Parenteral Nutrition Research Articles

Segmental Intestinal Reconfiguration (SIR) in Combined Reconstructions for Ultrashort Bowel Syndrome

BackgroundUltrashort bowel syndrome represents the most rare and complex variant of the short bowel syndrome. Autologous intestinal reconstructions for ultrashort bowel syndrome is typically reserved for severe cases characterized by symptomatic dysmotility within the ultrashort dilated segments. Limited surgical techniques are available to substantially increase the length of ultrashort bowels with asymmetric and highly dilated segments.We present a case series detailing the application of a technique for lengthening and tapering significantly dilated ultrashort bowels – segmental intestinal reconfiguration (SIR), based on the Yang-Monti principle. Our analysis delves into the technical features across various anatomical variants and provides mid-term results. MethodsFrom 2021 to 2022, patients experiencing dysmotility in dilated ultrashort bowel segments with a preserved colon underwent sequential combined intestinal reconstructions. Assessments were conducted 18–24 months post-surgery, and statistical calculations employed nonparametric methods to compare pre- and postoperative results. ResultsSix patients, with a median age of 48.5 months, underwent autologous intestinal reconstructions, including SIR. The serial transverse enteroplasty (STEP) was performed on the dilated duodenum in five children, and colon interposition in two. The length of the small bowel exhibited a significant difference before and after surgery (p=0.031). No complications were observed in the postoperative period. The postoperative group demonstrated a lower dependence on parenteral nutrition (NPEI/REE < 80% in 6 (100.0%); p=0.007). Enteral autonomy was restored in two children. ConclusionsThe results of SIR technique in combined reconstructions for ultrashort bowel syndrome in a carefully selected cohort of children demonstrate feasibility and reliability, as well as the restoration of intestinal transport function at midterm evaluation. This comprehensive approach resulted in increased enteral tolerance and reduced parenteral requirements.

Invasive candidiasis in a pediatric tertiary hospital: Epidemiology, antifungal susceptibility, and mortality rates.

Invasive infections caused by non-albicans Candida are increasing worldwide. However, there is still a lack of information on invasive candidiasis (IC) in the pediatric setting, including susceptibility profiles and clonal studies. We investigated the clinical, epidemiologic, and laboratory characteristics of IC, possible changes in antifungal susceptibility profiles over time, and the occurrence of clonality in our tertiary children's hospital. We analyzed 123 non-duplicate Candida isolates from sterile sites of pediatric patients in a tertiary hospital in southern Brazil, between 2016 and 2021. Data on demographics, comorbidities, and clinical outcomes were collected. Candida species distribution, antifungal susceptibility profiles, biofilm production, and molecular epidemiology of isolates were assessed using reference methods. The range of IC incidence was 0.88-1.55 cases/1000 hospitalized patients/year, and the IC-related mortality rate was 20.3%. Of the total IC cases, 42.3% were in patients aged<13 months. Mechanical ventilation, parenteral nutrition, and intensive care unit (ICU) admission were common in this group. In addition, ICU admission was identified as a risk factor for IC-related mortality. The main site of Candida spp. isolation was blood, and non-albicans Candida species were predominant (70.8%). No significant clonal spread was observed among isolates of the three most commonly isolated species, and 99.1% of all isolates were biofilm producers. Non-albicans Candida species were predominant in this study. Notably, clonal expansion and emergence of antifungal drug resistance were not observed in our pediatric setting.

Parenteral nutrition in advanced cancer: Exploring the clinical landscape

Parenteral nutrition in advanced cancer: Exploring the clinical landscape

Impact of Omega-3 fatty acids enriched lipid emulsion on liver function in adult patients on parenteral nutrition: A retrospective study

Impact of Omega-3 fatty acids enriched lipid emulsion on liver function in adult patients on parenteral nutrition: A retrospective study

Which BIVA parameter is of most interest in determining mortality in patients on parenteral nutrition during hospital admission?

