Journal of Parenteral and Enteral Nutrition最新文献

{"title":"Prediction of chronic severe intestinal failure–associated liver disease by current criteria in adults: A descriptive cohort study","authors":"Claudia Cipriano MBChB,&nbsp;Liat Deutsch MD,&nbsp;Maja Kopczynska MBBch,&nbsp;Liane Rabinowich MD,&nbsp;Anna Simona Sasdelli PhD,&nbsp;Loris Pironi PhD,&nbsp;Simon Lal PhD","doi":"10.1002/jpen.2719","DOIUrl":"10.1002/jpen.2719","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Intestinal failure–associated liver disease covers a spectrum of conditions from mild to end-stage disease. Currently, there are 9 diagnostic criteria divided to four categories: cholestasis, steatosis, fibrosis, and unclassified. Our aim was to evaluate the application of these criteria to patients with chronic severe liver disease in patients with intestinal failure.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This was a cross-sectional study of patients attending the home parenteral nutrition clinic of a national UK reference intestinal failure center from March 2015 to December 2019. Exclusion criteria included active malignancy, home parenteral nutrition for &lt;6 months duration, and liver transplantation. Clinically significant intestinal failure–associated liver disease was defined as moderate-severe fibrosis or cirrhosis on liver biopsy and/or radiological imaging compatible with liver cirrhosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Two hundred and twenty-one patients were included (age at home parenteral nutrition initiation: 50 ± 16.0 years; 63.6% female). There was a wide range of intestinal failure–associated liver disease point prevalence depending on the established criteria used (2.9%–35.1%). Twenty-three patients (9.5%) were diagnosed with clinically significant intestinal failure–associated liver disease, but no patient with clinically significant intestinal failure–associated liver disease met all diagnostic criteria, and 6 of 23 (26.1%) did not fit any of the established criteria.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Intestinal failure–associated liver disease is a poorly defined medical condition, and current noninvasive diagnostic methods are unreliable in predicting disease severity. Further studies are needed to develop the definition to reflect that intestinal failure–associated liver disease is a spectrum of disease that includes chronic severe liver disease and improve methods of disease diagnosis.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16668,"journal":{"name":"Journal of Parenteral and Enteral Nutrition","volume":"49 3","pages":"349-357"},"PeriodicalIF":3.2,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142895597","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":"Complications that arise with nasogastric tubes after hospitalization in the pediatric population: A mixed methods systematic review","authors":"Samantha Mekhuri MSc,&nbsp;Naomi Dussah MSc,&nbsp;Julie Quet MD,&nbsp;Margaret Sampson PhD,&nbsp;Katie O'Hearn MSc,&nbsp;Sara Loree MSLS,&nbsp;Julia Orkin MD,&nbsp;Krista Keilty PhD,&nbsp;Stephanie Chu MN,&nbsp;Nathalie Major MD,&nbsp;Reshma Amin MD","doi":"10.1002/jpen.2716","DOIUrl":"10.1002/jpen.2716","url":null,"abstract":"<p>Children use nasogastric tubes (NGTs) to ensure optimum nutrition and medication delivery when oral feeding fails or when they experience faltering growth. Although this method is less invasive, children may experience complications associated with NGTs. There is a gap in the literature regarding the types and prevention of complications of NGTs in the pediatric population at home. This review determines at-home complications associated with NGTs in the pediatric population (aged 0–18 years) and the type of education and support provided to caregivers. Databases MEDLINE, Embase using the Ovid interface, and CINAHL using the EBSCOhost interface were searched for relevant studies from January 1946 to November 2022. Twenty-four articles were found, of which 16 studies with 902 children with NGTs feeding were systematically reviewed. Two themes emerged: (1) prevalence and types of NGT complications and (2) preventable complications and education/management strategies for prevention. Seven studies reported main complications of vomiting, retching and gagging, nausea, aspiration, local granulation tissue, and inadvertent removal, with two studies reporting no complications. Most complications were managed at home, suggesting caregivers were able to address issues without seeking additional medical intervention. Key recommendations to mitigate complications included training caregivers in NGT management, troubleshooting common complications, and evaluating caregiver competency before discharge. This systematic review emphasized the need for structured training programs to improve caregiver competence and safety practices, highlighting key areas for clinical improvement, including caregiver education, reducing at-home complications, and standardizing care for children using NGTs.