Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition
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Comparative Study
Comparison of ideal body weight equations and published height-weight tables with body mass index tables for healthy adults in the United States.
The purpose of this paper was to compare the ideal body weight (IBW) formulas and published height-weight tables for healthy adults in the United States with the body mass index (BMI) of 22 kg/m2, which is associated with lowest mortality. There are numerous formulas and published height-weight tables available to determine IBW, but there are no published studies comparing the validity of formulas with each other or comparing formulas with BMIs. Data from height-weight tables, weight for specific heights determined by IBW formulas, and weight for BMIs of 20, 22, 25, and 30 kg/m2 at different heights were plotted for both men and women. ⋯ Height-weight tables' slopes were closer to the BMI slopes than formula slopes. Robinson's formula appears to be the best equation for calculating desirable/healthy weights in men; however, no formula predicted close to a BMI of 22 kg/m2 for women. Thus, in practice it might be more useful to use BMI ranges instead of IBW formulas for men and women.
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Comparative Study
Energy expenditure in children with severe head injury: lack of agreement between measured and estimated energy expenditure.
The purpose of this study was to test the hypotheses that estimates of resting energy expenditure (REE) vary significantly from measured energy expenditure in a population of head-injured children and are not accurate for use in determining nutrition needs in this population. ⋯ Energy expenditure in critically ill children cannot be estimated accurately; hence, nutrition for critically ill children with head injury should be provided according to measurement of REE to avoid the consequences of overfeeding or malnutrition.
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D-lactic acidosis, also referred to as D-lactate encephalopathy, is a rare neurologic syndrome that occurs in individuals with short bowel syndrome or following jejuno-ileal bypass surgery. Symptoms typically present after the ingestion of high-carbohydrate feedings. Neurologic symptoms include altered mental status, slurred speech, and ataxia, with patients often appearing drunk. ⋯ This review examines the pathophysiology of the production and accumulation of D-lactate while exploring the potential factors contributing to the development of neurologic manifestations. Methods of diagnosis and treatment are reviewed. Areas requiring further investigation are identified.
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The development of the percutaneous endoscopic gastrostomy (PEG) tube for enteral access was a revolutionary technological advance. This device has undergone some minor modification over the past 30 years but remains very similar to the original PEG tube design. Use of the PEG tube for gastric enteral feeding access continues to increase yearly both in pediatric and adult populations. ⋯ Historically, the predominant polymer material used for PEG tube composition was silicone. More recently, polyurethane has been examined as a potential, more durable material for PEG tube composition. Copolymers, or combinations of silicone and polyurethane and other polymer materials, are currently under investigation as the answer for the development of a bioinert, tissue-friendly, durable, PEG tube composition material.
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Comparative Study
Gastrostomy tube placement outcomes: comparison of surgical, endoscopic, and laparoscopic methods.
Advances in percutaneous endoscopic gastrostomy (PEG) and laparoscopic (LAP) techniques now allow for less invasive placement of gastrostomy tubes. This study compared morbidities and feeding outcomes of these procedures with standard surgical (OPEN) insertion. ⋯ PEG should be the procedure of choice for placement of gastrostomy tubes. If PEG is contraindicated, then OPEN technique may be best due to fewer complications, although insertion time is longer than the LAP technique.