Journal of Parenteral and Enteral Nutrition最新文献

{"title":"Medication errors involving parenteral nutrition preparations and concentrated electrolytes in a pediatric hospital: A qualitative analysis","authors":"Justiina Tuomisto MSc,&nbsp;Anna-Riia Holmström PhD,&nbsp;Sini Kuitunen PhD","doi":"10.1002/jpen.70049","DOIUrl":"10.1002/jpen.70049","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Parenteral nutrition and concentrated electrolytes are associated with medication errors in pediatrics; however, a systems-based understanding of these errors is lacking. We aimed to describe the errors, contributing factors, and proposed defenses related to these medications in pediatrics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The study analyzed self-reported medication safety incidents at a pediatric university hospital between 2018 and 2020, focusing on parenteral nutrition and concentrated electrolytes. The reports were investigated through qualitative content analysis, and the results were quantified in frequencies and percentages. Consequently, the Institute for Safe Medication Practices′ Hierarchy of Effectiveness of Risk-Reduction Strategies was used to categorize the proposed safety defenses. The analysis used a systems approach to medication risk management, guided by the theory of human error.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In total, 404 medication errors, 627 contributing factors, and 386 proposed defenses were identified within the study sample (<i>n</i> = 279 incident reports). Most errors occurred during the administration (54%) and preparation (25%) phases. Common issues included wrong dose (15%), wrong infusion rate (11%), and incorrectly prepared medicine (18%). Contributing factors were often linked to workload and resources (22%) and employee-related factors (21%). Most proposed defenses were classified as low leverage (71%), with the smallest portion at the highest leverage (6%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Errors often occur during preparation and administration, primarily because of the complexity of individualized dosing. Contributing factors include high workload, limited resources, and employee-related factors. Hospitals should prioritize implementing systems-based, technology-driven defenses over person-focused strategies. Future research is essential for developing and evaluating child-specific defenses.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16668,"journal":{"name":"Journal of Parenteral and Enteral Nutrition","volume":"50 3","pages":"374-384"},"PeriodicalIF":4.1,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13047297/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145914335","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":"Surrogate measure of gut blood flow via superior mesenteric circulation on ultrasound in adults who underwent esophagectomy: A descriptive cohort study","authors":"Tomonori Narita MD,&nbsp;Kazuhiko Fukatsu MD, PhD,&nbsp;Reo Inoue MD, PhD,&nbsp;Satoshi Murakoshi MD, PhD,&nbsp;Midori Noguchi BA,&nbsp;Nana Matsumoto RD, MS,&nbsp;Shoh Yajima MD, PhD,&nbsp;Koichi Yagi MD, PhD,&nbsp;Yoshifumi Baba MD, PhD","doi":"10.1002/jpen.70058","DOIUrl":"10.1002/jpen.70058","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Early enteral nutrition is recommended for critically ill patients. However, feeding an ischemic gastrointestinal tract with enteral nutrition may lead to gut necrosis. Although gut tolerance of enteral nutrition is assessed by various symptoms, none of them provide conclusive evidence of gut ischemia. We investigated the blood flow in the superior mesenteric artery and vein using ultrasonography after esophagectomy along with conventional physical findings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We enrolled 30 patients who underwent esophagectomy at The University of Tokyo Hospital from October 2022 to July 2023. Superior mesenteric artery, vein, and common carotid arteries blood flow were measured during the preoperative fasting period and on postoperative days 1, 2, 3, 5, 7, and 9. The relationships between blood flow and physical findings were analyzed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Superior mesenteric artery and vein blood flows were lower on postoperative day 1 than during the preoperative fasting period (superior mesenteric artery: 81% <i>P</i> = 0.03, superior mesenteric vein: 85% <i>P</i> = 0.01) but recovered to preoperative levels after postoperative day 2. Common carotid artery blood flow remained constant perioperatively. None of the physical findings observed correlated with the superior mesenteric artery and vein blood flows at any time point. Superior mesenteric artery and vein blood flows increased when enteral nutrition was initiated. No cases of gut necrosis were observed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Despite the relatively severe insult, gut blood flow recovered promptly. As traditional indicators did not correlate with gut blood flow, routine measurement of superior mesenteric artery and vein blood flows may allow assessment of potential gut hypoperfusion after major surgery.