Clinical nutrition ESPEN
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Clinical nutrition ESPEN · Oct 2019
Clinical Nutrition in Critical Care Medicine - Guideline of the German Society for Nutritional Medicine (DGEM).
Enteral and parenteral nutrition of adult critically ill patients varies in terms of the route of nutrient delivery, the amount and composition of macro- and micronutrients, and the choice of specific, immune-modulating substrates. Variations of clinical nutrition may affect clinical outcomes. The present guideline provides clinicians with updated consensus-based recommendations for clinical nutrition in adult critically ill patients who suffer from at least one acute organ dysfunction requiring specific drug therapy and/or a mechanical support device (e.g., mechanical ventilation) to maintain organ function. ⋯ The current guideline provides clinicians with up-to-date recommendations for enteral and parenteral nutrition of adult critically ill patients who suffer from at least one acute organ dysfunction requiring specific drug therapy and/or a mechanical support device (e.g., mechanical ventilation) to maintain organ function. The period of validity of the guideline is approximately fixed at five years (2018-2023).
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Clinical nutrition ESPEN · Oct 2019
Usual intake and dietary sources of Selenium in adolescents: A cross-sectional school-based study.
Selenium is a mineral that constitutes selenoproteins and, therefore, has been studied, especially in cardiovascular diseases. Some risk factors for the development of these diseases, such as obesity, hypertension and dyslipidemia, have been observed early in life, including in childhood and adolescence, and food and nutrient intake is an important associated factor for their development. The aim of this study was to assess usual intake of selenium (Se) and dietary inadequacies regarding the consumption of this mineral, and to identify the main dietary sources of Se among 12-17 year-old Brazilian adolescents. ⋯ Brazilian adolescents have an adequate Se intake because of the high consumption of meat, pasta, and poultry. Although Brazil nuts are the most important dietary source of Se, adolescents consume them in very small amounts, leading to a small contribution in the total intake.
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Clinical nutrition ESPEN · Oct 2019
Energy expenditure in acute pancreatitis evaluated by the Harris-Benedict equation compared with indirect calorimetry.
Enteral nutrition (EN) is recommended for severe acute pancreatitis (AP) and for biliary AP if cholecystectomy is delayed. Energy expenditure (EE) is calculated using the Harris-Benedict equation (HBE), but indirect calorimetry (IC) can also be employed. We wished to compare EE evaluated by the HBE equation, modified HBE (mHBE) and IC at study inclusion and 1 month after AP resolution. ⋯ The HBE underestimated EE for severe AP, whereas the mHBE overestimated it. IC seems to be the best means of EE evaluation for AP.
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Clinical nutrition ESPEN · Jun 2019
Food avoidance in outpatients with Inflammatory Bowel Disease - Who, what and why.
Food avoidance is common with Inflammatory Bowel Disease (IBD) and adherence to dietary guidelines is poor, contributing to under and over nutrition. Reasons for food avoidance have not been previously explored in detail. This study of IBD outpatients aimed to describe food avoidance patterns and rationale behind this, and describe source and confidence with dietary advice. ⋯ High prevalence of avoidance of nutritious foods and low confidence in dietetic advice amongst people with IBD is of concern. Further work is needed to build trust and ensure patients are provided with evidence-based nutrition recommendations to manage their symptoms whilst optimizing nutritional quality of their diet.
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Clinical nutrition ESPEN · Apr 2019
Malnutrition predicts long-term survival in hospitalized patients with gastroenterological and hepatological diseases.
Malnutrition is a common problem in hospitalized patients, influencing treatment outcomes, length of hospital stay, quality of life and overall survival. However, the association of nutritional status parameters with long-term mortality has not yet been studied systematically in gastroenterological-hepatological patients. The present study aimed to assess the association between nutritional status parameters as characterized by Nutritional Risk Screening (NRS), anthropometry, serum transferrin, bioelectrical impedance analysis (BIA) and long-term overall survival in hospitalized gastroenterological-hepatological patients. ⋯ Malnutrition is highly prevalent in hospitalized gastroenterological-hepatological patients and is associated with distinct clinical diagnoses. In the present study we demonstrated that malnutrition characterized by the NRS, anthropometry, serum transferrin and BIA, not only predicts short-term but also significantly poor long-term outcome in these patients.