Journal of Parenteral and Enteral Nutrition最新文献

{"title":"JPEN Journal Club 82. Stepped-wedge cluster randomized trials","authors":"Ronald L. Koretz MD","doi":"10.1002/jpen.2603","DOIUrl":"10.1002/jpen.2603","url":null,"abstract":"","PeriodicalId":16668,"journal":{"name":"Journal of Parenteral and Enteral Nutrition","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139650985","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":"Guidance for assessment of the inflammation etiologic criterion for the GLIM diagnosis of malnutrition: A modified Delphi approach","authors":"Gordon L. Jensen MD, PhD,&nbsp;Tommy Cederholm MD, PhD,&nbsp;Maria D. Ballesteros-Pomar PhD, MD,&nbsp;Renee Blaauw PhD, RD,&nbsp;M. Isabel T. D. Correia MD, PhD,&nbsp;Cristina Cuerda MD, PhD,&nbsp;David C. Evans MD,&nbsp;Ryoji Fukushima MD, PhD,&nbsp;Juan Bernardo Ochoa Gautier MD,&nbsp;M. Cristina Gonzalez MD, PhD,&nbsp;Andre van Gossum MD, PhD,&nbsp;Leah Gramlich MD,&nbsp;Joseph Hartono MD, PhD,&nbsp;Steven B. Heymsfield MD,&nbsp;Harriët Jager-Wittenaar PhD, RD,&nbsp;Renuka Jayatissa MSc, MD,&nbsp;Heather Keller PhD, RD,&nbsp;Ainsley Malone MS, RD,&nbsp;William Manzanares MD, PhD,&nbsp;M. Molly McMahon MD,&nbsp;Yolanda Mendez MD,&nbsp;Kris M. Mogensen MS, RD-AP,&nbsp;Naoharu Mori MD, PhD,&nbsp;Maurizio Muscaritoli MD,&nbsp;Guillermo Contreras Nogales MD, MSc,&nbsp;Ibolya Nyulasi MSc, APD,&nbsp;Wendy Phillips MS, RD,&nbsp;Matthias Pirlich MD,&nbsp;Veeradej Pisprasert MD, PhD,&nbsp;Elisabet Rothenberg PhD, RD,&nbsp;Marian de van der Schueren PhD, RD,&nbsp;Han Ping Shi MD, PhD,&nbsp;Alison Steiber PhD, RDN,&nbsp;Marion F. Winkler PhD, RD,&nbsp;Charlene Compher PhD, RD,&nbsp;Rocco Barazzoni MD, PhD","doi":"10.1002/jpen.2590","DOIUrl":"10.1002/jpen.2590","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The Global Leadership Initiative on Malnutrition (GLIM) approach to malnutrition diagnosis is based on assessment of three phenotypic (weight loss, low body mass index, and reduced skeletal muscle mass) and two etiologic (reduced food intake/assimilation and disease burden/inflammation) criteria, with diagnosis confirmed by fulfillment of any combination of at least one phenotypic and at least one etiologic criterion. The original GLIM description provided limited guidance regarding assessment of inflammation, and this has been a factor impeding further implementation of the GLIM criteria. We now seek to provide practical guidance for assessment of inflammation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A GLIM-constituted working group with 36 participants developed consensus-based guidance through a modified Delphi review. A multiround review and revision process served to develop seven guidance statements.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The final round of review was highly favorable, with 99% overall “agree” or “strongly agree” responses. The presence of acute or chronic disease, infection, or injury that is usually associated with inflammatory activity may be used to fulfill the GLIM disease burden/inflammation criterion, without the need for laboratory confirmation. However, we recommend that recognition of underlying medical conditions commonly associated with inflammation be supported by C-reactive protein (CRP) measurements when the contribution of inflammatory components is uncertain. Interpretation of CRP requires that consideration be given to the method, reference values, and units (milligrams per deciliter or milligram per liter) for the clinical laboratory that is being used.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Confirmation of inflammation should be guided by clinical judgment based on underlying diagnosis or condition, clinical signs, or CRP.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16668,"journal":{"name":"Journal of Parenteral and Enteral Nutrition","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jpen.2590","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139466170","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 Reviewers Acknowledgment","authors":"","doi":"10.1002/jpen.2593","DOIUrl":"10.1002/jpen.2593","url":null,"abstract":"","PeriodicalId":16668,"journal":{"name":"Journal of Parenteral and Enteral Nutrition","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139424937","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":"Inflammation and response to nutrition interventions","authors":"Carla Wunderle MSC,&nbsp;Franziska Stumpf BSC,&nbsp;Philipp Schuetz MD, MPH","doi":"10.1002/jpen.2534","DOIUrl":"https://doi.org/10.1002/jpen.2534","url":null,"abstract":"<p>The complex interplay between nutrition and inflammation has become a major focus of research in recent years across different clinical settings and patient populations. Inflammation has been identified as a key driver for disease-related malnutrition promoting anorexia, reduced food intake, muscle loss, and on a cellular level, insulin resistance, which together stimulate catabolism. However, these effects may well be bidirectional, and there is strong evidence showing that nutrition influences inflammation. Several single nutrients and dietary patterns with either proinflammatory or anti-inflammatory properties have been studied, such as the long-chain ω-3 fatty acids eicosapentaenoic acid or docosahexaenoic acid. The Mediterranean diet combines several such nutrients and has been shown to improve medical outcomes in the outpatient setting. In addition, there is increasing evidence suggesting that inflammation affects the metabolism and modulates the response to nutrition support interventions. In fact, recent studies from the medical inpatient setting suggest that inflammation, mirrored by high levels of C-reactive protein, diminishes the positive effects of nutrition support. This may explain the lack of positive effects of some nutrition trials in severely ill patients, whereas similar approaches to nutritional support have shown positive results in less severely ill patients. The use of biomarkers, such as C-reactive protein, may help to identify patients with a lower response to nutrition, in whom other treatment options need to be used. There is need for additional research to understand how to best address the malnourished patient with inflammation by specifically lowering inflammation through anti-inflammatory medical treatments and/or nutrition interventions.