scholarly journals Impact of Nutrition Support Team on Postoperative Nutritional Status and Outcome of Patients with Congenital Gastrointestinal Anomalies

2020 ◽  
Vol 12 (2) ◽  
pp. 116-122
Author(s):  
Parisa Zarei-shargh ◽  
Emad Yuzbashian ◽  
Atieh Mehdizadeh-Hakkak ◽  
Zahra Khorasanchi ◽  
Abdolreza Norouzy ◽  
...  
Keyword(s):  
Weight Gain ◽  
Enteral Nutrition ◽  
Nutritional Status ◽  
Enteral Feeding ◽  
Neonatal Intensive Care ◽  
Nutrition Support ◽  
Retrospective Clinical Study ◽  
Significant Difference ◽  
Congenital Gastrointestinal Anomalies ◽  
Simple Sampling

BACKGROUND The aim of this study was to evaluate postoperative nutritional status in patients who underwent operations due to congenital gastrointestinal anomalies in surgical neonatal intensive care units (NICUs) and to investigate the role of nutrition support teams (NSTs) on the outcome. METHODS A retrospective clinical study was carried out at two NICUs in Dr. Sheikh Pediatric Hospital, Mashhad, Iran. One of the NICUs was supported by NST and the other was not. A total of 120 patients were included through a non-random simple sampling. Different variables such as age, sex, prematurity, type of anomaly, birth weight, use of vasoactive drugs, weight gain in NICU, length of NICU stay, postoperative enteral nutrition initiation, duration of mechanical ventilation, mortality rate, maximum of blood sugar, the amount of calorie delivered to the calorie requirement ratio, and distribution of energy from enteral or parenteral roots were compared between the patients of two NICUs. RESULTS Median weight gain and the amount of calorie delivered during NICU stay in subjects of NSTsupported NICU was significantly more than other NICU. There was no significant difference in the length of NICU stay, enteral nutrition initiation after the operation, ventilation days, and percent of mortality between the two groups. The percentage of enteral feeding was also increased by about 2.8%, which was not significant. CONCLUSION NST could increase post-operative weight gain and calorie delivery in patients as well as providing an increase in enteral feeding rather than parenteral.

Long-term Enteral Access in Aspiration-prone Patients

1995 ◽  
Vol 10 (4) ◽  
pp. 179-186 ◽  
Author(s):  
Alex C. Cech ◽  
Jon B. Morris ◽  
James L. Mullen ◽  
Gary W. Crooks
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Enteral Nutrition ◽  
Critically Ill ◽  
Enteral Feeding ◽  
Critically Ill Patients ◽  
Nutrition Support ◽  
Enteral Access ◽  
Enteral Nutrition Support

Aspiration pneumonia is a serious complication of enteral feeding. Many critically ill patients are particularly at risk for aspiration. Few studies have rigorously compared various access devices. Risk factors for aspiration and studies examining aspiration associated with enteral feeding devices are reviewed. We recommend a surgical jejunostomy for all patients at high risk for aspiration who require more than 3 weeks of enteral nutrition support.

scholarly journals Nutritional status of preterm neonates at discharge in sanglah hospital

2020 ◽  
Vol 4 (3) ◽  
pp. 10-19
Author(s):  
I Made Samitha Wijaya ◽  
Made Sukmawati ◽  
Putu Junara Putra ◽  
I Made Kardana ◽  
I Wayan Dharma Artana
Keyword(s):  
Weight Gain ◽  
Birth Weight ◽  
Breast Milk ◽  
Low Birth Weight ◽  
Nutritional Status ◽  
Enteral Feeding ◽  
Preterm Neonate ◽  
Descriptive Study ◽  
Preterm Neonates ◽  
Neonatal Ward

