Clinical Effects of a Pectin-Containing Oligomeric Formula in Tube Feeding Patients: A Multicenter Randomized Clinical Trial.
CONCLUSIONS: The results of this study suggest that POF is less likely to cause EN-related events, especially diarrhea, than SPF is. PMID: 31606903 [PubMed - as supplied by publisher] (Source: Nutrition in Clinical Practice)
Source: Nutrition in Clinical Practice - October 13, 2019 Category: Nutrition Authors: Maruyama M, Goshi S, Kashima Y, Mizuhara A, Higashiguchi T Tags: Nutr Clin Pract Source Type: research

Effects of Citrulline Supplementation on Body Weight in Patients With Hepatobiliary Pancreatic Surgery.
This study was to evaluate whether an oral citrulline supplement affects body weight changes and laboratory values in patients with hepatobiliary and pancreatic surgery. METHODS: Patients who underwent hepatobiliary and pancreatic surgery during January to June 2015 were screened for analysis. Patients using citrulline during hospital stay and at discharge were classified as the citrulline group, whereas those without any records of citrulline were designated as the control group. The primary efficacy outcome was the change in body weight at discharge and at first outpatient visit. Other outcomes included change in la...
Source: Nutrition in Clinical Practice - October 13, 2019 Category: Nutrition Authors: Yang JA, Lee KE, Park JH, Yee J, Kim JY, Gwak HS Tags: Nutr Clin Pract Source Type: research

Hypercalcemia Without Hypervitaminosis D During Cholecalciferol Supplementation in Critically Ill Patients.
Abstract BACKGROUND: Vitamin D deficiency during critical illness has been associated with worsened outcomes. Because most critically ill patients with severe traumatic injuries are vitamin D deficient, we investigated the efficacy and safety of cholecalciferol therapy for these patients. METHODS: Fifty-three patients (>17 years of age) admitted to the trauma intensive care unit who had a serum 25-hydroxy vitamin D (25-OH vit D) concentration 1.32 mmol/L) or hypervitaminosis D (25-OH vit D>79.9 nmol/L). Patients were monitored for 2 weeks during cholecalciferol therapy. RESULTS: Twen...
Source: Nutrition in Clinical Practice - October 11, 2019 Category: Nutrition Authors: Holmes WL, Maish GO, Minard G, Croce MA, Dickerson RN Tags: Nutr Clin Pract Source Type: research

Nutrition Risk Screening in Intensive Care Units: Agreement Between NUTRIC and NRS 2002 Tools.
CONCLUSION: Despite the ability to identify patients with high nutrition risk, NUTRIC and NRS 2002 performed differently and were not concordant, suggesting that are not equivalent for clinical practice in the ICU. PMID: 31602679 [PubMed - as supplied by publisher] (Source: Nutrition in Clinical Practice)
Source: Nutrition in Clinical Practice - October 10, 2019 Category: Nutrition Authors: Coruja MK, Cobalchini Y, Wentzel C, Fink JDS Tags: Nutr Clin Pract Source Type: research

Pellagra, an Almost-Forgotten Differential Diagnosis of Chronic Diarrhea: More Prevalent Than We Think.
We report that a recently treated patient with the full spectrum of 3D clinical features of pellagra presents as chronic diarrhea of unknown etiology for 1 year. It reminds us that keeping a high index of suspicion and maintaining a broad differential diagnosis are critical for recognition and management of this potentially fatal but treatable condition. PMID: 31599018 [PubMed - as supplied by publisher] (Source: Nutrition in Clinical Practice)
Source: Nutrition in Clinical Practice - October 9, 2019 Category: Nutrition Authors: Cao S, Wang X, Cestodio K Tags: Nutr Clin Pract Source Type: research

Metabolic Support for 40  years at a University Hospital.
Metabolic Support for 40 years at a University Hospital. Nutr Clin Pract. 2019 Oct 08;: Authors: Van Way CW, Raman A, Kohmetscher L, Mackeben N, Gonzalez K PMID: 31595544 [PubMed - as supplied by publisher] (Source: Nutrition in Clinical Practice)
Source: Nutrition in Clinical Practice - October 8, 2019 Category: Nutrition Authors: Van Way CW, Raman A, Kohmetscher L, Mackeben N, Gonzalez K Tags: Nutr Clin Pract Source Type: research

