JPEN. Journal of parenteral and enteral nutrition最新文献

{"title":"Reduced calf circumference is an independent predictor of worse quality of life, severity of disease, frequent exacerbation, and death in patients with chronic obstructive pulmonary disease admitted to a pulmonary rehabilitation program: A historic cohort study.","authors":"Simone Bernardes,&nbsp;Flávia Moraes Silva,&nbsp;Cassia Cinara da Costa,&nbsp;Rafael Machado de Souza,&nbsp;Paulo José Zimermann Teixeira","doi":"10.1002/jpen.2214","DOIUrl":"https://doi.org/10.1002/jpen.2214","url":null,"abstract":"<p><strong>Background: </strong>Muscle wasting is associated with worse outcomes in chronic obstructive pulmonary disease (COPD) patients. We assessed the association of calf circumference (CC) measurements with clinical outcomes in COPD patients referred to an outpatient pulmonary rehabilitation program (PRP).</p><p><strong>Methods: </strong>In this single-center, retrospective study, we analyzed demographic and clinical data ( spirometry tests, comorbidities, COPD exacerbations, dyspnea scoring, exercise capacity, quality-of-life scores, BMI, CC measurements, and all-cause deaths [for 2 years]) from COPD patients PRP medical records. Patients were grouped according to CC into reduced CC (male, ≤34 cm; female, ≤33 cm) or adequate CC groups.</p><p><strong>Results: </strong>We evaluated 144 patients (aged 64.6 ± 8.5 years; mostly males; forced expiratory volume in 1 s, 40.3% ± 15.8%, predicted). Eighteen patients (12.5%) died during the 2 years of follow-up. Logistic regression showed that patients with reduced CC were more likely to present worse outcomes compared with COPD patients with adequate CC: more advanced disease severity (odds ratio [OR] = 5.09; 95% CI, 2.00-12.96), COPD frequent exacerbators (OR = 2.34; 95% CI, 1.11-4.91), worse total quality-of-life score (OR = 2.70, 95% CI, 1.22-6.00), and higher mortality (OR = 3.69; 95% CI, 1.06-12.87).</p><p><strong>Conclusion: </strong>Reduced CC in COPD patients under initial assessment for PRP admission was associated with disease severity, frequent exacerbation, poor health status, and higher mortality in 2 years of follow-up. Considering its clinical applicability, CC measurement should be introduced in the nutrition assessment of COPD patients admitted to the PRP.</p>","PeriodicalId":520701,"journal":{"name":"JPEN. Journal of parenteral and enteral nutrition","volume":" ","pages":"546-555"},"PeriodicalIF":3.4,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/jpen.2214","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39029141","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":"The impact of donor breast milk on metabolic bone disease, postnatal growth, and neurodevelopmental outcomes at 18 months' corrected age.","authors":"Sadaf H Kazmi,&nbsp;Sarah Berman,&nbsp;Martha Caprio,&nbsp;Elena V Wachtel","doi":"10.1002/jpen.2132","DOIUrl":"https://doi.org/10.1002/jpen.2132","url":null,"abstract":"<p><strong>Background: </strong>Preterm infants are at risk for metabolic bone disease (MBD). Analysis of donor breast milk (DBM) shows lower levels of macronutrients compared with mother's own milk (MOM). The purpose of this study was to investigate the prevalence of MBD, rate of postnatal growth, and long-term neurodevelopmental outcomes in infants fed predominantly MOM vs DBM.</p><p><strong>Methods: </strong>Retrospective observational study of infants born <1500g and <32 weeks at New York University Langone Health or Bellevue Hospital from January 2014 to January 2018. Infants were divided into two groups: those who received >70% of feeds with either MOM or DBM by 34 weeks' corrected age (CA). MBD was assessed using alkaline phosphatase (AlkPO4) levels and radiographic findings. Data was also collected on growth, feeding tolerance, and long-term neurodevelopmental outcomes.</p><p><strong>Results: </strong>A total of 210 infants were included (MOM =156 and DBM =54). The DBM group had higher AlkPO4 levels for the first 3 weeks of life (P < .01). Growth was similar between the groups, and both groups demonstrated catch-up growth after discharge. No difference was seen in feeding intolerance, incidence of necrotizing enterocolitis, or sepsis. The DBM group had lower cognitive (odds ratio [OR], 0.93 [0.88-0.98]; P < .01) and language (OR, 0.95 [0.90-0.99]; P < .01) scores at 18 months' CA.</p><p><strong>Conclusion: </strong>Infants fed predominantly DBM had elevated AlkPO4 levels suggestive of MBD but did not develop osteopenia. Despite appropriate growth and comparable short-term outcomes, infants fed DBM had lower cognitive and language scores at 18 months' CA.