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https://www.readbyqxmd.com/read/29034711/electromagnetically-guided-bedside-placement-of-post-pyloric-feeding-tubes-in-critical-care
#1
Danielle E Bear, Alice Champion, Katie Lei, Luigi Camporota, Nicholas A Barrett
Post-pyloric feeding is recommended in critically ill patients with gastro-intestinal intolerance. However, traditional placement methods are logistically difficult and carry potential risks. The authors retrospectively compared the position of post-pyloric feeding tubes (PPFTs) using an electromagnetic device that demonstrated by X-ray and analysed the complication rates, proportion of lung placements avoided and the time taken to establish enteral feeding. Forty placements in 37 mechanically ventilated patients were analysed; there was a success rate of 87...
October 12, 2017: British Journal of Nursing: BJN
https://www.readbyqxmd.com/read/29034175/refining-low-protein-modular-feeds-for-children-on-low-protein-tube-feeds-with-organic-acidaemias
#2
A Daly, S Evans, C Ashmore, S Chahal, S Santra, A MacDonald
Children with inherited metabolic disorders (IMD) who are dependent on tube feeding and require a protein restriction are commonly fed by 'modular tube feeds' consisting of several ingredients. A longitudinal, prospective two-phase study, conducted over 18 months assessed the long-term efficacy of a pre-measured protein-free composite feed. This was specifically designed to meet the non-protein nutritional requirements of children (aged over 1 year) with organic acidaemias on low protein enteral feeds and to be used as a supplement with an enteral feeding protein source...
December 2017: Molecular Genetics and Metabolism Reports
https://www.readbyqxmd.com/read/29023191/use-of-nasogastric-feeding-tubes-for-children-at-home-a-template-for-caregiver-education
#3
Beth Lyman, Gina Rempel, Kerrin Windsor, Peggi Guenter
There is a lack of knowledge on the part of caregivers who need to place nasogastric (NG) tubes in children for enteral nutrition therapy. This article provides the rationale, best practices, and a template for caregiver education. Canadian and Australian programs have excellent patient education materials. They have shared these step-by-step procedures for healthcare professionals to provide to caregivers to whom they are teaching placement and care of NG tubes.
October 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28986026/nutrition-prevention-and-management-of-nutritional-failure-in-cystic-fibrosis
#4
Jillian S Sullivan, Maria R Mascarenhas
Close monitoring of nutritional status is critical to the overall health of a patient with CF. As part of routine CF care, measurement of weight and height (and calculation of weight/length or BMI as appropriate) should be performed and analyzed at each visit. Early recognition of nutritional risk is imperative and evaluation with a multidisciplinary team should be performed to assess for caloric intake, caloric malabsorption, and other causes of poor weight gain and growth. Many tools are available to use for intervention, including oral supplementation, behavioral interventions, medications, nutritional therapies, and enteral tube feeding...
September 16, 2017: Journal of Cystic Fibrosis: Official Journal of the European Cystic Fibrosis Society
https://www.readbyqxmd.com/read/28960535/nutrition-related-hospital-presentations-and-admissions-among-radiotherapy-outpatients-a-systematic-literature-review
#5
REVIEW
E Hazzard, K Walton, A-T McMahon, M Milosavljevic, L C Tapsell
BACKGROUND: Unplanned presentations and admissions to hospital among outpatients with cancer are a key indicator of quality care in cancer services. Nutritional issues including malnutrition and dehydration, which fall under the dietitian's scope of practice, can result in unplanned contacts. The present review focused on cancer outpatients undergoing radiotherapy as a particular at risk group and aimed to provide a comprehensive overview of the range and prevalence of nutrition-related unplanned contacts and the associated factors, including the role of dietetic intervention...
