Journal of Parenteral and Enteral Nutrition最新文献

{"title":"Harry M. Vars Award Candidate Abstracts","authors":"","doi":"10.1002/jpen.2734","DOIUrl":"10.1002/jpen.2734","url":null,"abstract":"<p>Monday, March 24, 2025</p><p>Premier Paper Session and Vars Award Competition</p><p><b>Harry M. Vars Award Candidate</b></p><p>Lizl Veldsman, RD, M Nutr, BSc Dietetics<sup>1</sup>; Guy Richards, MD, PhD<sup>2</sup>; Daniel Nel, PhD<sup>3</sup>; Renée Blaauw, PhD, RD<sup>1</sup></p><p><sup>1</sup>Division of Human Nutrition, Department of Global Health, Faculty of Medicine & Health Sciences, Stellenbosch University, Cape Town, Western Cape; <sup>2</sup>Department of Surgery, Division of Critical Care, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, Gauteng; <sup>3</sup>Centre for Statistical Consultation, Department of Statistics and Actuarial Science, Stellenbosch University, Stellenbosch, Western Cape</p><p><b>Financial Support:</b> This research study was funded by the Fresenius Kabi Jumpstart Research grant.</p><p><b>Background:</b> Critical illness is associated with severe muscle wasting. A combination of protein supplementation and mobilization may attenuate muscle loss. We determined the effect of a combination of intravenous (IV) bolus amino acid (AA) supplementation and in-bed cycling, versus standard care only, on skeletal muscle mass during the first ICU week.</p><p><b>Methods:</b> This randomized controlled trial (ClinicalTrials.gov NCT04099108) was undertaken in a predominantly trauma adult surgical ICU. Participants were randomly assigned into two groups, both of which received standard care nutrition (SCN) and mobilization. The intervention group received an additional IV AA bolus, starting on ICU day 3 on-average, along with a 45-minute in-bed cycling session for a mean of 6 days. Histological change in vastus lateralis (VL) myofiber cross-sectional area (CSA) and ultrasound rectus femoris (RF) muscle CSA was measured from pre-intervention (average ICU day 2) to post-intervention (average ICU day 8) and analyzed using mixed model ANOVA and post hoc least significant difference (LSD) testing. Secondarily, we assessed the change in the protein-to-DNA ratio over time. We further compared responses between participants with and without baseline organ dysfunction (defined as SOFA≥2, due to infection or trauma-related inflammation).</p><p><b>Results:</b> Fifty critically ill patients (90% male, mean age 37±12 years, APACHE II score 13.5±6.6, SOFA score 4.5±3.2, BMI 24.8±4.0 kg/m<sup>2</sup>, modified NUTRIC 2.2±1.8) were included. The control (n = 25) and intervention (n = 25) groups received, on average, 87.62±32.18 and 85.53±29.29 grams of protein per day (1.26±0.41 and 1.29±0.40g/kg/day, respectively) from SCN, and the intervention group an additional 30.43±5.62 grams of AA (0.37±0.06g/kg protein equivalents) from the supplement. There was significant loss of muscle mass over time in all participants (VL myofiber CSA 11.76%, p = 0.011; RF muscle CSA 13.01% p < 0.001). No significant difference was found between groups, but a more compatible trend for greater muscle loss in the control group versus","PeriodicalId":16668,"journal":{"name":"Journal of Parenteral and Enteral Nutrition","volume":"49 S1","pages":"S81-S89"},"PeriodicalIF":3.2,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jpen.2734","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Introduction to Conference Abstracts","authors":"","doi":"10.1002/jpen.2731","DOIUrl":"10.1002/jpen.2731","url":null,"abstract":"<p>The American Society for Parenteral and Enteral Nutrition (ASPEN) is dedicated to improving patient care by advancing the science and practice of clinical nutrition and metabolism. Founded in 1975, ASPEN is an interprofessional organization whose members are involved in the provision of clinical nutrition therapies, including parenteral and enteral nutrition. With more than 6000 members from around the world, ASPEN is a community of dietitians, nurses, pharmacists, physicians, scientists, students, and other health professionals from every facet of nutrition support clinical practice, research, and education.</p><p>ASPEN hosts an annual forum for clinical nutrition research and education, the ASPEN Nutrition Science &amp; Practice Conference. The ASPEN Abstract Review Committee reviewed all abstracts submitted for the conference and selected those published herein for presentation. Selected abstracts feature data relevant to nutrition therapy and metabolic support, many of which were eligible for several of ASPEN's prestigious abstract awards.