JPEN. Journal of parenteral and enteral nutrition
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JPEN J Parenter Enteral Nutr · Jul 2016
Validation of the Society of Critical Care Medicine and American Society for Parenteral and Enteral Nutrition Recommendations for Caloric Provision to Critically Ill Obese Patients: A Pilot Study.
The Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (ASPEN) recommend that obese, critically ill patients receive 11-14 kcal/kg/d using actual body weight (ABW) or 22-25 kcal/kg/d using ideal body weight (IBW), because feeding these patients 50%-70% maintenance needs while administering high protein may improve outcomes. It is unknown whether these equations achieve this target when validated against indirect calorimetry, perform equally across all degrees of obesity, or compare well with other equations. ⋯ SCCM/ASPEN-recommended body weight equations are reasonable predictors of 65% MREE depending on the equation and degree of obesity. Assuming that feeding 65% MREE is appropriate, this study suggests that patients with a BMI 30-50 kg/m(2) should receive 11-14 kcal/kg/d using ABW and those with a BMI >50 kg/m(2) should receive 22-25 kcal/kg/d using IBW.
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JPEN J Parenter Enteral Nutr · Jul 2016
Impact of Process Optimization and Quality Improvement Measures on Neonatal Feeding Outcomes at an All-Referral Neonatal Intensive Care Unit.
We hypothesized that the implementation of a feeding quality improvement (QI) program among premature neonates accelerates feeding milestones, safely lowering hospital length of stay (LOS) compared with the baseline period. ⋯ Process optimization and the implementation of a standardized feeding strategy minimize practice variability, accelerating the attainment of enteral and oral feeding milestones and decreasing LOS without increasing adverse morbidities.