Clinical nutrition : official journal of the European Society of Parenteral and Enteral Nutrition
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Randomized Controlled Trial Clinical Trial
L-alanyl-L-glutamine-supplemented parenteral nutrition improves infectious morbidity in secondary peritonitis.
A growing number of randomized clinical trials suggest that glutamine (Gln) supplementation may be beneficial in a selected group of patients and conditions. However, the effects of Gln-enriched total parenteral nutrition (TPN) on recovery from acute intra-abdominal infection have not been thoroughly investigated. Therefore, the aim of this study was to investigate whether the provision of Gln-enriched TPN after surgical and medical treatment of secondary peritonitis improves infectious morbidity. ⋯ L-alanyl-L-glutamine-supplemented TPN improved the infectious morbidity of patients with secondary peritonitis. Gln supplementation to parenteral nutrition may be an alternative for enhancing host defenses and improving infectious morbidity.
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Randomized Controlled Trial Clinical Trial
Does additional feeding support provided by health care assistants improve nutritional status and outcome in acutely ill older in-patients?--a randomised control trial.
Malnutrition is common in the elderly and increases morbidity and mortality. Most attempts to reverse malnutrition have used liquid supplements, but the findings are inconsistent. This study tests a new approach using a randomised-controlled design. The aim was to examine whether health care assistants, trained to provide additional support with feeding, can improve acutely ill elderly in-patients' clinical outcomes. ⋯ It was concluded that the use of health care assistants in this specialised role, in an acute setting, without change to the food provision or without targeting higher risk patients, reduced the need for intravenous antibiotics. However, the intervention did not improve nutritional status or have an effect on length of stay in the time span studied. The results highlight the difficulties of improving the intake of acutely ill elderly patients during a hospital stay.
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Comparative Study
Experience of post-pyloric feeding in seriously ill patients in clinical practice.
Maintaining nutrition is an integral part of patient care and when it is possible enteral nutrition is regarded as superior to parenteral nutrition. Post-pyloric feeding may enable enteral feeding to be maintained in patients who cannot tolerate nasogastric feeding. The success of post-pyloric feeding in routine clinical practice is uncertain. ⋯ Post-pyloric feeding can be successfully used to maintain enteral nutrition in patients who would otherwise require parenteral nutrition.
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Traditional use of gastric residual volumes (GRVs) is insensitive and cannot distinguish retained enteral formula from the large volume of endogenous secretions. We designed this prospective study to determine whether refractometry and Brix value (BV) measurements could be used to monitor gastric emptying and tolerance in patients receiving continuous enteral feeding. ⋯ Refractometry and measurement of the BV may improve the clinical utilization of GRVs, by its ability to identify the component of formula within gastric contents and track changes in that component related to gastric emptying.