Nutrition in Clinical Practice最新文献

{"title":"Manganese restriction in parenteral nutrition for preterm neonates: A pilot randomized controlled trial.","authors":"Jason B Sauberan, Anup C Katheria","doi":"10.1002/ncp.11281","DOIUrl":"https://doi.org/10.1002/ncp.11281","url":null,"abstract":"<p><strong>Background: </strong>Manganese (Mn) is present in many parenteral nutrition (PN) ingredients, presumably as a contaminant during ingredient manufacturing. Exposure to Mn in PN may have negative health consequences in preterm neonates. The purpose of this study was to test the feasibility and safety of not adding supplemental Mn to PN prepared for extremely preterm and very preterm neonates compared with standard Mn supplementation.</p><p><strong>Methods: </strong>Neonates <32 weeks' gestational age were randomized on postnatal day 1 to receive test PN prepared without adding Mn or standard PN prepared with Mn 5 mcg/kg/day using a commercially available neonatal multitrace element product. Randomization assignment was blinded to the clinical team. Whole blood Mn levels were measured at baseline, 2 weeks, and 8 weeks postnatal age. Growth parameters and nutrition intake were also collected.</p><p><strong>Results: </strong>Twenty-six participants were enrolled and nineteen completed the trial. The median duration of PN was 11 days in the no Mn group and 12 days in the standard Mn group. Whole blood Mn levels were not significantly different between the two groups at any time point. Growth and nutrition outcomes were also not significantly different between the two groups.</p><p><strong>Conclusions: </strong>The provision of no-added-Mn PN in routine care was feasible and did not alter Mn blood levels or growth in the first 8 weeks of postnatal age compared with standard PN.</p>","PeriodicalId":19354,"journal":{"name":"Nutrition in Clinical Practice","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143449600","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":"The comparison of radiological gastrostomy tube placement: Balloon and bumper: A retropective cross-sectional study.","authors":"Zahra Beizavi, Mustafa Al-Ogaili, Sherief Ghozy, Aditya Khurana, Sadeer J Alzubaidi","doi":"10.1002/ncp.11275","DOIUrl":"https://doi.org/10.1002/ncp.11275","url":null,"abstract":"<p><strong>Background: </strong>Percutaneous endoscopic gastrostomy (PEG) and percutaneous radiologic gastrostomy (PRG) are used for gastric drainage, decompression, and feeding. Recent innovations enable bumper and balloon-type tube placement via transabdominal approach under guidance of fluoroscopy or sonography.</p><p><strong>Method: </strong>This is a single-center retrospective cohort study to evaluate the outcomes of balloon and bumper gastrostomy tube placement under guide of fluoroscopy and ultrasound. The total sample size was 470 consecutive patients. The eligibility criteria included all patients aged ≥18 years who underwent a balloon or bumper-type gastrostomy tube insertion for nutrition support in both the interventional radiology unit and at the bedside between 2017 and 2022.</p><p><strong>Result: </strong>This study revealed no significant differences between the two types of tubes in terms of time to tube replacement or requiring a gastrostomy tube. There was a positive correlation between the time that a patient has a gastrostomy tube and major complications (P = 0.005) and a positive correlation between number of tubes replaced and minor complications (P < 0.001). Both types of tubes were associated with low rates of complications. However, patients with a balloon tube were more likely to experience gastric-tube-related hospitalization/ED visits and require a >24-h hospital stay postoperation.</p><p><strong>Conclusion: </strong>These findings can help healthcare providers make informed decisions when selecting the appropriate type of tube for their patients to have more durability with less complication.</p>","PeriodicalId":19354,"journal":{"name":"Nutrition in Clinical Practice","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143441578","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":"Patient and clinician satisfaction with home parenteral nutrition intestinal failure telemedicine consultations: A survey of clinicians and patients.","authors":"Ayodele Sasegbon, Amy Woods, Francesca Vourloitis, Maria Barrett, Cristina Cuerda, Palle B Jeppesen, Francisca Joly, Georg Lamprecht, Manpreet Mundi, Kinga Szczepanek, Andre Van Gossum, Tim Vanuytsel, Geert Wanten, Loris Pironi, Simon Lal","doi":"10.1002/ncp.11280","DOIUrl":"https://doi.org/10.1002/ncp.11280","url":null,"abstract":"<p><strong>Introduction: </strong>Despite the widespread use of telemedicine to assess patients with intestinal failure (IF) receiving home parenteral nutrition (HPN), satisfaction with remote consultation methods has not been comprehensively assessed. Here, we assessed patient and clinician attitudes to telephone and video IF consultations.</p><p><strong>Methods: </strong>Telemedicine questionnaires were designed and distributed in paper form to patients with IF receiving HPN under the care of a UK national IF reference center and electronically to IF clinicians in Europe, North America, Australia, and New Zealand.