Nutrition in Clinical Practice最新文献_第5页

Prevalence, predictive factors, and outcomes of refeeding syndrome among medically critically ill patients: A retrospective cohort study. 内科重症患者再喂养综合征的发病率、预测因素和结果：一项回顾性队列研究。

IF 2.1 4区医学

Nutrition in Clinical Practice Pub Date : 2025-02-01 Epub Date: 2024-06-12 DOI: 10.1002/ncp.11160

Surat Tongyoo, Pratya Rawangban, Thummaporn Naorungroj

{"title":"Prevalence, predictive factors, and outcomes of refeeding syndrome among medically critically ill patients: A retrospective cohort study.","authors":"Surat Tongyoo, Pratya Rawangban, Thummaporn Naorungroj","doi":"10.1002/ncp.11160","DOIUrl":"10.1002/ncp.11160","url":null,"abstract":"Background: Refeeding syndrome (RFS) is a life-threatening metabolic derangement occurring when nutrition is reintroduced after prolonged starvation. Limited data exist regarding RFS prevalence, risk factors, and outcome, particularly in critically ill patients.Methods: A retrospective cohort study was conducted in a medical intensive care unit from June 2018 to August 2020. RFS diagnostic criteria from the National Institute for Health and Care Excellence (NICE) and the American Society for Parenteral and Enteral Nutrition (ASPEN) were used. The primary outcome was 30-day mortality.Results: Among 216 patients, RFS was diagnosed in 22.7% and 27.3% of patients per the NICE and ASPEN criteria, respectively. There was no significant difference in 30-day mortality between patients with and without RFS (22/59 [37.3%] vs 53/157 [33.8%]; P = 0.627). Independent predictors of RFS were malignancy (odds ratio [OR] = 2.09; 95% CI = 1.06-4.15; P = 0.035), septic shock (OR = 2.26; 95% CI = 1.17-4.39; P = 0.016), and high NICE RFS risk classification (OR = 2.52; 95% CI = 1.20-5.31; P = 0.015). Factors associated with reduced RFS risk were Sequential Organ Failure Assessment (SOFA) scores >12 (OR = 0.45; 95% CI = 0.23-0.88; P = 0.020) and high-dose vasopressor treatment (OR = 0.34; 95% CI = 0.14-0.79; P = 0.012).Conclusion: RFS affected one-fourth of the critically ill patients but did not significantly impact 30-day mortality. Malignancy, septic shock, and high NICE RFS risk classification were positively associated with RFS, whereas high SOFA scores and extensive vasopressor use were linked to decreased risk.","PeriodicalId":19354,"journal":{"name":"Nutrition in Clinical Practice","volume":" ","pages":"125-133"},"PeriodicalIF":2.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141306445","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}

引用次数: 0

Nutrition support for patients with renal dysfunction in the intensive care unit: A narrative review. 重症监护病房肾功能不全患者的营养支持：叙述性综述。

IF 2.1 4区医学

Nutrition in Clinical Practice Pub Date : 2025-02-01 Epub Date: 2024-10-24 DOI: 10.1002/ncp.11231

Joanna L Otis, Nicholas M Parker, Rebecca A Busch

引用次数: 0

Comparison of microbiological loads of enteral products at two different ambient room temperatures. 比较两种不同环境室温下肠内产品的微生物载量。

IF 2.1 4区医学

Nutrition in Clinical Practice Pub Date : 2025-02-01 Epub Date: 2024-10-24 DOI: 10.1002/ncp.11230

