Clinical nutrition ESPEN最新文献

{"title":"Multi-chamber parenteral nutrition (PN) bags are safe and cost-effective in replacing compounded PN regimens in hospitalised patients","authors":"Maja Kopczynska ,&nbsp;Simon Harrison ,&nbsp;Kirstine Farrer ,&nbsp;Gavin Leahy ,&nbsp;Charlotte Ollerenshaw-Ward ,&nbsp;Simon Lal","doi":"10.1016/j.clnesp.2024.09.009","DOIUrl":"10.1016/j.clnesp.2024.09.009","url":null,"abstract":"<div><h3>Background &amp; aims</h3><p>There is varied international practice in the use of ready-made multi-chamber bags (MCBs) and compounded parenteral nutrition (PN). Recent national aseptic pharmacy capacity limitations have restricted compounded PN production so we aimed to explore outcomes associated with the increased use of MCB vs compounded regimens during a period of change in PN supplies.</p></div><div><h3>Methods</h3><p>This was a point prevalence study conducted over two time periods, Period 1: 01.01.2022–31.03.2022 and Period 2: 01.10.2022–31.12.2022. Data were collected on PN regimen, outcomes, cost and aseptic time required to prepare PN bags.</p></div><div><h3>Results</h3><p>263 patients were included: 132 in Period 1 and 131 in Period 2. Overall, 2263 PN bags were utilised; 1179 in Period 1 and 1084 in Period 2. In Period 1, of all utilised bags, 138 (11.7%) were compounded PN, 356 (30.2%) supplemented MCBs and 685 (58.1%) manipulated MCBs whereas in Period 2, 0 were compounded PN, 546 (50.3%) supplemented MCBs and 538 (49.6%) manipulated MCBs. There were no significant differences in the proportion of patients with deranged blood tests between the study periods. In both periods there were only two episodes of catheter-related blood stream infection. The total cost saved in Period 2 compared to Period 1 was £20,684 and total aseptic staff time saved was 191 h.</p></div><div><h3>Conclusion</h3><p>Wider use of in-hospital MCB PN regimens could lead to a reduction in the need for compounded PN produced by aseptic pharmacy facilities, saving costs while maintaining good patient outcomes.</p></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"64 ","pages":"Pages 66-72"},"PeriodicalIF":2.9,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142270506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between salt sensitivity of blood pressure and dietary habits in survey population: A case-control study","authors":"Ji-hong Hu ,&nbsp;Shu-xia Wang ,&nbsp;Yun Wang ,&nbsp;Liangjia Cao ,&nbsp;Keye Ru ,&nbsp;Wenjuan Xu ,&nbsp;Li Wang ,&nbsp;Jiaxuan Zhang","doi":"10.1016/j.clnesp.2024.09.008","DOIUrl":"10.1016/j.clnesp.2024.09.008","url":null,"abstract":"<div><h3>Background</h3><div>Salt sensitivity of blood pressure (SSBP) is an independent risk factor for cardiovascular diseases (CVDs) and links dietary salt with blood pressure. However, the study on the relationship between SSBP and dietary habits is rare. This study investigated the relationship between diet and SSBP in different blood pressure statues.</div></div><div><h3>Methods</h3><div>1459 subjects were assigned into four groups based on a case (hypertension)-control (normotension) study of SSBP and hypertension: 561 Salt-sensitive hypertension (SSH) and 235 non-salt-sensitive hypertension (NSSH) and 424 salt-sensitive normotension (SSN) and 239 non-salt-sensitive normotension (NSSN). Foods information of weekly or daily intakes were recalled. SSBP was tested with the modified salt stress test and was diagnosed with the Sullivan criteria.</div></div><div><h3>Results</h3><div>Compared with the NSSH and SSN groups, SSH group have lower intake of fresh fruits (both <em>P</em> &lt; 0.05). Furthermore, NSSN group have the lowest intake of red meat, and bacon (<em>P</em> &lt; 0.05). SSH group have the lowest intake of fresh vegetables (<em>P</em> &lt; 0.05). SSN group have the highest intake of eggs, dairy products, white meat (all <em>P</em> &lt; 0.05). In hypertensive patients, staple food (OR = 0.37, 95%CI: 0.10–0.64) was associated with decreased risk of salt sensitivity. In normotensive subjects, white meat (OR = 0.28, 95%CI: 0.14–0.43) was associated with reduced risk of salt sensitivity, bacon (OR = 5.39, 95%CI: 2.11–8.67) and dairy products (OR = 4.22, 95%CI: 1.82–6.56) and red meat (OR = 2.95, 95%CI: 1.15–4.84) were associated with elevated risk of salt sensitivity.