The purpose of this study was to determine the nutritional status of preterm neonates when discharged from the hospital. A descriptive study was reviewed from the register of preterm neonate after hospitalization in neonatal ward Sanglah Hospital Denpasar. The number of total samples in this study was 190 patients. Most of the preterm neonates in this study were low birth weight (59.47%). At the beginning of the hospitalization, there were 83.86% preterm neonates with good nutritional status, decreased to 54.73% at discharge from the hospital. The group of neonates that had the highest number of decreases in the good nutritional status at discharge was found in 28-32 weeks gestational age. Most of the samples used breast milk for enteral feeding (68,42%). In preterm neonates with sepsis, only 42.52% neonates discharge with good nutritional status. Low birth weight preterm neonates with kangaroo method care were found increased weight gain in 78.57% neonates. The nutritional status of preterm neonates following hospitalization at Sanglah hospital is still not good. The preterm neonates with good nutritional status were decreased at discharge from the hospital.

Maximizing Nutrition Support Practice and Measuring Adherence to Nutrition Support Guidelines in a Canadian Tertiary Care ICU

2017 ◽  
Vol 33 (3) ◽  
pp. 209-217 ◽  
Author(s):  
Michele E. McCall ◽  
Alice Adamo ◽  
Katherine Latko ◽  
Ashley K. Rieder ◽  
Nicole Durand ◽  
...  
Keyword(s):  
Enteral Nutrition ◽  
Enteral Feeding ◽  
Tertiary Care ◽  
Nutritional Intake ◽  
Nutrition Support ◽  
Mechanically Ventilated ◽  
Tertiary Teaching ◽  
Gastrointestinal Intolerance ◽  
Surgical Icu ◽  
American Society

Objective: New comprehensive guidelines for nutrition support (NS) in the intensive care unit (ICU) can be used to improve quality of care and benchmark current practice. The objective of this study was to (a) compare NS practices in our medical/surgical ICU (MSICU) to 18 recommendations described in the Canadian Clinical Practice Guidelines and Society of Critical Care Medicine/American Society of Parenteral and Enteral Nutrition guidelines, (b) determine the percentage of goal calories and protein delivered, and (c) identify the barriers to successful NS delivery. Design: This was a prospective observation trial of up to 14 days duration. Setting: A 24-bed MSICU in a tertiary teaching hospital in Toronto, Canada. Patients: We studied 98 mechanically ventilated patients with any diagnosis who were expected to require either enteral nutrition (EN) or parenteral nutrition (PN) for >48 hours. Measurements: We measured nutritional intake, barriers to nutritional intake, and parameters that allowed comparison of our practice to 18 guidelines. Main Results: Mean delivery of protein and energy was 79.3% and 81.1% of goal, respectively. The average time to initiation of EN support was 29.5 ± 23.7 hours. The 3 main reasons for interruption to enteral feeding were airway management issues, procedures, and gastrointestinal intolerance. Enteral feeding during vasopressor therapy was well tolerated. Ten of the 18 guidelines were followed for ≥80% of the time. Protein goals for patients on renal replacement therapy and patients with liver disease were not reached. Head-of-bed positioning was also inadequate. The 13 patients requiring PN all had appropriate indications for this therapy, including gastrointestinal leaks, maldigestion, or malabsorption. Conclusions: Nutrition support delivery was successful for most patients in this study. However, only 10 of the 18 guidelines were adequately followed. This study helped identify NS practices that work well and others that require strategies for improvement.

scholarly journals Evaluation of Malnutrition in Children Admitted in Nutritional Rehabilitation Home of Pokhara Academy of Health Sciences- A Retrospective Cross-sectional Hospital Based Study

2020 ◽  
Vol 3 (2) ◽  
pp. 281-287
Author(s):  
Amrita Ghimire Paudel ◽  
Gita Ghimire ◽  
Shreekrishna Shrestha ◽  
Ramchandra Bastola ◽  
Yagyaraj Sigdel ◽  
...  
Keyword(s):  
Weight Gain ◽  
Nutritional Status ◽  
Severe Acute Malnutrition ◽  
Nutritional Intervention ◽  
Health Sciences ◽  
Acute Malnutrition ◽  
Nutritional Rehabilitation ◽  
Management Protocol ◽  
Significant Difference ◽  
Moderate Acute Malnutrition

