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Nutrition. Peds

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34 papers 0 to 25 followers
By M KKhan Pediatric Intensivist
https://www.readbyqxmd.com/read/24512952/nutrition-therapy-during-initiation-of-refeeding-in-underweight-children-and-adolescent-inpatients-with-anorexia-nervosa-a-systematic-review-of-the-evidence
#1
REVIEW
Tetyana Rocks, Fiona Pelly, Paul Wilkinson
Restoration of weight and nutritional rehabilitation are recognized as fundamental steps in the therapeutic treatment of children and adolescent inpatients with anorexia nervosa (AN). However, current recommendations on initial energy requirements for this population are inconsistent, with a clear lack of empirical evidence. Thus, the aim of our study was to systematically review, assess, and summarize the available evidence on the effect of differing nutrition therapies prescribed during refeeding on weight restoration in hospitalized children and adolescents (aged 19 years and younger) with diagnosed AN...
June 2014: Journal of the Academy of Nutrition and Dietetics
https://www.readbyqxmd.com/read/28031190/risk-factors-for-death-in-children-during-inpatient-treatment-of-severe-acute-malnutrition-a-prospective-cohort-study
#2
Maren Jh Rytter, Esther Babirekere-Iriso, Hanifa Namusoke, Vibeke B Christensen, Kim F Michaelsen, Christian Ritz, Charlotte G Mortensen, Ezekiel Mupere, Henrik Friis
BACKGROUND: Children who receive in-hospital treatment of severe acute malnutrition often have high mortality rates, and the reasons are not well understood. OBJECTIVE: We assessed risk factors for death in children who were treated for malnutrition in a hospital. DESIGN: In a prospective observational study of 120 children who were receiving in-hospital treatment of severe acute malnutrition in Uganda with therapeutic formulas F-75 and F-100, we collected data on symptoms, clinical findings, plasma markers of refeeding syndrome (electrolytes and phosphate), and acute phase reactants, and recorded the nutritional therapy given in hospital...
February 2017: American Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/28087222/revisiting-the-refeeding-syndrome-results-of-a-systematic-review
#3
REVIEW
Natalie Friedli, Zeno Stanga, Lubos Sobotka, Alison Culkin, Jens Kondrup, Alessandro Laviano, Beat Mueller, Philipp Schuetz
OBJECTIVE: Although described >70 y ago, the refeeding syndrome (RFS) remains understudied with lack of standardized definition and treatment recommendations. The aim of this systematic review was to gather evidence regarding standardized definition, incidence rate and time course of occurrence, association with adverse clinical outcomes, risk factors, and therapeutic strategies to prevent or treat this condition. METHODS: We searched MEDLINE and EMBASE for interventional and observational clinical trials focusing on RFS, excluding case reports and reviews...
March 2017: Nutrition
https://www.readbyqxmd.com/read/25280426/refeeding-syndrome-problems-with-definition-and-management
#4
Martin A Crook
Refeeding syndrome (RFS) broadly encompasses a severe electrolyte disturbance (principally low serum concentrations of intracellular ions such as phosphate, magnesium, and potassium) and metabolic abnormalities in undernourished patients undergoing refeeding whether orally, enterally, or parenterally. RFS reflects the change from catabolic to anabolic metabolism. RFS sometimes is undiagnosed and unfortunately some clinicians remain oblivious to its presence. This is particularly concerning as RFS is a life-threatening condition, although it need not be so and early recognition reduces morbidity and mortality...
November 2014: Nutrition
https://www.readbyqxmd.com/read/25456880/potassium-toxicity-at-low-serum-potassium-levels-with-refeeding-syndrome
#5
Praveen Vemula, Oliver G Abela, Keerthy Narisetty, David Rhine, George S Abela
Refeeding syndrome is a life-threatening condition occurring in severely malnourished patients after initiating feeding. Severe hypophosphatemia with reduced adenosine triphosphate production has been implicated, but little data are available regarding electrolyte abnormalities. In this case, we report electrocardiographic changes consistent with hyperkalemia during potassium replacement after a serum level increase from 1.9 to 2.9 mEq/L. This was reversed by lowering serum potassium back to 2.0 mEq/L. In conclusion, the patient with prolonged malnutrition became adapted to low potassium levels and developed potassium toxicity with replacement...
