbiological-to-a-clinically-based-diagnosis
#2
Siri Tribler, Christopher F Brandt, Mark Hvistendahl, Michael Staun, Per Brøbech, Claus E Moser, Palle B Jeppesen
BACKGROUND: A common complication in patients receiving home parenteral nutrition (HPN) is catheter-related bloodstream infections (CRBSIs). The CRBSI incidence has been advocated as an outcome parameter assessing the quality of care. This study aimed to illustrate how the use of different CRBSI definitions affects the reported incidence. MATERIALS AND METHODS: In an observational study based on the Copenhagen intestinal failure database, all clinically reported CRBSIs from 2002-2013 were compared with data from the affiliated microbiological database according to recommended CRBSI criteria...
February 2018: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/29436744/long-term-use-of-mixed-oil-lipid-emulsion-in-adult-home-parenteral-nutrition-patients-a-case-series
#3
Manpreet S Mundi, Megan T McMahon, Jennifer J Carnell, Ryan T Hurt
BACKGROUND: Despite providing significant benefits, home parenteral nutrition (HPN) can be associated with complications such as infections, intestinal failure-associated liver disease, and metabolic abnormalities. Soybean oil (SO)-based intravenous lipid emulsion (ILE) has been noted to contribute to some of these complications, leading to the development of alternative sources of ILE. Mixed-oil (MO) ILE has recently been approved for use in adults with short-term studies revealing a benefit over SO ILE...
February 13, 2018: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/29419661/hyperglycemia-is-associated-with-cardiac-complications-in-elderly-nondiabetic-patients-receiving-total-parenteral-nutrition
#4
Jinling Ma, Meng Gao, Rong Pan, Lei He, Lei Zhao, Jie Liu, Hongbin Liu
Adverse outcomes have been associated with hyperglycemia in patients receiving total parenteral nutrition (TPN). The relationship may be characteristic in elderly patients. However, limited data are available about the relationship between TPN-related hyperglycemia and cardiac adverse outcome in elderly patients without previously known diabetes. This study aims to identify whether there is an association between hyperglycemia and 45-day cardiac adverse outcomes in critically and noncritically ill elderly nondiabetic patients receiving TPN...
February 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29417204/the-influence-of-gestational-age-mode-of-delivery-and-abdominal-wall-closure-method-on-the-surgical-outcome-of-neonates-with-uncomplicated-gastroschisis
#5
Maria V Fraga, Pablo Laje, William H Peranteau, Holly L Hedrick, Nahla Khalek, Juliana S Gebb, Julie S Moldenhauer, Mark P Johnson, Alan W Flake, N Scott Adzick
AIM OF THE STUDY: To evaluate if gestational age (GA), mode of delivery and abdominal wall closure method influence outcomes in uncomplicated gastroschisis (GTC). METHODS: Retrospective review of NICU admissions for gastroschisis, August 2008-July 2016. Primary outcomes were: time to start enteral feeds (on-EF), time to discontinue parenteral nutrition (off-PN), and length of stay (LOS). MAIN RESULTS: A total of 200 patients with GTC were admitted to our NICU...
February 7, 2018: Pediatric Surgery International
https://www.readbyqxmd.com/read/29415837/parenteral-nutrition-associated-cholestasis-and-triglyceridemia-in-surgical-term-and-near-term-neonates-a-pilot-randomized-controlled-trial-of-two-mixed-intravenous-lipid-emulsions
#6
Luís Pereira-da-Silva, Sara Nóbrega, Maria Luísa Rosa, Marta Alves, Ana Pita, Daniel Virella, Ana Luísa Papoila, Micaela Serelha, Gonçalo Cordeiro-Ferreira, Berthold Koletzko
BACKGROUND: Cholestasis is a common complication in infants receiving prolonged parenteral nutrition (PN). We studied the effects of two intravenous lipid emulsions composed with either 30% soybean oil, 30% medium-chain triglycerides (MCT), 25% olive oil, and 15% fish oil (SMOF) or with 50% MCT and 50% soybean oil n-6 (MCT/SOY) on the incidence of cholestasis in surgical term and near-term neonates. METHODS: A single-center, double-blinded, randomized controlled trial compared the incidence of cholestasis using either SMOF or MCT/SOY in neonates born at gestational age ≥34 weeks undergoing major surgery...
