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Parenteral nutrition

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https://www.readbyqxmd.com/read/28727958/lipid-injectable-emulsion-survey-with-gap-analysis
#1
Michael L Christensen, Phil Ayers, Joseph I Boullata, Peggi Guenter, Kathleen M Gura, Beverly Holcombe, David S Seres, Gordon S Sacks
BACKGROUND: Lipid injectable emulsion (ILE) is an integral part of parenteral nutrition (PN), providing energy and essential fatty acids. With recent consensus recommendations for PN, clinical guidelines for ordering and preparation of PN, the U.S. Food and Drug Administration approval of new ILE products, and revised ILE labeling to include a 1.2-micron filter, a gap in current practice knowledge was apparent. MATERIALS AND METHODS: The American Society for Parenteral and Enteral Nutrition PN Safety Committee surveyed clinicians on how ILE products are prescribed, prepared, and administered to patients from neonates to adults...
July 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28727475/guidance-for-supplemental-enteral-nutrition-across-patient-populations
#2
Douglas L Nguyen
Enteral nutrition is preferred over parenteral nutrition as a result of the greater safety of enteral nutrition therapy and comparative convenience. A wide variety of enteral nutrition products have been developed, including disease-specific products to help manage the nutritional needs of patients with kidney failure, liver failure, lung disease, diabetes, and other conditions. An assessment of each patient's nutritional needs and digestive function should be conducted prior to initiation of enteral nutrition therapy...
July 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/28724572/a-new-case-of-congenital-malabsorptive-diarrhea-and-diabetes-secondary-to-mutant-neurogenin-3
#3
Marta Germán-Díaz, Yolanda Rodriguez-Gil, Jaime Cruz-Rojo, Fabienne Charbit-Henrion, Nadine Cerf-Bensussan, Javier Manzanares-López Manzanares, José Manuel Moreno-Villares
Congenital diarrheal disorders are a group of rare enteropathies that often present with life-threatening diarrhea in the first weeks of life. Enteric anendocrinosis, characterized by a lack of intestinal enteroendocrine cells due to recessively inherited mutations in the Neurogenin-3 (NEUROG3) gene, has been described as a cause of congenital malabsorptive diarrhea. Diabetes mellitus also is typically associated with NEUROG3 mutations, be it early onset or a later presentation. Here we report a case of a 16-year-old male patient with severe malabsorptive diarrhea from birth, who was parenteral nutrition dependent and who developed diabetes mellitus at 11 years old...
July 19, 2017: Pediatrics
https://www.readbyqxmd.com/read/28724193/saline-irrigation-for-the-management-of-skin-extravasation-injury-in-neonates
#4
REVIEW
P N Gopalakrishnan, Nitin Goel, Sujoy Banerjee
BACKGROUND: Extravasation injury, a complication commonly seen in the neonatal intensive care unit, can result in scarring with cosmetic and functional sequelae. A wide variety of treatments are available, including subcutaneous irrigation with saline (with or without hyaluronidase), liposuction, use of specific antidotes, topical applications, and normal wound care with dry or wet dressings. All such treatments aim to prevent or reduce the severity of complications. OBJECTIVES: Primary objective To compare the efficacy and safety of saline irrigation or saline irrigation with prior hyaluronidase infiltration versus no intervention or normal wound care for tissue healing in neonates with extravasation injury...
July 19, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28721569/management-of-enterocutaneous-fistula-outcomes-in-276-patients
#5
Martha Quinn, Stuart Falconer, Ruth F McKee
OBJECTIVE: To assess the outcomes of patients with type II intestinal failure due to enterocutaneous fistulae in a tertiary referral centre over a 15 year period. Intestinal failure secondary to enterocutaneous fistula (ECF) requires multidisciplinary management at significant cost. Mortality and morbidity are high. METHODS: Patients were identified from a prospectively collected database of patients requiring inpatient parenteral nutrition (1998-2013). Data collected included: demographics, mode of admission, pathological grouping and outcome...