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16668,"journal":{"name":"Journal of Parenteral and Enteral Nutrition","volume":"50 3","pages":"430-439"},"PeriodicalIF":4.1,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13047303/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146097729","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":"Body composition analysis and handgrip strength as predictors of 12-month mortality in hospitalized adults receiving parenteral nutrition: A descriptive cohort study","authors":"Natalia Montero Madrid RN,&nbsp;Raul Rodríguez Juárez MD,&nbsp;Rocío Fernández-Jiménez PhD,&nbsp;Alvaro Vidal Suarez MD,&nbsp;Patricia Guirado Peláez MD,&nbsp;Maria Angeles Martín-Fontalba RN,&nbsp;Beatriz Fernández Medina MD,&nbsp;Isabel Vegas Aguilar BSc,&nbsp;Maria del Mar Amaya Campos BSc,&nbsp;Victor Simón Frapolli MD,&nbsp;Maria Teresa Zarco Martín PhD,&nbsp;Francisco Tinahones-Madueño PhD,&nbsp;Maria Luisa Fernández Soto PhD,&nbsp;José Manuel García-Almeida PhD","doi":"10.1002/jpen.70069","DOIUrl":"10.1002/jpen.70069","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Nutrition assessment in patients receiving parenteral nutrition often relies on classical parameters with limited prognostic value. Morphofunctional tools such as phase angle and handgrip strength measurement offer a more comprehensive evaluation of nutrition status and may better predict clinical outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To evaluate the predictive value of phase angle and handgrip strength for 12-month mortality in hospitalized patients receiving parenteral nutrition.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective observational study was conducted in 614 patients treated with parenteral nutrition. Anthropometric assessments were realized. Morphofunctional assessments included bioelectrical impedance analysis to determine phase angle and dynamometry to measure handgrip strength. Survival analysis was performed using Cox proportional hazards models and Kaplan-Meier curves and cutoff values by receiver operating characteristic curve analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Six hundred fourteen patients received parenteral nutrition, with a mean age of 64 ± 14.6 years; 58.2% were male. After 1 year, the mortality rate was 26.1%, and the average hospital stay was 27.9 ± 23.8 days. Twelve-month survival was reduced in patients with low phase angle (57%) and low handgrip strength (62.8%) compared with those with preserved values (84% and 82.2%, respectively). In the multivariable logistic regression model adjusted for age, sex, and body mass index, each unit increase in phase angle and handgrip strength was associated with a 4% and 2% reduction in mortality odds, respectively (phase angle: odds ratio [OR], 0.6; 95% CI, 0.5–0.7; <i>P</i> &lt; 0.001; handgrip strength: OR, 0.9; 95% CI, 0.9–1.0; <i>P</i> = 0.03624).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Phase angle and handgrip strength are predictors of 12-month mortality in patients receiving parenteral nutrition.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16668,"journal":{"name":"Journal of Parenteral and Enteral Nutrition","volume":"50 3","pages":"412-420"},"PeriodicalIF":4.1,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13047292/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147367543","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":"JPEN Journal Club 96. Scoping reviews","authors":"Ronald L. Koretz MD","doi":"10.1002/jpen.70025","DOIUrl":"10.1002/jpen.70025","url":null,"abstract":"","PeriodicalId":16668,"journal":{"name":"Journal of Parenteral and Enteral Nutrition","volume":"50 3","pages":"448-450"},"PeriodicalIF":4.1,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145396184","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":"Response to Letter to the Editor: Association between mixed fatty acid emulsion and parenteral nutrition-associated cholestasis in extremely low-birth-weight infants: A retrospective cohort study","authors":"Tian Xie MD,&nbsp;Zheng Chen MD","doi":"10.1002/jpen.70063","DOIUrl":"10.1002/jpen.70063","url":null,"abstract":"","PeriodicalId":16668,"journal":{"name":"Journal of Parenteral and Enteral Nutrition","volume":"50 3","pages":"357-358"},"PeriodicalIF":4.1,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146197954","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":"Letter to the Editor: Association between mixed fatty acid emulsion and parenteral nutrition–associated cholestasis in extremely low birthweight infants: A retrospective cohort study","authors":"Jiaxin Du MM,&nbsp;Mengxin Zhang MM,&nbsp;Shuaibo Qiao MM,&nbsp;Yuesheng Gong BM,&nbsp;Lei Dong PhD","doi":"10.1002/jpen.70036","DOIUrl":"10.1002/jpen.70036","url":null,"abstract":"","PeriodicalId":16668,"journal":{"name":"Journal of Parenteral and Enteral Nutrition","volume":"50 3","pages":"355-356"},"PeriodicalIF":4.1,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145491437","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":"Oral rehydration solution for the management of fluid and electrolyte disturbances in patients with an ileostomy: A scoping review","authors":"Austin J. Hoeg MD, MPH,&nbsp;Jessica Jaques BS,&nbsp;Remy Johnson BA,&nbsp;Megan Kocher MLIS,&nbsp;Alexa Weingarden MD, PhD,&nbsp;Byron Vaughn MD, MS,&nbsp;Alexander Khoruts MD,&nbsp;Cyrus Jahansouz MD,&nbsp;Ryan T. Hurt MD, PhD,&nbsp;Levi M. Teigen PhD, RD","doi":"10.1002/jpen.70050","DOIUrl":"10.1002/jpen.70050","url":null,"abstract":"<p>Ileostomy creation is common among patients with colorectal