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Total nutrition parenteral

Wasim Khasawneh, Salar Bani Hani
Medication errors remain among the major problems seen in hospitals. Such errors can relate to the prescription, dispensation, or administration of drugs. Human factors account for most of these mistakes, but other factors such as infusion pump programming defects should always be considered. Worldwide, medication errors have been reported to affect 2-30% of patients, depending on the institution. Intravenous lipid emulsion (ILE) infusion is frequently used as part of total parenteral nutrition in patients of all ages with feeding and gastrointestinal issues...
March 19, 2018: Drug Safety—Case Reports
Jose C Jara-Aguirre, Steven W Smeets, Amy M Wockenfus, Brad S Karon
OBJECTIVE: Evaluate the effects of blood gas sample contamination with total parenteral nutrition (TPN)/lipid emulsion and dextrose 50% (D50) solutions on blood gas and electrolyte measurement; and determine whether glucose concentration can predict blood gas sample contamination with TPN/lipid emulsion or D50. DESIGN AND METHODS: Residual lithium heparin arterial blood gas samples were spiked with TPN/lipid emulsion (0 to 15%) and D50 solutions (0 to 2.5%). Blood gas (pH, pCO2, pO2), electrolytes (Na+, K+ ionized calcium) and hemoglobin were measured with a Radiometer ABL90...
March 16, 2018: Clinical Biochemistry
John Spiliotis, Nikolaos Kopanakis, Anastasia Prodromidou, Alexis Terras, Anastasia Polichronaki, Christina Koutikova, Anna Gogou, Christina Sidera, Elias Efstathiou
PURPOSE: Home parenteral nutrition (HPN) has been proposed as the treatment of choice in patients suffering from intestinal failure (IF) and has been claimed to improve survival and quality of life either in patients with benign disorders or even in those with malignancies. The purpose of the present analysis was to report characteristics and outcomes of adult patients with IF receiving HPN in Greece. METHODS: Patients that received HPN between 2011 and 2017 were included in this retrospective analysis...
January 2018: Journal of B.U.ON.: Official Journal of the Balkan Union of Oncology
Yunlei Wang, Jianwei Zheng, Zhigang Gao, Xiaofeng Han, Fanrong Qiu
PURPOSE: To investigate the malnutrition, the incidence of nutritional risk and the application of nutritional support for patients with colorectal cancer, so as to provide a basis for the rational clinical application of nutritional support. METHODS: A total of 264 surgical patients with colorectal cancer treated/followed up from January 2016 to March 2017 in Beijing Chaoyang Hospital were selected. The nutritional risk was assessed using the Nutritional Risk Screening 2002 (NRS2002), and the nutritional risk and application of nutritional support for patients with different gender, age and clinical disease stage were analyzed; the hospitalization duration and postoperative complications were also analyzed and compared...
January 2018: Journal of B.U.ON.: Official Journal of the Balkan Union of Oncology
Geneviève Huard, M Isabel Fiel, Jang Moon, Kishore Iyer, Thomas D Schiano
INTRODUCTION: Intestinal failure-associated liver disease (IFALD) occurs commonly in intestinal transplant (ITx) candidates receiving parenteral nutrition (PN). The aim of this study is to establish the prevalence and risk factors for advanced liver fibrosis in adults at the time of ITx. METHODS: Retrospective chart review of all ITx was performed in adults between January 2000 and May 2014. Advanced liver fibrosis was defined as stage 3 or stage 4 fibrosis. RESULTS: Fifty-three patients met the inclusion criteria...
March 13, 2018: JPEN. Journal of Parenteral and Enteral Nutrition
Sara Nejatinamini, Catherine Kubrak, Mirey Álvarez-Camacho, Vickie E Baracos, Sunita Ghosh, Wendy V Wismer, Vera C Mazurak
This study assessed dietary and micronutrient intakes of head and neck cancer (HNC) patients at key points in the disease trajectory and evaluated the contribution of oral nutritional supplements (ONS) to micronutrient intake. HNC patients (n = 114) completed a three-day dietary record and a tool to assess Nutrition Impact Scores (NIS) at baseline, post-treatment, and follow-up. Foods were classified into food categories. Micronutrient, protein, and energy intakes were compared to European Society for Parenteral and Enteral Nutrition guidelines for cancer patients...
March 13, 2018: Nutrition and Cancer
Sabrina M Bierman, Sarah J Peterson, Yimin Chen
BACKGROUND: The American Academy of Nutrition and Dietetics and the American Society of Parenteral and Enteral Nutrition released a pediatric malnutrition consensus statement in 2014 recommending the use of z-scores as indicators for identification and documentation of malnutrition. A shift in focus is needed on standardizing pediatric malnutrition language at institutions nationwide to make study data comparable. With this standardized language, establishment of institutional baselines for identification, coding, and reimbursement of pediatric malnutrition is crucial to measure process improvements...