ASPEN Value Project: What the Field Needs to Move Forward.
PMID: 31595556 [PubMed - as supplied by publisher] (Source: Nutrition in Clinical Practice)
Source: Nutrition in Clinical Practice - October 8, 2019 Category: Nutrition Authors: Tyler R, Barrocas A, Guenter P, American Society for Parenteral and Enteral Nutrition (ASPEN) Value Project Scientific Advisory Council Tags: Nutr Clin Pract Source Type: research

Learning Gaps and Family Experience, Nurse-Facilitated Home Parenteral Nutrition Simulation-Based Discharge Training: Proof-of-Concept Study.
CONCLUSION: HPN discharge training is a novel use for high-fidelity simulation to address family/caregiver satisfaction and to identify learning gaps. Further studies are needed to refine predischarge training materials and examine the impact on postdischarge outcomes. PMID: 31589007 [PubMed - as supplied by publisher] (Source: Nutrition in Clinical Practice)
Source: Nutrition in Clinical Practice - October 7, 2019 Category: Nutrition Authors: Raphael BP, Takvorian-Bené M, Gallotto M, Tascione C, McClelland J, Rosa C, Dinan J, O'Connell B, Weinstock P Tags: Nutr Clin Pract Source Type: research

Management of Exocrine Pancreatic Insufficiency in Children.
Abstract The diagnosis of exocrine pancreatic insufficiency (EPI) can be difficult, as symptoms may be nonspecific. A delayed diagnosis of EPI can negatively impact health through poor weight gain, impaired growth, and malabsorption of nutrients. Because of active growth and development, children are more vulnerable to the consequences of untreated EPI. Pancreatic enzyme replacement therapy is the cornerstone of management and offers both symptomatic relief and improvement in clinical outcomes. Additionally, a high-energy diet with unrestricted fat and supplementation with fat-soluble vitamins is often required to...
Source: Nutrition in Clinical Practice - September 21, 2019 Category: Nutrition Authors: Sankararaman S, Schindler T, Sferra TJ Tags: Nutr Clin Pract Source Type: research

Editor's Note.
PMID: 31535733 [PubMed - in process] (Source: Nutrition in Clinical Practice)
Source: Nutrition in Clinical Practice - September 21, 2019 Category: Nutrition Authors: Hurt RT, McClave SA Tags: Nutr Clin Pract Source Type: research

Nutrition Management in Acute Pancreatitis.
Abstract Acute pancreatitis (AP) is one of the most prevalent gastrointestinal conditions necessitating inpatient care. In the United States, over 275,000 patients are hospitalized for management of AP, with an estimate that over $2.5 billion is spent annually in treatment, with incidence continuing to rise. AP is a highly inflammatory and catabolic state, putting all patients with the condition at risk of malnutrition. Numerous approaches to nutrition support in pancreatitis have been evaluated and remain controversial. In this narrative review, we aim to give an overview of indications for nutrition and approach...
Source: Nutrition in Clinical Practice - September 21, 2019 Category: Nutrition Authors: Ramanathan M, Aadam AA Tags: Nutr Clin Pract Source Type: research

Nonalcoholic Fatty Pancreas Disease.
Abstract Nonalcoholic fatty pancreas disease (NAFPD) describes a phenotype of pancreatic steatosis (PS) that is not caused by alcohol consumption, viral infections, toxins, or congenital metabolic syndromes but is associated with insulin resistance, malnutrition, obesity, metabolic syndrome, or increasing age. NAFPD is a relatively new disease entity, as the clinical significance of fatty infiltration of pancreas has gained attention recently. Clinical consequences of NAFPD remain largely unknown despite clinical associations. This review aims to study similarities and differences between hepatic and PS and explor...
Source: Nutrition in Clinical Practice - September 21, 2019 Category: Nutrition Authors: Shah N, Rocha JP, Bhutiani N, Endashaw O Tags: Nutr Clin Pract Source Type: research

Chronic Pancreatitis and Nutrition Therapy.
Abstract Chronic pancreatitis is a complex and irreversible disease of the pancreas and is associated with significant morbidity and mortality. Nutrition deficiencies in chronic pancreatitis are common and can be atypical in nature. As such, the management of these deficiencies can be individualized for patients. The aim of this review is to discuss the components of nutrition deficiencies in chronic pancreatitis, their management, and the current areas of research that are being explored. The clinical guidelines of major national and international societies were analyzed for recommendations on the nutrition manag...
Source: Nutrition in Clinical Practice - September 21, 2019 Category: Nutrition Authors: O'Brien SJ, Omer E Tags: Nutr Clin Pract Source Type: research