January 1, 2015: American Journal of Cardiology
https://www.readbyqxmd.com/read/28168570/early-enteral-nutrition-in-critically-ill-patients-esicm-clinical-practice-guidelines
#6
REVIEW
Annika Reintam Blaser, Joel Starkopf, Waleed Alhazzani, Mette M Berger, Michael P Casaer, Adam M Deane, Sonja Fruhwald, Michael Hiesmayr, Carole Ichai, Stephan M Jakob, Cecilia I Loudet, Manu L N G Malbrain, Juan C Montejo González, Catherine Paugam-Burtz, Martijn Poeze, Jean-Charles Preiser, Pierre Singer, Arthur R H van Zanten, Jan De Waele, Julia Wendon, Jan Wernerman, Tony Whitehouse, Alexander Wilmer, Heleen M Oudemans-van Straaten
PURPOSE: To provide evidence-based guidelines for early enteral nutrition (EEN) during critical illness. METHODS: We aimed to compare EEN vs. early parenteral nutrition (PN) and vs. delayed EN. We defined "early" EN as EN started within 48 h independent of type or amount. We listed, a priori, conditions in which EN is often delayed, and performed systematic reviews in 24 such subtopics. If sufficient evidence was available, we performed meta-analyses; if not, we qualitatively summarized the evidence and based our recommendations on expert opinion...
March 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/27049096/early-enteral-and-parenteral-nutrition-on-immune-functions-of-neurocritically-ill-patients
#7
S Y Qi, W T Wang, C Y Chen, Z D Chu, X J Liu, X J Liu
This study was designed to investigate the influence of early enteral and parenteral nutrition on immune functions of neurocritically ill patients. Patients who were admitted to the neurological intensive care unit (ICU) of The Second Affiliated Hospital of Zhengzhou University between May 2014 and January 2016 were selected. They had been hospitalized for more than one week and received enteral nutrition (EN) via nasogastric tube, with a gross energy of 25 kcal/(Kg • d). Patients were divided into EN group, EN + early PN (EPN) group and EN + supplemental PN (SPN) group according to the time of PN support...
January 2016: Journal of Biological Regulators and Homeostatic Agents
https://www.readbyqxmd.com/read/26814623/vitamin-d-has-the-new-dawn-for-dietary-recommendations-arrived
#8
EDITORIAL
S A Lanham-New, L R Wilson
No abstract text is available yet for this article.
February 2016: Journal of Human Nutrition and Dietetics: the Official Journal of the British Dietetic Association
https://www.readbyqxmd.com/read/27856012/nutrient-delivery-in-mechanically-ventilated-surgical-patients-in-the-pediatric-critical-care-unit
#9
Cristine S Velazco, David Zurakowski, Brenna S Fullerton, Lori J Bechard, Tom Jaksic, Nilesh M Mehta
PURPOSE: Inadequate nutrient intake is associated with poor outcomes in critically ill children. We examined macronutrient delivery in surgical patients in the pediatric intensive care unit (PICU). METHODS: In a prospective international cohort study of mechanically ventilated children (1month to 18years), we recorded adequacy of cumulative nutrient delivery in the PICU. Surgical patients enrolled in this study were included in the current analysis. Protein intake <60% of the prescribed goal was deemed inadequate...