</div></div><div><h3>Conclusions</h3><div>Dietary habits play an important role in SSBP and the role varies with blood pressure especially among population.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"64 ","pages":"Pages 229-235"},"PeriodicalIF":2.9,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142281298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of uric acid with body adiposity and biochemical parameters in kidney transplant patients","authors":"Thamiris S. Vieira,&nbsp;Larissa S. Limirio,&nbsp;Erick P. de Oliveira","doi":"10.1016/j.clnesp.2024.09.007","DOIUrl":"10.1016/j.clnesp.2024.09.007","url":null,"abstract":"<div><h3>Background</h3><div>Obesity and various biochemical parameters, including triglycerides, cholesterol, glucose, C-reactive protein, and estimated glomerular filtration rate, have been linked to elevated uric acid (UA) levels in populations with normal kidney function due to decreased UA excretion and/or increased UA synthesis. However, it remains unclear whether all these factors exhibit similar associations with UA levels in clinical populations characterized by compromised renal function, such as kidney transplant patients (KTPs).</div></div><div><h3>Objective</h3><div>To evaluate whether serum UA levels are associated with body adiposity and biochemical parameters in KTPs.</div></div><div><h3>Methods</h3><div>A cross-sectional study involving 113 KTPs was conducted. Body fat was estimated using bioelectrical impedance, and waist circumference was measured using an inelastic tape. Serum levels of UA, creatinine, glucose, triglycerides, total cholesterol, and its fractions were measured using the colorimetric method. C-reactive protein levels were assessed using the immunoturbidimetric method, and urea levels were determined via enzymatic kinetics. Glomerular filtration rate was estimated using the chronic kidney disease epidemiology collaboration equation. Linear regression analyses were employed to assess the association between serum UA levels and body adiposity as well as biochemical parameters, while adjusting for confounders.</div></div><div><h3>Results</h3><div>Serum UA levels exhibited a positive association with creatinine (β = 0.402; p = 0.013) and urea (β = 0.024; p = 0.001), while demonstrating an inverse association with estimated glomerular filtration rate (β = −0.030; p &lt; 0.001). However, serum UA levels were not significantly associated with fat mass (both in kilograms and as a percentage), waist circumference, triglycerides, C-reactive protein, glucose, HDL cholesterol, LDL cholesterol, VLDL cholesterol, or total cholesterol.</div></div><div><h3>Conclusion</h3><div>Serum UA levels are only associated with biochemical parameters linked to renal function in KTPs. Consequently, in individuals with suboptimal renal function, such as KTPs, UA does not exhibit associations with other biochemical parameters and body adiposity, as commonly observed in non-renal disease populations.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"64 ","pages":"Pages 84-91"},"PeriodicalIF":2.9,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142281299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Concurrent and predictive validity of the Global Leadership Initiative on Malnutrition criteria for adult patients in convalescent rehabilitation wards","authors":"Shinta Nishioka ,&nbsp;Marina Kawano ,&nbsp;Emi Nishioka ,&nbsp;Amika Okazaki ,&nbsp;Manato Takagi ,&nbsp;Tatsuya Matsushita ,&nbsp;Yuka Tanaka ,&nbsp;Yutaka Taketani ,&nbsp;Shinya Onizuka","doi":"10.1016/j.clnesp.2024.09.005","DOIUrl":"10.1016/j.clnesp.2024.09.005","url":null,"abstract":"<div><h3>Background &amp; aims</h3><p>The Global Leadership Initiative on Malnutrition (GLIM) criteria has been recognised as major diagnostic criteria for malnutrition in adults worldwide; however, its validity in rehabilitation settings remains unclear. This study investigated the concurrent and predictive validity of the GLIM criteria for adult patients in convalescent rehabilitation wards.