JPEN. Journal of parenteral and enteral nutrition最新文献

{"title":"Practice Guideline Recommendations on Perioperative Fasting: A Systematic Review.","authors":"Eva Lambert, Sharon Carey","doi":"10.1177/0148607114567713","DOIUrl":"10.1177/0148607114567713","url":null,"abstract":"<p><strong>Background: </strong>Traditionally, perioperative fasting consisted of being nil by mouth (NBM) from midnight before surgery and fasting postoperatively until recovery of bowel function. These outdated practices persist despite emerging evidence revealing that excessive fasting results in negative outcomes and delayed recovery. Various evidence-based, multimodal, enhanced recovery protocols incorporating minimized perioperative fasting have arisen to improve patient outcomes and streamline recovery, but implementation remains limited. This article aims to review current fasting guidelines, assess their quality, summarize relevant recommendations, and identify gaps in evidence.</p><p><strong>Methods: </strong>A systematic literature search of Medline and CINAHL and a manual search of relevant websites identified guidelines containing suitable grading systems and fasting recommendations. Guideline quality was assessed using the Appraisal of Guidelines Research and Evaluation (AGREE) tool. Grading systems were standardized to the American Society for Parenteral and Enteral Nutrition format and recommendations summarized based on grading and guideline quality.</p><p><strong>Results: </strong>Nineteen guidelines were included. Rigor of development scores ranged from 29%-95%, with only 8 guidelines explicitly declaring the use of systematic methodology. Applicability scores were lowest, averaging 32%. Ten recommendation types were extracted and summarized. Strong and consistent evidence exists for the minimization of perioperative fasting, for a 2-hour preoperative fast after clear fluids, and for early recommencement of oral food and fluid intake postoperatively.</p><p><strong>Conclusions: </strong>This article presents several high-level recommendations ready for immediate implementation, while poorly graded and inconsistent recommendations reveal key areas for future research. Meanwhile, guideline quality requires improvement, especially regarding rigor of development and applicability, through systematic methodology, reporting transparency, and implementation strategies.</p>","PeriodicalId":520701,"journal":{"name":"JPEN. Journal of parenteral and enteral nutrition","volume":" ","pages":"1158-1165"},"PeriodicalIF":0.0,"publicationDate":"2016-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32964253","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 23. GRADEing Guidelines.","authors":"Ronald L Koretz","doi":"10.1177/0148607116662974","DOIUrl":"https://doi.org/10.1177/0148607116662974","url":null,"abstract":"","PeriodicalId":520701,"journal":{"name":"JPEN. Journal of parenteral and enteral nutrition","volume":" ","pages":"1197-1199"},"PeriodicalIF":3.4,"publicationDate":"2016-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/0148607116662974","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39981384","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":"Malassezia Pneumonia: A Rare Complication of Parenteral Nutrition Therapy.","authors":"Richelle M Baker,&nbsp;Ryan J Stegink,&nbsp;John J Manaloor,&nbsp;Bryan H Schmitt,&nbsp;John C Stevens,&nbsp;John C Christenson","doi":"10.1177/0148607115595224","DOIUrl":"https://doi.org/10.1177/0148607115595224","url":null,"abstract":"<p><p>Malassezia species (formerly known as Pityrosporum) are part of normal human skin flora and have been associated with benign dermatologic conditions, such as seborrheic dermatitis and tinea versicolor. In rare cases, however, Malassezia has been associated with systemic disease in immunocompromised patients and infants in the neonatal intensive care unit. Malassezia species require long-chain fatty acids for growth and therefore have a known predilection for individuals receiving lipid containing intravenous parenteral nutrition (PN). Systemic infections are characterized by prolonged fevers and illness but can include nonspecific signs and symptoms. We present the diagnosis and management of a rare case of an immunocompetent, nonneonatal, PN-dependent child with Malassezia furfur pneumonia.