Jpen Parenter Enter
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Jpen Parenter Enter · May 2014
Multicenter StudyEarly enteral nutrition is associated with lower mortality in critically ill children.
The purpose of this study was to examine the association of early enteral nutrition (EEN), defined as the provision of 25% of goal calories enterally over the first 48 hours of admission, with mortality and morbidity in critically ill children. ⋯ EEN is strongly associated with lower mortality in patients with PICU LOS of ≥96 hours. LOS and duration of MV are slightly longer in patients receiving EEN, but the differences are not statistically significant.
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Jpen Parenter Enter · May 2014
Pharmaconutrition: acute fatty acid modulation of circulating cytokines in elderly patients in the ICU.
Enteral supply of ω-3 polyunsaturated fatty acids has been used in an attempt to modulate inflammation and improve outcome in critically ill patients. However, enteral administration may be slow to change membrane composition and therefore may not be the best route to supply these fatty acids in patients with acute conditions. This study evaluated the effects of short-term intravenous (IV) administration of fish oil-based lipid emulsion (FLE) as pharmaconutrition on cytokine levels in critically ill elderly patients. ⋯ Short-term IV FLE modulates some inflammatory markers in critically ill elderly patients receiving enteral nutrition (EN), suggesting an anti-inflammatory effect. This may be a benefit and suggests a role for FLE administration as a supplement in elderly ICU patients receiving standard EN.
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Jpen Parenter Enter · May 2014
Case ReportsBariatric surgery complications leading to small bowel transplant: a report of 4 cases.
Obesity is a major chronic disease affecting the U. S. population. Bariatric surgery has consistently shown greater weight loss and improved outcomes compared with conservative therapy. ⋯ Surgical procedures to treat morbid obesity are common and growing in popularity but are not without risk of serious complications, including intestinal failure and HPN dependency. Despite methods to prevent complications, failure of HPN may lead to the need for transplant evaluation. In selected cases, the best therapeutic treatment may be a small bowel transplant to resolve irreversible, post-bariatric surgery intestinal failure.