Alev Yıldız Ilıman, Merve Yurttaş, Dursun Fırat Ergül, Salim Tutkaoğlu

{"title":"Comparison of microbiological loads of enteral products at two different ambient room temperatures.","authors":"Alev Yıldız Ilıman, Merve Yurttaş, Dursun Fırat Ergül, Salim Tutkaoğlu","doi":"10.1002/ncp.11230","DOIUrl":"10.1002/ncp.11230","url":null,"abstract":"Background: Despite the high risk of bacterial contamination, no studies have been found that evaluate the optimal hanging time of open-system enteral sets under room temperature and intensive care conditions. This study aims to determine the differences in microbial loads of solutions taken from open-system enteral feeding sets hanging for 24 h under room temperature and intensive care conditions.Methods: This study is a descriptive type of research. The study sample consisted of a total of 40 samples, with 20 samples under room temperature (25.2-23.3°C) and 20 samples under intensive care conditions (21.1-24.2°C). A simple random sampling method was used for sample selection. The assessment of microbial quality was based on the US Food and Drug Administration online Bacteriological Analytical Manual.Results: In this study, it was determined that 5% of the samples taken from intensive care and 15% of the samples taken at room temperature exceeded the accepted limit for aerobic mesophilic bacteria count. The count of catalase and coagulase-negative Staphylococcus spp was 5% in intensive care samples and 40% in room temperature samples. The total coliform count was not detected in intensive care samples but was 35% in room temperature samples. Escherichia coli was not detected in either group.Conclusion: Differences in microbial loads were observed when commercial enteral solutions were administered using open-system enteral feeding sets under room and intensive care conditions for 24 h. Therefore, large-scale studies are needed to determine the safe use of open-system enteral feeding sets under room temperature conditions.","PeriodicalId":19354,"journal":{"name":"Nutrition in Clinical Practice","volume":" ","pages":"167-175"},"PeriodicalIF":2.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142504873","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}

引用次数: 0

The challenge of integrating a diagnosis of malnutrition in the practical application of nutrition care in the intensive care unit. 在重症监护室营养护理的实际应用中整合营养不良诊断的挑战。

IF 2.1 4区医学

Nutrition in Clinical Practice Pub Date : 2025-02-01 Epub Date: 2024-12-20 DOI: 10.1002/ncp.11260

Stephen A McClave, Endashaw M Omer, Cynthia C Lowen, Robert G Martindale

引用次数: 0

Zinc as a potential prophylactic adjuvant therapy for prolonged hospitalization: A systematic review and meta-analysis of an umbrella of randomized controlled trials. 锌作为长期住院的潜在预防性辅助疗法：随机对照试验的系统回顾和荟萃分析。

IF 2.1 4区医学

Nutrition in Clinical Practice Pub Date : 2025-02-01 Epub Date: 2024-10-22 DOI: 10.1002/ncp.11221

Hoda Atef Abdelsattar Ibrahim, Mohammed Bendary, Ahmed Sabt, Khaled Saad

{"title":"Zinc as a potential prophylactic adjuvant therapy for prolonged hospitalization: A systematic review and meta-analysis of an umbrella of randomized controlled trials.","authors":"Hoda Atef Abdelsattar Ibrahim, Mohammed Bendary, Ahmed Sabt, Khaled Saad","doi":"10.1002/ncp.11221","DOIUrl":"10.1002/ncp.11221","url":null,"abstract":"Aims: The present study evaluated the effect of oral zinc supplementation on shortening hospital length of stay.Methods: A systematic review was conducted for randomized control trials in patients who were hospitalized regardless of age and cause of admission. Studies were collected from PubMed, Web of Science, SCOPUS, and the Cochrane Library until July 2023. Results were compared between the zinc group and those who received a placebo and/or the standard therapy.Results: Eight studies were qualified for our meta-analysis. Of the 1267 patients, 633 and 634 were in the zinc supplementation and control groups, respectively. The meta-analysis found that oral zinc supplementation group experienced a lower length of hospital stay than the control group (mean difference, -0.43 days; 95% confidence interval, -0.65 to -0.22; P < 0.0001; heterogeneity, I2 = 20%).Conclusion: The administration of oral zinc supplements was associated with a slightly reduced duration of hospital stay.","PeriodicalId":19354,"journal":{"name":"Nutrition in Clinical Practice","volume":" ","pages":"93-105"},"PeriodicalIF":2.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142471016","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}

引用次数: 0

Preoperative body composition measured by bioelectrical impedance analysis can predict pancreatic fistula after pancreatic surgery. 通过生物电阻抗分析测量的术前身体成分可预测胰腺手术后的胰瘘。

IF 2.1 4区医学

Nutrition in Clinical Practice Pub Date : 2025-02-01 Epub Date: 2024-07-15 DOI: 10.1002/ncp.11192

Qianwen Jin, Jun Zhang, Jiabin Jin, Jiaqiang Zhang, Si Fei, Yang Liu, Zhiwei Xu, Yongmei Shi

