Jpen Parenter Enter
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Jpen Parenter Enter · Nov 2012
Randomized Controlled TrialHuman leukocyte death after a preoperative infusion of medium/long-chain triglyceride and fish oil parenteral emulsions: a randomized study in gastrointestinal cancer patients.
Parenteral lipid emulsions (LEs) can influence leukocyte functions. The authors investigated the effect of 2 LEs on leukocyte death in surgical patients with gastrointestinal cancer. ⋯ In patients with gastrointestinal cancer, preoperative MCT/LCT infusion was associated with postoperative lymphocyte and neutrophil apoptosis. FO has a protective effect on postoperative lymphocyte apoptosis.
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Jpen Parenter Enter · Nov 2012
Comparative StudyLongitudinal prediction of metabolic rate in critically ill patients.
Indirect calorimetry is the criterion method for assessment of energy expenditure in critically ill patients but is decidedly uncommon. Thus, calculation methods proliferate. Even if indirect calorimetry is available, it usually is not repeated more than weekly on the same patient, creating potential for error. The purpose of the current study was to quantify estimation errors against indirect calorimetry measurements in critically ill patients over time. ⋯ On average, the Penn State equations predict resting metabolic rate over time within 5% of the measured value. This performance is similar to the practice of making 1 measurement and extrapolating it over 1 week. The ACCP method has an unacceptably wide limit of agreement.
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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.
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Jpen Parenter Enter · Sep 2012
Randomized Controlled Trial Multicenter StudyInfluence of parenteral nutrition delivery system on the development of bloodstream infections in critically ill patients: an international, multicenter, prospective, open-label, controlled study--EPICOS study.
Parenteral nutrition (PN) is associated with an increased risk of developing bloodstream infections (BSIs) but the impact of the PN delivery system upon BSI rates remains unclear. This was an international, multicenter, prospective, randomized, open-label, controlled trial that investigated the differences of BSIs associated with 2 different PN systems. ⋯ Compounded PN was associated with a higher incidence of BSIs and CLABs, suggesting that the use of MCB PN may play a role in reducing the incidence of BSIs in patients who receive PN.