Jpen Parenter Enter
-
Jpen Parenter Enter · Mar 1997
Clinical characteristics of preoperative hypoalbuminemia predict outcome of cardiovascular surgery.
To define the clinical characteristics and outcome of preoperative hypoalbuminemia in adult cardiovascular surgery. ⋯ Preoperative hypoalbuminemia was attributed to malnutrition cachexia, liver insufficiency or congestive heart failure in < 50% of cardiac patients undergoing cardiovascular surgery. All types of hypoalbuminemia except for malnutrition cachexia increased the likelihood of postoperative organ dysfunction, nosocomial infections, prolonged mechanical ventilation, and death. The morbidity and mortality attributed to hypoalbuminemia could be explained by the underlying clinical characteristics rather than malnutrition cachexia in cardiac patients.
-
Jpen Parenter Enter · Jan 1997
Randomized Controlled Trial Comparative Study Clinical TrialComparison of the safety of early enteral vs parenteral nutrition in mild acute pancreatitis.
This prospective study was designed to compare the safety, efficacy, cost, and impact on patient outcome of early total enteral nutrition (TEN) vs total parenteral nutrition (TPN) in acute pancreatitis. ⋯ TEN for acute pancreatitis is as safe and effective, but is significantly less costly than TPN. Compared with TPN, TEN may promote more rapid resolution of the toxicity and stress response to pancreatitis. TEN via jejunal feeding should be used preferentially in this disease setting.
-
Jpen Parenter Enter · Nov 1996
Randomized Controlled Trial Clinical TrialErythromycin facilitates postpyloric placement of nasoduodenal feeding tubes in intensive care unit patients: randomized, double-blinded, placebo-controlled trial.
To determine whether administration of erythromycin (E) could facilitate passage of a nasoenteric feeding tube into the duodenum for postpyloric feedings, this randomized, double-blind, placebo-controlled trial was performed. ⋯ These data suggest that, overall, E is effective in facilitating placement of a nasoenteric feeding tube into the duodenum in ICU patients. It is clearly beneficial in those patients with normal mental status and may be useful in patients with diabetes mellitus.
-
Esophageal bezoars are rare but are known to occur in patients with structural or functional abnormalities of the esophagus. Additionally, sucralfate and casein containing enteral feeding formulas have been implicated in the formation of esophageal bezoars, particularly in the setting of decreased esophageal pH. We present a case in which a patient with functional impairment of the esophagus related to myasthenia gravis developed an esophageal bezoar. ⋯ An esophagram demonstrated a large bezoar filling the middle and distal thirds of the esophagus. The conditions predisposing to bezoar formation and the proposed mechanisms are discussed. We also summarize the reported cases of esophageal bezoars related to enteral feeding formula, sucralfate, or both.
-
Jpen Parenter Enter · Mar 1996
Randomized Controlled Trial Clinical TrialGlucose response to discontinuation of parenteral nutrition in patients less than 3 years of age.
The effects of abrupt discontinuation and tapering of total parenteral nutrition (TPN) on glucose concentration were compared in patients < 3 years of age. ⋯ The high incidence of hypoglycemia after TPN discontinuation in children < 3 years of age requires monitoring of serum glucose concentration when initiating intermittent TPN until tolerance is documented.