</p>","PeriodicalId":16668,"journal":{"name":"Journal of Parenteral and Enteral Nutrition","volume":"49 3","pages":"280-306"},"PeriodicalIF":3.2,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142895596","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":"Topiramate treatment of pediatric metabolic dysfunction–associated steatotic liver disease: A descriptive cohort study","authors":"Taisa Kohut MD,&nbsp;Andrea Tou MD,&nbsp;Emily Carr MD, MPH,&nbsp;Stavra Xanthakos MD, MS,&nbsp;Ana Catalina Arce-Clachar MD,&nbsp;Rima Fawaz MD,&nbsp;Pamela L. Valentino MD, MSc,&nbsp;Jennifer Panganiban MD,&nbsp;Marialena Mouzaki MD, MSc","doi":"10.1002/jpen.2722","DOIUrl":"10.1002/jpen.2722","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Metabolic dysfunction–associated steatotic liver disease (MASLD) is a common disease in children. Lifestyle modification is the primary treatment but difficult to achieve and maintain. Topiramate is a component of an approved weight loss medication (topiramate-phentermine) in children aged 12 years and older but is more commonly used as a single agent, off-label, for pediatric obesity. Our aim is to describe change in anthropometrics and laboratory values while providing topiramate treatment of pediatric MASLD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Descriptive cohort study including patients aged &lt;18 years with MASLD and body mass index (BMI) &gt;95th percentile treated with topiramate for weight loss for ≥3 months from January 1, 2010, to December 30, 2023. The primary outcome was change in serum alanine aminotransferase (ALT) levels from baseline to 3–6 months. Secondary outcomes were changes in BMI <i>z</i> score, glycated hemoglobin, and lipid profile.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 43 patients prescribed topiramate, 11 were excluded for nonadherence, leaving 32 (56% boys, 72% non-Hispanic) for further analyses. With topiramate, ALT levels improved (76 vs 50 U/L, <i>p</i> = 0.001). Further, 43% of patients had either ALT normalization or reduction by &gt;50% from baseline. BMI <i>z</i> score decreased by 0.1 from baseline to 3–6 months. There were no improvements in glycated hemoglobin or lipids. Eight patients (25%) reported mild side effects.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Topiramate, as an adjunct to lifestyle intervention, may be considered in the treatment of pediatric MASLD, specifically in the context of failed lifestyle modification and inability to tolerate or qualify for other obesity pharmacotherapy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16668,"journal":{"name":"Journal of Parenteral and Enteral Nutrition","volume":"49 3","pages":"308-313"},"PeriodicalIF":3.2,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142885754","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":"The relationship between muscle mass changes and protein or energy intake in critically ill children: A systematic review and meta-analysis","authors":"Lewis J. Stacey,&nbsp;Frederic V. Valla MD, PhD,&nbsp;Chao Huang PhD,&nbsp;Paul Comfort BSc, PhD,&nbsp;Corinne Jotterand Chaparro RD, PhD,&nbsp;Lynne Latten RD, BSc,&nbsp;Lyvonne N. Tume RN, PhD","doi":"10.1002/jpen.2715","DOIUrl":"10.1002/jpen.2715","url":null,"abstract":"<p>Survivorship after pediatric critical illness is high in developed countries, but many suffer physical morbidities afterwards. The increasing focus on follow-up after critical illness has led to more pediatric studies reporting muscle mass changes (using ultrasound), albeit with different results. A systematic literature review was undertaken examining muscle mass changes, assessed by ultrasound of the quadriceps femoris muscle in children who are critically ill. Secondary objectives were to determine if muscle mass was associated with protein intake and/or energy. Databases were searched in July 2024. Eligible experimental or observational studies, published from January 2010 to July 2024 and including children who are critically ill that were aged between ≥37 weeks' gestational age and 18 years who were admitted to the pediatric critical care unit were included. The Joanna Briggs Institute for observational studies critical appraisal instrument was used to assess studies for methodological quality. One hundred and thirty-five studies were screened, and eight prospective cohort studies were included, involving 411 children. Overall, muscle mass changes reported in seven out of eight of the papers showed a pooled mean muscle mass loss of 8.9% (95% confidence interval [CI] 6.6–11.4) from baseline to days 5–7. Five of the eight publications defined muscular atrophy as a decrease in muscle mass of &gt;10%. Using this cutoff, 92 (49.2%) children developed muscular atrophy during their PICU admission. Overall, muscle mass decreased by nearly 10% during a child's first week in PICU, with almost half of children developing muscular atrophy during their admission.