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Parenteral nutrition children

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
Vigdis Staven, Herra Iqbal, Siri Wang, Ingrid Grønlie, Ingunn Tho
OBJECTIVES: Infusion of precipitate or destabilized emulsion can be harmful. The purpose of this study was to obtain Y-site compatibility data on intravenous drugs and total parenteral nutrition (TPN) relevant for children. METHODS: Two three-in-one TPN admixtures (Olimel N5E and Numeta G16E) used for children of different age groups were tested with ten drugs (ampicillin, ceftazidime, clindamycin, dexamethasone, fluconazole, fosphenytoin, furosemide, metronidazole, ondansetron and paracetamol)...
October 7, 2016: Journal of Pharmacy and Pharmacology
Theodoric Wong, Girish Gupte
Children with intestinal failure have had improved survival, particularly those with extreme short bowel syndrome, over the last 10-15 y. This has been attributed to better understanding of the pathophysiology of intestinal failure, improvement in line care, recognition of the importance of a team approach as well as the progress of intestinal transplant as a viable option. Parenteral nutrition remains the cornerstone for the continual survival of these patients. This review will cover contemporary approaches to intestinal failure including post surgical approaches, non-transplant surgery, dietetic and medication approaches during the adaptation process, considerations for home parenteral nutrition and latest in intestinal transplantation...
October 5, 2016: Indian Journal of Pediatrics
Jan Hau Lee, Elizabeth Rogers, Yek Kee Chor, Rujipat Samransamruajkit, Pei Lin Koh, Mohamad Miqdady, Ali Ibrahim Al-Mehaidib, Antonius Pudjiadi, Sunit Singhi, Nilesh M Mehta
BACKGROUND AND OBJECTIVES: Current practices and available resources for nutrition therapy in paediatric intensive care units (PICUs) in the Asia Pacific-Middle East region are expected to differ from western countries. Existing guidelines for nutrition management in critically ill children may not be directly applicable in this region. This paper outlines consensus statements developed by the Asia Pacific-Middle East Consensus Working Group on Nutrition Therapy in the Paediatric Critical Care Environment...
December 2016: Asia Pacific Journal of Clinical 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
Kirsten Risby, Steffen Husby, Niels Qvist, Marianne S Jakobsen
BACKGROUND: During the last decades neonatal outcomes for children born with gastroschisis have improved significantly. Survival rates >90% have been reported. Early prenatal diagnosis and increased survival enforce the need for valid data for long-term outcome in the pre- and postnatal counseling of parents with a child with gastroschisis. METHODS: Long-term follow-up on all newborns with gastroschisis at Odense University Hospital (OUH) from January 1 1997-December 31 2009...
September 2, 2016: Journal of Pediatric Surgery
Nilesh M Mehta
No abstract text is available yet for this article.
September 2016: Journal of Pediatrics
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
Filiz Serdaroglu, Yavuz S Koca, Fatma Saltik, Tugba Koca, Selim Dereci, Mustafa Akcam, Fusun Z Akcam
AIM: The aim of this study was to determine demographic and clinical features in children diagnosed with gallstones, risk factors for gallstone formation, the effectiveness of ursodeoxycholic acid therapy, and the course of the disease. MATERIALS AND METHODS: Patients aged 0-18 years were followed up for at least 6 months after the diagnosis of gallstones with ultrasonography and were evaluated retrospectively. Patients were evaluated with respect to age, sex, presenting symptoms, BMI, facilitating factors, accompanying diseases, family history of gallstones, history of ceftriaxone use, laboratory tests, ultrasonography findings and follow-up, and therapeutic approaches and results...
August 18, 2016: European Journal of Gastroenterology & Hepatology
Caroline Cole
CASE SUMMARY: A 6 yr old 45 kg child with severe Cushinoid features was admitted to PICU with probable hypertensive encephalopathy. She presented with increasing headaches, vomiting and seizures becoming unresponsive with a GCS of 3. She was profoundly hypertensive and her cortisol levels were significantly elevated (>2000 nmol/L). Rapid reduction in cortisol levels was required to stabilise her condition prior to surgery. Etomidate is the only readily available intravenous preparation which reliably suppresses adrenocortical function...