{"title":"Preoperative body composition measured by bioelectrical impedance analysis can predict pancreatic fistula after pancreatic surgery.","authors":"Qianwen Jin, Jun Zhang, Jiabin Jin, Jiaqiang Zhang, Si Fei, Yang Liu, Zhiwei Xu, Yongmei Shi","doi":"10.1002/ncp.11192","DOIUrl":"10.1002/ncp.11192","url":null,"abstract":"Background: Postoperative pancreatic fistula (POPF) remains one of the most severe complications after pancreatic surgery. The methods for predicting pancreatic fistula are limited. We aimed to investigate the predictive value of body composition parameters measured by preoperative bioelectrical impedance analysis (BIA) on the development of POPF.Methods: A total of 168 consecutive patients undergoing pancreatic surgery from March 2022 to December 2022 at our institution were included in the study and randomly assigned at a 3:2 ratio to the training group and the validation group. All data, including previously reported risk factors for POPF and parameters measured by BIA, were collected. Risk factors were analyzed by univariable and multivariable logistic regression analysis. A prediction model was established to predict the development of POPF based on these parameters.Results: POPF occurred in 41 of 168 (24.4%) patients. In the training group of 101 enrolled patients, visceral fat area (VFA) (odds ratio [OR] = 1.077, P = 0.001) and fat mass index (FMI) (OR = 0.628, P = 0.027) were found to be independently associated with POPF according to multivariable analysis. A prediction model including VFA and FMI was established to predict the development of POPF with an area under the receiver operating characteristic curve (AUC) of 0.753. The efficacy of the prediction model was also confirmed in the internal validation group (AUC 0.785, 95% CI 0.659-0.911).Conclusions: Preoperative assessment of body fat distribution by BIA can predict the risk of POPF after pancreatic surgery.","PeriodicalId":19354,"journal":{"name":"Nutrition in Clinical Practice","volume":" ","pages":"156-166"},"PeriodicalIF":2.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11713216/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141620523","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}

引用次数: 0

Nutrition and outcomes in venovenous extracorporeal membrane oxygenation: An observational cohort study. 静脉体外膜肺氧合的营养与疗效：一项观察性队列研究。

IF 2.1 4区医学

Nutrition in Clinical Practice Pub Date : 2025-02-01 Epub Date: 2024-02-20 DOI: 10.1002/ncp.11132

Stacy Pelekhaty, Julie Gessler, Siddhartha Dante, Nicholas Rector, Samuel Galvagno, Stephen Stachnik, Joseph Rabin, Ali Tabatabai

{"title":"Nutrition and outcomes in venovenous extracorporeal membrane oxygenation: An observational cohort study.","authors":"Stacy Pelekhaty, Julie Gessler, Siddhartha Dante, Nicholas Rector, Samuel Galvagno, Stephen Stachnik, Joseph Rabin, Ali Tabatabai","doi":"10.1002/ncp.11132","DOIUrl":"10.1002/ncp.11132","url":null,"abstract":"Background: Overfeeding and underfeeding are associated with negative outcomes during critical illness. The purpose of this retrospective study was to assess the association between nutrition intake and outcomes for patients receiving venovenous (VV) extracorporeal membrane oxygenation (ECMO).Methods: Adults who received VV ECMO August 2017 to June 2020 were screened. Patients with <3 ECMO nutrition support days were excluded. Age, sex, height, weight, ideal body weight (IBW), body mass index, sequential organ failure assessment score, respiratory ECMO survival prediction score, energy, and protein goals were collected. All nutrition intake was collected for the first 14 days of ECMO or until death, decannulation, or oral diet initiation. Outcomes analyzed included mortality and VV ECMO duration. The relationship between nutrition delivery and outcomes was tested with multivariate analysis. Univariate analyses were conducted on obese and nonobese subgroups.Results: A total of 2044 nutrition days in 178 patients were analyzed. The median estimated needs were 24 (interquartile range: 22.3-28.3) kcal/kg/day and 2.25 (interquartile range: 2.25-2.77) g/kg/day of protein using IBW in patients with obesity and actual weight in patients without obesity. Patients received 83% of energy and 63.3% of protein targets. Patients with obesity who received ≥2 g/kg IBW of protein had a significantly shorter ECMO duration (P = 0.037). Increased protein intake was independently associated with a reduced risk of death (odds ratio: 0.06; 95% confidence interval: 0.01-0.43).Conclusion: Higher protein intake was associated with reduced mortality. Optimal energy targets for patients receiving ECMO are currently unknown and warrant further study.","PeriodicalId":19354,"journal":{"name":"Nutrition in Clinical Practice","volume":" ","pages":"117-124"},"PeriodicalIF":2.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139906171","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}