September 28, 2017: Journal of Human Nutrition and Dietetics: the Official Journal of the British Dietetic Association
https://www.readbyqxmd.com/read/28956273/tube-feed-necrosis-after-major-gastrointestinal-oncologic-surgery-institutional-lessons-and-a-review-of-the-literature
#6
S A Sethuraman, V K Dhar, D A Habib, J E Sussman, S A Ahmad, S A Shah, B J Tsuei, J J Sussman, Daniel E Abbott
BACKGROUND: Small bowel necrosis after enteral feeding through a jejunostomy tube (tube feed necrosis, TFN) is a rare, serious complication of major abdominal surgery. However, strategies to reduce the incidence and morbidity of TFN are not well established. Here, in the largest series of TFN presented to date, we report our institutional experience and a comprehensive review of the literature. METHODS: Eight patients who experienced TFN from 2000 to 2014 after major abdominal surgery for oncologic indications at the University of Cincinnati were reviewed...
September 27, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28950897/blind-bedside-postpyloric-placement-of-spiral-tube-as-rescue-therapy-in-critically-ill-patients-a-prospective-tricentric-observational-study
#7
Bo Lv, Linhui Hu, Lifang Chen, Bei Hu, Yanlin Zhang, Heng Ye, Cheng Sun, Xiunong Zhang, Huilan Lan, Chunbo Chen
BACKGROUND: Various special techniques for blind bedside transpyloric tube placement have been introduced into clinical practice. However, transpyloric spiral tube placement facilitated by a blind bedside method has not yet been reported. The objective of this prospective study was to evaluate the safety and efficiency of blind bedside postpyloric placement of a spiral tube as a rescue therapy subsequent to failed spontaneous transpyloric migration in critically ill patients. METHODS: This prospective, tricentric, observational study was conducted in the intensive care units (ICUs) of three tertiary hospitals...
September 26, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28942701/feeding-tubes-and-health-care-service-utilization-in-amyotrophic-lateral-sclerosis-benefits-and-limits-to-a-retrospective-multicenter-study-using-big-data
#8
Keith M Swetz, Stephanie M Peterson, Lindsey R Sangaralingham, Ryan T Hurt, Shannon M Dunlay, Nilay D Shah, Jon C Tilburt
Amyotrophic lateral sclerosis (ALS) is a progressive, fatal neurologic disorder with predictable challenges regarding disease progression and end-of-life care. These include need for respiratory and nutritional support. Little is known about how such choices impact end-of-life health service utilization for these patients. Using OptumLabs Data Warehouse, a large administrative claims database with more than 150 million privately insured, geographically diverse enrollees, we sought to explore outcomes associated with the use of enteral nutrition (EN)...
January 1, 2017: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/28929948/moderately-high-protein-enteral-formula-improved-retinol-binding-protein-in-tube-fed-patients-a-multicentre-open-study
#9
Veeradej Pisprasert, Prapimporn Chattranukulchai Shantavasinkul, Sornwichate Rattanachaiwong, Tanarat Lepananon, Surat Komindr
BACKGROUND: Long-term inadequate dietary consumption may increase the possibility of malnutrition, morbidity and mortality. Enteral nutrition (EN) is a beneficial support that could help to maintain nutritional status and gut function. AIM: Our aim was to evaluate the effect of moderately high-protein enteral formula containing fibre on nutritional status, and its safety. METHOD: A total of 23 tube-feeding-dependent adult patients were included in this multicentre, open-label study...
September 2017: Nutrition and Health
https://www.readbyqxmd.com/read/28929778/direct-percutaneous-endoscopic-jejunostomy-should-we-move-on-to-single-and-double-balloon-enteroscopy-techniques
#10
Klaus Mönkemüller, Carolina Olano, Steffen Rickes
Direct percutaneous endoscopic jejunostomy (DPEJ) is a useful technique to access the jejunum in order to: a) provide enteral nutrition to individuals when the gastric route is absent or contraindicated; and b) to decompress the jejunum in patients with malignant small bowel obstruction. Traditionally, DPEJ is performed using a colonoscope or enteroscope, which is advanced as deep as possible into the jejunum. The insertion technique of the feeding tube is identical to the one used for a gastrostomy tube (Ponsky-Gauderer method)...
