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Home parenteral nutrition

Melanie Streicher, Michael Themessl-Huber, Karin Schindler, Cornel Christian Sieber, Michael Hiesmayr, Dorothee Volkert
OBJECTIVES: Malnutrition in older persons is associated with an increased risk of mortality. Useful strategies to counteract malnutrition are nutritional interventions, such as fortified diets, oral nutritional supplements (ONS), tube feeding, and parenteral nutrition. Presently, it is not known if these strategies can reduce mortality risk of nursing home (NH) residents who are malnourished or at risk of malnutrition. Thus, the aim of this study was to investigate if nutritional intake and interventions are associated with mortality in this specific population...
October 11, 2016: Journal of the American Medical Directors Association
Milan Dastych, Michal Šenkyřík, Milan Dastych, František Novák, Petr Wohl, Jan Maňák, Pavel Kohout
BACKGROUND: The objective of the present study was to determine concentrations of zinc (Zn), copper (Cu), iron (Fe), selenium (Se) in blood plasma and manganese (Mn) in the whole blood in patients with long-term home parenteral nutrition (HPN) in comparison to the control group. PATIENTS AND METHODS: We examined 68 patients (16 men and 52 women) aged from 28 to 68 years on a long-term HPN lasting from 4 to 96 months. The short bowel syndrome was an indication for HPN...
October 14, 2016: Annals of Nutrition & Metabolism
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
Jarosław Szefel, Wiesław J Kruszewski, Mariusz Szajewski, Maciej Ciesielski, Ewa Sobczak, Maksymilian Czerepko, Wiesława Łysiak-Szydłowska
INTRODUCTION: Currently there are no established guidelines regarding the use of long-chain triglycerides (LCT) vs. medium-chain triglycerides medium-chain triglycerides (MCT)/long-chain triglycerides (LCT) in total parenteral nutrition (TPN). Severe malnutrition of patients with refractory cachexia (RC) often causes their disqualification from invasive methods of treatment thus decreasing their quality of life and survival time. AIM: To compare the changes in nutritional state of patients with RC receiving PN with LCT and LCT/MCT lipid emulsions and to assess the influence of enteral nutrition on their survival time...
2016: Przegla̜d Gastroenterologiczny
Michał Ławiński, Karol Forysiński, Agnieszka Bzikowska, Justyna Z Kostro, Aleksandra Gradowska, Marek Pertkiewicz
INTRODUCTION: The ESPEN guidelines on long-term (> 3 months) parenteral nutrition recommend the use of tunnelled central venous catheters (CVCs) to minimise the risk of insertion site infection. A developed symptomatic infection of the soft tissue tunnel surrounding a CVC may rapidly become directly life threatening if the infection progresses along the catheter tunnel towards its end inserted into the venous system. This requires immediate management to eliminate infection and limit its effects...
2016: Przegla̜d Gastroenterologiczny
Jessica Hellyer, Hunter Oliver-Allen, Majid Shafiq, Alisha Tolani, Maurice Druzin, Michael Jeng, Stanley Rockson, Robert Lowsky
Introduction Gorham-Stout Disease (GSD) is a rare disorder of bony destruction due to lymphangiomatosis, and is often triggered by hormones. One complication of GSD is the development of chylothorax, which carries a high mortality rate. Very little experience has been published to guide management in GSD during pregnancy to optimize both fetal and maternal health. Case Study A 20-year-old woman with known GSD presented with shortness of breath at 18 weeks of pregnancy, due to bilateral chylothoraces which required daily drainage...
October 2016: American Journal of Perinatology Reports
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
Sara C Keller, Deborah Williams, Mitra Gavgani, David Hirsch, John Adamovich, Dawn Hohl, Amanda Krosche, Sara Cosgrove, Trish M Perl
BACKGROUND Patients are frequently discharged with central venous catheters (CVCs) for home infusion therapy. OBJECTIVE To study a prospective cohort of patients receiving home infusion therapy to identify environmental and other risk factors for complications. DESIGN Prospective cohort study between March and December 2015. SETTING Home infusion therapy after discharge from academic medical centers. PARTICIPANTS Of 368 eligible patients discharged from 2 academic hospitals to home with peripherally inserted central catheters and tunneled CVCs, 222 consented...
