NUTRITION IN CLINICAL PRACTICE

Screening, identification, and diagnosis of malnutrition in hospitalized patients with solid tumors: A retrospective cohort study
Aktas A, Walsh D, Boselli D, Finch L, Wallander ML and Kadakia KC
Malnutrition is common in hospitalized patients with cancer and adversely affects clinical outcomes. We evaluated the prevalence of malnutrition risk, dietitian-identified malnutrition (DIMN), and physician-diagnosed malnutrition (PDMN) at admission.
Quality improvement initiative to achieve early enteral feeds in preterm infants at a level IV neonatal intensive care unit
Prasad U, Johnson K, McGuire S, Haines K, Spizzoucco A and Lainwala S
We report the results of a quality improvement initiative to reduce the time to full enteral feeds and number of central line and parenteral nutrition days in premature infants in a level IV neonatal intensive care unit (NICU) by 20%.
Global Leadership Initiative on Malnutrition criteria: Clinical benefits for patients with gastric cancer
Zheng J, Wang X, Yu J, Hu Q, Zhan Z, Zhou S, Xu J, Li Q, Song C, Wang C, Zhao Q, Xu H, Shi H, Guo Z and
Malnutrition is a prevalent condition among patients with gastric cancer and is associated with poor survival outcomes. This study aimed to evaluate the clinical utility of the Global Leadership Initiative on Malnutrition (GLIM) criteria in predicting survival among patients with gastric cancer. The multicenter retrospective cohort study (INSCOC study) included 1406 patients enrolled between December 2012 and April 2020, with follow-up data collected until June 2023. Various indices for muscle evaluation, such as calf circumference (CC) and body weight-standardized hand grip strength (HGS/W), were used to diagnose malnutrition. Kaplan-Meier curves were used to analyze the relationship between nutrition status, as defined by GLIM criteria, and survival outcomes in these patients. The analysis revealed that using CC or HGS/W as positive indicators of malnutrition effectively identified patients with survival-related malnutrition. The incidence of malnutrition was 54.5%, with patients' median overall survival times of 1169 days for stage I and 575 days for stage II cancer (P < 0.001). Malnutrition was identified as an independent risk factor for survival. Additionally, a nomogram developed through Cox regression analysis demonstrated precise predictive capability, incorporating factors such as tumor node metastasis staging, Karnofsky Performance Status Scale, direct bilirubin levels, and nutrition intervention. The study concludes that the GLIM criteria are effective in diagnosing malnutrition and predicting survival in patients with gastric cancer. Nutrition interventions significantly enhance survival outcomes, underscoring the importance of standardized nutrition treatments in improving patient prognosis.
Parenteral nutrition dependence and growth in pediatric patients with intestinal failure following transition to blenderized tube feedings: A case series
DePaula B, Mitchell PD, Reese E, Gray M and Duggan CP
Human milk and amino acid (AA) formulas are correlated with a shorter duration of parenteral nutrition (PN) dependence for infants with intestinal failure (IF). Literature to guide feeding practices beyond infancy in this population is limited. We aimed to assess PN dependence, growth patterns, and stool frequency in pediatric patients with IF who transitioned from AA or hydrolyzed formula to blenderized tube feedings (BTFs).
Impact of adherence to oral nutritional supplements on nutrition status and muscle strength in patients with gastrointestinal cancer: A prospective observational longitudinal study
Ferreira WA, Martucci RB and Souza NC
Given the lack of evidence regarding the effects of adherence to oral nutritional supplements (ONS) and the types of formulas used in clinical practice, we aimed to assess the impact of adherence to ONS and the high-protein formula on the nutrition status and muscle strength in patients with gastrointestinal cancer.
Pediatric liver transplant for acute liver failure: Defining the standard nutrition and clinical evolution: An observational study
Zamberlan P, Bonfim MAC, Tannuri U, de Carvalho WB and Delgado AF
Pediatric acute liver failure (PALF) is a clinical diagnosis in which previously asymptomatic children exhibit a rapid loss of liver function.