October 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28924528/near-fatal-gastrointestinal-hemorrhage-in-a-child-with-medulloblastoma-on-high-dose-dexamethasone
#11
Derek Yecies, Daniel Tawfik, Jennifer Damman, Chad Thorson, David S Hong, Gerald A Grant, Rachel Bensen, Mihaela Damian
A four-year-old female was admitted to a university-based children's hospital with a newly-diagnosed posterior fossa tumor. She was started on famotidine and high-dose dexamethasone and underwent gross total resection of a medulloblastoma. She was continued on dexamethasone and famotidine. She exhibited postoperative posterior fossa syndrome and was started on enteral feeds via the nasoduodenal tube. She had small gastrointestinal bleeds on postoperative days eight, 11, and 18, and was found to have a well-circumscribed posterior duodenal ulcer...
July 7, 2017: Curēus
https://www.readbyqxmd.com/read/28919081/body-weight-and-body-mass-index-in-patients-with-end-stage-cystic-fibrosis-stabilize-after-the-start-of-enteral-tube-feeding
#12
Francis M Hollander, Nicole M de Roos, Gerdien Belle van Meerkerk, Ferdinand Teding van Berkhout, Harry G M Heijerman, Ed A van de Graaf
BACKGROUND: Enteral tube feeding (ETF) is widely used in patients with cystic fibrosis (CF) and end-stage lung disease, but previous studies have been limited to investigating whether ETF improves outcomes in patients with moderately or mildly impaired pulmonary function. OBJECTIVE: This study investigated body weight, body mass index (BMI; calculated as kg/m(2)), pulmonary function, and the presence of CF-related diabetes before and after the start of ETF. DESIGN: This was a retrospective observational study...
September 11, 2017: Journal of the Academy of Nutrition and Dietetics
https://www.readbyqxmd.com/read/28912913/paraneoplastic-dermatomyositis-syndrome-presenting-as-dysphagia
#13
Emmanuel Ofori, Daryl Ramai, Mel Ona, Madhavi Reddy
Dermatomyositis (DM) is a rare autoimmune condition which predominantly affects females in the fifth and sixth decades of life. DM presents acutely or progressively as painless proximal skeletal muscle weakness and can be associated with a heliotropic rash around the eyes, and Gottron's papules on extensor surfaces of the hands. While the pathophysiology of DM is still unclear, abnormal T- and B-cell immune activity has been reported. DM has been associated with malignancy and has been shown to appear before, concurrently with, or after diagnosis of cancer...
August 2017: Gastroenterology Research
https://www.readbyqxmd.com/read/28877087/percutaneous-endoscopic-gastrostomy-under-conscious-sedation-in-patients-with-amyotrophic-lateral-sclerosis-is-safe-an-observational-study
#14
Denise Strijbos, José Hofstede, Daniel Keszthelyi, Ad A M Masclee, Lennard P L Gilissen
OBJECTIVES: Amyotrophic lateral sclerosis (ALS) is a progressive neuromuscular disease that causes muscle weakness with respiratory and swallowing dysfunction, eventually leading to death. Permanent enteral feeding is indicated in almost all patients. A percutaneous endoscopic gastrostomy (PEG) tube is considered the first choice, usually performed under conscious sedation (intravenous midazolam). Guidelines are very cautious with respect to sedation in ALS because of the risk for respiratory complications...
November 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28865925/refining-patient-selection-for-reirradiation-of-head-and-neck-squamous-carcinoma-in-the-imrt-era-a-multi-institution-cohort-study-by-the-miri-collaborative
#15
Matthew C Ward, Nadeem Riaz, Jimmy J Caudell, Neal E Dunlap, Derek Isrow, Sara J Zakem, Joshua Dault, Musaddiq J Awan, John A Vargo, Dwight E Heron, Kristin A Higgins, Jonathan J Beitler, Samuel Marcrom, Drexell H Boggs, Comron Hassanzadeh, Chandana A Reddy, James A Bonner, Min Yao, Mitchell Machtay, Farzan Siddiqui, Andy M Trotti, Nancy Y Lee, Shlomo A Koyfman
PURPOSE: The therapeutic ratio of reirradiation for recurrent or second primary (RSP) squamous carcinoma of the head and neck may be improved in the intensity modulated radiation therapy (IMRT) era. However, patient selection for reirradiation remains challenging. We performed a multi-institution cohort study to investigate modern outcomes after IMRT-based reirradiation and to identify prognostic subgroups. PATIENTS AND METHODS: Patients with RSP squamous carcinoma originating in a previously irradiated field (≥40 Gy) who underwent reirradiation with IMRT (≥40 Gy re-IMRT) were included...
