Jpen Parenter Enter
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Jpen Parenter Enter · Mar 2000
Randomized Controlled Trial Clinical TrialIncidence of gastroesophageal reflux and aspiration in mechanically ventilated patients using small-bore nasogastric tubes.
Use of a large-bore nasogastric tube (NGT) and patient position are considered key factors in promoting gastroesophageal reflux (GER) and pulmonary aspiration in critically ill patients. The objective of this study was to determine the incidence of GER and pulmonary aspiration of gastric contents in mechanically ventilated (MV) patients using small-bore NGTs. ⋯ GER and aspiration of gastric contents were not detected in MV patients using small-bore NGTs and may be a simple measure to prevent ventilator-associated pneumonia.
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Jpen Parenter Enter · Mar 2000
Arginine-supplemented diet decreases expression of inflammatory cytokines and improves survival in burned rats.
We examined whether the expression of inflammatory cytokines in organs was influenced by the enteral diet supplemented with arginine in burned rats. ⋯ The data suggest that dietary arginine supplementation decreases the mRNA expression of inflammatory cytokines in organs and improves the survival rate after thermal injury.
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With reports of deleterious effects of total parenteral nutrition (TPN) in adults in addition to our surveys, which indicated that 1/4, and as many as 1/2, of US academic medical centers were using excess glucose in TPN, our objective was to devise a computer program to optimize nutrients in parenteral and enteral nutrition in adult and pediatric patients. ⋯ The program, http://epen.kumc.edu, provides rapid definition of the TPN or enteral prescription for adult and pediatric patients, with reduced likelihood of providing excessive glucose and energy in parenteral or enteral nutrition.
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Jpen Parenter Enter · Nov 1999
Randomized Controlled Trial Clinical TrialA prospective, randomized clinical trial on perioperative feeding with an arginine-, omega-3 fatty acid-, and RNA-enriched enteral diet: effect on host response and nutritional status.
The use of immune-enhancing enteral diets in the postoperative period has given contrasting results. The purpose of this prospective, randomized, double-blinded clinical study was to evaluate the effect of immunonutrition given perioperatively on cytokine release and nutritional parameters. ⋯ Perioperative feeding with a supplemented enteral diet modulates cytokine production and enhances cell-mediated immunity and the synthesis of short half-life proteins.
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Jpen Parenter Enter · Sep 1999
Blood clearance and tissue uptake of intravenous lipid emulsions containing long-chain and medium-chain triglycerides and fish oil in a mouse model.
Increasing interest in using different triglycerides (TGs) for specific clinical applications raised the question as to how the emulsion TG composition would affect blood clearance and emulsion delivery to hepatic and extrahepatic tissues. ⋯ Results indicate slow blood clearance of pure omega-3 TG emulsion from the blood compared with emulsion in which omega-3 TG was mixed with LCT and MCT. Earlier data showed that omega-3 TG are poorly hydrolyzed in extracellular media and therefore are delivered to tissues as part of the core of emulsion remnants. Thus, our data suggest that the incorporation of omega-3 TG with LCT/MCT will result in greater delivery of omega-3 fatty acids to extrahepatic tissue, which could be important in modulating immune and other responses.