scholarly journals Comparison of Biochemical and Pathological Parameters and Parenteral Nutrition of ICU Patients Under Supervision of Dietitians and Surgeons

2021 ◽  
Vol 8 ◽  
Author(s):  
Mojgan Behrad Nasab ◽  
Mohammad Esmail Akbari ◽  
Samira Rastgoo ◽  
Somayeh Gholami ◽  
Azadeh Hajipour ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Parenteral Nutrition ◽  
Gastrointestinal Surgery ◽  
Vitamin B ◽  
Clinical Parameters ◽  
Blood Cell Count ◽  
Icu Patients ◽  
Nutrient Imbalance ◽  
To Receive ◽  
Lower Vitamin

Background: Nutrient imbalance can frequently occur in patients with indications for parenteral nutrition (PN) after gastrointestinal surgery. This study aimed to compare the recommendations of a surgeon to those of a dietitian in the field of parenteral nutrition.Methods: This study was performed on 256 patients undergoing gastrointestinal surgery who received PN, which included 120 patients who received PN based on recommendations of the surgeons and 136 patients who were referred to receive PN under the supervision of a dietitian in Razi Hospital in Rasht, Iran. Data on PN and clinical outcomes of the patients were collected.Results: Patients under the supervision of dietitians received higher vitamin B complex and lipids and lower vitamin A and vitamin E than the surgeon-supervised patients (all P < 0.001). In the group receiving PN under the supervision of a surgeon, the level of blood glucose (207 vs. 182, P < 0.01), sodium (138 vs. 136, P = 0.01), potassium (3.97 vs. 3.53, P < 0.01), and white blood cell count (9.83 vs. 9.28, P < 0.01) increased significantly at the end of the PN compared to baseline. In the group receiving PN under the supervision of a dietician, the level of serum Cr (1.23 vs. 1.32, P = 0.04), Mg (2.07 vs. 1.84, P < 0.01), and pH (7.45 vs. 7.5, P = 0.03) significantly improved after receiving parenteral nutrition compared to baseline.Conclusion: The amounts of nutrients recommended for PN by the surgeon and dietitian were different. Implementation of dietitian recommendations in critically ill patients under PN can improve patients' clinical parameters.

Interpretation of data in patients with enteral and parenteral nutrition

Open Medicine ◽  
2012 ◽  
Vol 7 (6) ◽  
pp. 720-728
Author(s):  
Radka Tomova ◽  
Penka Tzaneva ◽  
Marian Nikolov ◽  
Vasil Simeonov
Keyword(s):  
Statistical Analysis ◽  
Parenteral Nutrition ◽  
Clinical Data ◽  
Multivariate Statistical Analysis ◽  
Clinical Status ◽  
Gastrointestinal Surgery ◽  
Metabolic Stress ◽  
Clinical Parameters ◽  
Multivariate Statistical ◽  
Enteral And Parenteral Nutrition

AbstractMultivariate statistical analysis is performed using clinical data characterizing the state of patients subject to early enteral (EEN) and pareneteral (PN) nutrition after major gastrointestinal surgery. Several patterns of linkage, between the clinical parameters for both groups of observed patients (with mixed (EEN+PN) and with parenteral nutrition only (TPN)), were found and interpreted. Discriminating indices for the internal grouping of patients were found related to the type of nutrition and the clinical status of the patients. It was found that the mixed (enteral and parenteral) nutrition offers better options for the overcoming of the metabolic stress after the surgery.

Presenting White Blood Cell Count and Kinetics of Molecular Remission Predict Prognosis in Acute Promyelocytic Leukemia Treated With All-Trans Retinoic Acid: Result of the Randomized MRC Trial

Blood ◽  
1999 ◽  
Vol 93 (12) ◽  
pp. 4131-4143 ◽  
Author(s):  
Alan K. Burnett ◽  
David Grimwade ◽  
Ellen Solomon ◽  
Keith Wheatley ◽  
Anthony H. Goldstone
Keyword(s):  
Retinoic Acid ◽  
Promyelocytic Leukemia ◽  
Rt Pcr ◽  
Blood Cell Count ◽  
Relapse Risk ◽  
Trans Retinoic Acid ◽  
All Trans Retinoic Acid ◽  
To Receive ◽  
Risk Of Relapse

