JPEN. Journal of parenteral and enteral nutrition最新文献

{"title":"Correction to \"Measured energy expenditure according to the phases of critical illness: A descriptive cohort study\".","authors":"","doi":"10.1002/jpen.70003","DOIUrl":"https://doi.org/10.1002/jpen.70003","url":null,"abstract":"","PeriodicalId":520701,"journal":{"name":"JPEN. Journal of parenteral and enteral nutrition","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144677209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to \"Variations in adverse events associated with different infusion modalities of parenteral nutrition: A pharmacovigilance study\".","authors":"","doi":"10.1002/jpen.70002","DOIUrl":"https://doi.org/10.1002/jpen.70002","url":null,"abstract":"","PeriodicalId":520701,"journal":{"name":"JPEN. Journal of parenteral and enteral nutrition","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144669288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"JPEN Journal Club 94. Qualitative systematic reviews.","authors":"Ronald L Koretz","doi":"10.1002/jpen.70000","DOIUrl":"https://doi.org/10.1002/jpen.70000","url":null,"abstract":"","PeriodicalId":520701,"journal":{"name":"JPEN. Journal of parenteral and enteral nutrition","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144669289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fat-free mass index cutoff values for reduced muscle mass in older community-dwelling adults in Japan: A descriptive cohort study.","authors":"Sahoko Takagi, Keisuke Maeda, Shosuke Satake, Shuzo Miyahara, Yuria Ishida, Hiroyasu Akatsu, Hidenori Arai","doi":"10.1002/jpen.2806","DOIUrl":"https://doi.org/10.1002/jpen.2806","url":null,"abstract":"<p><strong>Background: </strong>The Global Leadership Initiative on Malnutrition criteria emphasize the importance of assessing muscle mass, recommending the fat-free mass index (FFMI) as a key measure. This study aimed to establish FFMI cutoff values for Japanese individuals and examine the risk factors of falls using these values.</p><p><strong>Methods: </strong>This descriptive cohort study included 696 older adults from a Japanese outpatient frailty clinic located within a hospital. FFMI was measured via bioelectrical impedance analysis, and the appendicular skeletal muscle index (ASMI) was measured using dual-energy X-ray absorptiometry. Receiver operating characteristic analysis identified optimal FFMI cut-offs against low ASMI (<7.0 kg/m² for men; <5.4 kg/m² for women). Logistic regression was used to analyze the relationship between reduced muscle mass and falls over 1 year.</p><p><strong>Results: </strong>Participants (mean age 76.1 ± 7.4 years; 64.8% female) experienced falls in 180 cases (25.9%), with 244 participants (35.1%) exhibiting low ASMI. The optimal FFMI cut-offs were <17.5 kg/m² for men (area under the curve [AUC]: 0.926; 95% confidence interval [CI]: 0.893-0.958) and <14.4 kg/m² for women (AUC: 0.927; 95% CI: 0.902-0.953), yielding 84.0% sensitivity, 91.2% specificity, and 88.6% accuracy. Low ASMI was not significantly linked to falls (odds ratio [OR: 1.04; 95% CI: 0.70-1.53; P = 0.860), whereas low FFMI was predictive (OR: 1.49; 95% CI: 1.01-2.20; P = 0.044).</p><p><strong>Conclusion: </strong>FFMI cut-offs of <17.5 kg/m² for men and <14.4 kg/m² for women effectively identified reduced muscle mass and predicted falls. The results suggest that FFMI may be a useful tool in malnutrition diagnosis.</p>","PeriodicalId":520701,"journal":{"name":"JPEN. Journal of parenteral and enteral nutrition","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144610952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Energy and protein intake adequacy in geriatric rehabilitation inpatients: A descriptive cohort study.","authors":"Jeewanadee Hettiarachchi, Esmee M Reijnierse, Andrea B Maier, Kate Fetterplace","doi":"10.1002/jpen.2804","DOIUrl":"https://doi.org/10.1002/jpen.2804","url":null,"abstract":"<p><strong>Background: </strong>Indirect calorimetry (IC) provides an accurate measure of energy expenditure, which informs energy requirements. Achieving energy and protein requirements is fundamental in nutrition care. This study aims to determine if the energy requirements informed by IC and estimated protein requirements are met in geriatric rehabilitation inpatients receiving dietitian-led individualized nutrition care.