December 2017: Clinical Nutrition ESPEN
https://www.readbyqxmd.com/read/29413020/nutritional-aspects-of-acute-pancreatitis
#7
REVIEW
Kristen M Roberts, Marcia Nahikian-Nelms, Andrew Ukleja, Luis F Lara
The goal of nutritional support in acute pancreatitis is to reduce inflammation, prevent nutritional depletion, correct a negative nitrogen balance, and improve outcomes. Enteral nutrition (EN) in severe acute pancreatitis (SAP) should be preferred to parenteral nutrition. It maintains the integrity of the gut barrier, decreases intestinal permeability, downregulates the systemic inflammatory response, maintains intestinal microbiota equilibrium, and reduces the complications of the early phase of SAP, improving morbidity and possibly improving mortality, and it is less expensive...
March 2018: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/29413018/parenteral-nutrition-indications-access-and-complications
#8
REVIEW
Brian M Lappas, Dhyanesh Patel, Vanessa Kumpf, Dawn Wiese Adams, Douglas L Seidner
Parenteral nutrition (PN) is a life-sustaining therapy in patients with intestinal failure who are unable to tolerate enteral feedings. Patient selection should be based on a thorough assessment to identify those at high nutrition risk based on both disease severity and nutritional status. This article reviews both the acute and chronic indications for PN as well as special formulation consideration in specific disease states, vascular access, and complications of both short-term and long-term PN.
March 2018: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/29408798/conservative-treatment-of-postoperative-chylothorax-a-case-report
#9
Sachinkumar Wagh, Sanjay Deshmukh, Shrikant Ankolikar
BACKGROUND: Chylothorax is a well-documented complication of thoracic trauma and is associated with high rates of morbidity and mortality. Treatment for chylothorax includes conservative measures (total parenteral nutrition, pleural drainage, and pleurodesis) and surgery (thoracic duct ligation). CASE PRESENTATION: We present the case of a 65-year-old man who developed chylothorax after an elective surgical procedure. In this report conservative treatment aims to reduce chyle flow, to drain the pleural cavity in an effective manner, and to prevent chronic sequelae...
February 6, 2018: Journal of Basic and Clinical Physiology and Pharmacology
https://www.readbyqxmd.com/read/29407314/multimodal-surgical-approach-for-adult-patients-with-chronic-intestinal-pseudo-obstruction-clinical-and-psychosocial-long-term-outcomes
#10
A Lauro, A D Pinna, E Tossani, V Stanghellini, M Manno, G Caio, L Golfieri, C Zanfi, N Cautero, A Bagni, U Volta, M Di Simone, L Pironi, R F Cogliandro, M Serra, A Venturoli, S Grandi, R De Giorgio
BACKGROUND: Clinical and psychosocial outcomes of a multimodal surgical approach for chronic intestinal pseudo-obstruction were analyzed in 24 patients who were followed over a 2- to 12-year period in a single center after surgery or intestinal/multivisceral transplant (CTx). METHODS: The main reasons for surgery were sub-occlusion in surgery and parenteral nutrition-related irreversible complications with chronic intestinal failure in CTx. RESULTS: At the end of follow-up (February 2015), 45...
