Journal of Parenteral and Enteral Nutrition最新文献_第3页

Impact of early enteral nutrition in critically ill children: A systematic review and meta-analysis.

IF 3.2 3区医学

Journal of Parenteral and Enteral Nutrition Pub Date : 2025-02-19 DOI: 10.1002/jpen.2738

Ana Cristina Assumpção Benjamin, Humberto Magalhães Silva, Raísa Sanches Uzun, Andrea Maria Cordeiro Ventura, Isabel de Siqueira Ferraz, Roberto José Negrão Nogueira, Tiago Henrique De Souza

{"title":"Impact of early enteral nutrition in critically ill children: A systematic review and meta-analysis.","authors":"Ana Cristina Assumpção Benjamin, Humberto Magalhães Silva, Raísa Sanches Uzun, Andrea Maria Cordeiro Ventura, Isabel de Siqueira Ferraz, Roberto José Negrão Nogueira, Tiago Henrique De Souza","doi":"10.1002/jpen.2738","DOIUrl":"https://doi.org/10.1002/jpen.2738","url":null,"abstract":"Background: This study aims to evaluate the impact of early enteral nutrition (EEN) compared with late enteral nutrition on clinical outcomes in critically ill children.Methods: PubMed, Embase, and the Cochrane Library were systematically searched until December 2024. The primary outcome was all-cause mortality, with secondary outcomes including duration of mechanical ventilation and length of stay in the pediatric intensive care unit (PICU) and hospital. The meta-analysis used a random-effects model with inverse variance weighting.Results: Twenty-one studies (10,006 children) were included. Definitions of EEN varied across studies, ranging from 24 to 72 h. EEN was associated with decreased mortality in both randomized controlled trials (RCTs) (odds ratio [OR] = 0.64; 95% CI, 0.43-0.96; P = 0.03) and observational studies (OR = 0.38; 95% CI, 0.23-0.62; P < 0.001). A sensitivity analysis was conducted by combining studies with similar EEN definitions. EEN initiated within 24 h of PICU admission was not significantly associated with mortality (OR = 0.72; 95% CI, 0.43-1.20; P = 0.21). However, EEN within 48 h was significantly associated with reduced mortality (OR = 0.37; 95% CI, 0.25-0.56; P < 0.001). The certainty of evidence (Grading of Recommendations Assessment, Development and Evaluation) from RCTs was evaluated as low, whereas that from observational studies was evaluated as very low.Conclusion: The evidence from this study suggests that EEN benefits critically ill children by reducing mortality and shortening hospital stays. However, the high risk of bias and very low certainty of the evidence highlight the need for further research.","PeriodicalId":16668,"journal":{"name":"Journal of Parenteral and Enteral Nutrition","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143458373","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}

引用次数: 0

JPEN Journal Club 91. Choosing the population to study.

IF 3.2 3区医学

Journal of Parenteral and Enteral Nutrition Pub Date : 2025-02-19 DOI: 10.1002/jpen.2737

Ronald L Koretz

引用次数: 0

Metabolic profiles and malnutrition in hospitalized adults: A metabolomic cohort study.

IF 3.2 3区医学

Journal of Parenteral and Enteral Nutrition Pub Date : 2025-02-17 DOI: 10.1002/jpen.2728

Marte A Trollebø, Randi J Tangvik, Eli Skeie, Ottar Nygård, Tomas M L Eagan, Adrian McCann, Jutta Dierkes

{"title":"Metabolic profiles and malnutrition in hospitalized adults: A metabolomic cohort study.","authors":"Marte A Trollebø, Randi J Tangvik, Eli Skeie, Ottar Nygård, Tomas M L Eagan, Adrian McCann, Jutta Dierkes","doi":"10.1002/jpen.2728","DOIUrl":"https://doi.org/10.1002/jpen.2728","url":null,"abstract":"Background: Malnutrition or risk of malnutrition is present in about one-third of patients admitted to Western hospitals and is identified by either screening for malnutrition or further nutrition assessment. To date, there are no commonly accepted biomarkers of malnutrition, which could expedite screening efforts, ease diagnosis, and hasten treatment. We aimed to investigate whether metabolomics could identify markers associated with malnutrition in hospitalized patients and performed a retrospective metabolomic cohort study in this patients' group.Methods: The study population included adult patients hospitalized in a medical unit. Malnutrition was identified by the second step of the Global Leadership Initiative on Malnutrition criteria independently of the outcome of the screening step (nutritional risk screening 2002). Amino acids were determined by targeted metabolomics using gas chromatography-tandem mass spectrometry and liquid chromatography-tandem mass spectrometry. Logistic regression analyses with Benjamini-Hochberg procedure to reduce false discovery rate were used to identify biomarkers associated with malnutrition.Results: In total, 218 patients were included in the final analysis, with 62 patients having a diagnosis of malnutrition. In crude analyses, 11 metabolites were associated with malnutrition, but further adjustment attenuated the associations. After multiple adjustment, neopterin and cystatin C were positively associated with malnutrition, whereas His, Cys, and kynurenine to tryptophan ratio were negatively associated.Conclusion: The observed associations require confirmation in a replication cohort before they can be recommended as biomarkers of malnutrition.","PeriodicalId":16668,"journal":{"name":"Journal of Parenteral and Enteral Nutrition","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143441277","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}

