Nutrition in Clinical Practice最新文献

{"title":"Retrospective review of growth in pediatric intestinal failure after weaning from parenteral nutrition","authors":"Anita M. Nucci, Hillary Bashaw, Alexander Kirpich, Jeffrey Rudolph","doi":"10.1002/ncp.11209","DOIUrl":"https://doi.org/10.1002/ncp.11209","url":null,"abstract":"BackgroundGrowth outcomes in children with intestinal failure (IF) after weaning from parenteral nutrition (PN) may be modified by primary diagnosis and interventions aimed at achieving enteral tolerance. We evaluated growth after weaning by diagnosis and intestinal transplant status and during treatment with the glucagon‐like peptide‐2 analog teduglutide.MethodsA two‐center retrospective review was conducted on children diagnosed with IF at age &lt;12 months. The <jats:italic>z</jats:italic> scores for weight and length/height were examined up to 5 years after PN weaning and in children who received teduglutide for &gt;6 months. Data were reported as median and interquartile range (IQR).ResultsA total of 362 children (58% male and 72% White) were reviewed; 41% (<jats:italic>n</jats:italic> = 150) weaned from PN at age 1.5 years (IQR = 0.96–3). Weight and length/height data were available for 144 children; 46 received an intestinal transplant. Median weight and length/height <jats:italic>z</jats:italic> scores at weaning were −1.15 (IQR = −2.09 to −0.39) and −1.89 (IQR = −2.9 to −1.02), respectively. In those not transplanted, <jats:italic>z</jats:italic> scores remained stable (± 0.5 change). Children with small bowel atresia experienced accelerated linear growth (&gt; +0.5 change) beginning in year 3. Most children transplanted experienced growth acceleration beginning in year 2. Fourteen children received teduglutide (median = 840 [IQR = 425–1530] days), and growth remained stable throughout treatment. Five were weaned from PN within 1 year.ConclusionWe observed stable growth with limited catch‐up after PN weaning, with minimal variation by diagnosis, and during teduglutide therapy. Children who received an intestinal transplant experienced acceleration in weight and linear growth after weaning.","PeriodicalId":19354,"journal":{"name":"Nutrition in Clinical Practice","volume":"158 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142200075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Description of the etiological factors behind acute moderate and severe malnutrition in children under 5 years hospitalized at two high‐complexity referral centers: Case series","authors":"Mónica Olarte‐Bernal, Fabian Ricardo Guevara‐Santamaría, Jennyfer Carolina Jacome‐Suarez, María Alejandra Palacios‐Ariza, Jorge Medina‐Parra, Ricardo Alfonso Merchán‐Chaverra, Yeny Marjorie Cuellar‐Fernandez","doi":"10.1002/ncp.11206","DOIUrl":"https://doi.org/10.1002/ncp.11206","url":null,"abstract":"BackgroundAcute malnutrition in children &lt;5 years of age has a direct relationship with medical complications and mortality. We aimed to describe the etiologic factors in children with moderate and severe non–illness‐related acute malnutrition who required hospitalization for treatment of malnutrition in two high‐complexity hospital centers in Bogotá, Colombia.MethodsThis is a multicenter case series (December 2016 to December 2020) including patients aged 1–59 months with a weight/height indicator less than −2 SD. Electronic health records were reviewed, and demographic (sex, age, city of origin, and socioeconomic status) and clinical data (gestational age at birth, edema, and nutrition status) were collected. Descriptive analysis of information was performed. An exploratory bivariate analysis by diagnostic categories of moderate and severe acute malnutrition vs days of hospitalization was also performed.ResultsForty‐five patients were included, 62.2% of whom were male, with a median age of 14 months (Q1–Q3: 7–24). The main etiologic factors of malnutrition were related to problems with total food intake (33.3%), transition in consistency of feeding (31.1%), and breastfeeding technique (22.2%). Only 13.3% had problems related to food insecurity. There were no statistically significant differences between moderate (median: 7 days; Q1–Q3: 5–12) and severe (median: 8 days; Q1–Q3: 5–16) acute malnutrition when compared by days of hospitalization.ConclusionsThe main etiologic factors of malnutrition in our study population were related to problems in the amount of food provided and transition in consistency of complementary feeding.","PeriodicalId":19354,"journal":{"name":"Nutrition in Clinical Practice","volume":"42 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142200076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors for the development of refeeding syndrome in adults: A systematic review.","authors":"Ping Zheng, Yilin Chen, Feng Chen, Min Zhou, Caixia Xie","doi":"10.1002/ncp.11203","DOIUrl":"https://doi.org/10.1002/ncp.11203","url":null,"abstract":"<p><p>Identifying patients with a particularly high risk of refeeding syndrome (RFS) is essential for taking preventive measures. To guide the development