</p><p>The abstracts in this supplement have not been copyedited. Any errors contained within the abstracts are the sole responsibility of the authors. ASPEN does not assume liability for any errors herein. This content does not constitute medical or other professional advice. Please visit ASPEN's conference webpage for more information: https://www.nutritioncare.org/conference/</p>","PeriodicalId":16668,"journal":{"name":"Journal of Parenteral and Enteral Nutrition","volume":"49 S1","pages":"S4"},"PeriodicalIF":3.2,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jpen.2731","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intestinal failure-associated liver disease in adult patients with chronic intestinal failure receiving home parenteral nutrition: A descriptive cohort study.","authors":"Sarah Frezet, Paul Hermabessière, Laurianne Kerlogot, Eva Wilsius, Coraline Balde, Gauthier Pellet, Constance Chevrier, Jean Castinel, Victor de Ledinghen, Florian Poullenot","doi":"10.1002/jpen.2746","DOIUrl":"https://doi.org/10.1002/jpen.2746","url":null,"abstract":"<p><strong>Background: </strong>Intestinal failure-associated liver disease (IFALD) is a major complication of chronic intestinal failure. Few data exist about hepatic monitoring of IFALD using the liver stiffness measurement. The aim of this study was to provide a descriptive analysis of IFALD and its prevalence in a tertiary center and to determine the IFALD risk factors and high liver stiffness measurement values using FibroScan.</p><p><strong>Methods: </strong>Adult patients with chronic intestinal failure treated with home parenteral nutrition and followed in a tertiary center with no underlying liver disease and at least one liver stiffness measurement record were included between January 1, 2007, and June 6, 2023.</p><p><strong>Results: </strong>Eighty-nine patients were included from this cohort of 145 patients. The prevalence of IFALD was 34%. A total of 14% had a liver stiffness measurement >10 kPa, and 49% had a liver stiffness measurement <5 kPa. In multivariate analysis, IFALD was positively associated with the use of a customized admixture (odds ratio [OR] = 7.04; 95% CI, 1.44-43.64; P = 0.017) and negatively associated with the colon in continuity (OR = 0.25; 95% CI, 0.07-0.87; P = 0.029). No significant association was observed between liver stiffness measurement values and IFALD.</p><p><strong>Conclusion: </strong>The prevalence of IFALD was low in our study. Absence of the colon and the use of a customized admixture were risk factors for IFALD. Liver stiffness measurement was abnormal in 51% of cases. A long-term follow-up of this cohort will help to assess the prognostic relevance of IFALD and liver stiffness measurement in these patients.</p>","PeriodicalId":16668,"journal":{"name":"Journal of Parenteral and Enteral Nutrition","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633929","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Measured resting energy expenditure and predicted resting energy expenditure based on ASPEN critical care guidelines for nutrition support: An agreement study.","authors":"Kiara Gaspari, Jessica Flechner-Klein, Tamara R Cohen, Courtney Wedemire","doi":"10.1002/jpen.2744","DOIUrl":"https://doi.org/10.1002/jpen.2744","url":null,"abstract":"<p><strong>Background: </strong>Predictive equations often inaccurately estimate energy needs in critically ill patients. This study evaluated the level of agreement between resting energy expenditure using 12 and 25 kcal/kg as recommended by the 2021 American Society for Parenteral and Enteral Nutrition critical care guidelines for nutrition support and energy expenditure measured by indirect calorimetry in patients in the intensive care unit.</p><p><strong>Methods: </strong>An agreement study was conducted on mechanically ventilated adults who had a documented measured energy expenditure within 10 days of intensive care unit admission. Agreement was assessed using Bland-Altman plots and Wilcoxon signed rank tests. A subgroup analysis was performed for patients with a body mass index of ≥30 kg/m² using actual body weight, adjusted body weight, and ideal body weight. Correlations between measured energy expenditure and patient characteristics were also explored.</p><p><strong>Results: </strong>Fifty-eight patients were included and were a median age of 64 years, 63.8% male, and a median body mass index of 28.0 kg/m². The 12 kcal/kg and 25 kcal/kg differed significantly from measured energy expenditure (P < 0.001). Bland-Altman plots showed mean biases of -644.6 kcal/day for 12 kcal/kg and 406.5 kcal/day for 25 kcal/kg. In the body mass index ≥30 kg/m² subgroup (n = 22), 12 kcal/kg underestimated measured energy expenditure across all weights, and 25 kcal/kg was more accurate when using ideal or adjusted body weights.</p><p><strong>Conclusions: </strong>Predicted energy expenditure using 12 kcal/kg and 25 kcal/kg based on the 2021 American Society for Parenteral and Enteral Nutrition critical care guidelines for nutrition support had poor agreement with measured energy expenditure in mechanically ventilated patients.