</p>","PeriodicalId":16668,"journal":{"name":"Journal of Parenteral and Enteral Nutrition","volume":"49 2","pages":"152-164"},"PeriodicalIF":3.2,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jpen.2715","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142882278","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":"Association between a 6-h feeding protocol and postprocedure hospital length of stay following percutaneous endoscopic gastrostomy in hospitalized adults: A before-and-after cohort study","authors":"Jeffrey L. Roberson MD, MBA,&nbsp;Jesse E. Passman MD, MPH,&nbsp;Marianne Aloupis MS, RD,&nbsp;Yessenia Caballero-Tilleria MA,&nbsp;Anthony Audia MA,&nbsp;Melissa R. Ramirez MA,&nbsp;Patricia Martinez Quinones MD, PhD,&nbsp;Patrick Kim MD, MHCI,&nbsp;Elinore J. Kaufman MD, MSHP,&nbsp;Catherine E. Sharoky MD, MSCE","doi":"10.1002/jpen.2718","DOIUrl":"10.1002/jpen.2718","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Tolerance of enteral nutrition following percutaneous endoscopic gastrostomy is a barrier to discharge. This study investigated the impact of an expedited feeding protocol following percutaneous endoscopic gastrostomy on postprocedure length of stay (LOS).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We performed a before-and-after cohort study on hospitalized adults in whom percutaneous endoscopic gastrostomy was placed by surgeons following the implementation of a standardized feeding protocol in which enteral feeds were resumed at the preoperative rate 6 h later.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Enteral feeding resumed within 6 h postoperatively in 93% of patients after protocol initiation. The mean ± SD time to the goal enteral rate after percutaneous endoscopic gastrostomy was significantly shorter following protocol implementation (15 ± 10 vs 50 ± 26 h, <i>P</i> ≤ 0.0001). Compared with the preprotocol cohort, there was no change in postoperative aspiration at 1 week (6% vs 4%, <i>P</i> = 0.531) or rates of tube dislodgement (10% vs 9%, <i>P</i> = 0.89), return to the operating room (10% vs 6%, <i>P</i> = 0.36), and surgical-site infection (9% vs 8%, <i>P</i> = 0.92) at 1 month in the protocol implementation cohort. On multivariable regression, an expedited feeding protocol generated a significantly shorter postprocedure LOS for patients remaining in the hospital for ≤1 week (<i>β</i> = −2.14, 95% CI, −2.98 to −1.30; <i>P</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>An expedited feeding protocol following percutaneous endoscopic gastrostomy placement had a high degree of provider uptake without any significant change in safety outcomes. Beginning enteral nutrition within 6 h postoperatively at the preoperative rate reduced LOS by &gt;2 days, suggesting that these protocols can address common delays to discharge.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16668,"journal":{"name":"Journal of Parenteral and Enteral Nutrition","volume":"49 2","pages":"222-228"},"PeriodicalIF":3.2,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142877453","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":"Fish oil lipid emulsion compared with soybean oil lipid emulsion in pediatric patients with parenteral nutrition-associated cholestasis: A cost-effectiveness study","authors":"Massimiliano Povero PhD,&nbsp;Kathleen M. Gura PharmD,&nbsp;Muralidhar H. Premkumar MBBS,&nbsp;Lorenzo Pradelli MD,&nbsp;Mark Puder MD, PhD,&nbsp;Kara L. Calkins MD, MS","doi":"10.1002/jpen.2713","DOIUrl":"10.1002/jpen.2713","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Evidence indicates that, in pediatric patients with parenteral nutrition–associated cholestasis (PNAC), the use of a 100% fish oil lipid emulsion (FOLE) increased the likelihood of PNAC resolution and reduced the likelihood of liver transplantation compared with a 100% soybean oil lipid emulsion (SOLE). To evaluate the potential economic benefit, we conducted a cost-effectiveness analysis comparing FOLE with SOLE.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Study Design</h3>\u0000 \u0000 <p>A discrete event simulation model evaluated cost-effectiveness by simulating clinical outcomes and estimating associated healthcare costs in pediatric patients with PNAC receiving parenteral nutrition (PN) with FOLE (1 g/kg) or SOLE (1.9 g/kg) over a time horizon of 6 years. Model inputs for clinical outcomes were derived from the integrated analysis of two US Phase 3 trials (NCT00910104 and NCT00738101). Cost estimates were estimated from the perspective of the US payer including the cost of PN, transplantation, and adverse events.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The total cost associated with FOLE was $69,847 USD vs $141,605 USD for SOLE. The cost reduction of $71,757 USD was attributable to the avoidance of liver transplantation (−15.7%) and reduction in adverse events (−4.8%). Life-years and the quality-adjusted life-years were increased with FOLE compared with SOLE (by 0.248 and 0.295, respectively).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>By reducing the need for liver transplant and providing time to transition to full enteral nutrition, FOLE leads to cost-savings, compared with SOLE, in pediatric patients with PNAC in the perspective of the US payer. These findings support the use of FOLE in pediatric patients with PNAC who require PN.