</p>","PeriodicalId":16668,"journal":{"name":"Journal of Parenteral and Enteral Nutrition","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jpen.2534","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139399987","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":"Commentary on “Guidelines for parenteral nutrition in preterm infants: The American Society for Parenteral and Enteral Nutrition”","authors":"Caren Liviskie PharmD,&nbsp;Christopher McPherson PharmD,&nbsp;Brandy Zeller PharmD","doi":"10.1002/jpen.2580","DOIUrl":"10.1002/jpen.2580","url":null,"abstract":"","PeriodicalId":16668,"journal":{"name":"Journal of Parenteral and Enteral Nutrition","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139377867","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 “Commentary on ‘Guidelines for parenteral nutrition in preterm infants: The American Society for Parenteral and Enteral Nutrition’”","authors":"Daniel T. Robinson MD, MSc,&nbsp;Kara L. Calkins MD, MS,&nbsp;Yimin Chen PhD, RDN,&nbsp;M. Petrea Cober PharmD,&nbsp;Gustave H. Falciglia MD, MSc, MSHQPS,&nbsp;David D. Church PhD,&nbsp;Jacob Mey PhD, RDN,&nbsp;Timothy Sentongo MD,&nbsp;Liam McKeever PhD, RDN","doi":"10.1002/jpen.2579","DOIUrl":"10.1002/jpen.2579","url":null,"abstract":"","PeriodicalId":16668,"journal":{"name":"Journal of Parenteral and Enteral Nutrition","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139377869","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":"Corrigendum to “Guidelines for parenteral nutrition in preterm infants: The American Society for Parenteral and Enteral Nutrition”","authors":"","doi":"10.1002/jpen.2582","DOIUrl":"10.1002/jpen.2582","url":null,"abstract":"<p>This corrigendum concerns the secondary outcomes for population, intervention, comparison, outcome, and time (PICOT) question 2.<span>¹</span> The need for these corrections stems from the mistaken inclusion of a study that included more than one intervention. The Strommen et al study<span>²</span> had more than one intervention and so was unable to directly inform on the specific effect of higher vs lower amino acid dosing. The following corrections are put forth as a result of removing this study from analysis.</p><p>Removing the Strommen et al study meant removal of the study from Figure S4, which examined the relationship between intravenous amino acid dosing and bronchopulmonary dysplasia. The figure has been corrected in the Supporting Information for the article and is shown here as Supplemental Corrected Figure S4. The resulting statistic remains insignificant. The updated risk difference (RD) and 95% CI for the relationship between intravenous amino acid dosing and bronchopulmonary dysplasia is RD = 0.02 (95% CI = −0.09 to 0.14; <i>P</i> = 0.70). Figure S5, examining the impact of amino acid dosing on sepsis, has also been rerun with the study removed. Figure S5 has been corrected in the Supporting Information for the article and is shown here as Supplemental Corrected Figure S5. The result remains statistically insignificant. The updated RD and 95% CI for the relationship between intravenous amino acid dosing and sepsis is RD = 0.01 (95% CI = −0.07 to 0.09; <i>P</i> = 0.84). Given that funnel plots for assessing publication bias are not accurate when &lt;10 studies are included, the funnel plot for Figure S10 is no longer valid. The figure has been removed from the Supporting Information for the article. To address these changes in the published guideline, on page 840 in the second paragraph of the ‘Secondary outcomes’ section for Question 2, the sentence, “However, one of these trials altered both ILE dose and composition and could not be included in the combined analysis” should be corrected to “However, both of these trials contained multiple interventions and could therefore not be included in the combined analysis.”</p><p>Finally, in the recommendation itself in Table 1 on page 832 and the text on page 835 for Question 2, we reference the Strommen et al study as part of the reasoning behind our decision. Had there been no evidence of harm in the Strommen et al study, this would have implied safety in initiating amino acid dosing at 3.5 g/kg/day. This was not the case. We acknowledge that we cannot say for sure whether the amino acid component of this intervention was the problem. For now, we believe that this study, along with the logic that follows in the recommendation, is useful for informing our expert opinion. We feel the verbiage should remain as published.