Editor's Note.
PMID: 31509894 [PubMed - in process] (Source: Nutrition in Clinical Practice)
Source: Nutrition in Clinical Practice - September 12, 2019 Category: Nutrition Authors: Hasse JM Tags: Nutr Clin Pract Source Type: research

Should the Energy Contribution of Commercial Thickeners Be Considered in the Nutrition Plan of Patients With Dysphagia?
ra JJ Abstract BACKGROUND: Clinical management options for dysphagia include the use of thickeners to increase the consistency of liquids. Health professionals may not be aware of the nutrition value of these products, since there are no such recommendation in clinical guidelines. Our aim was to estimate the added nutrition value of the 2 types of commercial thickeners (starch and xanthan gum) to daily nutrition intake and compare their nutrition value for nectar, honey, and pudding consistencies. Additionally, we compared the nutrition value of both thickeners with a high-energy powder, since they share the same ...
Source: Nutrition in Clinical Practice - September 5, 2019 Category: Nutrition Authors: Miranda D, Breda J, Cardoso R, Gonçalves N, Caldas AC, Ferreira JJ Tags: Nutr Clin Pract Source Type: research

Effect of Oral Versus Intramuscular Vitamin D Replacement on Oxidative Stress and Outcomes in Traumatic Mechanical Ventilated Patients Admitted to Intensive Care Unit.
This study aimed to evaluate the safety and efficacy of 2 forms of vitamin D supplementation on oxidative stress and weaning from the ventilator in patients with traumatic injury and vitamin D deficiency. METHODS: Seventy-two patients were randomly divided into 3 groups: receiving 50,000 IU pearl cholecalciferol daily for 6 days, 1 intramuscular injection of 300,000 IU of cholecalciferol, or a control group that did not receive any supplement. Duration of mechanical ventilation, body composition, and biochemical biomarkers were measured before and after the intervention. RESULT: At the end of the study, th...
Source: Nutrition in Clinical Practice - September 5, 2019 Category: Nutrition Authors: Hasanloei MAV, Rahimlou M, Eivazloo A, Sane S, Ayremlou P, Hashemi R Tags: Nutr Clin Pract Source Type: research

Physicochemical Compatibility of Dexmedetomidine With Parenteral Nutrition.
CONCLUSION: Dexmedetomidine is physicochemically compatible with PN during simulated Y-site administration at the tested infusion rates. PMID: 31482649 [PubMed - as supplied by publisher] (Source: Nutrition in Clinical Practice)
Source: Nutrition in Clinical Practice - September 4, 2019 Category: Nutrition Authors: Campos-Baeta Y, Saavedra-Mitjans M, Garin N, Cardenete J, Cardona D, Riera P Tags: Nutr Clin Pract Source Type: research

Necrotizing Enterocolitis Reduction Using an Exclusive Human-Milk Diet and Probiotic Supplementation in Infants With 1000-1499 Gram Birth Weight.
CONCLUSIONS: Quality-improvement initiatives utilizing an exclusive human-milk diet and daily probiotic supplementation were associated with a decreased incidence of NEC in infants with a birth weight of 1000-1499 g. Implementation of the NEC reduction bundle did not affect infant growth. PMID: 31482674 [PubMed - as supplied by publisher] (Source: Nutrition in Clinical Practice)
Source: Nutrition in Clinical Practice - September 4, 2019 Category: Nutrition Authors: Sato R, Malai S, Razmjouy B Tags: Nutr Clin Pract Source Type: research

Case Report: Transitioning to a Mixed-Oil Intravenous Lipid Emulsion in an Adult Patient Receiving Home Parenteral Nutrition.
Abstract A potential risk of long-term parenteral nutrition (PN) is intestinal failure-associated liver disease (IFALD). One recommendation for mitigating risk is limiting the fat dose to reduce the harmful effects of the ω-6 fatty acids, which are the main ingredient in traditional fats. SMOFlipid (SMOF) (Kabi-Fresenius, Bad Homburg, Germany) is a combination of soybean oil, medium-chain triglycerides, olive oil, and fish oil emulsion. This fat source may alleviate the risk of IFALD and improve liver function tests. A patient with a long history of PN reliance and IFALD is presented in this case report. Aft...
Source: Nutrition in Clinical Practice - September 2, 2019 Category: Nutrition Authors: Bathgate JR, Matarese L, Ziegler J, Touger-Decker R Tags: Nutr Clin Pract Source Type: research

