Clinical nutrition : official journal of the European Society of Parenteral and Enteral Nutrition
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Large surveys auditing feeding regimen in the ICU consistently reported hypocaloric 23 enteral feedings patterns and many studies described the association between 24 energy deficit and increased complication rate. ESPEN and ASPEN experts 25 recommend early (after 48 h) or late (after 7-10 days) catch up of the 26 energy deficit with parenteral nutrition (PN) respectively, but the level of evidence 27 was poor and larger PRCT were missing. ⋯ However, weaknesses 30 in the study design and some mixing of the 3 questions have created confusion in the 31 message delivered. In addition, the severity of the acute illness was not always similar 32 in these studies, mixing short-term acutely ill patients (less than 4 days in the ICU) 33 with long term patients (more than 10 days in the ICU).
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We describe an observational study in critically ill medical patients showing the association between serum Vitamin B12 levels measured on or near admission and the outcome in these patients. ⋯ Our data show that high serum Vitamin B12 levels are associated with increased mortality in critically ill medical patients. We suggest that Vitamin B12 levels should be included in the work-up of all medical intensive care patients, particularly those with a chronic health history and increased severity of illness.
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Randomized Controlled Trial Comparative Study Clinical Trial
Reducing glucose infusion safely prevents hyperglycemia in post-surgical children.
To investigate the effects of two different glucose infusions on glucose homeostasis and amino acid metabolism in post-surgical children. ⋯ The current recommended glucose infusion induces hyperglycemia in post-surgical children. A reduced glucose infusion safely reduced high glucose levels, while children were capable to sustain normoglycemia with increased endogenous glucose production. The reduced glucose infusion did not exacerbate the mild catabolic state in which the patients were.
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Randomized Controlled Trial Clinical Trial
Perioperative nutrition in malnourished surgical cancer patients - a prospective, randomized, controlled clinical trial.
Malnourished surgical patients are supposed to benefit from perioperative nutrition. It is unclear, however, whether enteral intervention really surpasses the parenteral one, and whether the modification of standard formula matters. The aim of the study was to evaluate the clinical value of the route and type of perioperative nutritional support. ⋯ Results demonstrated that postoperative nutritional intervention generates comparable results regardless of the route and formula used and that preoperative intervention is of the utmost importance. The study was registered in the Clinical Trials Database - number: NCT 00558155.