July 18, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28720151/supplementation-with-lactobacillus-paracasei-or-pediococcus-pentosaceus-does-not-prevent-diarrhoea-in-neonatal-pigs-infected-with-escherichia-coli-f18
#6
Anders D Andersen, Malene S Cilieborg, Charlotte Lauridsen, Anne Louise Mørkbak, Per Torp Sangild
Infectious diarrhoea is a worldwide problem in newborns. Optimal bacterial colonisation may enhance gut maturation and protect against pathogenic bacteria after birth. We hypothesised that lactic acid bacteria (LAB) administration prevents pathogen-induced diarrhoea in formula-fed newborns. Newborn caesarean-delivered, colostrum-deprived term piglets on parenteral nutrition for the first 15 h, were used as models for sensitive newborn infants. A commercially available probiotic strain, Lactobacillus paracasei F19 (LAP, 2·6×108 colony-forming units (CFU)/kg per d) and a novel LAB isolate, Pediococcus pentosaceus (PEP, 1·3×1010 CFU/kg per d), were administered for 5 d with or without inoculation of the porcine pathogen, Escherichia coli F18 (F18, 1010 CFU/d)...
July 19, 2017: British Journal of Nutrition
https://www.readbyqxmd.com/read/28719764/surgical-anatomy-does-not-affect-the-progression-of-intestinal-failure-associated-liver-disease-in-neonatal-piglets
#7
Celeste M Lavallee, Pamela R Wizzard, Marihan Lansing, Donna F Vine, Patrick N Nation, Jason Y Yap, Benjamin P Willing, Paul W Wales, Justine M Turner
BACKGROUND: Intestinal failure-associated liver disease (IFALD) causes significant morbidity in neonates with short bowel syndrome (SBS) dependent on parenteral nutrition (PN). Resected ileum, with loss of the ileocecal valve (ICV), is the most common anatomy in SBS, yet its impact on IFALD has not been adequately studied. METHODS: Neonatal piglets were randomized to 75% intestinal resection with jejunocolic anastomosis (JC, n = 12), 75% resection with jejunoileal anastomosis and intact ICV (JI, n = 13), PN-fed sham (sham, n = 14), or sow-fed control (SF, n = 8)...
July 1, 2017: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28719710/conservative-management-of-postoperative-chylous-fistula-with-octreotide-and-peripheral-total-parenteral-nutrition
#8
Jason Y Chan, Eddy W Wong, S K Ng, C Andrew van Hasselt, Alexander C Vlantis
Postoperative chylous fistula after neck dissection is an uncommon complication associated with significant patient morbidity. Octreotide acetate is a somatostatin analogue established in the treatment of chylothorax; however, its utility in the management of cervical chylous fistulae has not been fully evaluated. The investigators hypothesized that chylous fistula can be managed by a combination of octreotide and peripheral total parenteral nutrition (TPN). A retrospective review of cases compiled at our institution from 2009 to 2015 was conducted...
July 2017: Ear, Nose, & Throat Journal
https://www.readbyqxmd.com/read/28716867/syndromic-congenital-diarrhoea-new-spint2-mutation-identified-in-the-uae
#9
Solange Bou Chaaya, Julian D Eason, Bibian N Ofoegbu
We are reporting a new mutation in the SPINT2 gene (c.443G>A (p. Arg148His)) that explains the association of choanal atresia with congenital sodium diarrhoea (CSD) in an Emirati family in the Middle East. To our knowledge, this mutation is neither listed in a mutation database nor described in the literature. Similar to other patients with CSD associated with SPINT2, this child remains dependent on parenteral nutrition for fluids and nutritional support resulting in failure to thrive. The determination of the molecular basis of syndromic CSD will facilitate prenatal and postnatal diagnosis of patients and will contribute to counselling of affected families, especially in areas like the UAE where consanguineous marriages are not uncommon...
July 16, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28715295/prevalence-of-home-parenteral-and-enteral-nutrition-in-the-united-states
#10
Manpreet S Mundi, Adele Pattinson, Megan T McMahon, Jacob Davidson, Ryan T Hurt
BACKGROUND: Malnutrition is highly prevalent and associated with increased morbidity and mortality. Studies continue to reveal significant clinical benefits with nutrition support, including improved wound healing, reduction in complications and length of stay, and mortality. Due to these benefits, the prevalence of home parenteral and enteral nutrition (HPEN) continues to increase worldwide. In the United States, given our healthcare insurance landscape, it has been very difficult to ascertain the true prevalence of HPEN...