January 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29405447/nutritional-therapy-complications-in-children-with-ultra-short-bowel-syndrome-include-growth-deficiency-but-not-cholestasis
#11
Katarzyna Olszewska, Janusz Ksiazyk, Dariusz Kozlowski, Magdalena Pajdowska, Malgorzata Janusz, Maciej Jaworski
AIM: Children with ultra-short bowel syndrome (USBS) have not been extensively studied to date because the condition is rare. The aim of the study was to assess the nutritional status of children with USBS receiving home parenteral nutrition, by using citrulline serum concentration and cholestasis. METHODS: We studied 17 patients with USBS, with a median age of 6.6 years and median duration of parenteral nutrition of 6.6 years. The study was carried out at The Children's Memorial Health Institute, Warsaw, from January 2014 to January 2015...
February 6, 2018: Acta Paediatrica
https://www.readbyqxmd.com/read/29390542/particularities-of-the-management-and-the-treatment-in-a-rare-sepsis-with-candida-tropicalis-of-a-collodion-baby-case-report
#12
Alina Mariela Murgu, Irina Geanina Crişcov, Silvia Fotea, Ginel Baciu, Anca Chiriac, Elena Tarca, Violeta Streanga
RATIONALE: Collodion baby is a rare autosomal recessive disorder. It can be the first expression of some forms of ichthyosis. PATIENT CONCERNS: The authors present the case of a newborn diagnosed with severe Collodion baby syndrome who required prolonged hospitalization in the intensive care unit because of infectious complications like the fungal sepsis and other bacterial superinfections. DIAGNOSES: The case has many diagnostic and therapeutic particularities and management difficulties...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29377204/meta-analysis-of-early-enteral-nutrition-provided-within-24-hours-of-admission-on-clinical-outcomes-in-acute-pancreatitis
#13
Desheng Qi, Bo Yu, Jia Huang, Milin Peng
BACKGROUND: Enteral nutrition (EN) is more beneficial than parenteral nutrition (PN) in reducing organ failure, infectious complications, and mortality of acute pancreatitis (AP), but its timing is controversial. We attempted to evaluate the safety and clinical outcomes of early EN within 24 hours of admission in patients with AP, especially in predicted severe or severe acute pancreatitis (SAP). METHODS: We searched PubMed, EMBASE Databases, Web of Science, and the Cochrane Library for relevant articles before June 2016 using RevMan 5...
January 26, 2018: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/29356765/resolving-malnutrition-with-parenteral-nutrition-before-liver-transplant-in-biliary-atresia
#14
Danielle Wendel, Melissa Mortensen, Alisha Harmeson, Michele L Shaffer, Evelyn Hsu, Simon Horslen
OBJECTIVE: Malnutrition is a common complication of end-stage liver disease (ESLD) associated with poor liver transplant outcomes. Nasogastric feeds are used for nutritional supplementation, but some patients remain malnourished. Parenteral nutrition (PN) can be effective, but has potential complications. The primary objective was to evaluate the effect of PN on anthropometric measures in children with ESLD awaiting liver transplant. Secondary objectives were evaluation of PN-associated complications, liver function tests, pediatric end-stage liver disease scores, waitlist time, and post-transplant length of stay (total and time in the intensive care unit)...
February 2018: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/29356696/parenteral-nutrition-in-intensive-care-patients-medicoeconomic-aspects
#15
Mette M Berger, Najate Achamrah, Claude Pichard
PURPOSE OF REVIEW: Parenteral nutrition alone or as supplemental parenteral nutrition (SPN) has been shown to prevent negative cumulative energy balance, to improve protein delivery and, in some studies, to reduce infectious morbidity in ICU patients who fail to cover their needs with enteral nutrition alone. RECENT FINDINGS: The optimization of energy provision to an individualized energy target using either early parenteral nutrition or SPN within 3-4 days after admission has recently been reported to be a cost-saving strategy mediated by a reduction of infectious complications in selected intensive care patients...
