JPEN. Journal of parenteral and enteral nutrition
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JPEN J Parenter Enteral Nutr · May 2017
Volume-Based Enteral Nutrition Support Regimen Improves Caloric Delivery but May Not Affect Clinical Outcomes in Critically Ill Patients.
Meeting enteral nutrition goals is an ongoing challenge in the intensive care unit (ICU). Most hospitals use rate-based (RB) protocols for nutrient delivery. Previous studies have found that volume-based (VB) protocols improve delivery of prescribed calories. However, these studies did not assess clinical outcomes. We hypothesize that a VB method will improve the delivery of prescribed calories and lead to improved clinical outcomes. ⋯ VB enteral feeding allows for a significantly greater provision of prescribed calories but may not affect clinical outcomes. A larger sample size is needed for adequate power to corroborate these findings.
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JPEN J Parenter Enteral Nutr · Mar 2017
Randomized Controlled TrialClinical Trial of Vitamin D2 vs D3 Supplementation in Critically Ill Pediatric Burn Patients.
Hypovitaminosis D exists postburn. However, evidence-based guidelines for vitamin D repletion are unknown. This investigation examined differences between D2 and D3 supplementation on outcome in children with burn injuries. ⋯ The high incidence of low serum D25 levels 1 year following serious thermal injury indicates prolonged compromise. Continued treatment with vitamin D3 beyond the acute phase postburn is recommended to counteract the trajectory of abnormal serum levels and associated morbidity.
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JPEN J Parenter Enteral Nutr · Feb 2017
Multicenter StudyValidation of Bedside Ultrasound of Muscle Layer Thickness of the Quadriceps in the Critically Ill Patient (VALIDUM Study).
In critically ill patients, muscle atrophy is associated with long-term disability and mortality. Bedside ultrasound may quantify muscle mass, but it has not been validated in the intensive care unit (ICU). Here, we compared ultrasound-based quadriceps muscle layer thickness (QMLT) with precise quantifications of computed tomography (CT)-based muscle cross-sectional area (CSA). ⋯ Our results suggest that QMLT alone with our current protocol may not accurately identify patients with low muscle mass.
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JPEN J Parenter Enteral Nutr · Nov 2016
Case ReportsClinical Management of Patients With Parenteral Nutrition-Dependent Short Bowel Syndrome During Teduglutide Therapy.
Patients with intestinal failure, who are dependent on parenteral nutrition (PN) to supplement their limited absorption of dietary nutrients, are subject to complications associated with long-term PN therapy. Medication therapy that results in improved dietary nutrient absorption may enable these patients to reduce or even become independent from PN therapy and its related complications. The glucagon-like peptide 2 (GLP-2) analogue teduglutide was approved for use in such patients by the U.S. Food and Drug Administration in 2012. ⋯ While some patients had uncomplicated PN reduction, others experienced various complications. Careful monitoring of patients' clinical course is needed during drug therapy.