Jpen Parenter Enter
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The potential of nutritional assessment parameters in predicting sepsis in burn patients was investigated. Sixty-two consecutive patients (mean age 41 years) with an average burn size of 19% were studied. ⋯ Parameters predictive of imminent septic episode included serum albumin less than 3.0 g/dl (p less than 0.001), total lymphocyte count less than 1500/mm3 (p less than 0.001), anergy (p less than 0.001), and serum transferrin less than 150 mg/dl (p less than 0.001). Nitrogen balance and percentage of ideal body weight were not found to contribute to group discrimination.
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Trace metal deficiencies are now a well-documented complication of total parenteral nutrition (TPN). Zinc deficiency may present in a variety of ways including acrodermatitis skin lesions, impaired immunity, poor growth or impaired wound healing, and mental disturbances. ⋯ We currently recommended regular monitoring and supplementation of these four trace metals during TPN administration. This article describes the clinical abnormalities that may develop when deficiencies of trace metals occur during TPN administration, and we present recommendations for trace metal supplementation during TPN administration.
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Jpen Parenter Enter · Jul 1981
Cluster analysis of nutritional and immunological indicators for identification of high risk surgical patients.
In spite of the many anthropometric, biohumoral, and immunologic parameters employed in the nutritional assessment of hospitalized patients, it is difficult in clinical practice to evaluate accurately the degree and type of malnutrition and to assess the prognostic significance of this determination. The purpose of this study is to evaluate nutritional status of surgical patients by means of cluster analysis in orderr to identify different nutritional patterns and to evaluate their clinical and prognostic significance. Nutritional assessment of 71 surgical patients was carried out at admission, and the sets of data were evaluated by means of cluster analysis. ⋯ Sepsis, palliative procedures and mortality rate were significantly more frequent in these clusters (p less than 0.05, p less than 0.001, p less than 0.05). A different distribution in the clusters was recorded in gastrointestinal tract cancers and other neoplasms. Only the incidence of gastrointestinal tract cancers increases progressively in the clusters with poorer prognosis, suggesting that this type of neoplasia is more frequently associated with major changes of nutritional status.