引用次数: 0

Performance of GLIM with different nutrition risk screening tools in predicting 90-day mortality in critically ill adults with acute stroke: A comparison study.

IF 3.2 3区医学

Journal of Parenteral and Enteral Nutrition Pub Date : 2025-02-08 DOI: 10.1002/jpen.2730

Junzhuo Li, Xin Li, Jiajia Yang, Yaqi Wang, Wenmei Gong

{"title":"Performance of GLIM with different nutrition risk screening tools in predicting 90-day mortality in critically ill adults with acute stroke: A comparison study.","authors":"Junzhuo Li, Xin Li, Jiajia Yang, Yaqi Wang, Wenmei Gong","doi":"10.1002/jpen.2730","DOIUrl":"https://doi.org/10.1002/jpen.2730","url":null,"abstract":"Background: The Global Leadership Initiative on Malnutrition (GLIM) proposes a diagnostic process for malnutrition, including initial screening with nutrition screening tools, followed by diagnostic evaluation. This study aimed to compare the performance of GLIM with different nutrition screening tools in predicting 90-day mortality in adults who are critically ill with acute stroke.Methods: A comparative study was conducted on 308 adults (who critically ill) with acute stroke. Multiple nutrition screening tools were evaluated upon admission. Nutrition status was assessed using GLIM criteria. The predictive performance of GLIM on mortality was analyzed using Cox regression.Results: The prevalence of malnutrition ranged from 17.86% to 28.25%, depending on the nutrition screening tools used for classification. During 90-day of follow-ups, 112 (36.36%) deaths occurred. GLIM effectively predicted 90-day mortality, with GLIM and the modified Nutritional Risk in the Critically Ill (mNUTRIC) screening demonstrating the best predictive ability [Hazard Ratio: 2.807 (1.816-4.339)].Conclusion: Malnutrition identified by GLIM with mNUTRIC demonstrates a good ability to predict mortality in critically ill adults with acute stroke. GLIM criteria anticipate mortality and might guide interventions, with important implications for clinical practice and research.","PeriodicalId":16668,"journal":{"name":"Journal of Parenteral and Enteral Nutrition","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143374178","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}

引用次数: 0

JPEN Journal Club 90. Emulated clinical trials.

IF 3.2 3区医学

Journal of Parenteral and Enteral Nutrition Pub Date : 2025-02-06 DOI: 10.1002/jpen.2729

Ronald L Koretz

引用次数: 0

Enhanced metabolic regulation in II/R injury: Comparing multiroute and monoroute enteral nutrition.

IF 3.2 3区医学

Journal of Parenteral and Enteral Nutrition Pub Date : 2025-02-05 DOI: 10.1002/jpen.2726

Jianfeng Duan, Jiali Liu, Jiawen Chen, Suwan Qian, Xinran Liang, Yanyu Han, Beiyuan Zhang, Tao Gao, Gang Wang, Xiaoyao Li, Wenkui Yu

{"title":"Enhanced metabolic regulation in II/R injury: Comparing multiroute and monoroute enteral nutrition.","authors":"Jianfeng Duan, Jiali Liu, Jiawen Chen, Suwan Qian, Xinran Liang, Yanyu Han, Beiyuan Zhang, Tao Gao, Gang Wang, Xiaoyao Li, Wenkui Yu","doi":"10.1002/jpen.2726","DOIUrl":"https://doi.org/10.1002/jpen.2726","url":null,"abstract":"Objective: This study aimed to compare the effects of enteral nutrition (EN) administered via multiroute or via monoroute on metabolic regulation in intestinal ischemia-reperfusion (II/R) injury rat model.Methods: The rats were divided into sham operation and II/R injury groups. The rats in each group were further treated with either multiroute or monoroute EN. Rats subjected to multiroute EN were administered a continuous infusion of 30 kcal/kg × day of nutrition via a gastric tube and additionally provided with 0.5 g of standard rat forage for oral intake q8h (for a total of approximately 20 kcal/kg × day) each day. Conversely, rats on the monoroute regimen underwent a continuous infusion of 50 kcal/kg × day of EN through a gastric tube. Hypercatabolism was evaluated by assessing skeletal muscle protein synthesis and atrophy, and insulin resistance. Moreover, serum gastrointestinal hormone levels, hypothalamic ghrelin, and neuropeptide pro-opiomelanocortin (POMC) were detected.Results: In rats subjected to II/R injury, multiroute EN more effectively restored serum and hypothalamic ghrelin levels, decreased the expression of the POMC neuropeptide, decreased skeletal muscle atrophy, and enhanced skeletal muscle synthesis. These effects collectively contributed to a reduction in muscle wasting, an improvement in hypercatabolic status, and a mitigation of body weight loss.Conclusion: Compared with monoroute nutrition, multiroute EN may further improve hypercatabolic metabolism, reduce muscle wasting, and prevent weight loss in II/R injury rat. This research suggested that an optimized multiroute EN regimen is superior to the monoroute EN approach.","PeriodicalId":16668,"journal":{"name":"Journal of Parenteral and Enteral Nutrition","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143256045","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}