Introduction: The burden of malnutrition is of significant concern in Nepal. The objectives of this study are to classify the nutritional status in children admitted in nutritional rehabilitation home of Pokhara Academy of Health Sciences and to relate the demographic characteristics and the effectiveness of the nutritional intervention measures on status of malnutrition which can help in the policy formulation to tackle the burden of malnutrition. Materials and Methods: This is a hospital based retrospective study in which total of 238 children with malnutrition admitted in nutritional rehabilitation home of Pokhara Academy of Health Sciences during July 2014 to July 2018 were followed. The socio-demographic factors and nutritional status were analyzed at admission and at discharge using the available record. Data was analyzed using SPSS 16. Results: Out of 238 malnourished children, 167(70.2%) were cases of moderate acute malnutrition and 76(29.8%) were cases of severe acute malnutrition. The mean weight at admission was 7.18±1.73 kg, mean weight at discharge was 7.82±1.82 kg and mean weight increased after nutritional intervention was 0.62 kg±0.40. The average weight gain in severe acute malnutrition was 4.7gm/kg/day. A statistically significant difference was obtained between mean weight (p=0.00, t= - 24.62) of children at admission and discharge. There was significant statistical difference between mean weight gain (p<0.05, t= -3.1) in severe acute malnutrition (0.76±0.49 kg) and in moderate acute malnutrition (0.59±0.34 kg). Conclusion: Nutritional rehabilitation homes are effective in improving the nutritional status of undernourished children, more effective in severe acute malnutrition. However it is important to reassess the management protocol to meet the intake targets so that the rate of weight gain is improved.

Enteral nutrition to improve nutritional status, treatment tolerance, and outcomes in patients with esophageal cancer undergoing concurrent chemoradiotherapy (CCRT): Results of a prospective, randomized, controlled, multicenter trial (NCT 02399306).

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 4033-4033
Author(s):  
Tao Li ◽  
Jiahua Lv ◽  
Guangying Zhu ◽  
Jie Li ◽  
Shu chai Zhu ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Body Weight ◽  
Enteral Nutrition ◽  
Nutritional Status ◽  
Multicenter Trial ◽  
Nutrition Intervention ◽  
Control Group ◽  
Blood Parameter ◽  
Significant Difference ◽  
Treatment Tolerance

4033 Background: Patients with esophageal cancer undergoing CCRT are at high risk of malnutrition. The aim of this study was to investigate the influence of enteral nutrition on nutritional status, treatment tolerance and outcomes in esophageal cancer patients undergoing CCRT. Methods: Patients with inoperable esophageal cancer were randomly assigned (2:1 ratio) to the enteral nutrition group (EN group) or the control group. Patients in the EN group were supported with individual enteral nutrition intervention according to the nutritional status assessment results. The control group was treated with conventional diet guidance. The primary endpoint was the change in body weight from baseline after treatment. Secondary endpoints were nutrition related blood parameter changes, treatment tolerance and outcomes. Results: Between Mar. 2015 and Jan. 2017, 158 patients from ten hospitals were randomised into the EN group (n = 106) and the control group (n = 52). Following CCRT, patients in EN group lost only 0.72±3.27 kg of body weight compared with 2.10±2.89 kg in the control group (P < 0.001). Participants who received EN had less decline than controls in serum albumin (2.66±5.05 g/L and 4.75±4.94 g/L, P < 0.001) and hemoglobin (10.29±15.78 g/L and 18.48±14.66 g/L, P < 0.001). Grade 3/4 leukopenia in the control group was significantly more frequent than the EN group (33.3% vs. 20.0 %, P = 0.011). Patients supported on EN experienced greater chemoradiotherapy completion rates (92.5% vs. 67.3%, P = 0.001) and lower infection rates (18.8% vs 31.7%, P = 0.021). There was significant difference in tumor response between two groups (EN group: 81.1%, control group: 67.3%, P = 0.004). The 1- and 2-year OS rates in the EN group were significantly greater (89.6% and 75.4%, respectively) compared with the control group (78.5% and 57.9%, respectively). Conclusions: Enteral nutrition may be advantageous in patients with esophageal cancer undergoing CCRT by improving nutritional status, treatment tolerance and outcomes. Clinical trial information: NCT 02399306.