</p><p><strong>Methods: </strong>Geriatric rehabilitation inpatients referred to dietitians were included. Resting metabolic rate was measured using IC at inclusion in the study and within 48 h before discharge. Food intake was assessed using plate waste observation. The patient's energy requirement was calculated using the resting metabolic rate and physical activity factor and adjusted for the weight goal. Protein requirements were estimated by the dietitian. The energy and protein intake adequacy was calculated as a percentage of the individual requirement and defined \"adequate\" if ≥100%.</p><p><strong>Results: </strong>Fifty-three patients were included (mean age, 84.3 [standard deviation, 8.44] years; 22 [41.5%] women). The median energy and protein intake adequacy was 101.7% (interquartile range [IQR], 76.4-112.9) and 87.6% (IQR, 71.9-122.2) at the start of the nutrition care (n = 53) and 99.9% (IQR, 63.9-113.8) and 80.1% (IQR, 65.1-99.6) at discharge (n = 29), respectively. Only 15 of 53 (28.3%) patients at the start of nutition care and 6 of 29 (20.7%) patients at discharge achieved both energy and protein intake adequacy.</p><p><strong>Conclusions: </strong>Energy requirements were met, but the protein requirements were not met in geriatric rehabilitation inpatients receiving nutrition care. However, less than one-third of patients achieved both energy and protein intake adequacy.</p>","PeriodicalId":520701,"journal":{"name":"JPEN. Journal of parenteral and enteral nutrition","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144568316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between late parenteral nutrition initiation and length of hospital stay in late preterm and term infants: A retrospective cohort study.","authors":"Katrina A Savioli, Carl E Hunt, Anwar E Ahmed, Cara H Olsen, Reese H Clark, Nicole R Dobson","doi":"10.1002/jpen.2805","DOIUrl":"https://doi.org/10.1002/jpen.2805","url":null,"abstract":"<p><strong>Background: </strong>We aimed to determine the association between timing of parenteral nutrition initiation and length of hospital stay in late preterm and term infants.</p><p><strong>Methods: </strong>This retrospective cohort study includes infants ≥35 weeks gestation admitted to a Pediatrix Medical Group neonatal intensive care unit in 2009-2019. Propensity score matching was used to control for demographics, delivery characteristics, and severity of illness. The primary outcome was length of hospital stay. Secondary outcomes were duration of mechanical ventilation, late-onset sepsis, and mortality. Early parenteral nutrition was defined as initiation on the day of birth and late as initiation after.</p><p><strong>Results: </strong>The total cohort has 475,708 infants; of 259,495 eligible infants, 97,577 (37.6%) received parenteral nutrition. After propensity score matching, outcomes were analyzed for 13,712 infants. Infants receiving late parenteral nutrition (n = 6856) have no difference in length of hospital stay compared with early. Analysis of secondary outcomes reveals no differences between groups. Negative binomial regression shows decreased length of hospital stay when parenteral nutrition is initiated on days of life 1-3 compared with day of birth or days 4-10.</p><p><strong>Conclusion: </strong>Initiating parenteral nutrition on day 1 or later vs day of birth is not associated with increased length of hospital stay in late preterm and term infants. Exploratory analysis suggests that initiation of parenteral nutrition on days 1-3 instead of day of birth or days 4-10 is associated with decreased hospital stay. Prospective clinical trials are needed to better understand optimal timing of parenteral nutrition in this population.</p>","PeriodicalId":520701,"journal":{"name":"JPEN. Journal of parenteral and enteral nutrition","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144577599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Roles, responsibilities, and opportunities for the nutrition support physician working with adults: A critical review.","authors":"Manpreet S Mundi, Jeffrey I Mechanick, Jayshil Patel, Carolyn Newberry, Senthilkumar Sankararaman, Martin Rosenthal, Osman Mohamed Elfadil, Jamie Bering, Jennifer Katz, Christian Stoppe, Robert Martindale, Stephen McClave","doi":"10.1002/jpen.2790","DOIUrl":"https://doi.org/10.1002/jpen.2790","url":null,"abstract":"<p><p>The dual burden of undernutrition and overnutrition requires a greater understanding