Clinical nutrition : official journal of the European Society of Parenteral and Enteral Nutrition
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Several hip fracture patients are malnourished, but no study has attempted to determine the optimal nutritional screening tool for predicting functional outcomes. We investigated the association between each nutritional status assessed by four nutritional screening tools at admission and functional outcomes during the postoperative acute phase in hip fracture patients. ⋯ The MNA-SF was found to be an optimal nutritional screening tool to associate with functional outcomes during the postoperative acute phase of elderly hip fracture patients.
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Randomized Controlled Trial
Effect of an enhanced recovery after surgery protocol in patients undergoing pancreaticoduodenectomy: A randomized controlled trial.
Evidence of the advantages of enhanced recovery after surgery (ERAS) protocols following pancreaticoduodenectomy (PD) is limited. The aim of this study was to examine the efficiency of ERAS protocols in patients following PD. ⋯ UMIN000014068.
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Malnutrition-inflammation complex syndrome (MICS), hyperhomocysteinemia, calcium and phosphate levels derangement have been predicted as important contributing factors for the progression of cardiovascular burden. Among patients with earlier stage of CKD, hypoalbuminaemia and inflammation deliberated as non-traditional cardiovascular risk factors, which add more burden to circulatory disease, mortality and rapid advancement to CKD stage 5. ⋯ This study shows MIS is an important factor that determines mortality in pre-dialysis CKD patients during 36 and more months of follow-up time. Patients with MIS ≥7 have high risk for mortality and needs close monitoring. In clinical setting application of MIS has a greater utilization in pre-dialysis CKD patients. Further research with longitudinal assessment of MIS and its association with outcomes are warranted. Pre-dialysis CKD patients should be assessed for their nutritional status and inflammation using MIS regularly to prevent malnutrition and its associated complications through appropriate medical and nutritional intervention.
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Little data evaluate the enteral nutrition (EN) for patients with acute mesenteric ischaemia (AMI) in the intensive care unit (ICU). This study assessed the outcomes of EN for recanalised AMI patients in the ICU. ⋯ Acute mesenteric ischaemia (AMI) is a catastrophic abdominal vascular emergency in the surgical intensive care unit (ICU), and the mortality of AMI remains unchanged despite significant progress of endovascular techniques. A multidisciplinary and multimodal management approach of AMI in the ICU has been recently proposed to improve patient's survival and prevent the intestinal failure. Post-recanalisation nutrition therapy may significantly improve the overall survival of AMI patients is quite underemphasised in the ICU. Definitive data comparing EN with TPN for this patient population are very lacking. This study provides the clinical data to suggest that early EN starting after ICU admission represents a favourable alternative to TPN for recanalised AMI patients. The nutrition therapy protocol in the ICU for this special cohort needs to be updated with more high-level evidence in the future.
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Observational Study
Adequacy of nutrition support during extracorporeal membrane oxygenation.
The use of veno-venous extracorporeal membrane oxygenation (vv-ECMO) is increasing in adults with severe respiratory failure. Observational data suggest that there are significant challenges to providing adequate nutrition support for patients on vv-ECMO. We aimed to describe firstly the nutrition support practices in a large single-centre providing vv-ECMO to adults and secondly any association with clinical outcome. ⋯ Adequate energy and protein delivery during vv-ECMO is possible but underfeeding is still common, especially in those who are more severely ill or who have more severe organ dysfunction. Patients with inadequate energy or protein delivery did not differ in ICU and 6-month survival. Prospective studies investigating optimal feeding in this patient cohort are required.