</p><p><strong>Results: </strong>Seventy-eight patients (53 women and 25 men) and 110 clinicians agreed to complete the questionnaires. Sixty seven percent of patients who had telephone consultations and 50% of patients who had video consultations were satisfied with their consultations. Forty nine percent and 83% of patients who had telephone and video consultations, respectively, felt they were of the same standard as their face-to-face consultations. Despite 60% of clinicians feeling telemedicine training would be useful, 55% of clinicians stated they mostly or always met all of the needs of their patients via telephone consultations, whereas 96% of clinicians felt similarly for video consultations (P = 0.002). A total of 33% and 57% of clinicians felt telephone and video consultations, respectively, were of the same standard as face-to-face consultations (P = 0.004).</p><p><strong>Conclusion: </strong>This study comprehensively assesses attitudes to IF telemedicine consultations. Our data show that a large proportion of patients and clinicians are satisfied with IF telephone and video consultations. However, there is an unmet need amongst clinicians for telemedicine training.</p>","PeriodicalId":19354,"journal":{"name":"Nutrition in Clinical Practice","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143409657","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 support in children with medical complexity and chronic critical illness: A narrative review.","authors":"Jennifer M Perez, Robert J Graham, Nilesh M Mehta, Enid E Martinez","doi":"10.1002/ncp.11217","DOIUrl":"10.1002/ncp.11217","url":null,"abstract":"<p><p>Children with medical complexity (CMC) and children with chronic critical illness (CCI) represent growing populations with high healthcare use and dependence on specialized care, both in the hospital and community setting. Nutrition assessment and delivery represent critical components of addressing the short-term and long-term health needs for these populations across the care continuum. This article provides a framework and reviews existing literature for the assessment of nutrition status and subsequent delivery of nutrition prescriptions in CMC and children with CCI. The specific aims are to (1) describe the epidemiology of health services experience for CMC and children with CCI, with a focus on their nutrition outcomes; (2) detail how to assess their nutrition status and energy requirements; (3) review methods of delivery of the nutrient prescription; (4) introduce perioperative considerations; (5) highlight examples of special populations of CMC and children with CCI; and (6) propose future research initiatives to improve nutrition and overall outcomes for these populations.</p>","PeriodicalId":19354,"journal":{"name":"Nutrition in Clinical Practice","volume":" ","pages":"54-63"},"PeriodicalIF":2.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142378140","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":"Parenteral nutrition dependence and growth in pediatric patients with intestinal failure following transition to blenderized tube feedings: A case series.","authors":"Brittany DePaula, Paul D Mitchell, E Reese, Megan Gray, Christopher P Duggan","doi":"10.1002/ncp.11232","DOIUrl":"10.1002/ncp.11232","url":null,"abstract":"<p><strong>Background: </strong>Human milk and amino acid (AA) formulas are correlated with a shorter duration of parenteral nutrition (PN) dependence for infants with intestinal failure (IF). Literature to guide feeding practices beyond infancy in this population is limited. We aimed to assess PN dependence, growth patterns, and stool frequency in pediatric patients with IF who transitioned from AA or hydrolyzed formula to blenderized tube feedings (BTFs).</p><p><strong>Methods: </strong>We performed a retrospective review among children with IF observed at Boston Children's Hospital from January 2014 to January 2019. Inclusion criteria were receipt of BTF for ≥3 months at a volume of ≥200 ml/day and ≥2 outpatient visits during the study period. Patients who received BTF in combination with another formula or food purees were excluded.</p><p><strong>Results: </strong>Twelve children met criteria. Eleven had a small bowel resection with mean residual small bowel length of 51 ± 47 cm. Two retained their ileocecal valve (ICV), and eight had colonic resection. All patients were dependent on PN with mean (SD) energy intake of 51 ± 21 kcal/kg/day. After transition to BTF, three patients (25%) achieved enteral autonomy, and seven (58%) had a reduction in PN energy intake. Anthropometric data and stool frequency were generally unchanged.</p><p><strong>Conclusion: </strong>The transition from AA or hydrolyzed formula to BTF was associated with a substantial reduction in PN support in 12 children with IF. Stool frequency and growth parameters were not significantly changed. Our findings suggest that the use of BTF in older children with IF should be considered.</p>","PeriodicalId":19354,"journal":{"name":"Nutrition in Clinical Practice","volume":" ","pages":"188-194"},"PeriodicalIF":2.