Role of the Nutrition Support Clinician on a Hospital Bioethics Committee.
Abstract Hospital bioethics committees comprise a diverse group of healthcare professionals to deal with ethical issues within the institution that arise during patient care. The nutrition support clinicians (NSCs) have an important role on a bioethics committee because of their knowledge and expertise of different nutrition routes and the benefits vs burdens and risks of these modalities, both enteral and parenteral nutrition. Ethics expertise is built on an understanding of ethical principles, when applied in clinical ethics, using critical thinking to prevent ethical dilemmas and to assist in healthcare decisio...
Source: Nutrition in Clinical Practice - August 28, 2019 Category: Nutrition Authors: Schwartz DB, Pavic-Zabinski K, Tull K Tags: Nutr Clin Pract Source Type: research

Safety and Tolerance of Intraoperative Enteral Nutrition Support in Pediatric Burn Patients.
CONCLUSION: EN has been safely provided with marginal intolerance during surgical procedures over the past 20 years. Continuous nutrition support with negligible interruption is integral to meet nutrient needs for wound healing, preservation of weight and nutrition parameters, and optimize length of stay in pediatric patients with extensive thermal injuries. PMID: 31448446 [PubMed - as supplied by publisher] (Source: Nutrition in Clinical Practice)
Source: Nutrition in Clinical Practice - August 25, 2019 Category: Nutrition Authors: Sunderman CA, Gottschlich MM, Allgeier C, Warden G Tags: Nutr Clin Pract Source Type: research

High-Carbohydrate vs High-Fat Nutrition for Burn Patients.
Abstract Nutrition is an essential component of the healing and recovery process after severe burn injury. For many burn patients, nutrition support is necessary to meet nutrition goals. The ratio of carbohydrates and fat is particularly important for burn patients, as an essential fatty acid deficiency can contribute to poor wound healing. However, there is evidence to suggest that diets containing more carbohydrates and less fat may result in better patient outcomes. A literature search was conducted to identify studies related to nutrition support and macronutrient ratios in burn patients. Eleven published pape...
Source: Nutrition in Clinical Practice - August 22, 2019 Category: Nutrition Authors: Shields BA, VanFosson CA, Pruskowski KA, Gurney JM, Rizzo JA, Cancio LC Tags: Nutr Clin Pract Source Type: research

Feeding During Resuscitation After Burn Injury.
Abstract Burn injury results in a sustained hypermetabolic state with resulting increased caloric and protein requirements to support the stress and immune responses; augmented protein, fat, and carbohydrate catabolism; oxidative stress; and exudative losses. Along with surgical debridement, nutrition and resuscitation are the foundations of patient management after severe burn injury. Recent literature has demonstrated a clear benefit to early enteral nutrition initiation during the resuscitation period. This review aims to examine recent literature discussing both physiologic impact of burn injury and approaches...
Source: Nutrition in Clinical Practice - August 22, 2019 Category: Nutrition Authors: Masch JL, Bhutiani N, Bozeman MC Tags: Nutr Clin Pract Source Type: research

Use of Predictive Equations for Energy Prescription Results in Inaccurate Estimation in Trauma Patients.
CONCLUSION: In critically injured patients, predictive equations for energy needs do not account for dynamic metabolic changes over time and could result in underfeeding or overfeeding. Adjusting daily prescription based on continuous IC may result in better individualized treatment. PMID: 31423668 [PubMed - as supplied by publisher] (Source: Nutrition in Clinical Practice)
Source: Nutrition in Clinical Practice - August 18, 2019 Category: Nutrition Authors: Vasileiou G, Qian S, Iyengar R, Mulder MB, Gass LM, Parks J, Pust GD, Rattan R, Lineen E, Byers P, Yeh DD Tags: Nutr Clin Pract Source Type: research

Energy Expenditure and Protein Requirements Following Burn Injury.
Abstract Severe burn injuries have long been known to have a profound effect on metabolic equilibrium that can persist after resolution of the cutaneous injuries. Following burn injury, metabolism is a dynamic state resulting in the need for frequent interval reassessment over the course of the care continuum. The acute phase of injury transitions to chronic alterations in macronutrient utilization characterized by futile energy cycling and disproportionate catabolism of skeletal muscle. Protein supplementation appears to be preferentially distributed to the burn wound rather than the skeletal muscle pool. Accurat...
Source: Nutrition in Clinical Practice - August 16, 2019 Category: Nutrition Authors: Wise AK, Hromatka KA, Miller KR Tags: Nutr Clin Pract Source Type: research

