Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition
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Comparative Study
Cholestasis, bronchopulmonary dysplasia, and lipid profile in preterm infants receiving MCT/ω-3-PUFA-containing or soybean-based lipid emulsions.
This study aimed to compare the effect of 2 lipid emulsions (LEs), a medium-chain triglyceride (MCT)/ω-3-polyunsaturated fatty acid (PUFA)-containing LE and a soybean-based LE, on the incidence of neonatal cholestasis, bronchopulmonary dysplasia (BPD), and lipid profile of preterm infants. Patients and ⋯ In VLBW infants, the MCT/ω-3-PUFA-containing LE administration is associated with decreased BPD and more favorable lipoprotein profile. Although a trend toward a lower incidence of cholestasis was observed, a preventive effect of MCT/ω-3-PUFA-containing LE on parenteral nutrition-associated cholestasis is not supported.
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Over- and underfeeding critically ill patients have significant clinical consequences. These patients are often given a combination of enteral nutrition (EN) and parenteral nutrition (PN), potentially increasing their risk of overfeeding. No published protocol describing the process for weaning from parenteral to enteral feeding and its effects on over- and underfeeding exists. This study aimed to evaluate the introduction of such a protocol. ⋯ A structured protocol for weaning patients from PN to EN can reduce overfeeding in critically ill patients given nutrition support via a combination of routes.
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The practice of holding enteral nutrition (EN) 8 hours prior to surgery is common. We hypothesized that it was safe to continue postpyloric EN, and we developed an institutional practice pattern to investigate our hypothesis. ⋯ Perioperative continuation of postpyloric EN is feasible in some critically ill surgical patients and can result in additional calories provided. A multidisciplinary approach and an institutional policy can increase the likelihood of meeting nutrition goals in these patients.
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Malnutrition and weight loss negatively affect outcomes in surgical cancer patients. Decades of research have sought to identify the most appropriate use of nutrition support in these patients. National and international guidelines help to direct clinicians' use of nutrition support in surgical patients, but a number of specific issues concerning the use of nutrition support continue to evolve. This review focuses on 5 key issues related to perioperative nutrition support in cancer patients: (1) Which perioperative cancer patients should receive nutrition support? (2) How can the nutrition status and requirements of these patients be optimally assessed? (3) What is the optimal route of administration (parenteral nutrition vs enteral nutrition) and composition of nutrition support in this setting? (4) When should feedings be initiated? (5) What is the role of glycemic control in these patients?
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Hyperhomocysteinemia might be at least partially due to compromised B vitamin status in critically ill patients and has been linked with critical illness. This study was conducted to examine the association between plasma homocysteine with B vitamins and clinical outcomes in critically ill surgical patients. ⋯ Lower plasma PLP might be a significant factor for increased plasma homocysteine in critically ill surgical patients. The association between plasma homocysteine and clinical outcomes was not found.