</p>","PeriodicalId":16668,"journal":{"name":"Journal of Parenteral and Enteral Nutrition","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143615791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Indirect calorimetry in traumatically injured patients: A descriptive cohort study.","authors":"Stacy Pelekhaty, Karina Rozenberg, Rosemary Kozar","doi":"10.1002/jpen.2745","DOIUrl":"https://doi.org/10.1002/jpen.2745","url":null,"abstract":"<p><strong>Background: </strong>Trauma patients have historically been considered profoundly hypermetabolic. The purpose of this study was to describe energy expenditure using indirect calorimetry and to compare indirect calorimetry to predictive equations in trauma patients.</p><p><strong>Methods: </strong>Indirect calorimetry was performed using a Q-NRG+ by a trained dietitian nutritionist. Results were obtained in mechanically ventilated trauma patients between September 2023 and June 2024. Demographic data, injury characteristics, and outcomes were collected. Results were compared with energy expenditure predicted with 20, 25, and 30 kcal/kg; Penn State 2003b; and Schofield in adolescents on the day of indirect calorimetry using the Wilcoxon test. Subanalysis was completed in adolescents and older adults. Energy expenditure was evaluated over time.</p><p><strong>Results: </strong>A total of 164 indirect calorimetry results from 117 patients were analyzed. Among participants, median age was 43 (28-62) years, 85% were with blunt mechanism of injury, and and 80% were male. Median energy expenditure was 1869 kcal/day (1618-2265 kcal/day). In the full cohort, 20 kcal/kg underestimated energy needs, whereas other equations overestimated needs. In adolescents, 25 kcal/kg and Schofield were not significantly different than indirect calorimetry (P = 0.15 and 0.64). In older adults, 20 kcal/kg was not significantly different from indirect calorimetry (P = 0.58). A weak association was observed between prescribed and measured energy (r = 0.32, P < 0.001).</p><p><strong>Conclusion: </strong>Predictive equations recommended in critical care do not accurately reflect energy expenditure in trauma patients. Indirect calorimetry remains the preferred method for determining energy needs and the availability of the bedside dietitian nutritionist to perform these assessments facilitates timely, serial testing.</p>","PeriodicalId":16668,"journal":{"name":"Journal of Parenteral and Enteral Nutrition","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Determination of macronutrient profile and energy composition in human milk via Mid-Infrared Spectrometer Analysis: An experimental study.","authors":"Maria Lithoxopoulou, Anastasia Gkampeta, Dimitrios Rallis, Katerina Tzafilkou, Eftychia Drogouti, Christos Tsakalidis","doi":"10.1002/jpen.2741","DOIUrl":"https://doi.org/10.1002/jpen.2741","url":null,"abstract":"<p><strong>Background: </strong>To study the effect of specific maternal and neonatal variables on the macronutrients and energy composition of expressed human milk samples.</p><p><strong>Methods: </strong>A prospective study was conducted including 296 samples of human milk delivered from 201 participant mothers. Human milk was analyzed using Mid-Infrared Spectrometer Analysis.</p><p><strong>Results: </strong>Colostrum exhibited significantly higher crude protein and lower fat, carbohydrate, total solids, and energy content compared with transitional or mature milk. Milk from mothers who were obese showed significantly higher total solids levels and energy, compared with milk from mothers who were overweight, or of normal weight. Milk from mothers of preterm infants had higher crude protein, and lower carbohydrate content, compared with that of full-term infants. Finally, significant differences were observed in fat, carbohydrate, total solids, and energy between extremely and very low, low, or normal birth weight infants. Maternal body mass index and the phase of lactation were significantly associated with crude protein, whereas pregnancy duration and birth weight were positively correlated with carbohydrates and negatively correlated with fat, total solids, and energy content.</p><p><strong>Conclusion: </strong>Neonatal and maternal factors are associated with the macronutrients and energy content of expressed human milk samples. Further research is warranted to explore the specific preterm infants' nutrition needs.