Importance of nutrition adequacy by enteral nutrition in the acute phase of critical illness
Coruja MK, Antunes LDC, Leotti VB and Steemburgo T
Need for Gastroschisis Feeding Protocols
Trivedi A, Jyoti J, James-Nunez K, Spence K, Parkinson B and Thomas G
Nutrition care and overall survival
Arends J
Sarcopenia screening and clinical outcomes in surgical patients: A longitudinal study
Tarnowski MDS, Burgel CF, Dariva AA, Marques IC, Alves LP, Beretta MV, Silva FM and Gottschall CBA
The SARC-CalF was developed as a screening tool for sarcopenia, but little is still known about its validity in surgical patients. Thus, this study aimed to assess the prognostic value of SARC-CalF in predicting clinical outcomes in patients admitted for any elective surgery in a hospital.
Outpatient diabetes management influences glycemic control for critically ill patients during nutrition support: A retrospective observational study
Dickerson RN, McLeod AR, Stonecipher AE, Farrar JE, Byerly S, Filiberto DM and Fischer PE
The purpose of this study was to determine whether successful outpatient management of diabetes, as assessed by hemoglobin A1c (Hgb A1c), influences inpatient glycemic control.
Use of parenteral nutrition in the management of enterocutaneous fistula
Kumpf VJ and Yeh DD
Nutrition plays an integral role in the management of patients with enterocutaneous fistula (ECF), but practice guidelines are often vague because of limited evidence. As a result, clinicians must rely on expert consensus and sound nutrition principles to guide practice. The initial phase of ECF management involves recognition (eg, fistula location and quantifying output) and stabilization (eg, source control and fluid and electrolyte balance). All patients with ECF should be considered at risk of malnutrition because of malabsorption, high gastrointestinal fluid and nutrient losses, and chronic inflammation. Strict bowel rest in conjunction with parenteral nutrition (PN) is typically warranted on initial presentation, but patients can often transition to oral diet or enteral nutrition if ECF output is low (<500 ml/day) and there is good control of ECF drainage at the skin level. Patients with high-output ECF (>500 ml/day) may require PN to meet fluid, electrolyte, and nutrient requirements to support spontaneous or surgical closure of the ECF. Because the healing process can take months, transfer from the inpatient to home setting should be considered when a patient is medically stable. Preparing for discharge home requires stabilization of fluid and electrolyte balance, achievement of glycemic control, containment of ECF output, and patient and/or caregiver training. A long-term PN treatment plan should be developed that incorporates outpatient monitoring, determination of target weight, and desired PN end point. The purpose of this article is to review the optimal use of PN in adult patients with ECF.
A prospective observational study on microbiological isolation in low-profile gastrostomy's feeding extension sets in children on long-term home enteral nutrition
Rodriguez-Manchon S, Sanchez Fernandez-Bravo C, Hernández-Milán B, Cañedo-Villarroya E, Alonso-Sanz M and Pedron-Giner C
Although reuse of enteral feeding equipment has been linked to risk of microbial contamination and risk of infection, there is a paucity of research in this area. Per the manufacturer's instructions low-profile gastrostomy feeding extension sets (LPG-FES) may be reusable for the same patient, but there are no recommendations on replacement intervals.
Associations between malnutrition and dehydration among older adults: A cross-sectional observational study
Heybeli C, Uzun O, Smith L, Veronese N, Rahmati M, Hajek A and Soysal P
There is debate as to the association between dehydration and malnutrition. Thus, this study aimed to investigate the correlation between dehydration and malnutrition and their impact on geriatric syndromes.
Nutrition adequacy and survival
Arends J
The nutrition profile and utility of banana puree as a liquid thickener for medically complex infants with dysphagia
Brinker K, Winn L, Woodbury AE, Finch A, Taggart M, Thomas D, Ermarth A and Chan B
Dysphagia among infants, particularly high-risk and preterm neonates, poses feeding challenges that can impact multiple systemic outcomes and delay hospital discharge. Limited therapeutic options for approved thickening agents for human milk and infant formula necessitate the exploration of alternatives, including banana puree.