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16668,"journal":{"name":"Journal of Parenteral and Enteral Nutrition","volume":"49 2","pages":"180-188"},"PeriodicalIF":3.2,"publicationDate":"2024-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142872283","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":"Nutrition provision over time in longer stay critically ill patients: A post hoc analysis of The Augmented vs Routine Approach to Giving Energy Trial","authors":"Elizabeth Viner Smith BND(Hons),&nbsp;Kylie Lange BSc(Ma&CompSci)(Hons),&nbsp;Sandra Peake PhD,&nbsp;Marianne J. Chapman PhD,&nbsp;Emma J. Ridley PhD,&nbsp;Christopher K. Rayner PhD,&nbsp;Lee-anne S. Chapple PhD","doi":"10.1002/jpen.2717","DOIUrl":"10.1002/jpen.2717","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Limited literature exists on nutrition practices for long-stay patients in the intensive care unit (ICU). We aimed to compare nutrition practices in the first and second weeks of an ICU admission.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>A post hoc exploratory analysis of The Augmented vs Routine Approach to Giving Energy Trial (TARGET) randomized controlled trial (RCT) was undertaken. Inclusion criteria were: enrolled in TARGET on day 1 or 2 of ICU admission and ICU length of stay (LOS) &gt;14 days. Clinical characteristics are described, and nutrition delivery and management compared between days 1–7 and 8–14. Data are <i>n</i> (%), mean ± SD, median (interquartile range [IQR]), or mean difference (MD) and 95% confidence interval (95% CI), with <i>P</i> &lt; 0.05 considered significant.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Data from 664 patients were analyzed (56.2 ± 16.3 years; 61% male; body mass index 29.2 ± 7.5 kg/m² and APACHE II 21.9 ± 8.1). When comparing days 1–7 to 8–14: (1) energy delivery was greater (all sources: 1826 ± 603 vs 1729 ± 689 (MD: 97 [95% CI: 52–140] kcal/day, <i>P</i> &lt; 0.001) and nonnutrition sources: 317 ± 230 vs 192 ± 197 (MD 125 [95% CI: 111–139] kcal/day; <i>P</i> &lt; 0.001); (2) protein delivery was similar (66 ± 20 vs 68 ± 24 (MD: −1.4 [95% CI: −3.2 to 0.4] g/day; <i>P</i> = 0.125]); and (3) fewer patients received parenteral nutrition (PN) (5% vs 9%, <i>P</i> &lt; 0.001) or small intestine feeding (3% vs 8%; <i>P</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In this post hoc analysis, patients with an ICU LOS &gt;14 days had greater energy delivery and fewer patients received PN or small intestine feeding during days 1–7 than days 8–14. Uncertainty remains regarding whether these data reflect usual practice and the clinical implications of this.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16668,"journal":{"name":"Journal of Parenteral and Enteral Nutrition","volume":"49 2","pages":"214-221"},"PeriodicalIF":3.2,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142864452","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 timing of maternal energy consumption and adiposity in breastfeeding infants: A prospective cohort study","authors":"Deniz Yaprak MD,&nbsp;Mina Mısırlıgil MD,&nbsp;Nüket Ünsal PhD,&nbsp;Necati Balamtekin MD,&nbsp;Belma Saygılı Karagöl MD,&nbsp;Ebru Dumlupınar PhD","doi":"10.1002/jpen.2714","DOIUrl":"10.1002/jpen.2714","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Lactating women's food intake timing may play a critical role in maternal and infant nutrition health. We aimed to examine associations of breastfeeding mothers' diet quantity and circadian timing of food intake with subsequent weight status of exclusively breastfed infants over a 6-month period.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This prospective observational study comprised pairs of healthy singleton breastfed infants and their corresponding healthy lactating mothers. Reported food intake times and diet content were used to define maternal eating patterns infant body mass index-for-age <i>z</i> scores (BAZs) at birth, 2 and 6 months. Association of maternal eating pattern with alterations in infant BAZ gain and nutritional status at age 6 months were investigated in multiple regression analyses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Compared with maternal daytime eating, maternal nighttime eating was linked to a greater increase in infantile BAZ from ages 2 to 6 months (adjusted <i>β</i> = 0.49; 95% CI, 0.05–0.92; <i>P</i> = 0.03) and a heightened likelihood of being overweight at age 6 months (adjusted odds ratio = 3.81; 95% CI, 1.41–6.63; <i>P</i> = 0.01) after adjusting for factors including maternal age, education level, household income, parity, pregestational body mass index, BAZ at 2 months, total daily energy consumption, and the percentages of energy derived from macronutrients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Disruption of rhythmic physiology from irregular eating habits can lead to circadian misalignment, which may result in abnormal weight gain in infants and an increased likelihood of being overweight in the early postnatal period. Circadian alignment is fundamental for regulating women-infant dyads health.