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142583576","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":"Importance of nutrition adequacy by enteral nutrition in the acute phase of critical illness.","authors":"Mariane Kubiszewski Coruja, Luciana da Conceição Antunes, Vanessa Bielefeldt Leotti, Thais Steemburgo","doi":"10.1002/ncp.11251","DOIUrl":"10.1002/ncp.11251","url":null,"abstract":"","PeriodicalId":19354,"journal":{"name":"Nutrition in Clinical Practice","volume":" ","pages":"273-274"},"PeriodicalIF":2.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142751436","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":"Collaboration between registered dietitians and gastroenterologists in cystic fibrosis care: Results of an international cross-sectional survey.","authors":"Senthilkumar Sankararaman, Terri Schindler, Amanda Leonard, Kay Vavrina, Julianna Bailey, Aravind Thavamani, Linda C Cummings, Maria Mascarenhas","doi":"10.1002/ncp.11219","DOIUrl":"10.1002/ncp.11219","url":null,"abstract":"<p><strong>Background: </strong>Collaboration between registered dietitians and gastroenterologists has not been evaluated in cystic fibrosis (CF). We surveyed registered dietitians and gastroenterologists regarding the current participation of gastroenterologists in CF centers and identified possible areas to enhance partnership between the two disciplines.</p><p><strong>Methods: </strong>An anonymous online survey was distributed targeting registered dietitians and gastroenterologists involved in CF care through three international listservs (CF Nutrition, CF DIGEST, and PEDGI) over a 6-week period. SurveyMonkey was used, and informed consent was obtained.</p><p><strong>Results: </strong>A total of 131 respondents participated in this survey, including 80 registered dietitians and 51 gastroenterologists (41 pediatric and 10 adult gastroenterologists). Most respondents (82%) were from the United States, and two-thirds had ≥5 years of experience in CF. A significant number of registered dietitians reported the nonavailability of gastroenterologists for collaboration and there was greater availability of gastroenterologists in pediatric centers. Barriers to interdisciplinary collaboration included lack of CF expertise and dedicated time among the gastroenterologists and difficulties in coordinating the gastroenterology clinics. More gastroenterologists than registered dietitians perceived that they worked collaboratively with the other discipline in various domains (clinical care, quality improvement, research, presentations, and publications). Both disciplines had mutual respect and interest to further the collaboration.</p><p><strong>Conclusion: </strong>There is an increased need for gastroenterologist participation and collaboration (particularly in adult centers) in CF alongside registered dietitians to enhance comprehensive patient care. Future efforts should focus on training more gastroenterologists in CF and facilitating easier access to gastroenterologists for the CF population.</p>","PeriodicalId":19354,"journal":{"name":"Nutrition in Clinical Practice","volume":" ","pages":"195-208"},"PeriodicalIF":2.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11713212/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142392171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outpatient diabetes management influences glycemic control for critically ill patients during nutrition support: A retrospective observational study.","authors":"Roland N Dickerson, Allison R McLeod, Alison E Stonecipher, Julie E Farrar, Saskya Byerly, Dina M Filiberto, Peter E Fischer","doi":"10.1002/ncp.11244","DOIUrl":"10.1002/ncp.11244","url":null,"abstract":"<p><strong>Background: </strong>The purpose of this study was to determine whether successful outpatient management of diabetes, as assessed by hemoglobin A1c (Hgb A1c), influences inpatient glycemic control.</p><p><strong>Methods: </strong>Adult patients, aged >17 years, admitted to the trauma intensive care unit, who received continuous nutrition therapy, and exhibited a blood glucose concentration (BG) > 149 mg/dl or 8.3 mmol/L were retrospectively evaluated. Controlled diabetes mellitus (DM-C) was defined as a history of DM and a Hgb A1c < 7%. Uncontrolled DM (DM-U) was defined as an Hgb A1c ≥ 7%. Those without a history of DM and an Hgb A1c < 6.5% were classified as without DM (no DM). Patients were managed via intravenous regular human insulin (RHI) infusion or subcutaneous neutral protamine Hagedorn insulin with intravenous sliding scale RHI (SSI) or SSI alone. Target BG range was 70-149 mg/dl (3.9-8.3 mmol/L). Glycemic control was evaluated for the first 7 days of nutrition therapy.</p><p><strong>Results: </strong>Twenty-two patients with DM-C, 24 with DM-U, and 32 with no DM were evaluated. Despite no difference in carbohydrate intake, those with DM-U received 70 ± 54 units daily vs 15 ± 16 and 14 ± 18 units daily for the DM-C and no DM groups, respectively (P = 0.001). Target BG range was achieved for 11 ± 5 h/day vs 14 ± 7 and 16 ± 6 h/day, respectively (P = 0.01).</p><p><strong>Conclusion: </strong>Early identification of DM-U would assist in recognizing patients with difficulty achieving glycemic control.</p>","PeriodicalId":19354,"journal":{"name":"Nutrition in Clinical Practice","volume":" ","pages":"134-146"},"PeriodicalIF":2.