Which BIVA parameter is of most interest in determining mortality in patients on parenteral nutrition during hospital admission?

THRIVE-1: A multi-center, cross-sectional, observational study to assess the prevalence of choline deficiency in patients dependent on parenteral nutrition

THRIVE-1: A multi-center, cross-sectional, observational study to assess the prevalence of choline deficiency in patients dependent on parenteral nutrition

Does parenteral nutrition with amino acids in fasting patients with aspiration pneumonia affect acute prognosis?

Does parenteral nutrition with amino acids in fasting patients with aspiration pneumonia affect acute prognosis?

Parenteral nutrition in advanced cancer: a qualitative study on decision-making and information needs of patients and carers

Parenteral nutrition in advanced cancer: a qualitative study on decision-making and information needs of patients and carers

Опыт лечения пораженных при аварии на Чернобыльской АЭС в условиях специализированного стационара

Summary. The purpose of the study is to analyze and summarize the experience of treating those affected by a radiation accident at the Chernobyl nuclear power plant (Chernobyl nuclear power plant) in a specialized hospital. Materials and research methods. The research materials are documented experience in organizing treatment and treating those injured in the Chernobyl accident with acute radiation injury. Research methods – analytical method and method of generalization. The results of the study and their analysis. 129 patients were sent to a specialized hospital in Moscow in the first two days, 84 of which were diagnosed with acute radiation disease (OLB) II-IV Art. severity. As the main diagnostic criteria for the early diagnosis of patients used: the timing and severity of the primary general and local (leather) reaction, the severity of lymphopenia and neutrophilic leukocytosis and other criteria. The main directions of early treatment of the affected were: – prevention and treatment of infectious complications; – detoxification therapy; – correction of water-electrolyte metabolism, parenteral nutrition in connection with common burns, oropharyngeal syndrome, intestinal syndrome, etc.; – pre-transplantation: HLA-typification of patients, the selection of donors, the actual transplantation of bone marrow from the donors of relatives and cells of the embryonic human liver (in the absence of donors) affected with irreversible damage to the bone marrow; – replacing therapy with blood cells. Based on the results of the study, the following conclusions were made: – the complex of medical measures was highly effective; – there were practically no fatal outcomes due only to infection in patients with bone marrow, even severe and extremely severe, form of OLB, not complicated by burns, radial enteritis or acute secondary disease due to bone marrow transplantation; – none of the patients died from hemorrhagic syndrome, most had no signs of bleeding even with deep and prolonged thrombocytopenia (&gt; 2–4 weeks); – the successful treatment of those affected in the Chernobyl accident was prepared by many years of experience in the work of the Clinical Division of Radiation Medicine of the Institute of Biophysics of the USSR Ministry of Health – State Research Center – Burnasyan Federal Medical Biophysical Center of Federal Medical Biological Agency for the treatment of those affected in other radiation accidents.

Percentage of patients using parenteral nutrition who have had a primary bloodstream infection – should this condition alert care teams?

Percentage of patients using parenteral nutrition who have had a primary bloodstream infection – should this condition alert care teams?

Nutritional status and cannula infections in pediatric patients on ventricular assist device support.

Ventricular assist devices (VADs) are used to bridge pediatric patients to heart transplantation. Paracorporeal VADs require the placement of cannulas, which can create an environment for infections. We examined cannula infections in pediatric VAD patients and the role of nutritional status. This retrospective study (2005-2021) included patients <20 years old on VAD support using Berlin Heart EXCOR® cannulas. Cannula infections were defined by a positive culture and need for antibiotic therapy. Malnutrition was defined using the American Society of Parenteral and Enteral Nutrition guidelines as well as the Michigan MTool. There were 76 patients with a median age at implant of 0.9 years (IQR 0.4, 3.6), 50% male, with 73.7% having non-congenital heart disease. More than one-quarter (26.3%) of patients developed a cannula infection. Higher pre-implant weight (OR = 1.93, p = 0.05), creatinine (OR = 1.02, p = 0.044), and pre-albumin (OR = 15.79, p = 0.025), as well as duration of VAD support (OR = 1.01; p = 0.003) were associated with increased odds of developing a cannula infection. There was no difference in the malnutrition parameters between those with and without an infection. Further exploration in a larger cohort is needed to see whether these associations remain and if the incorporation of objective measures of nutritional status at the time of infection are predictive.