</p>","PeriodicalId":16668,"journal":{"name":"Journal of Parenteral and Enteral Nutrition","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between prognostic immune nutritional index and disease-free survival in adults with esophageal cancer following surgery: A retrospective cohort study.","authors":"Shinji Yamashita, Yoshinaga Okugawa, Takahito Kitajima, Hideharu Ieki, Mai Shimamura, Ruiya Ma, Koki Higashi, Naru Mizuno, Yuki Sato, Takashi Ichikawa, Ryo Uratani, Tadanobu Shimura, Hiroki Imaoka, Mikio Kawamura, Hiromi Yasuda, Yuhki Koike, Yoshiki Okita, Shigeyuki Yoshiyama, Masaki Ohi, Yuji Toiyama","doi":"10.1002/jpen.2740","DOIUrl":"https://doi.org/10.1002/jpen.2740","url":null,"abstract":"<p><strong>Introduction: </strong>The clinical significance of the prognostic immune nutritional index in esophageal cancer has not been elucidated. The aim of this study was to evaluate the utility of the preoperative prognostic immune nutritional index in predicting oncological outcomes and the incidence of surgical site infection in patients with esophageal cancer.</p><p><strong>Methods: </strong>We analyzed preoperative prognostic immune nutritional index from 150 esophageal cancer patients who underwent surgical treatment between 2008 and 2018 to clarify its clinical relevance.</p><p><strong>Results: </strong>Patients with low preoperative prognostic immune nutritional index exhibited poor disease-free survival and overall survival (P = 0.030 and P < 0.001, respectively). Although statistical significance was not observed in the multivariate analysis, low prognostic immune nutritional index showed a tendency toward poorer disease-free survival (hazard ratio [HR]: 2.02; 95% confidence interval [CI]: 0.88-4.61; P = 0.096). Regarding overall survival, multivariate analysis revealed that low preoperative prognostic immune nutritional index was an independent prognostic factor for overall survival (HR: 2.67; 95% CI: 1.39-5.16; P = 0.003). Moreover, the low preoperative prognostic immune nutritional index was associated with a tendency toward an increased risk of surgical site infection (odds ratio: 2.38; 95% CI: 0.96-5.91; P = 0.062). In the subgroup analysis of patients who did not receive neoadjuvant therapy, low preoperative prognostic immune nutritional index was identified as an independent prognostic factor for disease-free survival (HR: 3.11; 95% CI: 1.00-9.71; P = 0.050) and overall survival (HR: 5.04; 95% CI: 1.80-14.13; P = 0.002).</p><p><strong>Conclusion: </strong>The preoperative prognostic immune nutritional index is a useful marker for perioperative and oncological management of esophageal cancer patients.</p>","PeriodicalId":16668,"journal":{"name":"Journal of Parenteral and Enteral Nutrition","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pediatric and adult commercial blenderized and real-food ingredient enteral formulas: A comparison study.","authors":"Elizabeth Evenson, Chelsea Britton, Lauren Storch, Nicole Shook, Miriam Knopp, Praveen S Goday","doi":"10.1002/jpen.2743","DOIUrl":"https://doi.org/10.1002/jpen.2743","url":null,"abstract":"<p><strong>Background: </strong>Traditional pediatric, cow milk-based formulas provide >90% of dietary reference intakes (\"complete\" nutrition) when a child receives a standard amount of formula. We aimed to assess the adequacy of essential nutrients provided to children by commercial real-food ingredient formulas and commercial blenderized formulas.</p><p><strong>Methods: </strong>We systematically identified all US-based real-food-based formulas via Google searches. We analyzed macronutrient and micronutrient nutriture by simulating feeds to 3-, 8-, 13-, and 18-year-olds and compared these with the dietary reference intakes and tolerable upper intake limits. We assessed the amounts provided by 1000 ml and 1000 kcal (at ages 3 and 8 years), 1500 ml and 1500 kcal (at all ages) and 2000 ml and 2000 kcal (at ages 13 and 18 years).</p><p><strong>Results: </strong>We identified 33 formulas (20 pediatric; 13 adult) of which 70% were vegan. Different nutrients, including essential amino acids and polyunsaturated fatty acids, were deficient at various volume and energy amounts. At age 13, adult formulas more consistently met dietary reference intakes (vs pediatric formulas). Nonvegan formulas were more likely to meet dietary reference intakes at various age groups (vs vegan formulas) but were also more likely to exceed tolerable upper intake limits.</p><p><strong>Conclusions: </strong>Nutrition provided by food-based formulas may not meet all the needs of children, particularly those exclusively fed these formulas. Adult formulas should be considered in teens and nonvegan formulas may increase nutrient adequacy. Children with gastrointestinal diseases or low energy needs may be at higher risk of nutrient deficiencies when on these formulas.