Abstract All-trans retinoic acid (ATRA) is an essential component of the treatment of acute promyelocytic leukemia (APL), but the optimal timing and duration remain to be determined. Molecular characterization of this disease can refine the diagnosis and could be potentially useful in monitoring response to treatment. Patients defined morphologically to have APL were randomized to receive a 5-day course of ATRA before commencing chemotherapy or to receive daily ATRA commencing with chemotherapy and continuing until complete remission (CR). The chemotherapy was that used in current MRC Leukaemia Trials. Outcome comparisons were by intention to treat with additional analysis for relevant risk factors. Patients were characterized by molecular techniques for the fusion products of the t(15;17) and monitored by reverse transcriptase-polymerase chain reaction (RT-PCR) during and after treatment. Two hundred thirty-nine patients were randomized. Treatment with extended ATRA resulted in a superior remission rate (87% v 70%, P < .001), due to fewer early and induction deaths (12% v 23%, P = .02), and less resistant disease (2% v 7%, P = .03), which was associated with a significantly more rapid recovery of neutrophils and platelets. Extended ATRA reduced relapse risk (20%v 36% at 4 years, P = .04) and resulted in superior survival (71% v 52% at 4 years, P = .005). Presenting white blood cell count (WBC) was a key determinant of outcome. The 70% of patients who presented with a WBC less than 10 × 109/L had a better CR (85% v62%, P = .0001) and reduced relapse risk (22% v42%, P = .002) and superior survival (69%v 43%, P < .0001). Within the low count group, extended ATRA resulted in a better CR (94% v 76%, P= .001), reduced relapse risk (13% v 35%, P = .04), and improved survival (80% v 57%, P = .0009). There was no evidence of benefit in patients presenting with a higher WBC (>10 × 109/L). Molecular monitoring after the third chemotherapy course had a correlation with risk of relapse. The relapse risk was 57% if the RT-PCR was positive versus 27% if the RT-PCR was negative (P = .006). APL patients who present with a low WBC derive substantial benefit from combining ATRA with induction chemotherapy until remission is achieved, whereas patients with a higher WBC did not benefit. Molecular characterization of disease can improve diagnostic precision and a positive RT-PCR after consolidation identifies patients at a higher risk of relapse.

scholarly journals Risk Scoring System of Mortality and Prediction Model of Hospital Stay for Critically Ill Patients Receiving Parenteral Nutrition

Healthcare ◽  
2021 ◽  
Vol 9 (7) ◽  
pp. 853
Author(s):  
Jee-Yun Kim ◽  
Jeong Yee ◽  
Tae-Im Park ◽  
So-Youn Shin ◽  
Man-Ho Ha ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Linear Regression ◽  
Parenteral Nutrition ◽  
Prediction Model ◽  
Scoring System ◽  
Prediction Equation ◽  
Icu Patients ◽  
Risk Scoring ◽  
Risk Scoring System

Predicting the clinical progression of intensive care unit (ICU) patients is crucial for survival and prognosis. Therefore, this retrospective study aimed to develop the risk scoring system of mortality and the prediction model of ICU length of stay (LOS) among patients admitted to the ICU. Data from ICU patients aged at least 18 years who received parenteral nutrition support for ≥50% of the daily calorie requirement from February 2014 to January 2018 were collected. In-hospital mortality and log-transformed LOS were analyzed by logistic regression and linear regression, respectively. For calculating risk scores, each coefficient was obtained based on regression model. Of 445 patients, 97 patients died in the ICU; the observed mortality rate was 21.8%. Using logistic regression analysis, APACHE II score (15–29: 1 point, 30 or higher: 2 points), qSOFA score ≥ 2 (2 points), serum albumin level < 3.4 g/dL (1 point), and infectious or respiratory disease (1 point) were incorporated into risk scoring system for mortality; patients with 0, 1, 2–4, and 5–6 points had approximately 10%, 20%, 40%, and 65% risk of death. For LOS, linear regression analysis showed the following prediction equation: log(LOS) = 0.01 × (APACHE II) + 0.04 × (total bilirubin) − 0.09 × (admission diagnosis of gastrointestinal disease or injury, poisoning, or other external cause) + 0.970. Our study provides the mortality risk score and LOS prediction equation. It could help clinicians to identify those at risk and optimize ICU management.

scholarly journals Total parenteral nutrition-induced Wernicke’s encephalopathy after oncologic gastrointestinal surgery

Open Medicine ◽  
2020 ◽  
Vol 15 (1) ◽  
pp. 709-713
Author(s):  
Piergiorgio Fedeli ◽  
Richard Justin Davies ◽  
Roberto Cirocchi ◽  
Georgi Popivanov ◽  
Paolo Bruzzone ◽  
...  
Keyword(s):  
Parenteral Nutrition ◽  
Total Parenteral Nutrition ◽  
Gastrointestinal Surgery ◽  
Vitamin B1 ◽  
Wernicke’S Encephalopathy ◽  
Wernicke's Encephalopathy ◽  
Vitamin Intake ◽  
Unbalanced Diet ◽  
Prolonged Hospital ◽  
Care Costs