January 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27831909/blended-foods-for-tube-fed-children-a-safe-and-realistic-option-a-rapid-review-of-the-evidence
#10
REVIEW
Jane Coad, Alex Toft, Susie Lapwood, Joseph Manning, Mark Hunter, Huw Jenkins, Clare Sadlier, Julie Hammonds, Ailsa Kennedy, Simon Murch, David Widdas
With the growing number of children and young people with complex care needs or life-limiting conditions, alternative routes for nutrition have been established (such as gastrostomy feeding). The conditions of children and young people who require such feeding are diverse but could relate to problems with swallowing (dysphagia), digestive disorders or neurological/muscular disorders. However, the use of a blended diet as an alternative to prescribed formula feeds for children fed via a gastrostomy is a contentious issue for clinicians and researchers...
March 2017: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/27788688/high-dose-intravenous-selenium-does-not-improve-clinical-outcomes-in-the-critically-ill-a-systematic-review-and-meta-analysis
#11
William Manzanares, Margot Lemieux, Gunnar Elke, Pascal L Langlois, Frank Bloos, Daren K Heyland
BACKGROUND: Selenium (Se) is an essential trace element with antioxidant, anti-inflammatory, and immunomodulatory effects. So far, several randomized clinical trials (RCTs) have demonstrated that parenteral Se may improve clinical outcomes in intensive care unit (ICU) patients. Since publication of our previous systematic review and meta-analysis on antioxidants in the ICU, reports of several trials have been published, including the largest RCT on Se therapy. The purpose of the present systematic review was to update our previous data on intravenous (IV) Se in the critically ill...
October 28, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27829456/is-the-glutamine-story-over
#12
Marie Smedberg, Jan Wernerman
Glutamine has been launched as a conditionally indispensible amino acid for the critically ill. Supplementation has been recommended in guidelines from international societies. Although data have been presented pointing out that glutamine supplementation may not be for everybody, recommendations for treatments and design of study protocols have included all critically ill patients. Results from more recent studies and meta-analyses indicate that indiscriminate use of glutamine supplementation in critically ill patients may actually cause harm rather than beneficial effects...
November 10, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27832823/resting-energy-expenditure-calorie-and-protein-consumption-in-critically-ill-patients-a-retrospective-cohort-study
#13
Oren Zusman, Miriam Theilla, Jonathan Cohen, Ilya Kagan, Itai Bendavid, Pierre Singer
BACKGROUND: Intense debate exists regarding the optimal energy and protein intake for intensive care unit (ICU) patients. However, most studies use predictive equations, demonstrated to be inaccurate to target energy intake. We sought to examine the outcome of a large cohort of ICU patients in relation to the percent of administered calories divided by resting energy expenditure (% AdCal/REE) obtained by indirect calorimetry (IC) and to protein intake. METHODS: Included patients were hospitalized from 2003 to 2015 at a 16-bed ICU at a university affiliated, tertiary care hospital, and had IC measurement to assess caloric targets...
November 10, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/22307571/initial-trophic-vs-full-enteral-feeding-in-patients-with-acute-lung-injury-the-eden-randomized-trial
#14
RANDOMIZED CONTROLLED TRIAL
Todd W Rice, Arthur P Wheeler, B Taylor Thompson, Jay Steingrub, R Duncan Hite, Marc Moss, Alan Morris, Ning Dong, Peter Rock
CONTEXT: The amount of enteral nutrition patients with acute lung injury need is unknown. OBJECTIVE: To determine if initial lower-volume trophic enteral feeding would increase ventilator-free days and decrease gastrointestinal intolerances compared with initial full enteral feeding. DESIGN, SETTING, AND PARTICIPANTS: The EDEN study, a randomized, open-label, multicenter trial conducted from January 2, 2008, through April 12, 2011. Participants were 1000 adults within 48 hours of developing acute lung injury requiring mechanical ventilation whose physicians intended to start enteral nutrition at 44 hospitals in the National Heart, Lung, and Blood Institute ARDS Clinical Trials Network...