Effect of multidisciplinary medical nutrition therapy on the nutrition status of patients receiving peritoneal dialysis: A randomized controlled trial
Liang Y, Xu F, Guo L, Jiang W, Li J and Shu P
Malnutrition is a prevalent complication in patients undergoing peritoneal dialysis (PD). This study established a multidisciplinary team for medical nutrition therapy (MNT) to investigate the impact of this approach on enhancing the nutrition, anemic, and microinflammatory status of patients receiving PD.
Exploring the lived experiences of adults using home enteral nutrition and their caregivers: A meta-aggregation qualitative systematic review
Sandhu R, Elliott T, Hussain W, Engbers J and Kassam R
Home enteral nutrition (HEN) provides nutrition through a tube to individuals at home who cannot meet their needs by mouth. Systematic reviews have explored the experiences of HEN subpopulations, such as those with head and neck cancers. Given HEN services care for adults with various underlying conditions, a synthesis of the experiences of all adults using HEN and their caregivers is warranted. The purpose of this study is to summarize the experiences of HEN adult users and their caregivers regardless of underlying condition. Medline, PsychINFO, EmBase and CINAHL were systematically searched in January 2024. Studies with qualitative results and adult participants and focused on HEN were included. Studies with participants in nursing facilities, results using word counts, or not in English were excluded. Study quality was assessed using the Johanna Briggs Institute (JBI) qualitative checklist. Study design and participants' details were extracted. Themes were collated using the JBI meta-aggregative method. Forty studies (n = 732) were included. Three synthesized findings were identified: positive experiences (very low ConQual score), negative experiences (low ConQual score), and facilitators and coping mechanisms (moderate ConQual score). Although more negative than positive experiences were reported, users and caregivers who developed coping mechanisms or accessed supports viewed HEN as a worthwhile experience. Those with few supports or coping mechanisms did not. Based on this review, it is proposed that before starting HEN, users and caregivers should be made aware of the available supports and coping mechanisms. As negative experiences arise, healthcare providers should help users and caregivers access supports to improve their experiences.
Peripheral parenteral nutrition: A retrospective observational study to evaluate utility and complications
Bidgood E, Huang J, Murphy E, Prentice R, Hede B and Russell D
Peripheral parenteral nutrition (PPN) provides an alternative nutrition support strategy to centrally administered PN for specific patients requiring short-term PN. Previous studies have demonstrated limited use of PPN and variable complication rates. This study aimed to evaluate PPN complications and usage at this center.
Comparing A-mode ultrasound and computed tomography for assessing cancer-related sarcopenia: A cross-sectional study
Sousa IM, Pereira JPDC, Rüegg RAB, Calado GCF, Xavier JG, Bennemann NA, do Nascimento MK and Fayh APT
A-mode ultrasound (US) is a potential method for directly measuring muscle thickness in patients with cancer, but its utility remains underexplored. We aimed to evaluate the feasibility of using A-mode US to assess muscle thickness, compare it with computed tomography (CT)-derived results, and assess its ability to diagnose sarcopenia.
Playing sport as a central-line carrier: a survey to collect the European pediatric intestinal failure centers' view
Pulvirenti R, Duci M, Lambe C, Mutanen A, Arnell H, Tabbers MM, Fascetti-Leon F and
The administration of home parenteral nutrition improves quality of life for patients with intestinal failure, thus fostering their will to actively participate to social activities. Nevertheless, sports participation can be risky for patients with a central venous catheter (CVC). Despite literature thoroughly proving the positive impact of sports on motor-psychosocial development, no consistent evidence assessing its role on central-line complications is available. This study aimed to report the European centers' approach to children with intestinal failure on home parenteral nutrition and interested in playing sports, further assessing complications and how to prevent them.