scholarly journals Protein-energy adequacy and nutritional evolution of preterm infants in neonatal intensive care unit

2018 ◽  
Vol 31 (2) ◽  
pp. 147-157
Author(s):  
Luciana Carla HOLZBACH ◽  
Renata Andrade de Medeiros MOREIRA ◽  
Renata Junqueira PEREIRA
Keyword(s):  
Nutritional Status ◽  
Preterm Infants ◽  
Neonatal Intensive Care ◽  
Growth Curves ◽  
Nutritional Therapy ◽  
Large For Gestational Age ◽  
National Guidelines ◽  
Significance Level ◽  
Protein Energy ◽  
Significant Difference

ABSTRACT Objective To evaluate the prescription of protein-calorie nutrition and its adequacy to the requirements of preterm newborns. Methods Prospective study with 30 preterm infants from a neonate intensive unit care. Anthropometric and nutritional therapy data were collected daily. Nutritional demands were defined according to the national guidelines. Protein-calorie nutritional support was considered adequate when it reached 70% of the calculated demand. The evolution of nutritional status was evaluated according to the growth curves of preterm infants. Statistical analyses were performed with the Statistical Package for Social Sciences 20.0, at a 5% significance level. Results The means of demand, prescription and infusion significantly differed from each other. The values of calories and proteins prescribed and infused were inadequate according to the calculated ones. There was no significant difference between the volume of prescribed and administered nutrition (p>0.05). At birth, 30% of the children were small, 66.7% were adequate, and 3.3% were large for gestational age. At discharge, the percentages were 33.3%; 63.3%; 3.3%, respectively. The values at birth significantly differed from those at discharge (p<0.01). Conclusion In the Unit of Neonatal Care studied, inadequate nutrient prescription and support is a factor that can compromise the nutritional status of the newborns at hospital discharge.

scholarly journals Comparison of Feeding Behaviors in Term and Preterm Infants at Six Months Corrected Age

2021 ◽  
Vol 20 (2) ◽  
pp. 140-149
Author(s):  
Mohadese Gholamiyan Arefi ◽  
◽  
Nasrin Shahouzaei ◽  
Zahra Esmaeili ◽  
Aliye Abedini ◽  
...  
Keyword(s):  
Weight Gain ◽  
Preterm Infants ◽  
Premature Infants ◽  
Neonatal Intensive Care ◽  
P Value ◽  
Feeding Problems ◽  
Speech And Language ◽  
Feeding Behaviors ◽  
Term Infants ◽  
Significant Difference

Background and Objectives: This study compares feeding behaviors and problems of in term Infants and preterm infants at 6 months corrected age. Subjects and Methods The study was of observational-sectional type (descriptive and analytic) and sampling was one-step cluster probability of the available population in the form of the whole number. Feeding behaviors of 90 infants, including 60 term infants and 30 preterm infants, were assessed by speech and language pathologists through interviews with parents and recorded in a questionnaire. The information in this questionnaire includes feeding behaviors, feeding problems, feeding period, infant weight at 2, 4, 6 months and the age of the child to start complementary feeding, SPSS software version 24 was used to analyze the data. In all the present study, P-value less than 5% was considered as a significant level. Results The results showed that the two groups were significantly different in the mean score of feeding behavior (P= 0.001), feeding problems (P= 0.047) and weight gain (P<0.001). While in feeding duration (P= 0.53) and Frequency of feeding (P= 0.1) there was no significant difference. Of the 90 infants studied, more than 80% of them started feeding in the form of puree in the age group of 4-6 months. Conclusion Premature infants have more feeding problems and less weight gain than normal infants. It is recommended that the speech and language pathologist evaluate and intervene appropriately for oral skills and nutrition of premature infants admitted to the neonatal intensive care unit.

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