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142710804","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":"Transforming the electronic health record from a documentation application to an automated diet program for personalizing neonatal nutrition and improving feeding administration safety through process improvement.","authors":"Alisha Harmeson Owen, Ameena Husain, David ElHalta, Suzie A Chen, Jennifer Spackman, Jennifer Murphy, Belinda Chan","doi":"10.1002/ncp.11212","DOIUrl":"10.1002/ncp.11212","url":null,"abstract":"<p><p>Delivering adequate nutrition to preterm and sick neonates is critical for growth. Infants in the neonatal intensive care unit (NICU) require additional calories to supplement feedings for higher metabolic demands. Traditionally, clinicians enter free-text diet orders for a milk technician to formulate recipes, and dietitians manually calculate nutrition components to monitor growth. This daily process is complex and labor intensive with potential for error. Our goal was to develop an electronic health record (EHR)-integrated solution for entering feeding orders with automated nutrition calculations and mixing instructions. The EHR-integrated automated diet program (ADP) was created and implemented at a 52-bed level III academic NICU. The configuration of the parenteral nutrition orderable item within the EHR was adapted to generate personalized milk mixing recipes. Caloric, macronutrient, and micronutrient constituents were automatically calculated and displayed. To enhance administration safety, handwritten milk bottle patient labels were substituted with electronically generated and scannable patient labels. The program was further enhanced by calculating fortifier powder displacement factors to improve mixing precision. Order entry was optimized to allow for more complex mixing recipes and include a preference list of frequently ordered feeds. The EHR-ADP's safeguarded features allowed for catching multiple near-missed feeding administration errors. The NICU preterm neonate cohort had an average of 6-day decrease (P = 0.01) in the length of stay after implementation while maintaining the same weight gain velocity. The EHR-ADP may improve safety and efficiency; further improvements and wider utilization are needed to demonstrate the growth benefits of personalized nutrition.</p>","PeriodicalId":19354,"journal":{"name":"Nutrition in Clinical Practice","volume":" ","pages":"252-265"},"PeriodicalIF":2.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11713221/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142292325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A cross-sectional observational study of quality of life in adult short bowel syndrome patients: What role does autologous gut reconstruction play?","authors":"Julia Braun, Jan Christian Arensmeyer, Annekristin Hausen, Verena Stolz, Peter Sebastian Keller, Nicola Amarell, Georg Lurje, Nico Schäfer, Jörg C Kalff, Martin W von Websky","doi":"10.1002/ncp.11253","DOIUrl":"10.1002/ncp.11253","url":null,"abstract":"<p><strong>Background: </strong>Intestinal failure (IF) describes a condition of insufficient absorption capacity and general function of the gastrointestinal tract and may necessitate long-term intravenous fluid and nutrient supplementation. Quality of life (QoL) may be reduced in these patients. The aim of the study was to analyze QoL by two tools (SBS-QoL and SF-12) to elucidate which parameters impact QoL in patients with IF.</p><p><strong>Methods: </strong>QoL was assessed in a cohort of 105 patients with IF at a tertiary referral center for intestinal rehabilitation. Complete data for SBS-QoL and SF-12 were available in 44 of 81 surviving patients at a single time point for a cross-sectional analysis. Medical data, outcome parameters, and comorbidities (Charlson comorbidity index [CCI]) were extracted and entered in a prospective database for analysis and correlation with QoL assessment.</p><p><strong>Results: </strong>Subscales of SBS-QoL and SF-12 highly correlated with each other (P = -0.64 for physical subscales; P = -0.75 for mental subscales). Significant differences in QoL were detected in patients with Messing Type I (end-jejunostomy) and Type III anatomy (ileocolonic anastomosis) (one-way ANOVA: P < 0.05). Performance of autologous gut reconstruction (AGR) was associated with significantly better physical QoL. CCI correlated significantly with QoL scores. Longer duration of illness resulted in higher QoL in SBS-QoL (reduction of 0.15 per month; P = 0.045).</p><p><strong>Conclusion: </strong>Both SBS-QoL and SF-12 are useful to determine QoL in patients with IF. AGR was associated with improved QoL by changing SBS-related anatomy and function. Thus, AGR surgery should be included in the treatment plan whenever possible. Comorbidities should be addressed interdisciplinarily to improve QoL.</p>","PeriodicalId":19354,"journal":{"name":"Nutrition in Clinical Practice","volume":" ","pages":"147-155"},"PeriodicalIF":2.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11713214/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142818753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}