引用次数: 0

JPEN Reviewer Acknowledgment

IF 3.2 3区医学

Journal of Parenteral and Enteral Nutrition Pub Date : 2025-02-04 DOI: 10.1002/jpen.2732

引用次数: 0

Association between enteral carboxymethyllysine intake and daily glycemic variability in critically ill adults: A retrospective cohort study.

IF 3.2 3区医学

Journal of Parenteral and Enteral Nutrition Pub Date : 2025-01-28 DOI: 10.1002/jpen.2727

Ra'eesa Doola, Alison Griffin, Josephine M Forbes, Peter S Kruger, Adam M Deane, Casper G Schalkwijk, Kyle C White

{"title":"Association between enteral carboxymethyllysine intake and daily glycemic variability in critically ill adults: A retrospective cohort study.","authors":"Ra'eesa Doola, Alison Griffin, Josephine M Forbes, Peter S Kruger, Adam M Deane, Casper G Schalkwijk, Kyle C White","doi":"10.1002/jpen.2727","DOIUrl":"https://doi.org/10.1002/jpen.2727","url":null,"abstract":"Background: Advanced glycation end-products (AGEs) can enter patients' circulation through exogenous sources, such as enteral nutrition formulae. Circulating AGEs, specifically carboxymethyllysine, can promote insulin resistance and activation of pro-inflammatory pathways leading to oxidative stress, cell death, and organ failure. Suboptimal kidney function increases the risk of elevated circulating AGEs because levels are controlled through urinary excretion. Our aim was to determine associations between carboxymethyllysine intake and glycemic control as well as clinical outcomes in critically ill patients and explore these in the subset of patients with an acute kidney injury (AKI).Methods: This was a retrospective cohort study. Data were extracted from electronic medical records. Patients were eligible if they were ≥18 years and received enteral nutrition, with known carboxymethyllysine content, for ≥3 days. AKI was defined using the Kidney Disease: Improving Global Outcomes guidelines. Linear and logistic regression models were used to determine adjusted associations.Results: Between 2015 and 2021, 2636 patients met the eligibility criteria, with 848 (32%) patients having an AKI. Most were male (n = 1752, 67%) with a median (interquartile range) Acute Physiology And Chronic Health Evaluation III score of 59 (45-77). For every 10-μmol increase in carboxymethyllysine provision, mean blood glucose increased by 0.05 mmol (95% CI, 0.03-0.07), and the odds of dying increased by 16% (odds ratio = 1.16; 95% CI, 1.06-1.27). A subgroup analysis indicated these associations persisted in patients with AKI but not in those without.Conclusion: Carboxymethyllysine intake was associated with increased mean blood glucose and odds of dying in our study cohort.","PeriodicalId":16668,"journal":{"name":"Journal of Parenteral and Enteral Nutrition","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143059255","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}

引用次数: 0

Comparison of taurolidine with 4% ethylenediaminetetraacetic acid on antimicrobial lock effectiveness: An experimental study.