January 19, 2018: Current Opinion in Clinical Nutrition and Metabolic Care
https://www.readbyqxmd.com/read/29353284/usefulness-of-totally-implantable-central-venous-access-devices-in-elderly-patients-a-retrospective-study
#16
Yuki Imaoka, Fumito Kuranishi, Yoshiteru Ogawa
BACKGROUND/AIMS: The need for totally implantable central venous access devices (TICVADs) has increased with increased opportunities in the use of chemotherapy and parenteral nutrition. This study aimed to determine the outcomes of TICVAD implantation and use in patients aged ≥85 years. METHODS: Between January 2010 and August 2016, 117 patients underwent TICVAD implantation and their records were retrospectively reviewed. RESULTS: Participants were divided into 2 groups (plus-85 and sub-85 groups)...
January 19, 2018: Annals of Nutrition & Metabolism
https://www.readbyqxmd.com/read/29351143/nutrition-in-the-icu-new-trends-versus-old-fashioned-standard-enteral-feeding
#17
Kristine W A C Koekkoek, Arthur R H van Zanten
PURPOSE OF REVIEW: The narrative review aims to summarize the relevant studies from the last 2 years and provide contextual information to understand findings. RECENT FINDINGS: Recent ICU studies have provided insight in the pathophysiology and time course of catabolism, anabolic resistance, and metabolic and endocrine derangements interacting with the provision of calories and proteins.Early provision of high protein intake and caloric overfeeding may confer harm...
January 18, 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29335838/effect-of-immunonutrition-on-colorectal-cancer-patients-undergoing-surgery-a-meta-analysis
#18
Jing Xu, Xian Sun, Qianqian Xin, Ying Cheng, Zhen Zhan, Junfeng Zhang, Juan Wu
PURPOSE: Immunonutrition has been used to prevent the complications after colorectal elective surgery. This systematic review aimed to analyze and assess the effect of immunonutrition on colorectal cancer patients who received elective surgery. METHODS: Three electronic databases (Medline, Embase, Cochrane) were used to search the latent studies which investigated the effects of enteral immunonutrition (EIN) compared with standard enteral nutrition (EN) or parenteral immunonutrition (PIN) compared with standard parenteral nutrition (PN) on colorectal cancer patients who are undergoing surgery until 21st of April, 2017...
January 15, 2018: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/29313724/early-enteral-nutrition-is-associated-with-faster-post-esophagectomy-recovery-in-chinese-esophageal-cancer-patients-a-retrospective-cohort-study
#19
Hongyu Han, Meixia Pan, Yang Tao, Runzhong Liu, Zhiliang Huang, Korinne Piccolo, Caiyun Zhong, Ranyi Liu
We retrospectively examined a large cohort of esophageal carcinoma patients who received early enteral nutrition (EEN) to clarify the validity of EEN compared with total parenteral nutrition (TPN). Included were a total of 665 consecutive patients with histologically confirmed carcinoma of the esophagus or esophagogastric junction; and all patients underwent esophagectomy. The patients were divided into two groups: TPN (n = 262) and EEN (n = 403). The TPN group consisted of patients who only received intravenous nutrition support after operation...
January 9, 2018: Nutrition and Cancer
https://www.readbyqxmd.com/read/29290518/enteral-nutrition-improves-clinical-outcome-and-reduces-costs-of-acute-mesenteric-ischaemia-after-recanalisation-in-the-intensive-care-unit
#20
Shuofei Yang, Jianming Guo, Qihong Ni, Jiaquan Chen, Xiangjiang Guo, Guanhua Xue, Meng Ye, Lan Zhang
BACKGROUND: Little data evaluate the enteral nutrition (EN) for patients with acute mesenteric ischaemia (AMI) in the intensive care unit (ICU). This study assessed the outcomes of EN for recanalised AMI patients in the ICU. METHODS: In this retrospective study, 183 AMI patients with mesenteric recanalisation admitted to two surgical ICUs were included. Patients were divided into EN (EN within first week, n = 95) and total parenteral nutrition (TPN) group (TPN in 1st week, n = 88)...
December 20, 2017: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
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