Validity of the "Rate-a-Plate" Method to Estimate Energy and Protein Intake in Acutely Ill, Hospitalized Patients.
CONCLUSION: The revised version of the "Rate-a-Plate" method is a valid method to monitor energy and protein intake of hospitalized patients and can be filled out by nutrition assistants. A larger validation study is required. PMID: 31407826 [PubMed - as supplied by publisher] (Source: Nutrition in Clinical Practice)
Source: Nutrition in Clinical Practice - August 13, 2019 Category: Nutrition Authors: Dekker IM, Langius JAE, Stelten S, de Vet HCW, Kruizenga HM, de van der Schueren MAE Tags: Nutr Clin Pract Source Type: research

A Systematic Review of Medical Nutrition Therapy Guidelines for Liver Cirrhosis: Do We Agree?
CONCLUSIONS: Several shortcomings and bias were recognized in cirrhosis-related medical nutrition therapy CPGs, indicating the need of improving CPG methodology. PMID: 31407834 [PubMed - as supplied by publisher] (Source: Nutrition in Clinical Practice)
Source: Nutrition in Clinical Practice - August 13, 2019 Category: Nutrition Authors: Theodoridis X, Grammatikopoulou MG, Petalidou A, Kontonika SM, Potamianos SP, Bogdanos DP Tags: Nutr Clin Pract Source Type: research

The Academy of Nutrition and Dietetics/The American Society for Parenteral and Enteral Nutrition Consensus Malnutrition Characteristics: Usability and Association With Outcomes-A Commentary.
PMID: 31407388 [PubMed - as supplied by publisher] (Source: Nutrition in Clinical Practice)
Source: Nutrition in Clinical Practice - August 12, 2019 Category: Nutrition Authors: Jensen GL, Malone A, Guenter P Tags: Nutr Clin Pract Source Type: research

The Role of Vitamin A in Wound Healing.
Abstract Vitamin A is an essential micronutrient that comes in multiple forms, including retinols, retinals, and retinoic acids. Dietary vitamin A is absorbed as retinol from preformed retinoids or as pro-vitamin A carotenoids that are converted into retinol in the enterocyte. These are then delivered to the liver for storage via chylomicrons and later released into the circulation and to its biologically active tissues bound to retinol-binding protein. Vitamin A is a crucial component of many important and diverse biological functions, including reproduction, embryological development, cellular differentiation, g...
Source: Nutrition in Clinical Practice - August 7, 2019 Category: Nutrition Authors: Polcz ME, Barbul A Tags: Nutr Clin Pract Source Type: research

Corrigendum: Pena NF, Mauricio SF, Rodrigues AMS, et  al. Association between standardized phase angle, nutrition status, and clinical outcomes in surgical cancer patients. Nutr Clin Pract. 2019;34(3):381-386.
Corrigendum: Pena NF, Mauricio SF, Rodrigues AMS, et al. Association between standardized phase angle, nutrition status, and clinical outcomes in surgical cancer patients. Nutr Clin Pract. 2019;34(3):381-386. Nutr Clin Pract. 2019 Aug;34(4):643 Authors: PMID: 31306542 [PubMed - in process] (Source: Nutrition in Clinical Practice)
Source: Nutrition in Clinical Practice - July 17, 2019 Category: Nutrition Tags: Nutr Clin Pract Source Type: research

Editor's Note.
PMID: 31306543 [PubMed - in process] (Source: Nutrition in Clinical Practice)
Source: Nutrition in Clinical Practice - July 17, 2019 Category: Nutrition Authors: Hasse JM Tags: Nutr Clin Pract Source Type: research

Screening for Pediatric Malnutrition at Hospital Admission: Which Screening Tool Is Best?
Abstract BACKGROUND: Identifying children at malnutrition risk on admission to hospital is considered best practice; however, nutrition screening in pediatric populations is not common. The aim of this study was to determine which screening tool is able to identify children with malnutrition on admission to hospital. METHODS: A nurse administered 2 pediatric nutrition screening tools, Screening Tool for Risk on Nutritional Status and Growth (STRONGkids) and Pediatric Nutrition Screening Tool (PNST) to patients admitted to medicine and surgery units (n = 165). The Subjective Global Nutritional Assessment (SGNA...
Source: Nutrition in Clinical Practice - July 9, 2019 Category: Nutrition Authors: Carter LE, Shoyele G, Southon S, Farmer A, Persad R, Mazurak VC, BrunetWood MK Tags: Nutr Clin Pract Source Type: research