</p>","PeriodicalId":520701,"journal":{"name":"JPEN. Journal of parenteral and enteral nutrition","volume":" ","pages":"600-607"},"PeriodicalIF":3.4,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/jpen.2132","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38916832","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":"Elimination of hospital-acquired central line-associated bloodstream infection on a mixed-service pediatric unit.","authors":"Ethan A Mezoff,&nbsp;Erika Roberts,&nbsp;Daniel Ernst,&nbsp;Michelle Gniadek,&nbsp;Wendi Beauseau,&nbsp;Jane Balint,&nbsp;Monica I Ardura,&nbsp;Molly Dienhart","doi":"10.1002/jpen.2195","DOIUrl":"https://doi.org/10.1002/jpen.2195","url":null,"abstract":"<p><strong>Introduction: </strong>Hospital-acquired central line-associated bloodstream infections (CLABSI) are \"never events\" in U.S. healthcare. National efforts to improve CLABSI rates are ongoing. Efforts are important for all patients with a central venous catheter (CVC) and critical to children with intestinal failure (IF) who depend on long-term, daily use of a CVC and undergo extended hospitalizations. We describe outcomes of a multidisciplinary CLABSI elimination effort on a 24-bed medical-surgical unit caring for children with IF.</p><p><strong>Methods: </strong>Unit CLABSI events from 1/9/2012 to 4/16/2020 were evaluated with multiple improvement interventions. We leveraged prospectively maintained clinical registries and National Healthcare Safety Network (NHSN) reporting data to extract patient and unit demographics, ethanol lock utilization, and unit CVC days. Interventions were developed utilizing expert consensus and CDC guidelines with active frontline staff engagement. Descriptive statistics and tests of non-parametric data were employed for analysis.</p><p><strong>Results: </strong>Ninety-five patients with IF and 862 non-IF patients experienced a total of 1,629 admissions with 20,372 CVC days. Twelve hospital-acquired CLABSI events occurred during the study period, including 7 following NHSN definition change on 1/1/2015 (0.56 per 1,000 CVC days). After the last unit CLABSI on 12/5/2016, there were 7,117 CVC days through study conclusion.</p><p><strong>Conclusions: </strong>Described interventions with an enhanced culture of collaborative care profoundly improved hospital-acquired CLABSI occurrence. Success in a specific population translated to all other unit patients with a CVC. Findings suggest elimination is not the result of a single new product or practice, but also includes support and empowerment of those caring for the patient and their CVC.</p>","PeriodicalId":520701,"journal":{"name":"JPEN. Journal of parenteral and enteral nutrition","volume":" ","pages":"608-617"},"PeriodicalIF":3.4,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/jpen.2195","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39006140","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":"Adverse perioperative outcomes among patients undergoing gastrointestinal cancer surgery: Quantifying attributable risk from malnutrition.","authors":"Erin Kenny,&nbsp;Hamed Samavat,&nbsp;Riva Touger-Decker,&nbsp;J Scott Parrott,&nbsp;Laura Byham-Gray,&nbsp;David Allen August","doi":"10.1002/jpen.2200","DOIUrl":"https://doi.org/10.1002/jpen.2200","url":null,"abstract":"<p><strong>Background: </strong>Preoperative malnutrition adversely impacts perioperative outcomes among patients with gastrointestinal (GI) cancer. The attributable risk (AR) that nutrition status contributes towards negative outcomes is poorly understood.</p><p><strong>Methods: </strong>Adults undergoing GI cancer surgeries were identified within the American College of Surgeons National Surgical Quality Improvement Program database (2005-2017). Emergency surgeries, outpatients, and cases with an American Society of Anesthesiologists status above III were excluded. Adjusted multivariable models were constructed to determine the associations between markers of nutrition status (body mass index, >10% weight loss in last 6 months, functional status, and serum albumin level) and adverse perioperative outcomes (presence and number of complications, death, 30-day readmission, and length of stay). Predictive accuracy statistics and population AR (PAR) were determined.</p><p><strong>Results: </strong>The final sample included 78,662 cases. Patients with >10% weight loss 6 months preceding surgery (compared with those who did not), had a significantly increased risk of complications (Relative Risk = 1.28; 95% CI, 1.20-1.37) and odds of death (odds ratio [OR] = 1.37; 95% CI, 1.18-1.59). A totally dependent functional status (compared with independent status) was associated with a 3.3-times higher odds of death (OR = 3.30; 95% CI, 1.53-7.15). Multivariable models were not predictive of adverse outcomes; PAR from the markers ranged 1%-2%.