AbstractCarl Wernicke described the disease bearing his name in 1881 and reported three cases characterized by the presence of mental confusion, ataxia, and ophthalmoplegia. Wernicke’s disease is mainly observed in alcoholic patients, due to decreased vitamin intake as a consequence of an unbalanced diet, and a reduction of absorption due to the effects of alcohol. Likewise, inadequate vitamin intake is prevalent in older patients. Wernicke’s encephalopathy due to inappropriate total parenteral nutrition (TPN) occurs infrequently; recently, there is an increase in the literature concerning Wernicke’s encephalopathy in patients after general and bariatric surgeries. We present two cases of Wernicke’s encephalopathy after oncologic gastrointestinal surgery by failure to administer vitamin B1 during TPN; to our knowledge, these are the first two cases of Wernicke’s encephalopathy after colorectal surgery for cancer. In our opinion, timely diagnosis and treatment are mandatory to avoid nonfunctional recovery and consequent malpractice legal actions as well as an increase in the health-care costs correlated with the prolonged hospital stay and with the nonfunctional recovery.

Perioperative Use of Total Parenteral Nutrition: Variations in Guidelines and Practice in Three Norwegian Hospitals

1995 ◽  
Vol 11 (4) ◽  
pp. 741-749 ◽  
Author(s):  
Marianne Mjaaland ◽  
Arthur Revhaug ◽  
Olav Helge Førde
Keyword(s):  
Retrospective Study ◽  
Parenteral Nutrition ◽  
Total Parenteral Nutrition ◽  
Gastrointestinal Surgery ◽  
Patient Characteristics ◽  
Substantial Part ◽  
Cross Sectional

AbstractIn a cross-sectional, retrospective study of 604 cases, variations among three Norwegian hospitals in use of perioperative parenteral nutrition (TPN) after gastrointestinal surgery was determined. Postoperative TPN rates were 25%, 34% (p =.05) and 56% (p <.0001). respectively. However, a substantial part of the variation was explained by differences in patient characteristics.

Comparison of supplemental cobalt form on fibre digestion and cobalamin concentrations in cattle

2017 ◽  
Vol 155 (5) ◽  
pp. 832-838 ◽  
Author(s):  
R. C. WATERMAN ◽  
W. L. KELLY ◽  
C. K. LARSON ◽  
M. K. PETERSEN
Keyword(s):  
Crude Protein ◽  
Dry Matter ◽  
National Research Council ◽  
Residual Effect ◽  
Vitamin B ◽  
Serum Concentrations ◽  
Forage Digestibility ◽  
Randomized Experimental Design ◽  
To Receive

SUMMARYCobalt (Co) is essential for rumen microbial metabolism to synthesize methane, acetate and methionine. It also serves as a structural component of vitamin B12(cobalamin), which functions as a coenzyme in energy metabolism. A study was conducted to determine if Co form (carbonatev. glucoheptonate) supplemented above the National Research Council requirements would improve digestibility of a low-quality forage diet and change serum cobalamin concentrations. Nineteen ruminally cannulated cows (577 ± 13 kg) were fed individually in a completely randomized experimental design. Cows were fed a grass hay diet that contained (79·2 g/kg crude protein, 565 g/kg total digestible nutrients, 633·2 g/kg neutral detergent fibre (NDF), 874·2 g/kg dry matter) at a rate of 0·02% of body weight on a as fed basis for a 62-day study, which consisted of three periods; acclimation (AC), treatment (TR) and residual (RE). Measurements taken in the AC period were used as covariates for analysis in the TR and RE periods. Cows were stratified by age (5 ± 0·4 years) and lactational history, and assigned to receive 12·5 mg supplemental Co in one of two forms: (1) 27·2 mg of Co carbonate (CC,n= 11 cows) or (2) 50 mg of Co glucoheptonate (CGH,n= 8 cows). Supplement was administered daily via a gelatin capsule placed directly into the rumen 2 h after feeding. During the last 96 h of each period, forage digestibility was measured using anin situnylon bag technique. Blood samples were collected 4 and 6 h following feeding, and 24 h before the end of each period. A treatment × period interaction was detected forin situorganic matter (OM) disappearance at 96 h; (TR period: 684 and 708 ± 81 g/kg; RE period: 676 and 668 ± 75 g/kg, for CC and CGH, respectively). Once inclusion of Co in the CGH group was removed, OM disappearance was reduced by 4·01% compared with 0·82% in the CC cows. The NDF disappearance (OM basis) was less for the TR compared with the RE at 48 h (629 and 652 ± 39 g/kg, respectively). However, by 96 h NDF disappearance was greater for TR than the RE (704 and 689 ± 44 g/kg; respectively). No differences were detected for cobalamin serum concentrations or rate of fibre fermentation. The outcomes of the current research signify that there may be a slight residual effect of Co supplementation on fermentation; there was also an indication that Co source may enhance the overall extent of fermentation.

Sign in / Sign up

Export Citation Format

Share Document