Parental Perspectives on Blenderized Tube Feeds for Children Requiring Supplemental Nutrition.
CONCLUSION: Families continue to choose BTFs and report a range of benefits, accessing much of their information online. Health professionals should recognize this and openly provide support, guidance, and monitoring as appropriate. PMID: 31282089 [PubMed - as supplied by publisher] (Source: Nutrition in Clinical Practice)
Source: Nutrition in Clinical Practice - July 7, 2019 Category: Nutrition Authors: Trollip A, Lindeback R, Banerjee K Tags: Nutr Clin Pract Source Type: research

Increased Needs for Copper in Parenteral Nutrition for Children in the Neonatal Intensive Care Unit With an Ostomy.
CONCLUSION: Providing 20 μg/kg/day of Cu in PN to neonates with ostomies is insufficient to prevent Cu deficiency. Further studies are warranted to determine an optimal dosage of parenteral Cu to prevent Cu deficiency. PMID: 31270844 [PubMed - as supplied by publisher] (Source: Nutrition in Clinical Practice)
Source: Nutrition in Clinical Practice - July 3, 2019 Category: Nutrition Authors: Adler A, Worley S, Radhakrishnan K Tags: Nutr Clin Pract Source Type: research

Glutamine in Burn Injury.
Abstract Burn injury is the most devastating of survivable injuries and is a worldwide public health crisis. Burn injury is among the most severe metabolic stresses a patient can sustain. A major burn leads to an inflammatory response and catabolism that, when compounded by burn wound nutrient losses, can lead to severe nutrition losses and deficiencies. These losses can impair immune function and wound healing and place burn patients at high risk for organ injury and mortality. Experimental data indicate glutamine (GLN) is well positioned mechanistically, perhaps above and beyond in any other intensive care unit ...
Source: Nutrition in Clinical Practice - July 3, 2019 Category: Nutrition Authors: Wischmeyer PE Tags: Nutr Clin Pract Source Type: research

Individualized Human Milk Fortification to Improve the Growth of Hospitalized Preterm Infants.
Abstract BACKGROUND: Human milk (HM) is the first choice for preterm infants, but exclusive HM feeding is inadequate for the growth of very preterm infants. The hypothesis of this trial is that infants fed according to an individualized fortification regimen will have higher protein intake and improved weight gain velocity (WGV). METHODS: A prospective, randomized, controlled study was conducted. Infants
Source: Nutrition in Clinical Practice - July 3, 2019 Category: Nutrition Authors: Quan M, Wang D, Gou L, Sun Z, Ma J, Zhang L, Wang C, Schibler K, Li Z Tags: Nutr Clin Pract Source Type: research

Achieving Protein Targets in the ICU Using a Specialized High-Protein Enteral Formula: A Quality Improvement Project.
CONCLUSIONS: We demonstrated in a QI study that a high-protein EN formula was tolerated in a small, heterogeneous group of ICU patients and effective in meeting protein targets without overfeeding. PMID: 31240750 [PubMed - as supplied by publisher] (Source: Nutrition in Clinical Practice)
Source: Nutrition in Clinical Practice - June 25, 2019 Category: Nutrition Authors: Hopkins B, Cohen SS, Irvin SR, Alberda C Tags: Nutr Clin Pract Source Type: research

Multifrequency Bioelectrical Impedance Analysis Compared With Computed Tomography for Assessment of Skeletal Muscle Mass in Primary Colorectal Malignancy: A Predictor of Short-Term Outcome After Surgery.
Abstract BACKGROUND: Herein, we evaluate the accuracy and reliability of multifrequency bioelectrical impedance analysis (BIA) to assess skeletal muscle mass (SMM) in the colorectal cancer patient compared with computed tomography (CT) scan and also analyze the association between SMM of BIA and postoperative outcomes. METHODS: From March to May 2017, the body composition of patients scheduled for elective surgery due to primary colorectal cancer in our institution was analyzed at the time of admission using BIA (InBody S20, Biospace Co Ltd, Seoul, South Korea). The relationship between the single cross-secti...
Source: Nutrition in Clinical Practice - June 24, 2019 Category: Nutrition Authors: Kim EY, Kim SR, Won DD, Choi MH, Lee IK Tags: Nutr Clin Pract Source Type: research