February 22, 2012: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/27790606/nutrition-a-primary-therapy-in-pediatric-acute-respiratory-distress-syndrome
#15
REVIEW
Bryan Wilson, Katri Typpo
Appropriate nutrition is an essential component of intensive care management of children with acute respiratory distress syndrome (ARDS) and is linked to patient outcomes. One out of every two children in the pediatric intensive care unit (PICU) will develop malnutrition or have worsening of baseline malnutrition and present with specific micronutrient deficiencies. Early and adequate enteral nutrition (EN) is associated with improved 60-day survival after pediatric critical illness, and, yet, despite early EN guidelines, critically ill children receive on average only 55% of goal calories by PICU day 10...
2016: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/27604334/effect-of-saline-0-9-or-plasma-lyte-148-therapy-on-feeding-intolerance-in-patients-receiving-nasogastric-enteral-nutrition
#16
Sumeet Reddy, Michael Bailey, Richard Beasley, Rinaldo Bellomo, Diane Mackle, Alex Psirides, Paul Young
OBJECTIVE: To compare the effect of Plasma-Lyte (PL)-148 and saline 0.9% (saline) on gastrointestinal (GI) feeding intolerance in mechanically ventilated patients receiving nasogastric (NG) feeding in an intensive care unit. DESIGN AND SETTING: A single-centre pilot study, nested within a multicentre, double-blind, cluster-randomised, double-crossover trial, performed in a mixed medical and surgical ICU. PARTICIPANTS: All adult patients who required crystalloid fluid therapy as part of the 0...
September 2016: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/27016160/controversies-in-critical-care-nutrition-support
#17
REVIEW
Jayshil J Patel, Panna Codner
Critical illness predisposes individuals to highly variable metabolic and immune responses, leading to muscle mass loss, impaired healing, immobility, and susceptibility to infections and cognitive impairment. Recommendations for nutrition in critically ill patients are supported by observational studies, small randomized controlled trials, and mechanistic data. There is no standardization of nutritional therapy in critically ill patients and controversies in the type, quantity, and timing of nutrition support persist...
April 2016: Critical Care Clinics
https://www.readbyqxmd.com/read/27755096/will-the-use-of-anthropometric-measurements-solely-to-assess-nutritional-status-in-picu-suffice
#18
Patrícia Zamberlan, Artur Figueiredo Delgado, Werther Brunow de Carvalho
No abstract text is available yet for this article.
November 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/26539926/nutritional-controversies-in-critical-care-revisiting-enteral-glutamine-during-critical-illness-and-injury
#19
REVIEW
John A Stroster, Selman Uranues, Rifat Latifi
PURPOSE OF REVIEW: This article examines some of the articles that inspired recent changes to critical care guidelines related to glutamine in enteral nutrition. RECENT FINDINGS: Two recent multicenter randomized controlled trials involving enteral glutamine have reported increased mortality rates in groups of mechanically ventilated adult patients, while demonstrating no additional benefits to other outcomes, such as nosocomial infections. SUMMARY: Recent studies suggest that enteral glutamine supplementation may not provide significant clinical benefits to adult patients on mechanical ventilation with multiple organ failure, but more information is still needed when attempting to apply these results to other groups of critical care patients...
December 2015: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/26808138/biomarkers-of-gut-barrier-failure-in-the-icu
#20
REVIEW
Gaël Piton, Gilles Capellier
PURPOSE OF REVIEW: Gut barrier failure is associated with bacterial translocation, systemic inflammation, and is presumed to be associated with the development of multiple organ dysfunction syndrome. As the gut barrier function is carried out by a monolayer of enterocytes, a minimum requirement is the integrity of the enterocytes, and controlled paracellular permeability between adjacent enterocytes. Many factors can cause critically ill patients to lose gut barrier function by a mechanism of enterocyte damage; for example, small bowel ischemia or hypoxia, sepsis, systemic inflammatory response syndrome, or absence of enteral feeding...
April 2016: Current Opinion in Critical Care
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