Jpen Parenter Enter
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Jpen Parenter Enter · Jul 2003
Randomized Controlled Trial Clinical TrialThe effect of supplemental enteral glutamine on plasma levels, gut function, and outcome in severe burns: a randomized, double-blind, controlled clinical trial.
This research was conducted to evaluate the effect of enterally administered glutamine (gln) dipeptide on metabolic, gastrointestinal, and outcome parameters after severe burn injury. ⋯ Enteral gln supplementation using a commercially available dipeptide supported plasma gln levels, improved gut permeability, and initially decreased plasma endotoxin levels in severely thermally injured patients. These alterations were associated with a reduction in the length of hospitalization and lower costs.
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Jpen Parenter Enter · Jul 2003
Gastric electrical stimulation for gastroparesis improves nutritional parameters at short, intermediate, and long-term follow-up.
Nutritional depletion, either macronutrient- or micronutrient-related, is common in patients with drug-refractory gastroparesis (GP) for which there is often no effective treatment. We studied a group of 12 patients (4 men, 8 women; mean age, 35.7 years) who had symptoms of GP and were a subset of the Gastric ElectroMechanical Stimulation trial of gastric electrical stimulation. Patients' symptoms were of long duration (7.3 years) and associated with diabetes mellitus (3 patients) or were idiopathic (9 patients) as etiology. ⋯ Gastric electrical stimulation implantation resulted in improvement of nutritional parameters throughout the first 12 months, as nausea and vomiting decreased and oral intake increased. This improvement in nutritional measures is maintained long-term and is associated with improvements in quality of life. Gastric electrical stimulation should be considered as a therapeutic option for any patients with refractory GP and nutritional compromise.
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Jpen Parenter Enter · Jul 2003
Intestinal and multivisceral transplantation: dynamics of nutritional management and functional autonomy.
The objective of this study was to describe the dynamics of nutrition management of intestinal transplant recipients and allograft functional autonomy. ⋯ These results reflect our early experience that led to surgical refinement of the operation and evolution of the recipient postoperative management. Nonetheless, even in this initial cohort, most of the engrafted intestines restored the recipient nutritional autonomy, and all survivors remained well nourished.
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Jpen Parenter Enter · May 2003
Randomized Controlled Trial Multicenter Study Clinical TrialSafety and metabolic tolerance of a concentrated long-chain triglyceride lipid emulsion in critically ill septic and trauma patients.
A concentrated fat emulsion (Intralipid 30%) with a phospholipid/triglyceride ratio of 0.04 was tested for clinical tolerance and metabolic effects in the short-term parenteral nutrition of septic and trauma critically ill patients and compared with Intralipid 20% (phospholipid/triglyceride ratio of 0.06). ⋯ Our results indicate that while both fat emulsions used in the TPN of critically ill patients are clinically safe, the 30% long-chain triglyceride fat emulsion with a phospholipid/triglyceride ratio of 0.04 causes fewer lipid metabolic disturbances.
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Jpen Parenter Enter · Mar 2003
Randomized Controlled Trial Multicenter Study Clinical TrialEffect of enteral feeding with eicosapentaenoic acid, gamma-linolenic acid, and antioxidants on antioxidant status in patients with acute respiratory distress syndrome.
We previously showed that enteral feeding of a diet containing eicosapentaenoic acid, gamma-linolenic acid, and elevated antioxidants improved clinical outcomes compared with a control diet in acute respiratory distress syndrome (ARDS) patients. It has been suggested that oxidative stress may overwhelm endogenous antioxidant levels and allow free radicals to further damage lung tissue. Therefore, we determined whether these ARDS patients were under oxidative stress and whether the experimental diet could improve antioxidant status. ⋯ Before treatment, ARDS patients were found to be in a state of oxidative stress and had reduced levels of antioxidants. Although enteral nutrition with the experimental diet for at least 4 to 7 days did not reduce oxidative stress as measured, it did restore plasma levels of beta-carotene and alpha-tocopherol to normal or higher levels and appeared to protect ARDS patients from further lipid peroxidation.