Jpen Parenter Enter
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Jpen Parenter Enter · May 2002
Randomized Controlled Trial Clinical TrialA double-blind, randomized, placebo-controlled trial of n-3 versus n-6 fatty acid-based lipid infusion in atopic dermatitis.
In the involved epidermis of patients with atopic dermatitis, changes in the metabolism of eicosanoids with increased quantities of the arachidonic acid (AA)-derived lipoxygenase products have been observed. Free eicosapentaenoic acid (EPA), a fish oil-derived alternative (n-3) fatty acid, may compete with AA, resulting in an anti-inflammatory effect. ⋯ IV n-3-fatty acid administration is effective in acutely improving the severity of atopic dermatitis, paralleled by changes in plasma and membrane fatty acid composition and lipid mediator synthesis. The long-term beneficial effects of IV n-6 fatty acids should be evaluated further.
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Jpen Parenter Enter · May 2002
Randomized Controlled Trial Clinical TrialContinuation of transpyloric feeding during weaning of mechanical ventilation and tracheal extubation in children: a randomized controlled trial.
Nutrition support is essential in the management of critically ill children. There is no current literature to support the common practice of discontinuing enteral nutrition delivered through a transpyloric feeding tube during the tracheal extubation process. We conducted a prospective, randomized controlled trial in mechanically ventilated children to examine the safety and efficacy of continuous transpyloric feeding compared with interrupted transpyloric feeding at the time of tracheal extubation. ⋯ Continuous transpyloric feeding during weaning from the ventilator and tracheal extubation is safe and results in the delivery of more optimal nutrition.
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Jpen Parenter Enter · May 2002
Clinical Trial Controlled Clinical TrialEarly versus late enteral feeding of mechanically ventilated patients: results of a clinical trial.
This study sought to compare 2 strategies for the administration of enteral feeding to mechanically ventilated medical patients. ⋯ The administration of more aggressive early enteral nutrition to mechanically ventilated medical patients is associated with greater infectious complications and prolonged lengths of stay in the hospital. Clinicians must balance the potential for complications resulting from early enteral feeding with the expected benefits of such therapy.
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The purpose of this study was to determine the course of oxidative stress in trauma patients as measured by antioxidant disappearance and modulation of DNA damage. The study also explored the role of injury severity and the effect of changes in plasma lipoprotein concentration as the result of hemodilution on lipid-soluble plasma antioxidant concentrations. ⋯ The difference in antioxidant concentrations between trauma patients and controls may have been associated with oxidative stress or with a poorer diet. The difference between antioxidant concentrations and cholesterol-adjusted antioxidant concentrations is likely caused by hemodilution or by changes in plasma lipid levels as a result of trauma. Therefore, individually adjusting lipid-soluble antioxidant concentrations by total cholesterol concentrations is important in trauma patients. Leukocyte 8OhdG to dG ratios were already elevated in trauma patients on admission but returned nearly to control levels 24 hours later, indicating short-term responsiveness to DNA oxidation in trauma patients and an extensive capacity for DNA repair within 24 hours.