October 4, 2016: Infection Control and Hospital Epidemiology
Melanie Streicher, Michael Themessl-Huber, Karin Schindler, Cornel Christian Sieber, Michael Hiesmayr, Dorothee Volkert
BACKGROUND & AIMS: Oral nutritional supplements (ONS) can be helpful for nursing home (NH) residents to prevent or treat malnutrition. Presently little is known about the use of ONS in NHs and the factors associated with its use. Thus, the aim of this analysis was to describe the use of ONS in NHs participating in the nutritionDay project and to determine characteristics of NH residents receiving ONS. METHODS: Data from nutritionDay (nD), a cross-sectional multicenter study with standardized questionnaires on resident and NH level were analyzed...
September 17, 2016: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
M Dolores López-Tejero, Núria Virgili, Jordi Targarona, Jorge Ruiz, Natalia García, Denise Oró, Judit García-Villoria, Gloria Creus, Ana M Pita
INTRODUCTION: Parenteral nutrition (PN) dependence in short bowel syndrome (SBS) patients is linked to the functionality of the remnant small bowel (RSB). Patients may wean off PN following a period of intestinal adaptation that restores this functionality. Currently, plasma citrulline is the standard biomarker for monitoring intestinal functionality and adaptation. However, available studies reveal that the relationship the biomarker with the length and function of the RSB is arguable...
2016: PloS One
A Van Gossum, L Pironi, C Chambrier, M Dreesen, C F Brandt, L Santarpia, F Joly
BACKGROUND & AIMS: Obesity is a worldwide health problem. Bariatric surgery (BS) is becoming one of the most commonly used methods for fighting obesity and its associated comorbidities. However, current BS techniques can be associated with early or late complications that may require nutritional support. The aim of this retrospective observational study was to determine the indications and outcomes for patients on Home parenteral nutrition (HPN) due to post-bariatric surgery complications...
September 8, 2016: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
Lore Billiauws, Laura Armengol Debeir, Florian Poullenot, Cécile Chambrier, Nicolas Cury, Pierre-François Ceccaldi, Emilie Latour Beaudet, Olivier Corcos, Evelyne Marinier, Olivier Goulet, Eric Lerebours, Francisca Joly
BACKGROUND & AIMS: Home parenteral nutrition (HPN) improves survival and quality of life in patients with chronic intestinal failure (IF). Few cases of pregnancy on HPN have been published. The aim of this study was to report pregnancy cases on long-term HPN in benign IF. METHODS: This retrospective study included all pregnant patients on HPN from 4 HPN referral centers. Data on demographics, ongoing pathology, HPN type, maternal and newborn complications were collected...
August 23, 2016: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
Lynn D Hiller, Robert F Shaw, Peter J Fabri
BACKGROUND: Previous studies have demonstrated an association between malnutrition and poor outcomes. The primary objective of this study was to explore the difference in the composite end point of readmission rate or mortality rate between hospitalized veterans with and without malnutrition. MATERIALS AND METHODS: This was a retrospective chart review comparing veterans with malnutrition based on a modified version of the Academy of Nutrition and Dietetics/American Society for Parenteral and Enteral Nutrition consensus characteristics that used 5 of the 6 clinical characteristics to a matched control group of nonmalnourished veterans based on age, admitting service, and date of admission who were admitted between August 1, 2012, and December 1, 2014...
September 8, 2016: JPEN. Journal of Parenteral and Enteral Nutrition
Karen Whitfield, Claudia Barkeij, Angela North
AIM: To present a case of an extremely premature infant and the role that the specialist neonatal pharmacist has on the quality of care of these patients. METHOD: Interventions and recommendations made by the pharmacists over the admission of a triplet born at 23 weeks and 5 days gestation were recorded. The type of interventions were categorised and classified for risk using a consequence/probability matrix.1 RESULTS: The patient required admission to the intensive care unit and subsequently the special care unit for a period of 163 days before discharge home...