</p>","PeriodicalId":520701,"journal":{"name":"JPEN. Journal of parenteral and enteral nutrition","volume":" ","pages":"1194-1196"},"PeriodicalIF":3.4,"publicationDate":"2016-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/0148607115595224","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34264087","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":"Characteristics of a Cohort of Home Parenteral Nutrition Patients at the Time of Enrollment in the Sustain Registry.","authors":"Marion F Winkler,&nbsp;Rose Ann DiMaria-Ghalili,&nbsp;Peggi Guenter,&nbsp;Helaine E Resnick,&nbsp;Lawrence Robinson,&nbsp;Beth Lyman,&nbsp;Carol Ireton-Jones,&nbsp;Lillian Harvey Banchik,&nbsp;Ezra Steiger","doi":"10.1177/0148607115586575","DOIUrl":"https://doi.org/10.1177/0148607115586575","url":null,"abstract":"<p><strong>Background: </strong>Home parenteral nutrition (HPN) is a vital lifesaving therapy for patients who are unable to maintain weight, fluid balance, nutrition, and functional status via oral or enteral nutrition alone. There are few current data sources describing HPN prevalence, patient demographics, or long-term outcomes in the United States.</p><p><strong>Objective: </strong>To describe demographics and baseline characteristics of patients receiving HPN therapy.</p><p><strong>Methods: </strong>This is a descriptive analysis of data from the first cohort of HPN patients at time of enrollment in the Sustain^TM Registry between August 2011 and February 2014.</p><p><strong>Results: </strong>There were 1251 patients enrolled from 29 sites. Eighty-five percent of patients were adults, with a mean age of 51.3 ± 15.3 years. Fifteen percent were pediatric, with a mean age of 4.9 ± 4.9 years. For both age groups, short-bowel syndrome was the most frequently reported HPN indication (24%). Adults most commonly had a peripherally inserted central catheter (47%) or a tunneled catheter (43%) for HPN administration. In contrast, most pediatric patients (72%) had a tunneled catheter. Most patients received parenteral nutrition daily and consumed some oral nutrition. Twenty-eight percent of all patients were expected to require HPN indefinitely.</p><p><strong>Conclusions: </strong>This is the first report of descriptive data from the Sustain Registry. The data reveal important characteristics of patients receiving HPN in 29 U.S. sites.</p>","PeriodicalId":520701,"journal":{"name":"JPEN. Journal of parenteral and enteral nutrition","volume":" ","pages":"1140-1149"},"PeriodicalIF":3.4,"publicationDate":"2016-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/0148607115586575","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33302157","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":"Acute Effects of a Glucagon-Like Peptide 2 Analogue, Teduglutide, on Gastrointestinal Motor Function and Permeability in Adult Patients With Short Bowel Syndrome on Home Parenteral Nutrition.","authors":"Johanna Iturrino,&nbsp;Michael Camilleri,&nbsp;Andres Acosta,&nbsp;Jessica O'Neill,&nbsp;Duane Burton,&nbsp;Jithinraj Edakkanambeth Varayil,&nbsp;Paula J Carlson,&nbsp;Alan R Zinsmeister,&nbsp;Ryan Hurt","doi":"10.1177/0148607115597644","DOIUrl":"https://doi.org/10.1177/0148607115597644","url":null,"abstract":"<p><strong>Background: </strong>Glucagon-like peptide 2 (GLP-2) agonists decrease the need for parenteral nutrition (PN) in short bowel syndrome (SBS); mechanisms evaluated to date have focused on the intestinotrophic effect of GLP-2 agonists such as increased absorptive capacity of the remnant intestine and increased citrulline levels. Other mechanisms may also play a role in effects of GLP-2 agonists.</p><p><strong>Aim: </strong>To measure effects of a GLP-2 agonist, teduglutide (TED), compared with placebo (PLA) on gastric emptying (GE), overall gut transit, fluid balance, intestinal monosaccharide absorption, and permeability in patients with SBS on home PN (HPN).</p><p><strong>Materials and methods: </strong>In 8 adults with SBS on HPN, we compared daily subcutaneous TED (0.05 mg/kg) and PLA (crossover design, each treatment 7 days with a 14-day washout) on gut transit, intestinal absorption, and permeability after oral mannitol (200 mg) and lactulose (1 g), as well as stool weight and urine volume over 8 hours. Analysis used the paired t test.</p><p><strong>Results: </strong>Of 8 patients, 4 were men, with a mean ± SD age of 54 ± 1 years, body mass index of 25 ± 4 kg/m², residual small intestine of 63 ± 12 cm, and 25% ± 15% of residual colon. The overall gut transit (% emptied at 6 hours) was 53.4% ± 15% for TED vs 62.4% ± 15.2% for PLA (P = .075), with no effect on GE (P = .74). TED increased urine mannitol excretion at 0-2 hours (16.2 ± 3.6 mg TED vs 11.3 ± 2.2 mg PLA, P = .20) and 0-8 hours (32.7 ± 5.9 mg PLA vs 48.8 ± 8.9 mg TED, P = .17). There were no differences in urine lactulose excretion or lactulose/mannitol ratio (0.024 ± 0.005 TED vs 0.021 ± 0.005 PLA). Over 8 hours, TED (vs PLA) numerically reduced stool weight (mean ± SEM, 77 ± 18 g TED vs 106 ± 43 g PLA, P = .42) and increased urine volume (408.9 ± 52.2 mL TED vs 365.7 ± 57.3 mL PLA, P = .34).