July 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28713798/incidence-and-severity-of-prescribing-errors-in-parenteral-nutrition-for-pediatric-inpatients-at-a-neonatal-and-pediatric-intensive-care-unit
#11
Theresa Hermanspann, Mark Schoberer, Eva Robel-Tillig, Christoph Härtel, Rangmar Goelz, Thorsten Orlikowsky, Albrecht Eisert
OBJECTIVES: Pediatric inpatients are particularly vulnerable to medication errors (MEs), especially in highly individualized preparations like parenteral nutrition (PN). Aside from prescribing via a computerized physician order entry system (CPOE), we evaluated the effect of cross-checking by a clinical pharmacist to prevent harm from PN order errors in a neonatal and pediatric intensive care unit (NICU/PICU). METHODS: The incidence of prescribing errors in PN in a tertiary level NICU/PICU was surveyed prospectively between March 2012 and July 2013 (n = 3,012 orders)...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28713382/recent-advances-on-nutrition-in-treatment-of-acute-pancreatitis
#12
REVIEW
Li-Long Pan, Jiahong Li, Muhammad Shamoon, Madhav Bhatia, Jia Sun
Acute pancreatitis (AP) is a common abdominal acute inflammatory disorder and the leading cause of hospital admission for gastrointestinal disorders in many countries. Clinical manifestations of AP vary from self-limiting local inflammation to devastating systemic pathological conditions causing significant morbidity and mortality. To date, despite extensive efforts in translating promising experimental therapeutic targets in clinical trials, disease-specific effective remedy remains obscure, and supportive care has still been the primary treatment for this disease...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/28710972/epidemiology-diagnosis-prevention-and-treatment-of-catheter-related-thrombosis-in-children-and-adults
#13
REVIEW
Lisa Baumann Kreuziger, Julie Jaffray, Marc Carrier
In this narrative review, the epidemiology, diagnosis, prevention strategies, and management of catheter-related thrombosis are outlined. Central venous catheters have significantly improved the quality of life of patients requiring chemotherapy, parenteral nutrition, and chronic transfusions. Catheter-related thrombosis (CRT) complicates between 1-5% of inserted catheters, with incidence varying between patient population, catheter type, and vein cannulated. Strategies to prevent CRT, including anticoagulation and locking solutions, have largely been ineffective...
July 4, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28710148/energy-protein-carbohydrate-and-lipid-intakes-and-their-effects-on-morbidity-and-mortality-in-critically-ill-adult-patients-a-systematic-review
#14
REVIEW
Anna Patkova, Vera Joskova, Eduard Havel, Miroslav Kovarik, Monika Kucharova, Zdenek Zadak, Miloslav Hronek
The guidelines for nutritional support in critically ill adult patients differ in various aspects. The optimal amount of energy and nutritional substrates supplied is important for reducing morbidity and mortality, but unfortunately this is not well known, because the topic is complex and every patient is individual. The aim of this review was to gather recent pertinent information concerning the nutritional support of critically ill patients in the intensive care unit (ICU) with respect to the energy, protein, carbohydrate, and lipid intakes and the effect of their specific utilization on morbidity and mortality...
July 2017: Advances in Nutrition
https://www.readbyqxmd.com/read/28707991/a-case-study-of-intractable-diarrhea-due-to-neonatal-microvillous-inclusion-disease
#15
Ozgul Bulut, Bulent Ahishali, Mine Gulluoglu, Sertac Arslanoglu
BACKGROUND: Microvillous inclusion disease (MVID) is one of the most severe congenital diarrhea disorders, caused by a genetic defect in enterocyte differentiation and polarization. CASE REPORT: We describe a neonate who presented with severe weight loss, hypernatremic dehydration and metabolic acidosis due to intractable diarrhea due to MVID, confirmed by electron microscopy Conclusion: MVID can present with severe weight loss, hypernatremic dehydration and metabolic acidosis that is life threatening...