</p><p><strong>Conclusion: </strong>Ten percent weight loss in preceding 6 months was associated with increased risk of adverse perioperative outcomes among adults undergoing GI cancer surgery. The contribution of nutrition status markers to surgical outcomes as assessed by PAR was small (1%-2%), a finding not previously reported. Future intervention studies should include validated nutrition risk markers, control for effects of perioperative variables, and evaluate PAR within the immediate/long-term postoperative periods.</p>","PeriodicalId":520701,"journal":{"name":"JPEN. Journal of parenteral and enteral nutrition","volume":" ","pages":"517-525"},"PeriodicalIF":3.4,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/jpen.2200","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39036518","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 64. Incorrect statistics.","authors":"Ronald L Koretz","doi":"10.1002/jpen.2245","DOIUrl":"https://doi.org/10.1002/jpen.2245","url":null,"abstract":"","PeriodicalId":520701,"journal":{"name":"JPEN. Journal of parenteral and enteral nutrition","volume":" ","pages":"734-736"},"PeriodicalIF":3.4,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/jpen.2245","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39273051","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":"Prospective evaluation of the family's health-related quality of life in pediatric intestinal failure.","authors":"Victoria C Neam,&nbsp;Anna Faino,&nbsp;Michael O'Hara,&nbsp;Danielle Wendel,&nbsp;Simon P Horslen,&nbsp;Patrick J Javid","doi":"10.1002/jpen.2212","DOIUrl":"https://doi.org/10.1002/jpen.2212","url":null,"abstract":"<p><strong>Background: </strong>Due to altered nutrition regimens and complex medical needs, pediatric intestinal failure (IF) may have a powerful impact on health-related quality of life (HRQOL). Studies have shown that children with IF experience lower HRQOL. Data on the HRQOL of families of children with IF are lacking.</p><p><strong>Methods: </strong>We performed a prospective analysis of the HRQOL of families of children with IF in a regional intestinal rehabilitation program from 2011 to 2018. The Pediatric Quality of Life Family Impact Module (FIM) was administered annually to parents. FIM scores were regressed on risk factors using linear mixed-effect models that accounted for repeated surveys within families.</p><p><strong>Results: </strong>A total of 117 families completed 272 surveys. FIM scores increased with patient age across nearly all survey dimensions. Total FIM scores were lower when compared to families of healthy children (median differences = -5, P = .01) and similar to families of chronically ill children. While IF families reported major deficits in the Communication (-11, P < .001) and Worry (-17, P < .001) dimensions, they also reported higher Family Relationship scores (+7, P < .01). On multivariable regression, presence of a major comorbidity and four or more hospital admissions in the prior year were associated with lower family HRQOL (P < .05). Parenteral nutrition dependence was independently associated with lower scores in the Communication (-7, P = .03) and Daily Activities (-10, P = .02) dimensions.</p><p><strong>Conclusion: </strong>Families of children with IF experience a decreased HRQOL that may improve with patient age. Intestinal rehabilitation programs should address the HRQOL of families in addition to patients.</p>","PeriodicalId":520701,"journal":{"name":"JPEN. Journal of parenteral and enteral nutrition","volume":" ","pages":"652-659"},"PeriodicalIF":3.4,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/jpen.2212","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39107828","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":"Characterization of American teduglutide consumers from 2015 to 2020: A large database study.","authors":"Adam Loutfy,&nbsp;Michael Kurin,&nbsp;Raj Shah,&nbsp;Perica Davitkov","doi":"10.1002/jpen.2221","DOIUrl":"https://doi.org/10.1002/jpen.2221","url":null,"abstract":"<p><strong>Introduction: </strong>Teduglutide, a glucagon-like peptide-2 analog, is a novel therapy for intestinal failure that reduces need for parenteral support, especially in patients without a functional terminal ileum or colon. It can also predispose patients to accelerated progression of gastrointestinal (GI) malignancy and fluid overload. We demographically and clinically characterized American patients prescribed teduglutide.