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16668,"journal":{"name":"Journal of Parenteral and Enteral Nutrition","volume":"49 2","pages":"189-199"},"PeriodicalIF":3.2,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142864449","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":"Factors associated with accelerated parenteral weaning in children with intestinal failure: A descriptive cohort study","authors":"Hadar Moran-Lev MD,&nbsp;Samuel A. Kocoshis MD,&nbsp;Isabel Córdova Amador BS,&nbsp;Mariah Mukasa,&nbsp;Stephanie B. Oliveira MD,&nbsp;Michael Helmrath MD,&nbsp;Conrad R. Cole MD","doi":"10.1002/jpen.2711","DOIUrl":"10.1002/jpen.2711","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The goal of intestinal rehabilitation in children is to wean from parenteral nutrition (PN). The aim of this study was to identify factors associated with accelerated weaning and to evaluate long-term outcomes of children receiving long-term PN.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This was a retrospective study of children managed by the Intestinal Rehabilitation Center at Cincinnati Children's Hospital. Medical history data were retrieved. The outcomes of children receiving long-term chronic PN (&gt;2 years) were compared with those of children receiving short-term chronic PN regimen (&lt;2 years).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The cohort consisted of 112 children (58% boys, median [IQR] age of 6.0 [3.7–9.5] years). The group treated with a long-term PN regimen had significantly shorter residual small bowel and large bowel compared with the group treated with a short-term PN regimen (20% vs 60% and 75% vs 100%, respectively; <i>P</i> &lt; 0.05). The lapse of time between PN and enteral feed initiation was longer in the group undergoing long-term PN regimen than in the short-term group (71 vs 32.5 days; <i>P</i> = 0.012). More episodes of central line–associated bloodstream infection (CLABSI) and a higher percentage of feeding aversion was demonstrated in the long-term PN group (2 [1–3] vs 1 [0–2] episodes and 36% vs 0%, respectively).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Small bowel, colon length, enteral feed initiation, and frequency of CLABSI are factors associated with duration of PN regimen. A long-term chronic PN regimen is associated with a higher risk of food aversion.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16668,"journal":{"name":"Journal of Parenteral and Enteral Nutrition","volume":"49 2","pages":"207-213"},"PeriodicalIF":3.2,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jpen.2711","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142846855","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":"Hunger and the transition from parenteral nutrition in hospitalized adults: A descriptive cohort study","authors":"Sergio Henrique Loss MD, PhD,&nbsp;Klara Muller Alves RD,&nbsp;Aline Camargo Nunes RN,&nbsp;Joel Stefani MD,&nbsp;Giovanna Peres Loureiro RD,&nbsp;Adriana Píscopo MD,&nbsp;Luciana Verçoza Viana MD, PhD","doi":"10.1002/jpen.2710","DOIUrl":"10.1002/jpen.2710","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Parenteral nutrition (PN) provides nutrition to patients who cannot use the digestive tract. Some patients experience delayed appetite recovery after PN, but the factors contributing to this remain unclear. This study aimed to investigate whether hospitalized patients receiving PN experience reduced hunger or appetite.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A descriptive cohort study was conducted on adults who underwent PN between April 2022 and July 2023. Data on patient characteristics and nutritional support were collected from medical records. Hunger and satiety were assessed using a validated tool during three phases: clinical stability with calorie-protein targets on PN, transition to oral/enteral feeding, and PN withdrawal. The primary outcome was the absence of hunger assessed by the tool.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 231 screened patients, 102 were included. Among these, 62.7% reported hunger during PN. Lipid doses and energy reduction strategies did not affect hunger or satiety. Transition success to oral/enteral nutrition was 2.38 times higher in patients who experienced hunger compared to those who did not (95% CI: 1.59–3.54). Poisson regression identified higher age, inflammation, and metastatic cancer as independent factors associated with the absence of hunger.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study suggests that PN does not suppress hunger and that factors other than nutritional therapy (age, inflammation, and cancer) could explain the absence of appetite. Considering individual conditions and needs, these findings could guide decision-making strategies regarding the transition from PN to oral/enteral feeding.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16668,"journal":{"name":"Journal of Parenteral and Enteral Nutrition","volume":"49 2","pages":"256-266"},"PeriodicalIF":3.2,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142837195","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}