Jpen Parenter Enter
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Jpen Parenter Enter · Jul 2009
Editorial Comment Multicenter StudyUse of nutrition to prevent stress-induced immunosuppression in the pediatric intensive care unit: a clinical trials minefield.
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Jpen Parenter Enter · Jul 2009
Nutrition intervention: a strategy against systemic inflammatory syndrome.
Sepsis and septic shock syndrome are the leading causes of death in critically ill patients. Lipopolysaccharide (LPS) released by the colonic microorganisms may translocate across a compromised lumen, leading to upregulated reactive oxidative stress, inflammation, and sepsis. The authors examined an enteral formula high in cysteine (antioxidant precursor), omega-3 fatty acids, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), and prebiotic fructooligosaccharides (FOS) against systemic inflammatory syndrome. ⋯ Data indicate that CYSPUFA, a diet rich in EPA-DHA-FOS, protects against LPS-induced systemic inflammatory responses and warrants clinical studies in critically ill patients.
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Jpen Parenter Enter · May 2009
Cumulative energy imbalance in the pediatric intensive care unit: role of targeted indirect calorimetry.
Failure to accurately estimate energy requirements may result in underfeeding or overfeeding. In this study, a dedicated multidisciplinary nutrition team measured energy expenditure in critically ill children. ⋯ A disparity was observed between equation-estimated energy expenditure, measured resting energy expenditure, and total energy intake, with a high incidence of underfeeding or overfeeding. A wide range of metabolic alterations were recorded, which could not be accurately predicted using standard clinical characteristics. Targeted indirect calorimetry on high-risk patients selected by a dedicated nutrition team may prevent cumulative excesses and deficits in energy balance.
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Jpen Parenter Enter · Mar 2009
Feasibility of implementing a reduced fasting protocol for critically ill trauma patients undergoing operative and nonoperative procedures.
This prospective, observational cohort study was designed to determine the feasibility of implementing a reduced enteral fasting protocol in mechanically ventilated trauma patients undergoing selected operative and nonoperative procedures. ⋯ A reduced fasting protocol was feasible for selected operative procedures, with trends toward improving nutrition delivery and no increase in adverse outcomes. A larger randomized study of this approach is warranted before adoption of this practice can be advocated.