September 2016: Archives of Disease in Childhood
Rhian Isaac, Astrid Gerrard, Kevin Bazaz
BACKGROUND: Pressures to open pharmacy services 7 days a week, with no financial input for these extra resources, has knock on effects that may dilute accessibility to clinical pharmacists in specialist areas. AIMS: The aim of this survey was to assess opinions of the users of the current pharmacy services to PICU and the planned extended hours provision. METHOD: An e-survey was sent to PIC Consultants, Advanced Nurse Practitioners, and Senior Nursing Staff following a six month period of increased clinical pharmacists time allocation to PIC...
September 2016: Archives of Disease in Childhood
Rebecca Riddell, Anthony Lewis, David Tuthill
AIM: To produce a leaflet for parents and carers of children receiving parenteral nutrition (PN) explaining:▸ What PN is▸ Why it is given▸ How it will be given▸ Risks & Complications▸ Other useful information▸ Nutrition team contact informationCurrent practice is for the nutrition team pharmacist to give a verbal account of the above information to parents/carers. It was felt that providing this information in a written format would introduce consisitency and allow parents/carers more time to take information on board...
September 2016: Archives of Disease in Childhood
T Hang Nghiem-Rao
Infants and children who depend on parenteral nutrition are among the most vulnerable to developing potentially devastating intestinal failure-associated liver disease. While the pathogenesis of intestinal failure-associated liver disease remains unclear, evidence for the contribution of fat emulsions to cholestasis and liver injury has rapidly increased in recent years. Data demonstrating the interaction among phytosterols, fatty acids, and antioxidants in cellular pathways that mediate bile flow and hepatic injury have led to the development of newer alternative fat emulsions...
October 2016: Nutrition in Clinical Practice
Lusine Ambartsumyan, Alejandro Flores, Samuel Nurko, Leonel Rodriguez
OBJECTIVES: Chronic intestinal pseudo-obstruction (CIPO) is a challenging disorder with high morbidity and mortality due to limited effective therapies that improve enteral tolerance. We aimed to present our experience using octreotide in children with CIPO and evaluate factors predicting therapy response. METHODS: The study population included total parenteral nutrition (TPN)-dependent children with CIPO receiving octreotide at a tertiary care center. Octreotide response was defined as an enteral feeding increase of ≥10 cc/kg/day...
October 2016: Paediatric Drugs
Prathima Nandivada, Meredith A Baker, Paul D Mitchell, Alison A O'Loughlin, Alexis K Potemkin, Lorenzo Anez-Bustillos, Sarah J Carlson, Duy T Dao, Gillian L Fell, Kathleen M Gura, Mark Puder
BACKGROUND: Parenteral fish-oil (FO) therapy is a safe and effective treatment for intestinal failure-associated liver disease (IFALD). Patients whose cholestasis does not resolve with FO may progress to end-stage liver disease. OBJECTIVE: We sought to identify factors associated with the failure of FO therapy in treating IFALD to guide prognostication and referral guidelines. DESIGN: Prospectively collected data for patients treated with FO at Boston Children's Hospital from 2004 to 2014 were retrospectively reviewed...
September 2016: American Journal of Clinical Nutrition
Alejandro A Floh, Julie Slicker, Steven M Schwartz
OBJECTIVES: The objectives of this review are to discuss the challenges of delivering adequate nutrition to children with congenital heart disease, including pre- and postoperative factors and the role of enteral and parenteral nutrition, as well as the evidence supporting current practices. DATA SOURCE: MEDLINE and PubMed. CONCLUSION: Providing adequate nutritional support is paramount for critically ill infants with congenital heart disease, a population at particular risk for malnutrition...
August 2016: Pediatric Critical Care Medicine
Mary Riedy, Brittany DePaula, Mark Puder, Kathleen M Gura, Kevin A Sztam
Fish oil-based lipid emulsions (FOLEs) have been used to treat cholestasis in children with intestinal failure-associated liver disease (IFALD). When FOLEs are dosed at 1 g/kg/d, essential fatty acid (EFA) deficiency typically does not occur. We describe the clinical course of a severely malnourished parenteral nutrition-dependent infant with IFALD. Baseline EFA panels were normal upon starting FOLE at 1 g/kg/d. Despite biochemical improvement in IFALD, weight velocity was below target and biochemical EFA status worsened, even after correction for other factors affecting weight...
August 1, 2016: JPEN. Journal of Parenteral and Enteral Nutrition
Bruce R Bistrian
No abstract text is available yet for this article.
July 28, 2016: New England Journal of Medicine
Yousheng Li, Yuhua Huang
No abstract text is available yet for this article.
July 28, 2016: New England Journal of Medicine
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