of clinical decision-making and risk prediction models or other screening tools for RFS, increased knowledge of risk factors is needed. Therefore, we conducted a systematic review to identify risk factors for the development of RFS. PubMed, EMBASE, Cochrane Library, and Web of Science were searched from January 1990 until March 2023. Studies investigating demographic, clinical, drug use, laboratory, and/or nutrition factors for RFS were considered. The Newcastle-Ottawa Scale was used to appraise the methodological quality of included studies. Of 1589 identified records, 30 studies were included. Thirty-three factors associated with increased risk of RFS after multivariable adjustments were identified. The following factors were reported by two or more studies, with 0-1 study reporting null findings: a previous history of alcohol misuse, cancer, comorbid hypertension, high Acute Physiology and Chronic Health Evaluation II score, high Sequential Organ Failure Assessment score, low Glasgow coma scale score, the use of diuretics before refeeding, low baseline serum prealbumin level, high baseline level of creatinine, and enteral nutrition. The majority of the studies (20, 66.7%) were of high methodological quality. In conclusion, this systematic review informs on several risk factors for RFS in patients. To improve risk stratification and guide development of risk prediction models or other screening tools, further confirmation is needed because there were a small number of studies and a low number of high-quality studies on each factor.</p>","PeriodicalId":19354,"journal":{"name":"Nutrition in Clinical Practice","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142073424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementing early feeding after liver transplant using implementation frameworks: A multimethod study.","authors":"Tahnie G Takefala, Hannah L Mayr, Raeesa Doola, Heidi E Johnston, Peter J Hodgkinson, Melita Andelkovic, Graeme A Macdonald, Ingrid J Hickman","doi":"10.1002/ncp.11198","DOIUrl":"https://doi.org/10.1002/ncp.11198","url":null,"abstract":"<p><strong>Background: </strong>Evidence-based guidelines (EBGs) in the nutrition management of advanced liver disease and enhanced recovery after surgery recommendations state that normal diet should recommence 12-24 h following liver transplantation. This study aimed to compare postoperative nutrition practices to guideline recommendations, explore clinician perceptions regarding feeding after transplant surgery, and implement and evaluate strategies to improve postoperative nutrition practices.</p><p><strong>Methods: </strong>A pre-post multimethod implementation study was undertaken, guided by the knowledge-to-action framework. A retrospective chart audit of postoperative dietary practice and semistructured interviews with clinicians were undertaken. Implementation strategies were informed by the Consolidated Framework for Implementation Research-Expert Recommendations for Implementing Change matching tool and then evaluated.</p><p><strong>Results: </strong>An evidence-practice gap was identified, with the median day to initiation of nutrition (free-fluid or full diet) on postoperative day (POD) 2 and only 25% of patients aligning with the EBGs. Clinician interviews identified belief in the importance of nutrition, with variation in surgical practice in relation to early nutrition, competing clinical priorities, and vulnerabilities in communication contributing to delays in returning to feeding. An endorsed postoperative nutrition protocol was implemented along with a suite of theory- and stakeholder-informed intervention strategies. Following implementation, the median time to initiate nutrition reduced to POD1 and alignment with EBGs improved to 60%.</p><p><strong>Conclusion: </strong>This study used implementation frameworks and strategies to understand, implement, and improve early feeding practices in line with EBGs after liver transplant. Ongoing sustainability of practice change as well as the impact on clinical outcomes have yet to be determined.</p>","PeriodicalId":19354,"journal":{"name":"Nutrition in Clinical Practice","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141996224","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nitrogen sources in donor human milk: True protein, nonprotein nitrogen, and amino acid profile.","authors":"Brian K Stansfield, Amy Gates","doi":"10.1002/ncp.11199","DOIUrl":"https://doi.org/10.1002/ncp.11199","url":null,"abstract":"<p><strong>Background: </strong>Devices measuring the macronutrient content of human milk are commonly used to assist with clinical decision-making. It is unknown if these devices accurately measure protein content in donor human milk (DHM). Our objective is to quantify the nitrogen sources and protein content in commercial DHM.</p><p><strong>Methods: </strong>The total nitrogen content (Dumas method) and nonprotein nitrogen content (Kjeldahl method) was measured in triplicate from six commercial DHM samples with protein content noted on the labels. In addition, the amino acid content was measured in 15 commercial DHM samples and protein content in each sample was calculated. The calculated protein content for each DHM sample was compared for consistency.