</p>","PeriodicalId":16668,"journal":{"name":"Journal of Parenteral and Enteral Nutrition","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143567466","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multiomics profiling and parenteral nutrition weaning in pediatric patients with intestinal failure: A longitudinal cohort study.","authors":"Niklas Tappauf, Yvonne Lamers, Ho Pan Sham, Hannah G Piper","doi":"10.1002/jpen.2742","DOIUrl":"https://doi.org/10.1002/jpen.2742","url":null,"abstract":"<p><strong>Background: </strong>Intestinal failure (IF) is a life-limiting condition that includes a variety of intestinal pathologies. Currently, there are few clinical biomarkers that reflect intestinal function or a patient's potential to wean off parenteral nutrition (PN), making it difficult to predict the clinical trajectory. By associating gut microbiome taxonomic and functional features and blood analytes with the proportion of daily energy delivered via PN-a proxy for intestinal function-our study aimed to discover potential predictors of intestinal function and PN weaning potential.</p><p><strong>Methods: </strong>In this longitudinal multiomics cohort study, we followed 18 pediatric patients with IF and PN support for ≤1.5 years. Fecal and stoma samples were analyzed using metagenomic shotgun sequencing to assess bacterial taxonomy and function and internal transcribed spacer 2 ribosomal RNA sequencing to characterize the fungal community. Targeted metabolomics was used to quantify 257 blood analytes. Linear mixed models were used to analyze the associations of PN dependence with microbiome features and blood analytes.</p><p><strong>Results: </strong>The bacterial and fungal taxonomic composition exhibited substantial interpatient and intrapatient variability, with no link to PN dependence. In contrast, bacterial functional analysis revealed 63 MetaCyc pathways significantly associated with PN dependence. Additionally, 32 blood analytes were associated with PN dependence.</p><p><strong>Conclusion: </strong>In this exploratory study, we found that functional microbiome features and blood metabolomic profiles-particularly urea cycle metabolites, creatinine, asparagine, and tryptophan-derived metabolites-show promise for predicting intestinal function. Furthermore, they may have therapeutic implications for promoting intestinal adaptation. Confirmatory trials with larger sample sizes are needed to validate these findings.</p>","PeriodicalId":16668,"journal":{"name":"Journal of Parenteral and Enteral Nutrition","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between early phosphate intake and refeeding syndrome in extremely low-birth-weight infants: A retrospective cohort study.","authors":"Thomas B Wright, Frank H Bloomfield, Tanith Alexander, Barbara E Cormack","doi":"10.1002/jpen.2739","DOIUrl":"https://doi.org/10.1002/jpen.2739","url":null,"abstract":"<p><strong>Background: </strong>Preterm infants are at risk of refeeding syndrome, a constellation of biochemical changes associated with nutrition. We aimed to determine whether increased early phosphate intake with routine biochemical monitoring is associated with a reduction in refeeding syndrome.</p><p><strong>Methods: </strong>Retrospective cohort study in two Auckland neonatal intensive care units comparing infants born <1000 g before (2014-2018, standard phosphate intake) and after (2020-2021, early phosphate intake) changes to intravenous nutrition protocols that increased phosphate intake and introduced biochemical monitoring. The standard phosphate intake cohort comprised the participants who received placebo in a randomized controlled trial of early increased amino acid intake. The early phosphate intake cohort was identified prospectively. Data were retrieved from the trial database or prospectively from electronic medical records. Groups were compared using either the chi-square test or pooled t test and logistic or multiple logistic regression analysis. Refeeding syndrome was defined as concurrent hypophosphatemia (serum phosphate <1.4 mmol L^-1) and hypercalcemia (serum calcium >2.8 mmol L^-1).</p><p><strong>Results: </strong>The incidence of refeeding syndrome in the first 5 days after birth decreased from 11.9% to 2.9%, hypophosphatemia from 53.5% to 21.2%, and severe hypophosphatemia (<0.9 mmol L^-1) from 11.3% to 1.2%. Probable early- and late-onset sepsis reduced from 51.4% to 28.2% and from 62.5% to 28.0%, respectively.</p><p><strong>Conclusions: </strong>Increased early phosphate intake with routine biochemical monitoring is associated with a lower incidence of refeeding syndrome, hypophosphatemia, and associated comorbidities. Whether these associations are causal requires further investigation.</p>","PeriodicalId":16668,"journal":{"name":"Journal of Parenteral and Enteral Nutrition","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143483554","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}