Clinical nutrition : official journal of the European Society of Parenteral and Enteral Nutrition
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Malnutrition is a recognized risk factor for perioperative morbidity, but there is currently no standardized definition of malnutrition. The Nutrition Risk Screening 2002 score was recently proposed to identify patients at nutritional risk who may benefit from nutritional support therapy, and has been officially adopted by the European Society of Parenteral and Enteral Nutrition. The aim of this study was to assess the value of the Nutrition Risk Screening 2002 score in predicting the incidence and severity of postoperative complications in gastrointestinal surgery. ⋯ The prevalence of nutritional risk patients in gastrointestinal surgery is high. We showed that nutritional risk screening using the NRS 2002 strongly predicts the incidence and severity of complications.
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Randomized Controlled Trial
Standard and immunomodulating enteral nutrition in patients after extended gastrointestinal surgery--a prospective, randomized, controlled clinical trial.
The immunomodulating enteral diets are intended to reduce the incidence of postoperative complications in surgical patients. The aim of the study was to assess the clinical effect of such nutrition. ⋯ Results of our study showed no benefit of immunomodulating enteral nutrition over standard enteral nutrition in patients after major gastrointestinal surgery. The Trial was registered in Clinical Trials Database--number: NCT00576940.
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Liver organ dysfunction is an important determinant for clinical deterioration and outcome in patients with sepsis. Although glutamate plays a central role in the metabolism of the liver, liver cellular injury during sepsis is clinically determined by plasma values of the enzymes alanine aminotransferase (ALT) and aspartate aminotransferase (AST). The aim of this study was to determine the predictive value of measuring the amino acids glutamate and glutamine concentrations in the early phases of septic shock. ⋯ Patients who die of septic shock with acute liver dysfunction can be predicted by significantly lowered plasma glutamate concentrations and lowered glutamate/glutamine ratios already in the first 24 h of septic shock.
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Multicenter Study
EuroOOPS: an international, multicentre study to implement nutritional risk screening and evaluate clinical outcome.
The aim of the study was to implement nutritional risk screening (NRS-2002) and to assess the association between nutritional risk and clinical outcome. ⋯ Components of NRS-2002 are independent predictors of poor clinical outcome.