Jpen Parenter Enter
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Jpen Parenter Enter · Nov 2012
Case ReportsEstablishing early enteral nutrition with the use of self-advancing postpyloric feeding tube in critically ill children.
Early nutrition support is an integral part of the care of critically ill children. Early enteral nutrition (EN) improves nitrogen balance and prevents bacterial translocation and gut mucosal atrophy. Adequate EN is often not achieved as gastric feeds are not tolerated and placing postpyloric feeding tubes can be difficult. Spontaneous transpyloric passage of standard feeding tubes without endoscopic intervention or use of anesthesia can range from 30%-80%. The authors report on their experience with a 14Fr polyurethane self-advancing jejunal feeding tube in a pediatric population. These tubes have been used in the adult population with success, but to the authors' knowledge, there have been no reports of its use in the pediatric age group. ⋯ The self-advancing jejunal feeding tube can be used effectively to establish early EN in critically ill children.
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Jpen Parenter Enter · Nov 2012
Relationship of vitamin D deficiency to clinical outcomes in critically ill patients.
Despite the numerous disease conditions associated with vitamin D deficiency in the general population, the relationship of this deficiency to outcome in critically ill patients remains unclear. The objective of this study is to determine the burden of vitamin D deficiency in intensive care unit (ICU) patients and determine if it is associated with poor patient outcomes. ⋯ This study demonstrates significant decreases in vitamin D status over the duration of the patient's ICU stay. Low levels of vitamin D are associated with longer time to ICU discharge alive and a trend toward increased risk of ICU-acquired infection.