July 14, 2017: Fetal and Pediatric Pathology
https://www.readbyqxmd.com/read/28707497/complications-of-central-lines-in-neonates-admitted-to-a-level-iii-neonatal-intensive-care-unit
#16
Beatriz Soares, Susana Pissarra, Ana Lídia Rouxinol-Dias, Sandra Costa, Hercília Guimarães
OBJECTIVE: To investigate the incidence and risk factors for central line related complications in neonates. METHODS: A retrospective cohort study of infants who underwent central line (CL) placement, from 1 July 2014 to 31 June 2016, was conducted in Neonatal Intensive Care Unit of Centro Hospitalar de São João. Infants hospitalized more than 2 days and CLs placed for more than 24 hours were included. Patients' demographic characteristics, hospital data and information on CLs were collected...
July 14, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28706885/omega-3-fatty-acids-inhibit-oxidative-stress-in-a-rat-model-of-liver-regeneration
#17
Ozgur Firat, Ozer Makay, Levent Yeniay, Goksel Gokce, Cigdem Yenisey, Ahmet Coker
PURPOSE: Lipid peroxidation and consequent reactive oxygen species in the setting of oxidative stress have crucial roles in liver regeneration, which may adversely affect the regeneration itself and lead to liver failure. The aim of the current study is to investigate whether omega-3 fatty acid supplementation inhibits oxidative stress in an experimental model of liver regeneration. METHODS: Forty rats were allocated to four groups. Rats in group A received a sham operation...
July 2017: Annals of Surgical Treatment and Research
https://www.readbyqxmd.com/read/28702267/total-parenteral-nutrition-successfully-treating-black-esophagus-secondary-to-hypovolemic-shock
#18
Tony S Brar, Richard Helton, Zareen Zaidi
We present a patient who developed black esophagus secondary to hypovolemic shock and was placed on total parenteral nutrition for three weeks after hospital discharge. The area of interest is the multimodal approach used in treatment of this noncompliant patient. Even with a high mortality rate, this case illustrates a successful outcome of a patient who responded to appropriate immediate therapy resulting in complete resolution of the necrosis with no further development of complications.
2017: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/28702099/strategies-for-early-metabolic-disturbances-in-patients-with-an-end-jejunostomy-or-end-ileostomy-experience-from-a-specialized-home-parenteral-nutrition-hpn-center
#19
Michał Ławiński, Dominika Haraszczuk, Aleksandra Gradowska, Justyna Z Kostro, Agnieszka Bzikowska, Jacek Sobocki
INTRODUCTION: An end stoma syndrome is usually the result of an intentional surgical intervention in the course of staged treatment or a complication of surgery. These patients most frequently suffer from water and electrolyte disturbances, malnutrition syndromes caused by malabsorption of trace elements and/or vitamins, and undernutrition. AIM: To present early metabolic disturbances observed in patients with an end jejunostomy or end ileostomy syndrome on the first day of their hospitalization in a specialist Home Parenteral Nutrition (HPN) center...
2017: Przegla̜d Gastroenterologiczny
https://www.readbyqxmd.com/read/28701844/effect-of-calories-delivered-on-clinical-outcomes-in-critically-ill-patients-systemic-review-and-meta-analysis
#20
Legese Chelkeba, Mojtaba Mojtahedzadeh, Zeleke Mekonnen
INTRODUCTION: International guidelines are promoting early enteral nutrition (EN) as a means of feeding critically ill adult patients to improve clinical outcomes. The question of how much calorie intake is enough to improve the outcomes still remained inconclusive. Therefore, we carried out a meta-analysis to evaluate the effect of low calorie (LC) versus high calorie (HC) delivery on critically ill patients' outcomes. METHODS: We included randomized clinical trials (RCTs) that compared LC EN with or without supplemental parenteral nutrition with HC delivery in this meta-analysis irrespective of the site of nutritional delivery in the gastrointestinal tract...
June 2017: Indian Journal of Critical Care Medicine
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