引用次数: 0

Nitrogen sources in donor human milk: True protein, nonprotein nitrogen, and amino acid profile. 供体母乳中的氮源：真蛋白、非蛋白氮和氨基酸谱。

IF 2.1 4区医学

Nutrition in Clinical Practice Pub Date : 2025-02-01 Epub Date: 2024-08-06 DOI: 10.1002/ncp.11199

Brian K Stansfield, Amy Gates

{"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":"10.1002/ncp.11199","url":null,"abstract":"Background: 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.Methods: 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.Results: 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.Conclusion: Common methods for assessing the macronutrient content of human milk may overestimate the protein content of DHM.","PeriodicalId":19354,"journal":{"name":"Nutrition in Clinical Practice","volume":" ","pages":"217-226"},"PeriodicalIF":2.1,"publicationDate":"2025-02-01","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}

引用次数: 0

Risk factors for the development of refeeding syndrome in adults: A systematic review. 成人发生反食综合征的风险因素：系统综述。

IF 2.1 4区医学

Nutrition in Clinical Practice Pub Date : 2025-02-01 Epub Date: 2024-08-26 DOI: 10.1002/ncp.11203

Ping Zheng, Yilin Chen, Feng Chen, Min Zhou, Caixia Xie

{"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":"10.1002/ncp.11203","url":null,"abstract":"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.","PeriodicalId":19354,"journal":{"name":"Nutrition in Clinical Practice","volume":" ","pages":"76-92"},"PeriodicalIF":2.1,"publicationDate":"2025-02-01","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}

引用次数: 0

Quality improvement initiative to achieve early enteral feeds in preterm infants at a level IV neonatal intensive care unit. 在四级新生儿重症监护病房对早产儿进行早期肠内喂养的质量改进措施。

IF 2.1 4区医学

Nutrition in Clinical Practice Pub Date : 2025-02-01 Epub Date: 2024-11-01 DOI: 10.1002/ncp.11236

Usha Prasad, Kendall Johnson, Stephanie McGuire, Kathleen Haines, Annmarie Spizzoucco, Shabnam Lainwala

{"title":"Quality improvement initiative to achieve early enteral feeds in preterm infants at a level IV neonatal intensive care unit.","authors":"Usha Prasad, Kendall Johnson, Stephanie McGuire, Kathleen Haines, Annmarie Spizzoucco, Shabnam Lainwala","doi":"10.1002/ncp.11236","DOIUrl":"10.1002/ncp.11236","url":null,"abstract":"Objective: We report the results of a quality improvement initiative to reduce the time to full enteral feeds and number of central line and parenteral nutrition days in premature infants in a level IV neonatal intensive care unit (NICU) by 20%.Study design: In 2020, a multidisciplinary team at our NICU initiated a quality improvement project to improve enteral feeding in infants with a birthweight <1800 g. The key drivers were early donor human milk consent, trophic feeds initiation, and modification of the enteral feeding guidelines. The interventions included prenatal donor human milk consents, mandatory staff education, and NICU newsletter reminders. Retrospective baseline data were collected May 1, 2020, to November 23, 2020, and prospective data were collected November 24, 2020, to September 30, 2022.Results: Special cause variation was detected for time to achieve full enteral feeds, central line days, and parenteral nutrition days with 30%, 44%, and 42% improvements, respectively. There was no increase in feeding intolerance or necrotizing enterocolitis.Conclusion: Small changes in feeding guideline processes improved enteral feedings in preterm infants without increase in morbidities. Our process measures are practical and easy to implement in most NICU settings.","PeriodicalId":19354,"journal":{"name":"Nutrition in Clinical Practice","volume":" ","pages":"209-216"},"PeriodicalIF":2.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142558379","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}

引用次数: 0