March 12, 2018: Nutrition in Clinical Practice
Ashley Ratliff, Amy Nishnick, Robert DeChicco, Rocio Lopez
BACKGROUND: Hyperglycemia is a common adverse event associated with parenteral nutrition (PN); however, there is no consensus on optimal glucose monitoring. Unnecessary point-of-care (POC) blood glucose (BG) testing can result in additional healthcare cost and discomfort to the patient. This study's aim was to determine whether decreasing the frequency of POC glucose testing in patients receiving PN can reduce costs without increasing the frequency of glycemic events. METHODS: This study examined adult, noncritically ill patients who require PN and are managed by a nutrition support team...
March 12, 2018: Nutrition in Clinical Practice
Aliana Meneses Ferreira, Frederico Moreira, Thais Guimaraes, Fernanda Spadão, Jessica Fernandes Ramos, Marjorie Vieira Batista, Jayr Schmidt Filho, Silvia Figueiredo Costa, Vanderson Rocha
BACKGROUND: Bloodstream infections (BSI) are a major complication in the early phase of a hematopoietic stem cell transplant (HSCT). AIM: To describe the incidence and risk factors for BSI occurring in the pre-engraftment phase of HSCT and its impact on mortality. METHODS: We retrospectively analysed clinical variables of 232 HSCT patients between 2014 and 2015. Univariate Cox regression analyses were performed to test the association between each covariate and the outcome...
March 9, 2018: Journal of Hospital Infection
Yan-Ting Song, Yong-Qin Wang, Yue-Hua Zhao, Hai-Ling Zhu, Qian Liu, Xiao Zhang, Yi-Wen Gao, Wei-Ye Zhang, Yu-Tong Sang
OBJECTIVE: To study the risk factors for elevated serum total bile acid (TBA) in preterm infants. METHODS: A retrospective analysis was performed for the clinical data of 216 preterm infants who were admitted to the neonatal intensive care unit. According to the presence or absence of elevated TBA (TBA >24.8 μmol/L), the preterm infants were divided into elevated TBA group with 53 infants and non-elevated TBA group with 163 infants. A univariate analysis and an unconditional multivariate logistic regression analysis were used to investigate the risk factors for elevated TBA...
March 2018: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
Mitchell A Rees, Nikhil B Amesur, Ruy J Cruz, Amir A Borhani, Kareem M Abu-Elmagd, Guilherme Costa, Anil K Dasyam
Intestinal transplantation has evolved from its experimental origins in the mid-20th century to its status today as an established treatment option for patients with end-stage intestinal failure who cannot be sustained with total parenteral nutrition. The most common source of intestinal failure in both adults and children is short-bowel syndrome, but a host of other disease processes can lead to this common end-point. The development of intestinal transplantation has presented multiple hurdles for the transplant community, including technical challenges, immunologic pitfalls, and infectious complications...
March 2018: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Nestoras Nicolas Mathioudakis, Estelle Everett, Shuvodra Routh, Peter J Pronovost, Hsin-Chieh Yeh, Sherita Hill Golden, Suchi Saria
Objective: To develop and validate a multivariable prediction model for insulin-associated hypoglycemia in non-critically ill hospitalized adults. Research design and methods: We collected pharmacologic, demographic, laboratory, and diagnostic data from 128 657 inpatient days in which at least 1 unit of subcutaneous insulin was administered in the absence of intravenous insulin, total parenteral nutrition, or insulin pump use (index days). These data were used to develop multivariable prediction models for biochemical and clinically significant hypoglycemia (blood glucose (BG) of ≤70 mg/dL and <54 mg/dL, respectively) occurring within 24 hours of the index day...
2018: BMJ Open Diabetes Research & Care
Yasmine Yousef, Fouad Youssef, Michael Homsy, Trish Dinh, Hayden Stagg, Robin Petroze, Robert Baird, Jean-Martin Larberge, Dan Poenaru, Pramod Puligandla, Kenneth Shaw, Sherif Emil
BACKGROUND: Total parenteral nutrition (TPN) is often used in children with perforated appendicitis, despite the absence of clear indications. We assessed the validity of specific clinical indications for initiation of TPN in this patient cohort. METHODS: Data were gathered prospectively on duration of nil per os (NPO) status and TPN use in a cohort of children treated under a perforated appendicitis protocol during a 19-month period. TPN was started in the immediate postoperative period in patients who had generalized peritonitis and severe intestinal dilatation at operation, or later per the discretion of the attending surgeon...
