Clinical nutrition : official journal of the European Society of Parenteral and Enteral Nutrition
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Hyperglycemia is a major risk factor for increased morbidity and mortality in the intensive care unit. Insulin therapy has emerged in adult intensive care units and several pediatric studies are currently being conducted. This review discusses hyperglycemia and the effects of insulin on metabolic and non-metabolic pathways, with a focus on pediatric critical illness. ⋯ Future studies on the effect of insulin on morbidity and mortality as well as on the mechanisms through which insulin exerts these effects are necessary in critically ill children. We propose these studies to be conducted under standardized conditions including precise definitions of hyperglycemia and rates of glucose intake.
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Although parenteral nutrition is a vital method of delivery essential nutrients in patients with malnutrition associated to gastro-intestinal insufficiency, its inappropriate use can increase the risk of complications and incur unnecessary expenses. ⋯ The presence of Nutritional Support Unit and clinical practice guidelines for colorectal cancer management and treatment, optimised the use of hospital resources, namely unnecessary use of parenteral nutrition, reduction along with decrease in number of complications and length of hospital stay.
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The aim of our study was to examine, in patients with gastric cancer, the correlation between nutritional status, QoL (quality of life) and serum levels of TNF-alpha, IL-1 and IL-6. ⋯ The prevalence of MN is high in patients with gastric cancer. A significant correlation was found between higher values of cytokines, especially TNF-alpha, MN and QoL.
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Randomized Controlled Trial
Immediate oral feeding in patients with mild acute pancreatitis is safe and may accelerate recovery--a randomized clinical study.
In acute pancreatitis, traditional treatment has been initial fasting on purpose to avoid activation of proteolytic enzymes and pancreatic enzyme secretion. The aim of the present study was to evaluate the efficacy and feasibility of immediate oral feeding as compared to traditional fasting in patients with mild acute pancreatitis. ⋯ No signs of exacerbation of the disease process were seen in terms of significant differences between treatment groups for amylase or systemic inflammatory response. In mild acute pancreatitis, immediate oral feeding was feasible and safe and may accelerate recovery without adverse gastrointestinal events.
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Randomized Controlled Trial
A diet enriched in eicosapentanoic acid, gamma-linolenic acid and antioxidants in the prevention of new pressure ulcer formation in critically ill patients with acute lung injury: A randomized, prospective, controlled study.
Pressure ulcers are a significant burden in the ICU. Many factors have found to be associated with pressure ulcers including malnutrition. While it has been recognized that high protein diets decrease the incidence of pressure ulcers, the role of lipids as well as vitamins and antioxidants remains unclear. The aim of this study was to evaluate the preventive and healing effects of an enteral diet enriched in eicosapentanoic acid (EPA) and gamma-linolenic acid (GLA) and vitamins (vitamins A, C and E) on pressure ulcers. ⋯ A diet enriched with EPA, GLA and vitamins A, C and E is associated with a significantly lower occurrence of new pressure ulcers in critically ill patients with acute lung injury.