</p><p><strong>Results: </strong>The nonprotein nitrogen content in DHM was consistently higher (0.33 ± 0.05 g/g) than previous reports, leading to overreporting of protein content on DHM labels by a median value of 0.15 g/dl (range 0.02-0.23 g/dl). Similarly, calculation of the protein content from the total nitrogen content with an assumption of 20% (grams per gram) nonprotein nitrogen consistently overrepresented the protein content as determined from the amino acid profile for DHM.</p><p><strong>Conclusion: </strong>Common methods for assessing the macronutrient content of human milk may overestimate the protein content of DHM.</p>","PeriodicalId":19354,"journal":{"name":"Nutrition in Clinical Practice","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141897910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"Optimal energy provision early in ICU stay for critically ill patients receiving parenteral nutrition\": A commentary.","authors":"Joel Stefani, Sérgio Renato da Rosa Decker, Sergio Henrique Loss","doi":"10.1002/ncp.11126","DOIUrl":"10.1002/ncp.11126","url":null,"abstract":"","PeriodicalId":19354,"journal":{"name":"Nutrition in Clinical Practice","volume":" ","pages":"957-958"},"PeriodicalIF":2.1,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139692554","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of the risk of contamination of enteral nutrition bottles based on the simulation of home use conditions and hygiene procedures.","authors":"Isabela T F da Silva, Caroline O Medeiros, Jaqueline Leobet, Márcia R Beux, Estela I Rabito, Schaina A P Etgeton, Lize S Fiori","doi":"10.1002/ncp.11144","DOIUrl":"10.1002/ncp.11144","url":null,"abstract":"<p><strong>Background: </strong>Home-prepared enteral formulations are supplied to patients through enteral nutrition bottles, via a gravity bag or other container, which may be inadequately sanitized and reused more times than recommended by the manufacturer. Such procedures increase the risk of contamination and can compromise the patient's clinical outcome. In light of this, the present study aimed to assess the risk of contamination of enteral nutrition bottles by simulating home use conditions and hygiene procedures.</p><p><strong>Methods: </strong>A simulation of bottle usage was conducted across the three categories of enteral nutrition (homemade enteral preparations, blended enteral preparations, and commercial enteral formulas) for 3 days, using three hygiene procedures reported by caregivers: use of detergent (DET); use of detergent and boiling water (DET+BW); and use of detergent and bleach (DET+BL). The microbiological contamination was determined by the analysis of aerobic mesophilic microorganisms.</p><p><strong>Results: </strong>The bottles that were used for 3 days, regardless of the enteral nutrition category, were within the acceptable limit for aerobic mesophilic microorganisms (between <4 and 8.0 colony-forming units [CFU]/cm²) when sanitized using the DET+BW and DET+BL procedures. The enteral nutrition bottles, when cleaned using the DET procedure during the 3 days of usage, showed low microbial contamination (between <4 and 3.0 CFU/cm²) in blended preparation and commercial formula only.</p><p><strong>Conclusion: </strong>Thus, regardless of the enteral nutrition category, we found that the bottles can be used for 3 days, as long as the DET+BW or DET+BL hygiene procedure is applied and safe food handling measures are adopted.</p>","PeriodicalId":19354,"journal":{"name":"Nutrition in Clinical Practice","volume":" ","pages":"873-880"},"PeriodicalIF":2.1,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140140519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimal energy provision early in ICU stay for critically ill patients receiving parenteral nutrition.","authors":"Ahmed Nagy, Justin Delic, James M Hollands, Song Oh, Stacy Pasciolla, Laura Pontiggia, Diana Solomon, Angela L Bingham","doi":"10.1002/ncp.11075","DOIUrl":"10.1002/ncp.11075","url":null,"abstract":"<p><strong>Background: </strong>Literature on optimal energy provision via parenteral nutrition (PN) is limited and the evidence quality is low. The purpose of this study is to determine if there is a difference in outcomes in adult critically ill patients when receiving lower vs higher calorie provision via PN early in intensive care unit (ICU) stay.</p><p><strong>Methods: </strong>Adult patients initiated on PN within the first 10 days of ICU stay from May 2014 to June 2021 were included in this retrospective study. The primary outcome was to determine the impact of lower (<20 kcal/kg/day) vs higher (>25 kcal/kg/day) calorie provision on all-cause, in-hospital mortality. Secondary outcomes were to determine the impact of calorie provision on hospital or ICU length of stay and incidence of complications.