</p></div><div><h3>Methods</h3><p>This retrospective cohort study was conducted using pre-established datasets from convalescent rehabilitation wards in a hospital. The inclusion criteria were adults aged ≥18 years admitted to the wards between November 2018 and October 2020 who were available for body composition assessment. Malnutrition diagnoses were determined by registered dietitians (RDs) using the GLIM criteria. The Subjective Global Assessment (SGA) was performed by another RD and used for the malnutrition reference standard. The GLIM criteria sensitivity and specificity were examined for SGA. The odds ratios and hazard ratios of GLIM-defined malnutrition for the total score of the Functional Independence Measure (tFIM) effectiveness and non-home discharge were calculated using univariable and multivariable logistic regression analyses and Cox proportional hazard models.</p></div><div><h3>Results</h3><p>Data from 723 patients were extracted from the dataset. GLIM-defined malnutrition was confirmed in 207 (28.6%) patients, 87 (12.0%) with moderate malnutrition and 120 (16.6%) with severe malnutrition. The SGA graded 146 (20.2%) patients with moderate malnutrition (grade B) and 86 (11.9%) with severe malnutrition (grade C). The GLIM criteria (malnutrition/no malnutrition) had fair sensitivity (76.7%, 95% confidence interval [CI]: 70.7–82.0%) and good specificity (94.1%, 95% CI: 91.6–96.0%), indicating acceptable concurrent validity. GLIM-defined moderate malnutrition had poorer sensitivity than severe malnutrition (42.5% vs 81.4%). Logistic regression analyses revealed no evidence for the association between GLIM-defined malnutrition and poor tFIM effectiveness (adjusted odds ratio [AOR]: 1.09, 95% CI: 0.71–1.69) and non-home discharge (AOR: 1.19, 95% CI: 0.76–1.84). The Cox proportional hazard analyses also showed no effect of malnutrition on outcomes.</p></div><div><h3>Conclusion</h3><p>The GLIM criteria had fair sensitivity and good specificity, indicating acceptable criteria for diagnosing malnutrition in rehabilitation settings. However, its predictive validity for functional recovery and discharge outcomes was insufficient.</p></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"64 ","pages":"Pages 57-65"},"PeriodicalIF":2.9,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142270507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ChatGPT is no nutrition encyclopedia nor knowledge base","authors":"Angeline Chatelan,&nbsp;Pierre-Alexandre Fonta","doi":"10.1016/j.clnesp.2024.09.006","DOIUrl":"10.1016/j.clnesp.2024.09.006","url":null,"abstract":"","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"64 ","pages":"Pages 26-27"},"PeriodicalIF":2.9,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142232273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of weight loss effects among overweight/obese adults: A network meta-analysis of mediterranean, low carbohydrate, and low-fat diets","authors":"Maryam Akbari ,&nbsp;Mohebat Vali ,&nbsp;Shahla Rezaei ,&nbsp;Sina Bazmi ,&nbsp;Reza Tabrizi ,&nbsp;Kamran B. Lankarani","doi":"10.1016/j.clnesp.2024.08.023","DOIUrl":"10.1016/j.clnesp.2024.08.023","url":null,"abstract":"<div><h3>Background &amp; aims</h3><p>Eating patterns significantly impact the weight loss process. This study aimed to investigate the influence of primary eating patterns on weight loss measures in overweight and obese adults using network meta-analysis.