IF 3.2 3区医学

Journal of Parenteral and Enteral Nutrition Pub Date : 2025-01-26 DOI: 10.1002/jpen.2725

Jakub Visek, Lenka Ryskova, Petra Cesakova, Jana Stanclova, Marie Vajrychova, Vladimir Blaha

{"title":"Comparison of taurolidine with 4% ethylenediaminetetraacetic acid on antimicrobial lock effectiveness: An experimental study.","authors":"Jakub Visek, Lenka Ryskova, Petra Cesakova, Jana Stanclova, Marie Vajrychova, Vladimir Blaha","doi":"10.1002/jpen.2725","DOIUrl":"https://doi.org/10.1002/jpen.2725","url":null,"abstract":"Background: Antimicrobial lock therapy is recommended for preventing and treating catheter-related bloodstream infections, but different solutions have uncertain efficacy.Methods: Two locks, 1.35% taurolidine and 4% ethylenediaminetetraacetic acid (EDTA), were tested on Staphylococcus epidermidis, Staphylococcus aureus, methicillin-resistant S. aureus, Pseudomonas aeruginosa, multidrug-resistant P. aeruginosa, vancomycin-resistant Enterococcus faecium, Klebsiella oxytoca (carbapenemase producing), K. pneumoniae (extended-spectrum β-lactamase producing), Candida albicans, and Candida glabrata. Broviac catheter segments were incubated with these organisms and then exposed to various lock solutions. Colony-forming units (CFUs) were counted after 2, 4, and 24 h of incubation.Results: Taurolidine showed a significant decrease in CFUs after 2 h in S. aureus, S. epidermidis, methicillin-resistant S. aureus, vancomycin-resistant E. faecium, P. aeruginosa (both sensitive and multidrug-resistant strains), K. oxytoca, C. albicans, and C. glabrata. After 4 h, significant reductions were noted in S. aureus, S. epidermidis, methicillin-resistant S. aureus, P. aeruginosa, multidrug-resistant P. aeruginosa, K. pneumoniae, K. oxytoca, and C. albicans. Taurolidine was also effective after 24 h, especially against methicillin-resistant S. aureus and multidrug-resistant P. aeruginosa. Four percent EDTA acid showed a significant reduction in CFUs after 2 h in S. aureus, vancomycin-resistant E. faecium, P. aeruginosa, K. oxytoca, C. albicans, and C. glabrata. After 4 h, reductions occurred in P. aeruginosa, multidrug-resistant P. aeruginosa, K. oxytoca, and C. albicans and after 24 h in methicillin-resistant S. aureus, P. aeruginosa, and K. oxytoca.Conclusion: Taurolidine is more effective than 4% EDTA acid in eradicating Gram-positive and Gram-negative microorganisms and fungi.","PeriodicalId":16668,"journal":{"name":"Journal of Parenteral and Enteral Nutrition","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143046924","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}

引用次数: 0

Association between oral feeding versus enteral feeding and cerumen impaction in older hospitalized adults: A retrospective cohort study. 老年住院成人口服喂养与肠内喂养与耵聍嵌塞的关系：一项回顾性队列研究。

IF 3.2 3区医学

Journal of Parenteral and Enteral Nutrition Pub Date : 2025-01-20 DOI: 10.1002/jpen.2724

Asil Mansour, Boaz M Ben-David, Ady Sasson, Jalal Farraj, Anwar Mansour, Yehonatan Roth, Michal Icht

{"title":"Association between oral feeding versus enteral feeding and cerumen impaction in older hospitalized adults: A retrospective cohort study.","authors":"Asil Mansour, Boaz M Ben-David, Ady Sasson, Jalal Farraj, Anwar Mansour, Yehonatan Roth, Michal Icht","doi":"10.1002/jpen.2724","DOIUrl":"https://doi.org/10.1002/jpen.2724","url":null,"abstract":"Background: Chewing involves jaw movements that propel cerumen along the ear canal. This mechanism may be reduced in dysphagia, especially for older individuals who are enterally fed. Those patients may be at a higher risk for cerumen impaction and may require longer hospital stays. Examining the relationship between diet type, cerumen impaction, and hospital stay duration was the focus of the present study.Methods: We performed a retrospective cohort study (not registered) among 114 hospitalized older adults. Data were collected on diet type: (1) oral feeding (individuals fed a solid diet or a pureed diet) or (2) enteral feeding (individuals fed via a feeding tube). The results of an otoscopy that quantified cerumen were recorded, as well as hospital stay duration.Results: In a mediation analysis, a hospital stay of >1 month was associated with an increased risk of enteral feeding, which in turn, increased the risk of cerumen impaction. Analysis indicated that the link between longer hospitalization and a more severe level of cerumen impaction was fully mediated by diet type (enteral feeding).Conclusions: Enteral feeding seems to be a risk factor for cerumen impaction, rather than merely hospitalization length, in our sample of geriatric patients. These results highlight the importance of continuous monitoring by ear, nose, and throat specialists, as well as regular auditory assessments for patients who are enterally fed for early detection and treatment of cerumen impaction. Particular attention should be paid to cases of prolonged hospitalization, which is associated with the severity of dysphagia.","PeriodicalId":16668,"journal":{"name":"Journal of Parenteral and Enteral Nutrition","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007181","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}

引用次数: 0