Jpen Parenter Enter
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Jpen Parenter Enter · Nov 2008
Meta AnalysisThe use of an inflammation-modulating diet in patients with acute lung injury or acute respiratory distress syndrome: a meta-analysis of outcome data.
This meta-analysis of clinical trials compares an inflammation-modulating diet enriched with eicosapentaenoic acid (EPA), gamma-linolenic acid (GLA), and elevated antioxidants (EPA + GLA) vs a control diet to determine the effectiveness of this specialized diet on oxygenation and clinical outcomes in mechanically ventilated patients with acute lung injury (ALI)/acute respiratory distress syndrome (ARDS). ⋯ The meta-analysis showed a significant reduction in the risk of mortality as well as relevant improvements in oxygenation and clinical outcomes of ventilated patients with ALI/ARDS given EPA + GLA.
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Jpen Parenter Enter · Nov 2008
Cost analysis of parenteral nutrition regimens in the intensive care unit: three-compartment bag system vs multibottle system.
Parenteral nutrition (PN) can be administered with separate bottles or as commercially prepared all-in-one systems. The aim of this study was to evaluate the overall cost of PN using the 3-compartment bag vs standard multibottle system. ⋯ The costs associated with PN using a 3-compartment bag system were lower than those associated with a multibottle system. Given the established therapeutic equivalence of the 2 systems, this study shows the 3-compartment bag system to be the system of choice to reduce costs.
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Jpen Parenter Enter · Nov 2008
Feasibility of self-propelling nasojejunal feeding tube in patients with acute pancreatitis.
To assess the success rate of a self-propelling nasojejunal feeding tube in patients with acute pancreatitis. ⋯ Use of a self-propelling nasojejunal tube is a simple technique that can be successfully performed in the majority of patients with acute pancreatitis. The utility of this procedure in the most severe cases of acute pancreatitis continues to pose a challenge.
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Jpen Parenter Enter · Sep 2008
Review Meta AnalysisZinc supplementation in critically ill patients: a key pharmaconutrient?
The purpose of the present paper is to provide a rationale for zinc supplementation as a potential therapeutic agent in critically ill patients by describing its role in health and disease, conducting a systematic review of current randomized trials in critical care, considering optimum route and dose of administration, and making recommendations for future research. Normal zinc homeostasis is required for a functional immune system, adequate antioxidant capacity, glucose homeostasis, and wound healing. In addition, zinc is a required cofactor for many enzymes, transcription factors, and replication factors. ⋯ Thus, because of the paucity of clinical data, there is inadequate evidence to recommend the routine use of high-dose zinc supplementation in the critically ill. A first step would be to determine the optimal dose that has a maximal positive effect on underlying inflammatory, immunologic, and metabolic processes yet is safe and tolerated by critically ill patients. Subsequently, large, rigorously designed, randomized trials are required to elucidate the efficacy of such doses of zinc supplementation in this patient population.