</p><p><strong>Conclusion: </strong>Seven-day TED treatment in 8 participants suggests beneficial effects on fluid balance and monosaccharide absorption, and it retarded overall gut transit with no effects on GE or mucosal permeability. Larger, longer, mechanistic studies of TED in SBS are warranted. This trial was registered at clinicaltrials.gov as NCT02099084.</p>","PeriodicalId":520701,"journal":{"name":"JPEN. Journal of parenteral and enteral nutrition","volume":" ","pages":"1089-1095"},"PeriodicalIF":3.4,"publicationDate":"2016-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/0148607115597644","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34049223","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":"Severe Hypothyroidism From Iodine Deficiency Associated With Parenteral Nutrition.","authors":"Marjorie C Golekoh,&nbsp;Conrad R Cole,&nbsp;Nana-Hawa Yayah Jones","doi":"10.1177/0148607115584002","DOIUrl":"https://doi.org/10.1177/0148607115584002","url":null,"abstract":"<p><p>Parenteral nutrition is crucial for supply of nutrients in children who cannot tolerate a full enteral diet. In the United States, it is not standard of care to give iodine to children dependent on parenteral nutrition, hence iodine is not routinely included in the micronutrient package. Herein, we present a case of a boy with hypothyroidism secondary to iodine deficiency after prolonged exclusive use of parenteral nutrition. Our case highlights the importance of screening for iodine deficiency and administering timely iodine supplementation in these at-risk children to prevent iatrogenic hypothyroidism.</p>","PeriodicalId":520701,"journal":{"name":"JPEN. Journal of parenteral and enteral nutrition","volume":" ","pages":"1191-1193"},"PeriodicalIF":3.4,"publicationDate":"2016-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/0148607115584002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33229492","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":"Gastrojejunostomy Tube Bowel Perforations in Low-Weight Infants.","authors":"Roxanne L Massoumi,&nbsp;Abdelhafeez H Abdelhafeez,&nbsp;Melissa A Christensen,&nbsp;Nghia J Vo,&nbsp;Praveen S Goday,&nbsp;Kathleen M Leack,&nbsp;Lori A Duesing,&nbsp;Amy J Wagner","doi":"10.1177/0148607115575741","DOIUrl":"https://doi.org/10.1177/0148607115575741","url":null,"abstract":"<p><p>This is a case series in which 3 infants with gastrojejunostomy tube (GJT) insertion developed delayed perforation secondary to pressure necrosis. A review of all patients who underwent a GJT placement in 2013 was performed. Three of these patients developed surgically confirmed perforation secondary to pressure necrosis during this time period; no patients developed perforation at the time of GJT insertion. The indications for GJT insertion for all 3 patients were severe gastroesophageal reflux disease; 2 patients also had recurrent aspiration. The patients were between 9 weeks and 10 months of age at the time of GJT insertion. The site of perforation for all 3 cases occurred just distal to the ligament of Treitz between 48 and 72 hours following insertion. Given our 3 cases of perforation in patients weighing <10 kg, there may be a higher risk of perforation in low-weight patients.</p>","PeriodicalId":520701,"journal":{"name":"JPEN. Journal of parenteral and enteral nutrition","volume":" ","pages":"1177-1182"},"PeriodicalIF":3.4,"publicationDate":"2016-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/0148607115575741","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33116238","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":"Clinical Management of Patients With Parenteral Nutrition-Dependent Short Bowel Syndrome During Teduglutide Therapy.","authors":"Charlene Compher,&nbsp;Joseph I Boullata,&nbsp;Octavia Pickett-Blakely,&nbsp;Phyllis Schiavone,&nbsp;Nancy Stoner,&nbsp;Bruce P Kinosian","doi":"10.1177/0148607115594010","DOIUrl":"https://doi.org/10.1177/0148607115594010","url":null,"abstract":"<p><strong>Background: </strong>Patients with intestinal failure, who are dependent on parenteral nutrition (PN) to supplement their limited absorption of dietary nutrients, are subject to complications associated with long-term PN therapy. Medication therapy that results in improved dietary nutrient absorption may enable these patients to reduce or even become independent from PN therapy and its related complications. The glucagon-like peptide 2 (GLP-2) analogue teduglutide was approved for use in such patients by the U.S. Food and Drug Administration in 2012.