</p></div><div><h3>Methods</h3><p>We systematically searched PubMed, Scopus, Web of Science (WOS), and Google Scholar until May 2, 2023. Our network meta-analysis followed the PRISMA extension guidelines for Comparing Mediterranean, low carbohydrate and low fat diet effects on weight loss among overweight/obese adults. We conducted a Frequentist random-effects network meta-analysis. Summary effects were presented as mean differences (MD) along with corresponding standard deviations (SD). P-scores were used for treatment ranking within the network.</p></div><div><h3>Results</h3><p>Initial literature searches yielded 1574 citations. Ultimately, 1004 participants from 7 RCTs (or 9 trials) met inclusion criteria. All diets resulted in weight loss. Comparatively, the low-carbohydrate diet exhibited a significant decrease in weight loss compared to the Mediterranean diet (MD = −2.70 kg, 95% CI: −4.65, −0.75). Indirect evidence revealed that both the low-carbohydrate diet (MD = −6.31 kg, 95% CI: −11.23, −1.39) and the low-fat diet (MD = −5.61 kg, 95% CI: −10.61, −0.61) significantly reduced weight among overweight/obese adults compared to the standard hypolipemic diet. Rankings indicated the low-carbohydrate diet as the most effective dietary intervention for enhancing weight loss (P-score = 0.8994) and reducing body fat (P-score = 0.7060).</p></div><div><h3>Conclusions</h3><p>Overall, a low-carb diet appears to be among the most effective approaches for weight loss and body fat reduction. However, it's essential to consider that its efficacy may vary based on factors such as age, gender, genetics, and lifestyle habits.</p></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"64 ","pages":"Pages 7-15"},"PeriodicalIF":2.9,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142172503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Apolipoprotein E4 and Alzheimer's disease causality under adverse environments and potential intervention by senolytic nutrients","authors":"Gabriella C.V. Ciurleo ,&nbsp;Orleâncio G.R. de Azevedo ,&nbsp;Camila G.M. Carvalho ,&nbsp;Michael P. Vitek ,&nbsp;Cirle A. Warren ,&nbsp;Richard L. Guerrant ,&nbsp;Reinaldo B. Oriá","doi":"10.1016/j.clnesp.2024.09.004","DOIUrl":"10.1016/j.clnesp.2024.09.004","url":null,"abstract":"<div><p>Apolipoprotein E (apoE) has a pivotal role in Alzheimer's Disease (AD) pathophysiology. <em>APOE</em>4 has been recognized as a risk factor for developing late-onset AD. Recently, <em>APOE</em>4 homozygosity was regarded as a new familial genetic trait of AD. In this opinion paper, we summarized the potential pleiotropic antagonism role of <em>APOE</em>4 in children living under early life adversity and afflicted with enteric infection/malnutrition-related pathogenic exposome. <em>APOE</em>4 was found to be neuroprotective early in life despite its increasing risk for AD with aging. We call for awareness of the potential burden this can bring to the public health system when <em>APOE</em>4 carriers, raised under adverse environmental conditions in early life and then aging with unhealthy lifestyles in later life may be at special risk for cognitive impairments and acquired AD. We postulate the importance of anti-senescence therapies to protect these individuals and remediate aging-related chronic illnesses.</p></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"64 ","pages":"Pages 16-20"},"PeriodicalIF":2.9,"publicationDate":"2024-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142228988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A plant-based diet is feasible in patients with Crohn's disease","authors":"Line Birch Arvidsson ,&nbsp;Helle Nygaard Lærke ,&nbsp;Charlotte Lauridsen ,&nbsp;Sabina Mikkelsen ,&nbsp;Henrik Højgaard Rasmussen ,&nbsp;Zeynep Cetin ,&nbsp;Stine Karstenskov Østergaard ,&nbsp;Mette Holst","doi":"10.1016/j.clnesp.2024.09.003","DOIUrl":"10.1016/j.clnesp.2024.09.003","url":null,"abstract":"<div><h3>Background</h3><p>Incorporating plant-based diets as a supplement to medical treatment may have a beneficial impact on patients with Crohn's disease, however, research with intervention studies is required.