Copper Deficiency: Causes, Manifestations, and Treatment.
CONCLUSION: Deficiency is more frequent than previously recognized, probably because of changing nutrition patterns but also because of some treatments that have become very common such as bypass bariatric surgery and, in acute medicine, prolonged continuous renal replacement therapy. The patients may present with severe hematologic and neurologic complications that go untreated because copper deficiency was not considered in the differential diagnosis: These complications often need active intravenous repletion with doses 4-8 times the usual nutrition recommendations. PMID: 31209935 [PubMed - as supplied by publisher...
Source: Nutrition in Clinical Practice - June 17, 2019 Category: Nutrition Authors: Altarelli M, Ben-Hamouda N, Schneider A, Berger MM Tags: Nutr Clin Pract Source Type: research

Energy Balance and Nutrition Status: A Prospective Assessment of Patients Undergoing Liver Transplantation.
Abstract BACKGROUND: Energy balance (EB) and its relation to nutrition status throughout the perioperative period of liver transplantation (LTx) patients has been poorly reported in the literature, and this is the primary objective of the current study. METHODS: A prospective observational study was conducted with patients undergoing LTx, who were assessed before and after the operation. Resting energy expenditure, total energy expenditure (TEE), dietary intake, and EB were evaluated, as well as anthropometry, handgrip strength, and standard phase angle (SPA). The presence of complications after the operation...
Source: Nutrition in Clinical Practice - June 13, 2019 Category: Nutrition Authors: Ribeiro HS, Coury NC, de Vasconcelos Generoso S, Lima AS, Correia MITD Tags: Nutr Clin Pract Source Type: research

High-Dose Vitamin B12 in Vasodilatory Shock: A Narrative Review.
Abstract Vasodilatory shock, as observed in postoperative states and sepsis, is hallmarked by low systemic vascular resistance and low blood pressure compensated by increased cardiac output. Gasotransmitters, such as nitric oxide and hydrogen sulfide, are implicated in the development and perpetuation of vasodilatory shock. Established therapies do not target these physiologic drivers of vasodilation. Due to their nontoxic and pleotropic effects, micronutrients are being used as rescue therapy in postoperative vasoplegia and septic shock. Here, we outline the pathophysiology of vasodilatory shock, describe the rat...
Source: Nutrition in Clinical Practice - June 12, 2019 Category: Nutrition Authors: Patel JJ, Venegas-Borsellino C, Willoughby R, Freed JK Tags: Nutr Clin Pract Source Type: research

Critical Appraisal of Bioelectrical Impedance Utility in Critically Ill Patients.
PMID: 31187546 [PubMed - as supplied by publisher] (Source: Nutrition in Clinical Practice)
Source: Nutrition in Clinical Practice - June 12, 2019 Category: Nutrition Authors: Zamberlan P, de Carvalho WB, Delgado AF Tags: Nutr Clin Pract Source Type: research

Do We Have Clinical Equipoise (or Uncertainty) About How Much Protein to Provide to Critically Ill Patients?
Abstract The current recommendation for protein dose in critically ill patients is 1.2-2.0 g/kg/d. Despite this recommendation, there is significant variation in the amount of protein prescribed and delivered worldwide. We contend clinical equipoise, or a state of genuine uncertainty about 2 (dosing) strategies, exists because guideline-based recommendations for protein dose in critically ill patients are rooted in a weak evidentiary base, leaving the clinician with no good basis for choosing a lower or higher protein dose. We outline evidence for and against high protein dose and introduce a pragmatic, registry-b...
Source: Nutrition in Clinical Practice - June 7, 2019 Category: Nutrition Authors: Patel JJ, Rice T, Compher C, Heyland DK Tags: Nutr Clin Pract Source Type: research

Examining Mid-Upper Arm Circumference Malnutrition z-Score Thresholds.
CONCLUSION: The sensitivity of proposed MUACz thresholds systematically decreases with increasing severity of malnutrition and will require optimization if we aim to limit the number of children at risk of misclassification. Indicators for overnutrition remain to be addressed but are explored herein. PMID: 31175704 [PubMed - as supplied by publisher] (Source: Nutrition in Clinical Practice)
Source: Nutrition in Clinical Practice - June 7, 2019 Category: Nutrition Authors: Stephens K, Orlick M, Beattie S, Snell A, Munsterman K, Oladitan L, Abdel-Rahman S Tags: Nutr Clin Pract Source Type: research