June 17, 2017: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/28864557/over-the-scope-clip-system-secured-nasojejunal-tube-feeding-in-refractory-hyperemesis-gravidarum
#16
Jan Kubovy, Agnieszka Them, Rees Cameron, Fali Langdana
Hyperemesis gravidarum (HG) is a severe form of nausea and vomiting in pregnancy. It complicates up to 2% of all pregnancies and can be associated with adverse outcomes. Its management commonly involves a combination pharmacotherapy, however, the efficacy of such treatment is limited. Supplemental nutrition is often required in refractory cases. Enteral route is preferred over parenteral, given the high rate of intravenous catheter-related complications. Enteral feeding tube placement can be challenging and is commonly thwarted by dislodgement...
September 1, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28859370/management-of-recurrent-tracheoesophageal-fistula-after-esophageal-atresia-and-follow-up
#17
J Wang, M Zhang, W Pan, W Wu, W Yan, W Cai
Recurrent tracheoesophageal fistula (rTEF) is a complex complication after the repair of esophageal atresia (EA) and remains a challenge because of difficulties in preoperative management and the substantial rates of mortality and morbidity after reoperation. By reviewing a single institution's experience in the management of rTEF and assessing the outcome, we aimed to provide an optimal approach for managing rTEF and to evaluate growth and feeding problems after reoperations. The medical records of 35 patients with rTEF treated at a single institution from June 2012 to December 2015 were reviewed, and follow-up data were collected from all survivors...
September 1, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/28836877/management-of-hyperglycemia-in-the-neurosurgery-patient
#18
REVIEW
Rene Daniel, Satya Villuri, Kevin Furlong
Hyperglycemia is associated with adverse outcomes in patients who are candidates for or underwent neurosurgical procedures. Specific concerns and settings that relate to these patients are preoperative glycemic control, intraoperative control, management in the neurological intensive care unit (NICU), and postoperative control. In each of these settings, physicians have to ensure appropriate glycemic control to prevent or minimize adverse events. The glycemic control is usually managed by a neurohospitalist in co-management with the neurosurgery team pre- and post-operatively, and by the neurocritical care team in the setting of NICU...
October 2017: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/28836089/risk-factors-for-sodium-valproate-induced-renal-tubular-dysfunction
#19
Satoko Koga, Takahisa Kimata, Sohsaku Yamanouchi, Shoji Tsuji, Ken Yoshimura, Atsushi Araki, Kazunari Kaneko
OBJECTIVE: To explore the risk factors for the development of sodium valproate (VPA)-induced renal tubular dysfunction for early diagnosis and treatment. STUDY DESIGN: The subjects were selected from patients who were diagnosed with epilepsy and administered VPA. Blood and spot urine samples were collected and measured the concentration of VPA, the level of serum phosphorus, serum uric acid, serum free carnitine, serum cystatin-c, and urine β2-microglobulin (BMG)...
August 23, 2017: Clinical and Experimental Nephrology
https://www.readbyqxmd.com/read/28835092/management-of-percutaneous-endoscopic-gastrostomy-site-gastric-ulcer-in-a-patient-with-an-esophageal-stricture-and-hiatus-hernia
#20
Clement C H Wu, James W Li, Keng Sin Ng, Daphne S Ang
Percutaneous endoscopic gastrostomy (PEG) is commonly performed for feeding difficulties, in patients suffering from complications of nasopharyngeal carcinoma (NPC) and its treatment, namely radiotherapy and surgery. This case report describes the challenges in hemostasis and subsequent re-establishment of enteral access for feeding, in an elderly patient with a history of NPC, treated surgically, followed by radiotherapy, who presented with massive hematemesis following reinsertion of her PEG shortly after an accidental dislodgement...
May 22, 2017: Clinical Endoscopy
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