February 9, 2018: Journal of Pediatric Surgery
Thomas Godet, Renaud Guérin, Camille Verlhac, Sophie Cayot, Matthieu Jabaudon, Jean-Etienne Bazin, Emmanuel Futier, Jean-Michel Constantin
No abstract text is available yet for this article.
April 2018: Annals of Surgery
Fulvio Pinelli, Elena Cecero, Dario Degl'Innocenti, Valentina Selmi, Rosa Giua, Gianluca Villa, Cosimo Chelazzi, Stefano Romagnoli, Mauro Pittiruti
Totally implantable venous access devices, or ports, are essential in the therapeutic management of patients who require long-term intermittent intravenous therapy. Totally implantable venous access devices guarantee safe infusion of chemotherapy, blood transfusion, parenteral nutrition, as well as repeated blood samples. Minimizing the need for frequent vascular access, totally implantable venous access devices also improve the patient's quality of life. Nonetheless, totally implantable venous access devices are not free from complications...
March 1, 2018: Journal of Vascular Access
Karina Miura Costa, Amulya Kumar Saxena
BACKGROUND: Postoperative chylothorax occurs due to trauma to lymphatic vessels and can occur after any thoracic procedure. This study reviewed recent literature to evaluate the management and outcomes of surgical chylothorax in neonates. METHODS: PubMed database was searched for articles in English, Portuguese and Spanish from 2000 to 2016. Data were collected for surgery, chylothorax management, complications, mortality and length of hospital stay (LOS). RESULTS: Twenty studies offered 107 neonates: congenital diaphragmatic hernia (CDH) (n = 76, 71%), cardiac malformations (n = 25, 23...
March 5, 2018: World Journal of Pediatrics: WJP
Pam M Ku, Jennifer L Waller, Claude Sportès, Amber B Clemmons
PURPOSE: Hematopoietic cell transplant (HCT) recipients often require intravenous (IV) magnesium repletion due to poor dietary intake, gastrointestinal loss, and use of concomitant magnesium wasting medications. Prolonging the IV magnesium infusion rate has been postulated to reduce renal clearance and improve retention; however, limited evidence supports this hypothesis. METHODS: We reviewed autologous and allogeneic HCT recipients (n = 82) who received IV magnesium at our institution between 2014 and 2016: 41 patients received IV magnesium at a prolonged rate of 0...
March 5, 2018: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
Koji Amano, Tatsuya Morita, Jiro Miyamoto, Teruaki Uno, Hirofumi Katayama, Ryohei Tatara
PURPOSE: Few studies have investigated the need for nutritional support in advanced cancer patients in palliative care settings. Therefore, we conducted a questionnaire to examine the relationship between the perception of need for nutritional support and cancer cachexia and the prevalence of specific needs, perceptions, and beliefs in nutritional support. METHODS: We conducted a questionnaire in palliative care settings. Patients were classified into two groups: (1) non-cachexia/pre-cachexia and (2) cachexia/refractory cachexia...
March 5, 2018: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
Meredith A Baker, Paul D Mitchell, Alison A O'Loughlin, Alexis K Potemkin, Lorenzo Anez-Bustillos, Duy T Dao, Gillian L Fell, Kathleen M Gura, Mark Puder
BACKGROUND: The purpose of this study was to characterize fatty acid profiles (FAPs) in parenteral nutrition (PN)-dependent infants with intestinal failure-associated liver disease (IFALD) receiving soybean oil-based lipid emulsion (SO) doses of ∼3 and ∼1 g/kg/d. METHODS: Prospectively collected data were retrospectively reviewed. Serum FAPs of patients <1 year old who experienced development of IFALD while receiving standard PN with SO were examined before transitioning to a fish oil-based lipid emulsion for IFALD treatment...
January 2018: JPEN. Journal of Parenteral and Enteral Nutrition
Kwai Lam, Lauren Schwartz, Jennifer Batisti, Kishore R Iyer
BACKGROUND: Teduglutide is a glucagon-like peptide 2 (GLP-2) analog that has been approved for the treatment of adult short bowel syndrome (SBS)-associated intestinal failure (IF; SBS-IF). Teduglutide increases villus height and crypt depth in the small bowel mucosa, promoting nutrition absorption and enteral independence from parenteral nutrition (PN). We aim to report our single-center experience with teduglutide in adult patients with SBS to provide real-world context to its use. METHOD: We conducted a retrospective analysis on patients managed within our tertiary-level intestinal rehabilitation program to identify patients with SBS-IF treated with teduglutide from 2009-2015...
January 2018: JPEN. Journal of Parenteral and Enteral Nutrition
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