September 2016: Archives of Disease in Childhood
Hiren Vallabh, Denise Konrad, Robert DeChicco, Gail Cresci, Rocio Lopez, Ezra Steiger, Donald F Kirby
BACKGROUND: Reducing hospital readmissions decreases healthcare costs and improves quality of care. There are no published studies examining the rate of, and risk factors for, 30-day readmissions for patients discharged with home parenteral support (HPS). OBJECTIVE: Determine the rate of 30-day readmissions for patients discharged with HPS and whether malnutrition and other demographic or clinical factors increase the risk. MATERIALS AND METHODS: Retrospective review of patients discharged with HPS from the Cleveland Clinic between July 1, 2013, and June 30, 2014, and followed by the Cleveland Clinic Home Nutrition Support Service...
August 18, 2016: JPEN. Journal of Parenteral and Enteral Nutrition
Manpreet S Mundi, Bradley R Salonen, Sara Bonnes
Since the first intravenous nutrition support attempt with olive oil in the 17th century, intravenous fat emulsions (IVFEs) have evolved to become an integral component in the management of patients receiving home parenteral nutrition (HPN). IVFEs serve as a calorie source and provide essential fatty acids (linoleic acid and α-linolenic acid) in patients unable to achieve adequate intake of these fatty acids through alternative means. However, IVFE use is also associated with multiple complications, including increased infection risk, liver disease, and systemic proinflammatory states...
October 2016: Nutrition in Clinical Practice
Esraa S Al-Tawil, Alanoud M Almuhareb, Hamdy M Amin
BACKGROUND/AIM: Parenteral nutrition (PN) is a lifesaving therapy for patients with many severe conditions, including intestinal failure. Some patients require long-term PN therapy, which makes home parenteral nutrition (HPN) an attractive option to improve the quality of life. Among the most common and serious complications observed in these patients are catheter-related blood stream infections (CRBSIs). The aim of our study is to determine the frequency of CRBSI among patients receiving long-term HPN...
July 2016: Saudi Journal of Gastroenterology: Official Journal of the Saudi Gastroenterology Association
Takafumi Kawano, Tatsuru Kaji, Shun Onishi, Koji Yamada, Waka Yamada, Kazuhiko Nakame, Motoi Mukai, Satoshi Ieiri
PURPOSE: Children with intestinal failure (IF) requiring central venous catheters (CVCs) often experience frequent catheter-related bloodstream infections (CRBSIs), which is a serious and life-threatening complication. To reduce the incidence of CRBSI, prophylactic ethanol lock therapy (ELT) was initiated. METHODS: Patients with IF received home parenteral nutrition via a silicone tunneled CVC. All of them had received therapeutic ELT from January 2009 (first period) and prophylactic ELT from December 2012 (second period)...
September 2016: Pediatric Surgery International
Karrie Derenski, Jennifer Catlin, Livia Allen
Parenteral nutrition (PN) is a life-sustaining therapy providing nutrients to individuals with impaired intestinal tract function and enteral access challenges. It is one of the most complex prescriptions written routinely in the hospital and home care settings. This article is to aid the nutrition support clinician in the safe provision of PN, including selecting appropriate patients for PN, vascular access, development of a PN admixture, appropriate therapy monitoring, recognition of preparation options, and awareness of preparation and stability concerns...
October 2016: Nutrition in Clinical Practice
Rosa Rosania, Costanza Chiapponi, Peter Malfertheiner, Marino Venerito
BACKGROUND: Nutritional management of patients with gastric cancer (GC) represents a challenge. SUMMARY: This review provides an overview of the present evidence on nutritional support in patients with GC undergoing surgery as well as in those with advanced disease. KEY MESSAGE: For patients undergoing surgery, the preoperative nutritional condition directly affects postoperative prognosis, overall survival and disease-specific survival. Perioperative nutritional support enriched with immune-stimulating nutrients reduces overall complications and hospital stay but not mortality after major elective gastrointestinal surgery...
May 2016: Gastrointestinal Tumors
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