and commitment to physician training and specialization in nutrition support. Despite the significant healthcare need and existence of organizations focused on nutrition support such as the American Society for Parenteral and Enteral Nutrition (ASPEN), physician involvement in the nutrition care of high-risk patients remains low. In an ASPEN survey of members, inadequate training among physicians was reported along with significant barriers to involvement in nutrition support, such as insufficient protected time, reduced reimbursement and financial support, inadequate support from administrators or supervisors, as well as a nationwide reduction in number of nutrition support teams. These changes in the healthcare landscape prompted the ASPEN Physician Engagement Committee to develop a critical review focused on domains of nutrition risk assessment, enteral and parenteral access and support, scholarly activities, board certification, administrative responsibilities, education and training opportunities, coding, and reimbursement. The aim of this critical review is to capacitate physicians to engage in nutrition support and enhance their acumen in clinical nutrition to improve patient care and enrich personal and professional development.</p>","PeriodicalId":520701,"journal":{"name":"JPEN. Journal of parenteral and enteral nutrition","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144556534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between enteral essential fatty acids and plasma phospholipid essential fatty acids related immune response in critically ill adults with COVID-19: A prospective cohort study.","authors":"Vera C Mazurak, Irma Magaly Rivas-Serna, Sarah R Parsons, Md Monirujjaman, Krista E Maybank, Oleksa G Rewa, Andrew J Cave, Caroline Richard, M Thomas Clandinin","doi":"10.1002/jpen.2783","DOIUrl":"https://doi.org/10.1002/jpen.2783","url":null,"abstract":"<p><strong>Background: </strong>Coronavirus disease 2019 (COVID-19) is a complicated disease with widely varying outcomes. Up to 20% of unvaccinated, hospitalized patients infected with COVID-19 may die during the initial three weeks. Our research shows that COVID-19 infection results in rapid, remarkable change in the balance between essential fatty acid constituents of plasma phospholipids that are substrates for synthesis of signals that regulate immunity, inflammation, and thrombosis.</p><p><strong>Methods: </strong>We assessed if enteral feeding of EPA (eicosapentaenoic acid, 20:5n-3) and DHA (docosahexaenoic acid; 22:6n-3) normalizes remodeling of plasma phospholipid essential fatty acid content caused by COVID-19 viral infection and modifies immune response. Blood samples were taken on day 1 of hospital admission. From the patient record, patients were categorized into two groups based on enteral formula fed by day 5 after admission: enteral feeds that contained EPA + DHA or not. These two groups were compared at 1 week and 3 weeks postadmission for plasma phospholipid fatty acids, cytokines, and chemokines.</p><p><strong>Results: </strong>Feeding EPA + DHA increases plasma content of these fatty acids in specific species of plasma phosphatidylcholine. Change in essential fatty acid status was associated with downregulation of the inflammatory signal macrophage inflammatory protein-1β and increase in interleukin-17, monocyte chemoattractant protein (MCP)-4, macrophage-derived chemokine and thymus- and activation-regulated chemokine signals. Plasma arachidonic acid content correlated with chemoattractant protein MCP-4 during early stages of infection.</p><p><strong>Conclusion: </strong>We conclude that feeding COVID-19 infected intensive care unit patients enteral formulas containing EPA and DHA may alter response to infection; however, the potential benefit to clinical outcome is not clear.</p>","PeriodicalId":520701,"journal":{"name":"JPEN. Journal of parenteral and enteral nutrition","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144532832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of home-based methods to defat human milk for infants with chylothorax: An experimental study.","authors":"Kaitlin Berris, Kendall Plant, Frances Jones, Diego Marquez, Vicki Hsieh, Rajavel Elango","doi":"10.1002/jpen.2782","DOIUrl":"https://doi.org/10.1002/jpen.2782","url":null,"abstract":"<p><strong>Background: </strong>Chylothorax is a postoperative complication for infants with congenital heart defects; with high nutrition risk. Defatted human milk is recommended; however, refrigerated centrifugation to process milk poses accessibility barriers for many hospitals and families at home. Creation of a simplified home-based defatted milk protocol allows infants with chylothorax to be provided the immunological benefits of human milk postoperatively.