cancer, diverticulitis, and inflammatory bowel disease. Surgical removal or diversion of the colon can result in nutrition complications, most notably dehydration—a leading cause of hospital readmission—and increased risk of kidney injury. Existing studies on fluid and electrolyte management after ileostomy largely focus on short bowel syndrome or high-output stomas, overlooking the physiological implications of ileostomy creation, even in patients with normal output. Given the absence of standardized oral rehydration protocols and limited interventional data, a scoping review was conducted to map the current evidence on oral rehydration solutions for postoperative fluid and electrolyte management in adults without short bowel syndrome or high-output stoma. Comprehensive searches across five databases identified 5738 articles, of which 6 met inclusion criteria. Eligible studies examined adults with ileostomy for any standard indication in which oral rehydration solution use was a study objective. The included studies were methodologically heterogeneous, encompassing randomized controlled, crossover, double-blinded comparator, retrospective cohort, and qualitative designs. Collectively, available evidence supports a pivotal role for oral rehydration solutions in both short-term and long-term management after ileostomy, improving hydration and reducing complications. This review highlights the need for standardized, evidence-based oral rehydration regimens and underscores opportunities to reduce postoperative morbidity, kidney injury, and hospital readmissions while optimizing long-term outcomes in this growing patient population.</p>","PeriodicalId":16668,"journal":{"name":"Journal of Parenteral and Enteral Nutrition","volume":"50 3","pages":"339-351"},"PeriodicalIF":4.1,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13047308/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145937448","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 enteral feeding guideline implementation and early enteral nutrition in children with critical bronchiolitis: An uncontrolled before-after study","authors":"Sabrina Huq DO,&nbsp;Rajat Pareek MD,&nbsp;Kyle Knapp MS,&nbsp;Theresa Mikhailov MD, PhD","doi":"10.1002/jpen.70055","DOIUrl":"10.1002/jpen.70055","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Malnutrition is a common problem in the pediatric intensive care unit (PICU). Enteral nutrition is often withheld in patients with respiratory failure because of risk of aspiration and potential need for intubation, as seen in patients with critical bronchiolitis managed on noninvasive ventilation. Studies show that enteral nutrition guidelines improve feeding tolerance, reduce complications, and decrease time to optimal nutrition. Before June 2019, our PICU had no enteral feeding guidelines, leading to inconsistency with starting feedings and reaching goal nutrition. Our objective was to determine if there was an association between implementing an enteral feeding guideline and the percentage of patients with critical bronchiolitis on noninvasive ventilation who receive early enteral nutrition.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A single-center retrospective study at a tertiary PICU provided the dataset for this study. We included patients with critical bronchiolitis aged ≤24 months, admitted to the PICU from November 2017 to March 2020, and managed on noninvasive ventilation. Our feeding guideline was implemented in June 2019. Our primary outcome was early enteral nutrition defined as achieving &gt;25% of dietary reference intake by 48 h of PICU admission. Our secondary outcome was goal feeds defined as &gt;60% of dietary reference intake during admission. We used chi-square analysis to analyze these data. Our institution's registered dietitians use dietary reference intake to calculate goal feeds.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>With initiation of the enteral feeding guideline, the percentage of patients who met early enteral nutrition increased from 53% to 76% (<i>P</i> &lt; 0.001), and those who reached goal feeds increased from 75% to 84% (<i>P</i> = 0.057).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study demonstrates that following implementation of the enteral feeding guideline, a greater proportion of patients with critical bronchiolitis on noninvasive ventilation started feeds earlier and achieved goal enteral nutrition during admission.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16668,"journal":{"name":"Journal of Parenteral and Enteral Nutrition","volume":"50 3","pages":"366-373"},"PeriodicalIF":4.1,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146021137","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":"","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":16668,"journal":{"name":"Journal of Parenteral and Enteral Nutrition","volume":"50 4","pages":"521-532"},"PeriodicalIF":4.1,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148100102","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":"","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":16668,"journal":{"name":"Journal of Parenteral and Enteral Nutrition","volume":"50 4","pages":"462-485"},"PeriodicalIF":4.1,"publicationDate":"2026-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148095289","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}