</p><p>The supporting information file for the article has been replaced with a new one containing corrected figures. The original Figure S4 is sho","PeriodicalId":16668,"journal":{"name":"Journal of Parenteral and Enteral Nutrition","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jpen.2582","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139377868","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":"Response to the letter to the editor regarding JPEN Journal Club 80. Prespecified outcomes","authors":"Ronald L. Koretz MD","doi":"10.1002/jpen.2591","DOIUrl":"10.1002/jpen.2591","url":null,"abstract":"","PeriodicalId":16668,"journal":{"name":"Journal of Parenteral and Enteral Nutrition","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2023-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139058450","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":"Absence of association between low calf circumference, adjusted or not for adiposity, and ICU mortality in critically ill adults: A secondary analysis of a cohort study","authors":"Simone Bernardes RD, PhD,&nbsp;Bruna Barbosa Stello RD,&nbsp;Danielle Silla Jobim Milanez RD, MSc,&nbsp;Elisa Loch Razzera RD, MSc,&nbsp;Flávia Moraes Silva RD, PhD","doi":"10.1002/jpen.2595","DOIUrl":"10.1002/jpen.2595","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Despite its correlation with skeletal muscle mass and its predictive value for adverse outcomes in clinical settings, calf circumference is a metric underexplored in intensive care. We aimed to determine whether adjusting low calf circumference for adiposity provides prognostic value superior to its unadjusted measurement for intensive care unit (ICU) mortality and other clinical outcomes in critically ill patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In a secondary analysis of a cohort study across five ICUs, we assessed critically ill patients within 24 h of ICU admission. We adjusted calf circumference for body mass index (BMI) (25–29.9, 30–39.9, and ≥40) by subtracting 3, 7, or 12 cm from it, respectively. Values ≤34 cm for men and ≤33 cm for women identified low calf circumference.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We analyzed 325 patients. In the primary risk-adjusted analysis, the ICU death risk was similar between the low and preserved calf circumference (BMI-adjusted) groups (hazard ratio, 0.90; 95% CI, 0.47–1.73). Low calf circumference (unadjusted) increased the odds of ICU readmission 2.91 times (95% CI, 1.40–6.05). Every 1-cm increase in calf circumference as a continuous variable reduced ICU readmission odds by 12%. Calf circumference showed no significant association with other clinical outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>BMI-adjusted calf circumference did not exhibit independent associations with ICU and in-hospital death, nor with ICU and in-hospital length of stay, compared with its unadjusted measurement. However, low calf circumference (unadjusted and BMI-adjusted) was independently associated with ICU readmission, mainly when analyzed as a continuous variable.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16668,"journal":{"name":"Journal of Parenteral and Enteral Nutrition","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2023-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139032343","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":"High protein intake and nitrogen balance in patients receiving venovenous extracorporeal membrane oxygenation: A descriptive cohort study","authors":"Stacy L. Pelekhaty MS,&nbsp;Meredith Peiffer MSN,&nbsp;Joshua L. Leibowitz MD,&nbsp;Ali Tabatabai MD","doi":"10.1002/jpen.2596","DOIUrl":"10.1002/jpen.2596","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>This retrospective cohort study sought to describe the ability of high protein regimens to achieve nitrogen equilibrium in patients receiving venovenous extracorporeal membrane oxygenation (VV ECMO).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients aged ≥18 years with a documented nitrogen balance study (NB) on VV ECMO between February 2018 and December 2021 were included. Studies with incomplete 24-h urine collections or changes in blood urea nitrogen ≥10 mg/dl were excluded. Data were summarized, correlation between first NB and potentially contributing variables was assessed with Kendall tau. Subanalysis described findings after stratifying for weight class (obese vs nonobese) and duration of VV ECMO at the time of NB.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 68 NBs in 30 patients were included; 47% of the cohort had obesity. The number of NBs per patient was 2.2 ± 1.1, which were completed on a median of 31.5 (interquartile range: 16, 53.8) days receiving ECMO. Nitrogen equilibrium or positive balance was achieved in 72% of studies despite elevated nitrogen excretion. Patients received 87.9 ± 16.8% of prescribed protein on NB days for average intakes of 2.4 ± 0.4 g/kg of actual weight per day and 2.4 ± 0.5 g/kg of ideal weight per day in patients without and with obesity. Median NB in patients without obesity was −1.46 (−8.96, 2.98) g/day and −0.21 (−10.58, 4.04) g/day in patients with obesity. A difference in median NB after stratification for timing was observed (<i>P</i> = 0.029).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Nitrogen equilibrium can be achieved with high protein intake in adults receiving VV ECMO. NB monitoring is one tool to individualize protein prescriptions throughout the course of VV ECMO.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16668,"journal":{"name":"Journal of Parenteral and Enteral Nutrition","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2023-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139032344","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}