</p><p><strong>Methods: </strong>Milk from 20 mothers was tested to compare refrigerated centrifugation as the standard defatting technique against gravity-based methods: syringe tip-down and gravy separator. Two timeframes, 24 h and 48 h, were tested to determine if additional time had a significant impact on fat reduction. The MIRIS human milk analyzer provided results for fat, true protein, carbohydrate, and energy content. One-way analysis of variance was used to determine a significant difference on fat content among methods.</p><p><strong>Results: </strong>All methods had a significant reduction in fat content, with centrifugation having the largest mean decline from 3.4 to 0.5 g/100 ml (P < 0.0001). The second most effective method to defat milk was 48-h gravy separator with a mean decline to 0.7 g/100 ml (P < 0.0001). Postpartum age of milk impacted the degree of fat removal in all methods. True protein content remained the same as baseline in all methods.</p><p><strong>Conclusion: </strong>A simplified home-based gravity separation method over 48 h reduced human milk fat by 80%. This is the first protocol to defat human milk without use of the more resource-intensive centrifugation method, that shows significant fat reduction with easy-to-use and accessible equipment for management of infants with chylothorax.</p>","PeriodicalId":520701,"journal":{"name":"JPEN. Journal of parenteral and enteral nutrition","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144478543","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between insulin dose and hyperglycemia in hospitalized adults with ischemic stroke receiving continuous enteral nutrition: A retrospective cohort study.","authors":"Heather M Wallhauser, Leslie A Hamilton, Skyler R Brown, Thomas J Christianson, Brian F Wiseman, Olivia N Bray, Hayden W Caldwell, A Shaun Rowe","doi":"10.1002/jpen.2787","DOIUrl":"https://doi.org/10.1002/jpen.2787","url":null,"abstract":"<p><strong>Background: </strong>Hyperglycemia following an acute ischemic stroke has been linked to increased morbidity and mortality. Because of changes in a hospital-wide sliding-scale insulin protocol to incorporate half-doses at midnight due to hypoglycemia risk, we aimed to evaluate the safety and efficacy of half-dose sliding-scale insulin at midnight compared with full doses in patients with acute ischemic stroke receiving enteral nutrition.</p><p><strong>Methods: </strong>This single-center, retrospective cohort study involved 151 patients with acute ischemic stroke and receiving enteral nutrition in a neurocritical care unit between January 1, 2014, and December 31, 2021. The exposure of interest was half-dose sliding-scale insulin at midnight compared with full-dose sliding-scale insulin at midnight. The primary outcome was the incidence of hyperglycemia for a 48-h period after stability while receiving enteral nutrition. Secondary outcomes were new infections, incidence of hypoglycemia, and incidence of delirium.</p><p><strong>Results: </strong>In the full-dose group, 52 patients experienced hyperglycemia compared with 60 patients in the half-dose group; however, after propensity matching for carbohydrate content in enteral nutrition and hemoglobin A1c, the results are not noninferior (risk difference, 3.9%; 95% CI, -21.2% to 13.3%; P = 0.1041). Delirium was significantly higher in the full-dose group, whereas the half-dose group had a higher rate of suspected bacterial infections.</p><p><strong>Conclusion: </strong>The study indicates that administering half-dose sliding-scale insulin at midnight in patients with acute ischemic stroke receiving enteral nutrition is not noninferior to full doses in controlling hyperglycemia. However, differences in delirium and infection rates suggest that glycemic changes may influence other outcomes.</p>","PeriodicalId":520701,"journal":{"name":"JPEN. Journal of parenteral and enteral nutrition","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144370066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}