</p></div><div><h3>Objective</h3><p>To investigate the feasibility of a plant-based diet intervention. Secondly, the purpose was to investigate whether such diet may reduce disease activity and enhance quality of life.</p></div><div><h3>Materials and methods</h3><p>This study was designed as a single arm feasibility study. Outpatients with Crohn's disease in biological therapy were guided over twelve weeks towards a dietary lifestyle change.</p></div><div><h3>Outcome measures</h3><p>Feasibility concerning recruitment, retention rate and compliance. Secondary outcomes were measures of patient reported outcome questionnaires (PROMS). Paired t-tests were used to examine changes in CO₂ emissions, anthropology, biomarkers, and patient-reported data. Δ-values were used to investigate difference between dietary intake and requirements. Linear regression analyses examined the association between biomarkers and PROMS.</p></div><div><h3>Results</h3><p>In total, 15 participants completed the intervention with easy recruitment and a retention rate at 87.6%. A clinically positive tendency was seen towards improved symptom scores for disease (HBI; p=0.028 and IBDQ; p=0.006) but not for fatigue (IBD-F; p = 0.097), although none of these were statistically significant. Adverse effects were decreased protein intake (p=0.069) and slightly reduced muscle mass. It remains unclear to what extent the intervention contributed to the improved self-reported effects although perception of disease activity was improved.</p></div><div><h3>Conclusion</h3><p>This study demonstrates that it is possible to retain patients following a plant-based diet. However, the dietary change required ongoing dietetic support with a focus on anti-inflammatory agents and the still unattainable protein requirements.</p></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"64 ","pages":"Pages 28-36"},"PeriodicalIF":2.9,"publicationDate":"2024-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405457724013032/pdfft?md5=eb00374facbca2449ba0822c18fa7279&pid=1-s2.0-S2405457724013032-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142239834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship between energetic gap and sensitivity to anti-programmed cell death 1 immune checkpoint inhibitors in non-small cell lung cancer patients: The ELY-2 study","authors":"Manuela Tiako Meyo ,&nbsp;Pascaline Boudou-Rouquette ,&nbsp;Jennifer Arrondeau ,&nbsp;Jeanne Qiong Yu Chen ,&nbsp;Laure Hirsch ,&nbsp;Nathalie Neveux ,&nbsp;Elizabeth Fabre ,&nbsp;Caroline Guidet ,&nbsp;Diane Damotte ,&nbsp;Marie Wislez ,&nbsp;Jérôme Alexandre ,&nbsp;Jean-Philippe Durand ,&nbsp;Guillaume Ulmann ,&nbsp;François Goldwasser","doi":"10.1016/j.clnesp.2024.09.002","DOIUrl":"10.1016/j.clnesp.2024.09.002","url":null,"abstract":"<div><h3>Background &amp; aims</h3><p>We previously reported in the ELY prospective study that increased resting energy expenditure (REE) – so-called hypermetabolism – worsened tumor response, 6-month progression-free (PFS) and overall survival (OS) in metastatic non-small cell lung cancer (mNSCLC) patients treated with immune checkpoint inhibitors (ICI). Here, we investigated the effect of caloric coverage on the sensitivity to ICI.</p></div><div><h3>Methods</h3><p>We retrospectively analysed a multicentric database of mNSCLC patients treated with ICI. All patients had a baseline nutritional assessment including REE measured with indirect calorimetry and a dietitian estimation of food intakes. Measured/theoretical REE ≥110% defined hypermetabolism. Intakes ≥90% of estimated needs defined caloric coverage. The primary endpoint was PFS. Secondary endpoints included response rate and OS.