</p><p><strong>Methods: </strong>The Explorys database is an aggregate of deidentified patient data from dozens of US healthcare systems. We used SNOMED classification to identify patients prescribed teduglutide from 2015 to 2019. Through the browse cohort feature we determined the demographics, postsurgical anatomy, comorbidities, and indication for teduglutide use among these patients.</p><p><strong>Results: </strong>Of approximately 72 million patients, 170 were prescribed teduglutide. A large majority were female (70.6%). Most common etiologies of short-bowel syndrome were intestinal obstruction (52.9%) and Crohn's disease (41.2%). Common postsurgical anatomy included total colectomy (41.2%) and ileostomy. Common incident symptoms included abdominal pain (41.2%) and nausea (23.5%). Thirty (17.6%) patients were prescribed teduglutide despite comorbid heart failure, and 5.9% despite prior GI malignancy. A total of 11.8% of patients had a history of benign GI neoplasms before starting teduglutide. A total of 5.9% of patients had posttreatment formation of colon polyps.</p><p><strong>Conclusion: </strong>In a large American database, the teduglutide prescription is rare. Only a minority have postsurgical anatomy associated with the most robust response to teduglutide. Serious adverse events appear rare, but a substantial number of patients are at risk for adverse effects because of the presence of comorbid heart failure or GI neoplasm.</p>","PeriodicalId":520701,"journal":{"name":"JPEN. Journal of parenteral and enteral nutrition","volume":" ","pages":"646-651"},"PeriodicalIF":3.4,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/jpen.2221","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39211593","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":"Fluoroscopic placement of nasojejunal feeding tubes in COVID-19 patients in the prone position.","authors":"Hordur Mar Kolbeinsson,&nbsp;James Veldkamp,&nbsp;James D Paauw","doi":"10.1002/jpen.2192","DOIUrl":"https://doi.org/10.1002/jpen.2192","url":null,"abstract":"<p><strong>Background: </strong>Coronavirus disease 2019 (COVID-19) has caused an increase in patients requiring enteral feeding access while undergoing proning for severe acute respiratory distress syndrome (ARDS). We investigated the safety and feasibility of fluoroscopy-guided nasojejunal (NJ) feeding tube placement in the prone position.</p><p><strong>Methods: </strong>This is a retrospective cohort study of all patients who underwent fluoroscopic placement of NJ feeding tubes at a single institution between March 2020 and December 2020. Primary end points were success rate and number of attempts. Chi-squared and Fischer exact tests were used to compare prone and supine groups.</p><p><strong>Results: </strong>A total of 210 patients were included in the study: 53 patients received NJ feeding tubes while prone and 157 while supine. All but one patient in the prone group had ARDS secondary to COVID-19, whereas 47 (30.3%) had COVID-19 in the supine group. The rate of successful placement was 94.3% in the prone group and 100% in the supine group. Mean number of attempts was 1.1 (SD, ±0.4) in the prone and 1.0 (SD, ±0.1) in the supine group (P = .14). Prone patients had a longer median fluoroscopy time (69 s, interquartile range [IQR] = 92; vs 48 s, IQR = 43; P < .001) and received a higher radiation dose during the procedure (47 mGy, IQR = 50; vs 25 mGy, IQR = 33; P = .004). No procedural complications were reported.</p><p><strong>Conclusion: </strong>Fluoroscopy-guided NJ feeding tube placement in prone patients is feasible and safe. Patient positioning should not delay obtaining postpyloric feeding access.</p>","PeriodicalId":520701,"journal":{"name":"JPEN. Journal of parenteral and enteral nutrition","volume":" ","pages":"556-560"},"PeriodicalIF":3.4,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/jpen.2192","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38925202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accuracy of isolated nutrition indicators in diagnosing malnutrition and their prognostic value to predict death in patients with gastric and colorectal cancer: A prospective study.","authors":"Iasmin Matias de Sousa,&nbsp;Flávia Moraes Silva,&nbsp;Ana Lucia Miranda de Carvalho,&nbsp;Ilanna Marques Gomes da Rocha,&nbsp;Ana Paula Trussardi Fayh","doi":"10.1002/jpen.2199","DOIUrl":"https://doi.org/10.1002/jpen.2199","url":null,"abstract":"<p><strong>Background: </strong>The study aims to evaluate the accuracy of isolated nutrition indicators in diagnosing malnutrition in patients with gastric and colorectal cancer and their association with mortality.