</p><p><strong>Purpose: </strong>The purpose of this article is to describe the experience of 7 patients with PN-dependent intestinal failure who were treated with teduglutide by a single center that had been involved in the teduglutide clinical trials.</p><p><strong>Results: </strong>Two patients who were treated during the clinical trials and 5 others who were treated since teduglutide came to market in the United States are described. Protocols used to prepare and monitor patients with this drug and PN weaning and adverse event outcomes are presented.</p><p><strong>Conclusions: </strong>While some patients had uncomplicated PN reduction, others experienced various complications. Careful monitoring of patients' clinical course is needed during drug therapy.</p>","PeriodicalId":520701,"journal":{"name":"JPEN. Journal of parenteral and enteral nutrition","volume":" ","pages":"1183-1190"},"PeriodicalIF":3.4,"publicationDate":"2016-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/0148607115594010","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33421230","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":"Glutamine Administration After Sublethal Lower Limb Ischemia Reduces Inflammatory Reaction and Offers Organ Protection in Ischemia/Reperfusion Injury.","authors":"Yao-Ming Shih,&nbsp;Juey-Ming Shih,&nbsp;Man-Hui Pai,&nbsp;Yu-Chen Hou,&nbsp;Chiu-Li Yeh,&nbsp;Sung-Ling Yeh","doi":"10.1177/0148607115587949","DOIUrl":"https://doi.org/10.1177/0148607115587949","url":null,"abstract":"<p><strong>Background: </strong>This study investigated the effects of intravenous glutamine (GLN) administration on the expression of adhesion molecules and inflammatory mediators in a mice model of hind limb ischemia/reperfusion (IR) injury.</p><p><strong>Methods: </strong>There were 3 IR groups and 1 normal control (NC) group. The NC group did not undergo the IR procedure. Mice in the IR groups underwent 90 minutes of limb ischemia followed by a variable period of reperfusion. Ischemia was performed by applying a 4.5-oz orthodontic rubber band to the left thigh. Mice in one IR group were sacrificed immediately after reperfusion. The other 2 IR groups were injected once with either 0.75 g GLN/kg body weight (G group) or an equal volume of saline (S group) via tail vein before reperfusion. Mice in the S and G groups were subdivided and sacrificed at 4 or 24 hours after reperfusion.</p><p><strong>Results: </strong>IR enhanced the inflammatory cytokine gene expressions in muscle. Also, plasma interleukin (IL)-6 levels, blood neutrophil percentage, and the adhesion molecule and chemokine receptors expressed by leukocytes were upregulated after reperfusion. The IR-induced muscle inflammatory mediator gene expressions, blood macrophage percentage, and plasma IL-6 concentration had declined at an early or a late phase of reperfusion when GLN was administered. Histologic findings also found that remote lung injury was attenuated during IR insult.</p><p><strong>Conclusions: </strong>A single dose of GLN administration immediately after sublethal lower limb ischemia reduces the inflammatory reaction locally and systemically; this may offer local and distant organ protection in hind limb IR injury.</p>","PeriodicalId":520701,"journal":{"name":"JPEN. Journal of parenteral and enteral nutrition","volume":" ","pages":"1122-1130"},"PeriodicalIF":3.4,"publicationDate":"2016-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/0148607115587949","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33374018","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":"Teduglutide and Intestinal Permeability in Short Bowel Syndrome.","authors":"Massimo Montalto,&nbsp;Gian Ludovico Rapaccini","doi":"10.1177/0148607116637847","DOIUrl":"https://doi.org/10.1177/0148607116637847","url":null,"abstract":"","PeriodicalId":520701,"journal":{"name":"JPEN. Journal of parenteral and enteral nutrition","volume":" ","pages":"1087"},"PeriodicalIF":3.4,"publicationDate":"2016-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/0148607116637847","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39980978","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}