</p></div><div><h3>Results</h3><p>Among 162 patients, 84 (51.9%) were normometabolic, and 78 (48.1%) hypermetabolic. In hypermetabolic patients, 40 (51.3%) met their caloric needs (group A) while 38 (48.7%) did not (group B). Median PFS was 4.3 vs. 1.9 months in groups A and B, respectively (HR: 0.49, 95%CI [0.31–0.80], p = 0.004). The PFS achieved in the group A and in normometabolic patients were similar (HR: 0.99, 95%CI [0.65–1.51], p = 0.95). In multivariate analysis, caloric coverage was independently associated with improved PFS in hypermetabolic patients (HR: 0.56, 95%CI [0.31–0.99], p = 0.048). Among hypermetabolic patients, the median OS was higher in the group A (HR: 0.58, 95%CI [0.35–0.95], p = 0.03).</p></div><div><h3>Conclusion</h3><p>Energy supply is a critical determinant of the sensitivity to ICI in NSCLC patients. A randomized study to evaluate the benefit of early nutritional intervention is warranted.</p></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"64 ","pages":"Pages 44-50"},"PeriodicalIF":2.9,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142145269","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of protein delivery on short-term and long-term clinical outcomes in critically ill patients: Protocol for a multicenter, prospective, observational study (The ACTION study)","authors":"Lijiang Zheng ,&nbsp;Xin Yuan ,&nbsp;Pingrong Wang ,&nbsp;Hengyu Zheng ,&nbsp;Jiajia Lin ,&nbsp;Chao Li ,&nbsp;Tao Chen ,&nbsp;Zhihui Tong ,&nbsp;Yuxiu Liu ,&nbsp;Lu Ke ,&nbsp;Penglin Ma ,&nbsp;Weiqin Li","doi":"10.1016/j.clnesp.2024.09.001","DOIUrl":"10.1016/j.clnesp.2024.09.001","url":null,"abstract":"<div><h3>Background and aims</h3><p>Nutrition therapy is a vital part of the management of critically ill patients. Efforts have been made to optimize nutrition therapy in the ICU setting, and it is argued that protein might be the most important substrate to deliver during critical illness. However, the impact of protein delivery on patient-centered outcomes, including short-term and long-term outcomes, is controversial. Moreover, previous studies showed that compliance with the guidelines is poor in practice, and the amounts of protein intake vary significantly among different hospitals. The objective of this study is to describe the current practice of protein delivery for critically ill patients and to investigate the association between different protein delivery amounts and approaches during ICU admission and multiple patient-centered outcomes (short-term and long-term).</p></div><div><h3>Methods</h3><p>This is a multicenter, prospective, observational study conducted in 70 hospitals, aiming to recruit more than 1800 newly admitted critically ill patients who are expected to stay in ICU for at least 48 h. Data, including the baseline characteristics, illness severity scores, requirements of organ support therapy, and daily nutritional therapy, will be recorded until day 28 after enrollment unless discharge from the ICU or death occurs first. The key long-term clinical outcomes, like readmission post the index discharge and health-related quality of life, will be collected via telephone contact on Day 90 and Day 180 after recruitment. Quality of life will be assessed by the EuroQol five dimensions five-level questionnaire (EQ5D5L) visual analogue scale score. Apart from descriptive data, multivariate analyses adjusted for potential confounders will be applied to assess the association between protein intake during ICU stay and short-term and long-term clinical outcomes.</p></div><div><h3>Ethics and trial registration</h3><p>This study was reviewed and approved by the ethics committee of Jinling Hospital (2021NZKY-027-01) and the participating sites. The study was registered at the Chinese Clinical Trials Registry (ChiCTR2200067016) before enrollment.</p></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"64 ","pages":"Pages 1-6"},"PeriodicalIF":2.9,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405457724013007/pdfft?md5=32f0e1c6963be31025250ca464390363&pid=1-s2.0-S2405457724013007-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142145281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}