</p><p><strong>Methods: </strong>Prospective cohort study involving patients with cancer (n = 178) attending a reference center of oncology at any point in the disease trajectory or treatment. Nutrition status was evaluated in a unique moment by body mass index (BMI), Patient-Generated Subjective Global Assessment (PG-SGA), handgrip strength (HGS), and calf circumference (CC). Kappa coefficient, accuracy, sensitivity, specificity, positive and negative predictive values, and area under the receiver operating characteristic curve (AUC) were calculated for each nutrition indicator (PG-SGA as the reference method). The Cox proportional hazards model was used to assess hazard ratio (HR) and CI of mortality.</p><p><strong>Results: </strong>From the total patients, 11% were underweight, 48% were malnourished (PG-SGA B or C), 43% had low HGS, and 55% presented low CC. There were 46 deaths (25.8%). BMI, HGS, and CC showed poor and fair agreements (κ < 0.30 for all ) and poor accuracy (AUC < 0.70 for all) in identifying malnutrition by PG-SGA. After the adjustment for confounders (age, treatment performed, site, and stage of cancer), PG-SGA (HR, 2.9; 95% CI, 1.5-5.9) and low CC (HR, 2.4; 95% CI, 1.1-5.2) were independent predictors of mortality.</p><p><strong>Conclusion: </strong>The nutrition indicators are not accurate in diagnosing malnutrition, whereas PG-SGA and low CC could predict mortality in gastric and colorectal cancer patients. Thus, CC should be combined with PG-SGA in nutrition assessments.</p>","PeriodicalId":520701,"journal":{"name":"JPEN. Journal of parenteral and enteral nutrition","volume":" ","pages":"508-516"},"PeriodicalIF":3.4,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/jpen.2199","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39033139","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":"Impact of early nutrition route in patients receiving extracorporeal membrane oxygenation: A retrospective cohort study.","authors":"Laurent Brisard,&nbsp;Arthur Bailly,&nbsp;Aurélie Le Thuaut,&nbsp;Philippe Bizouarn,&nbsp;Thierry Lepoivre,&nbsp;Johanna Nicolet,&nbsp;Jean-Christian Roussel,&nbsp;Thomas Senage,&nbsp;Bertrand Rozec","doi":"10.1002/jpen.2209","DOIUrl":"https://doi.org/10.1002/jpen.2209","url":null,"abstract":"<p><strong>Background: </strong>Early nutrition management in patients receiving extracorporeal membrane oxygenation (ECMO) remains controversial. Despite its potentially beneficial effect, enteral nutrition (EN) could be associated with gastrointestinal (GI) complications. Total daily energy requirements remain difficult to achieve with ECMO support. Analysis of nutrition practices could improve nutrition management of this particular population.</p><p><strong>Methods: </strong>A monocentric retrospective study of patients requiring ECMO in a cardiac surgery intensive care unit (ICU) between 2010 and 2014 with follow-up ≥6 days. Nutrition support was monitored daily until ECMO weaning. We compared patients exposed (EN group, n = 49) and unexposed (No EN group (NEN), n = 63) with EN, as well as the energy and protein intakes within 4 days after initiation of ECMO. Vital status and nosocomial infections were followed up until ICU discharge. Primary outcome was the incidence of GI intolerance and risk-factor identification. Secondary outcomes included impact of nutrition inadequacy and clinical outcome.</p><p><strong>Results: </strong>A total 112 patients were analyzed, representing 969 nutrition days. Median ratio of energy and protein prescribed/required daily was 81% (58-113) and 56% (36-86), respectively. GI intolerance was experienced by 53% (26 of 49) of patients in the EN group and was only associated with ECMO duration (odds ratio, 1.14: 95% CI, 1.00-1.31; P = .05). Low-energy and protein days were not associated with clinical outcomes such as nosocomial infections.</p><p><strong>Conclusion: </strong>EN is associated with almost 50% GI intolerance without clinical benefit for patients receiving ECMO. Adequacy in energy and protein amounts did not affect clinical outcome.</p>","PeriodicalId":520701,"journal":{"name":"JPEN. Journal of parenteral and enteral nutrition","volume":" ","pages":"526-537"},"PeriodicalIF":3.4,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/jpen.2209","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39103113","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}