</p><p><strong>Results: </strong>This study included 133 patients: a lower calorie provision group (n = 77) and a higher calorie provision group (n = 56). There was a significant difference in all-cause, in-hospital mortality between the lower and the higher calorie provision groups (36.36% and 17.86%, respectively; P = 0.02). However, upon a multivariate analysis of death at discharge, the specific calorie provision group did not affect the probability of death at hospital discharge. The secondary outcomes were not significantly different between groups.</p><p><strong>Conclusion: </strong>When comparing lower calorie provision with higher calorie provision in adult critically ill patients receiving PN early within their ICU stay, there were no differences in outcomes after controlling for significant confounders. Future larger prospective studies should further evaluate optimal caloric provision via PN in this population.</p>","PeriodicalId":19354,"journal":{"name":"Nutrition in Clinical Practice","volume":" ","pages":"859-872"},"PeriodicalIF":2.1,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41128582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Completion of a Nutrition-Focused Physical Exam with hospitalized adults and pediatric patients: Secondary analysis of a prospective cohort study.","authors":"Elizabeth Yakes Jimenez, Erin Lamers-Johnson, Julie M Long, Beth A Mordarski, Xingya Ma, Alison Steiber","doi":"10.1002/ncp.11137","DOIUrl":"10.1002/ncp.11137","url":null,"abstract":"<p><strong>Background: </strong>Nutrition-Focused Physical Exam (NFPE) feasibility is not well-studied. We describe registered dietitian nutritionist (RDN)-reported NFPE completion for hospitalized adult and pediatric patients overall and by assessment parameters.</p><p><strong>Methods: </strong>Trained RDNs systematically conducted NFPEs for hospitalized adult and pediatric patients during the Academy of Nutrition and Dietetics and American Society for Parenteral and Enteral Nutrition Indicators to diagnose Malnutrition multisite cohort study (ClinicalTrials.gov: NCT03928548). RDNs reported their ability to evaluate assessment sites for subcutaneous fat and muscle loss, fluid accumulation, and micronutrient status and to complete handgrip strength (adults and children ≥6 years) and mid-upper arm circumference measurements (children). RDNs noted if they could complete the full NFPE; if not, they noted challenges. We descriptively summarized results and used multilevel logistic regression models to examine relationships between patient characteristics and NFPE completion.</p><p><strong>Results: </strong>RDNs from 39 adult and 29 pediatric US hospitals conducted NFPEs for 327 adults and 214 children aged 1 month to 17.9 years. RDNs reported completing the examination for 44% (n = 145) of adults and 15% (n = 33) of children. They successfully evaluated 25 of 27 and 19 of 26 unique NFPE components in >80% of adults and children, respectively. Common reasons the full NFPE was not completed were limited mobility in adults and patient refusal in children. RDNs had lower odds of completing NFPEs in adults with lower vs higher education levels or higher vs lower nutrition complexity and in younger vs older children.</p><p><strong>Conclusion: </strong>RDNs evaluated NFPE components for a high proportion (>80%) of hospitalized patients.</p>","PeriodicalId":19354,"journal":{"name":"Nutrition in Clinical Practice","volume":" ","pages":"888-902"},"PeriodicalIF":2.1,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139900245","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nutrition, endocannabinoids, and the use of cannabis: An overview for the nutrition clinician.","authors":"Lindsey Russell, Kayla Condo, Tiffany DeFlorville","doi":"10.1002/ncp.11148","DOIUrl":"10.1002/ncp.11148","url":null,"abstract":"<p><p>The endocannabinoid system (ECs) is composed of multiple signaling compounds and receptors within the central and peripheral nervous system along with various organs, including the gut, liver, and skeletal muscle. The ECs has been implicated in metabolism, gut motility, and eating behaviors. The ECs is altered in disease states such as obesity. Recent studies have clarified the role of the gut microbiome and nutrition on the ECs. Exogenous cannabinoid (CB) use, either organic or synthetic, stimulates the ECs through CB1 and CB2 receptors. However, the role of CBs is unclear in regard to nutrition optimization or to treat disease states. This review briefly summarizes the effect of the ECs and exogenous CBs on metabolism and nutrition. With the increased legalization of cannabis, there is a corresponding increased use in the United States. Therefore, nutrition clinicians need to be aware of both the benefits and harm of cannabis use on overall nutrition status, as well as the gaps in knowledge for future research and guideline development.</p>","PeriodicalId":19354,"journal":{"name":"Nutrition in Clinical Practice","volume":" ","pages":"815-823"},"PeriodicalIF":2.1,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140329962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}