Clinical nutrition : official journal of the European Society of Parenteral and Enteral Nutrition
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Randomized Controlled Trial
Novel multi-sugar assay for site-specific gastrointestinal permeability analysis: a randomized controlled crossover trial.
Increased gastrointestinal (GI) permeability is an important hallmark of many conditions, potentially leading to antigen exposure and sepsis. Current permeability tests are hampered by analytical limitations. This study aims to compare the accuracy of our multi-sugar (MS) and the classical dual sugar (DS) test for detection of increased GI permeability. ⋯ Sensitive permeability analysis is feasible in plasma and urine using MS or DS test. In contrast to the DS test, monosaccharide excretion is not decreased by the MS test. In short, the MS test provides accurate, site-specific information on gastroduodenal, small, and large intestinal permeability. Registered at US National Library of Medicine (http://www.clinicaltrials.gov, NCT00943345).
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Meta Analysis
A meta-analysis of randomised controlled trials on preoperative oral carbohydrate treatment in elective surgery.
Whilst preoperative carbohydrate treatment (PCT) results in beneficial physiological effects, the effects on postoperative clinical outcomes remain unclear and were studied in this meta-analysis. ⋯ PCT may be associated with reduced length of stay in patients undergoing major abdominal surgery, however, the included studies were of low to moderate quality.
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Comparative Study
Indirect calorimetry in mechanically ventilated patients. A systematic comparison of three instruments.
Indirect calorimetry is the gold standard in determining energy expenditure to dose nutritional therapy for critically ill patients. The most commonly used system for indirect calorimetry in the ICU setting (Deltatrac Metabolic Monitor) is no longer in production. The aim of this study was to compare two new instruments for IC (Quark RMR, CCM Express) to the Deltatrac in mechanically ventilated patients. ⋯ Available instruments for indirect calorimetry give conflicting estimates of energy expenditure in mechanically ventilated patients. Whilst the Quark RMR compares better with the Deltatrac than CCM Express, the mechanisms behind this difference needs to be further explored.
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Review Meta Analysis Comparative Study
Effect of gastric versus post-pyloric feeding on the incidence of pneumonia in critically ill patients: observations from traditional and Bayesian random-effects meta-analysis.
Administration of enteral feeding is associated with a higher risk of nosocomial pneumonia. Herein, we systematically review the impact of gastric versus post-pyloric feeding on the incidence of pneumonia. ⋯ Comparing with gastric feeding, post-pyloric route can reduce incidence of pneumonia in critically ill patients.
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HPN patients with benign diseases deserve professional care as they have to deal with complex techniques and risk potentially dangerous complications. The aim was to highlight main outcome quality indicators and to develop a set of key interventions to direct multidisciplinary teams in providing qualitative care. ⋯ Using a two-round Delphi approach, consensus was reached for the majority of interventions concerning HPN patients with benign diseases. This set of 68 interventions could be of use as a starting point for quality-improvement programs.