Healthy sleep practices for consumers of home total parenteral nutrition: A mixed-methods community-based participatory study

Healthy sleep practices for consumers of home total parenteral nutrition: A mixed-methods community-based participatory study

S1117 Outcomes of Total Parental Nutrition in Inflammatory Bowel Disease: A Nationwide Inpatient Sample

S1117 Outcomes of Total Parental Nutrition in Inflammatory Bowel Disease: A Nationwide Inpatient Sample

S1937 Patterns and Predictors of Outcomes in Total Parenteral Nutrition Associated Liver Disease

S1937 Patterns and Predictors of Outcomes in Total Parenteral Nutrition Associated Liver Disease

The roll of glutamine and zinc additioned to total parenteral nutrition in the outcome of pacients with oral mucositis grade III and IV. Case report.

The roll of glutamine and zinc additioned to total parenteral nutrition in the outcome of pacients with oral mucositis grade III and IV. Case report.

Umbilical Catheter Extravasation Mimicking Necrotizing Enterocolitis in a Preterm Neonate: A Diagnostic Challenge.

Managing acute abdomen in very low birth weight (VLBW) and premature infants presents a diagnostic challenge, often necessitating a thorough assessment to discern underlying causes. Umbilical venous catheters (UVCs), commonly used in neonatal intensive care, are essential but not without risks. A 29-week premature male infant, born to a 23-year-old mother, was referred to our clinic on the 16th day of life with a suspected diagnosis of necrotizing enterocolitis (NEC). The infant had spent the first day intubated and received non-invasive respiratory support for 15 days. A 5 French UVC was inserted at the 2nd hour of life, and by the 3rd day of life, the infant transitioned to minimal enteral feeding. Between the 12th and 16th days of life, the infant initially diagnosed with NEC due to symptoms such as decreased stool passage and abdominal distension. The patient had been on a continuous course of antibiotic treatment throughout the entirety of his life, commencing on the very first day due to suspected early neonatal sepsis, followed by nosocomial sepsis during the hospitalization, and persisting with antibiotic therapy for suspected NEC. The case took a unique turn upon further evaluation after being referred to our unit. Despite a preliminary NEC diagnosis, further evaluation revealed umbilical catheter complications, leading to total parenteral nutrition extravasation. Removal of the catheter, drainage, and antibiotic adjustment resulted in improved clinical outcomes. In neonatal care, cautious management is vital when dealing with infants exhibiting abdominal symptoms. A nuanced approach, including differential diagnosis and careful antibiotic use, is essential.

Virtual reality for central catheter care training in patients on home parenteral nutrition: Description and preliminary data of the usefulness of the tool

Virtual reality for central catheter care training in patients on home parenteral nutrition: Description and preliminary data of the usefulness of the tool

Unveiling catheter related bloodstream infection rates in inpatient parenteral nutrition: A call for action

Unveiling catheter related bloodstream infection rates in inpatient parenteral nutrition: A call for action

Evaluation of parenteral nutrition treatment in hematological oncology patients in terms of appropriateness with ESPEN Guideline and pharmacoeconomics

Evaluation of parenteral nutrition treatment in hematological oncology patients in terms of appropriateness with ESPEN Guideline and pharmacoeconomics

Review of parenteral nutrition prescription in cancer patients in a comprehensive cancer centrE

Review of parenteral nutrition prescription in cancer patients in a comprehensive cancer centrE