Comment on "Improved Nutrition Status in Patients with Advanced Heart Failure Implanted with a Left Ventricular Assist Device" and Correlation Between Venous Congestion and Nutrition State.
Comment on "Improved Nutrition Status in Patients with Advanced Heart Failure Implanted with a Left Ventricular Assist Device" and Correlation Between Venous Congestion and Nutrition State. Nutr Clin Pract. 2019 Jun 07;: Authors: Saito A, Amiya E, Hatano M PMID: 31172558 [PubMed - as supplied by publisher] (Source: Nutrition in Clinical Practice)
Source: Nutrition in Clinical Practice - June 7, 2019 Category: Nutrition Authors: Saito A, Amiya E, Hatano M Tags: Nutr Clin Pract Source Type: research

Identifying High-Attenuating and Low-Attenuating Muscle Using Computerized Tomography and Exploring Its Impact on Physical Function and Muscle Strength in Obese Critically Ill Patients.
Abstract BACKGROUND: Computed tomography (CT) methods to estimate sarcopenia in obesity do not differentiate high-attenuating from low-attenuating muscle. The primary purpose of this study was to determine agreement between a CT method using general workstation-derived total and high-attenuating psoas muscle cross-sectional area (CSA) and a commercially available segmentation software-derived value. Secondary purpose was to explore the relationship between quantity of high-attenuating muscle to physical functioning in a pilot cohort of obese medical intensive care unit (MICU) patients. METHODS: We conducted a...
Source: Nutrition in Clinical Practice - June 6, 2019 Category: Nutrition Authors: Patel JJ, Baruah D, Sobush D, Koester K, Aase J, Zellner S, Graf J, Durand MJ, Szabo A, Shahir K Tags: Nutr Clin Pract Source Type: research

Folate as an Adjuvant Therapy in Methanol Poisoning.
Abstract Folate and its derivatives have long been used as an adjunctive treatment in methanol poisoning. Methanol is ultimately metabolized to formate, the toxic compound. The accumulation of formate can lead to acidemia, retinal damage, visual impairment, and death. Formate is converted to carbon dioxide and water in a folate-dependent manner, and folate is often given in cases of methanol poisoning. In this paper, the evidence for folate as an adjunctive therapy in methanol poisoning is reviewed. PMID: 31172585 [PubMed - as supplied by publisher] (Source: Nutrition in Clinical Practice)
Source: Nutrition in Clinical Practice - June 6, 2019 Category: Nutrition Authors: Theobald J, Lim C Tags: Nutr Clin Pract Source Type: research

Selenium in Cardiac Surgery.
Abstract Selenium (Se) is an essential trace element that plays a pivotal role in many of the body's regulatory and metabolic functions, especially during times of stress. After uptake, Se is incorporated into several Se-dependent proteins, which have potent anti-inflammatory and antioxidant capacities. Several observational clinical studies have demonstrated that Se deficiency can cause chronic cardiovascular diseases and aggravate organ dysfunction after cardiac surgery and that low levels of Se may be independently associated with the development of organ dysfunction after cardiac surgery. Based on these findin...
Source: Nutrition in Clinical Practice - June 6, 2019 Category: Nutrition Authors: Wendt S, Schomburg L, Manzanares W, Stoppe C Tags: Nutr Clin Pract Source Type: research

Dietitians' Evaluation of Clearing Luminal Occlusions of Gunk (DECLOG): A Pilot Feasibility Study.
The objective of this study was to assess the efficacy of a protocol incorporating prophylactic use of a declogging system with enhanced patient education and monitoring to proactively reduce the incidence of tube occlusions in the home care setting. METHODS: A convenient sample of patients discharged from hospital to home enteral nutrition (HEN) was screened for eligibility and randomized to control group (standard care) or study group (standard care with prophylactic protocol and monitoring). Study patients received 4 enzyme declogging kits before discharge and were instructed to administer them every 7 days for 4 w...
Source: Nutrition in Clinical Practice - June 2, 2019 Category: Nutrition Authors: Escuro AA, Burns B, McLaughlin K, Lopez R, Cresci GA Tags: Nutr Clin Pract Source Type: research

Editor's Note.
PMID: 31087808 [PubMed - in process] (Source: Nutrition in Clinical Practice)
Source: Nutrition in Clinical Practice - May 17, 2019 Category: Nutrition Authors: Hasse JM Tags: Nutr Clin Pract Source Type: research