JPEN. Journal of parenteral and enteral nutrition
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JPEN J Parenter Enteral Nutr · Jul 2021
Cost-Effectiveness of Parenteral Nutrition Containing ω-3 Fatty Acids in Hospitalized Adult Patients From 5 European Countries and the US.
ω-3 Fatty acid (FA)-containing parenteral nutrition (PN) is associated with improvements in patient outcomes and with reductions in hospital length of stay (HLOS) vs standard PN regimens (containing non-ω-3 FA lipid emulsions). We present a cost-effectiveness analysis of ω-3 FA-containing PN vs standard PN in 5 European countries (France, Germany, Italy, Spain, UK) and the US. ⋯ This cost-effectiveness analysis in 6 countries demonstrates that the superior clinical efficacy of ω-3 FA-containing PN translates into significant decreases in mean treatment cost, rendering it an attractive cost-saving alternative to standard PN across different healthcare systems.
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JPEN J Parenter Enteral Nutr · Jul 2021
Observational StudyUse of Nutrition Risk in Critically Ill (NUTRIC) Scoring System for Nutrition Risk Assessment and Prognosis Prediction in Critically Ill Neurological Patients: A Prospective Observational Study.
Critically ill patients who are hospitalized in a neurological intensive care unit (NICU) are largely susceptible to nutrition risk. However, only a limited number of studies have investigated the applicable assessment tool in NICUs. ⋯ The mNUTRIC scoring system is not only a useful tool for nutrition risk assessment but also, and more importantly, it is independently related to the risk of 28-day mortality in NICU patients. Therefore, mNUTRIC scoring is an appropriate tool for nutrition risk assessment and prognosis prediction of NICU patients.
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JPEN J Parenter Enteral Nutr · May 2021
Comparative Complication Rates of 854 Central Venous Access Devices for Home Parenteral Nutrition in Cancer Patients: A Prospective Study of Over 169,000 Catheter-Days.
Whether peripherally inserted central catheters (PICCs) are appropriate as safe and durable venous access devices (VADs) is still controversial. The aim of this 7-year, prospective cohort study was to compare the incidence rate differences of catheter-related complications (CRCs) among 4 types of central VADs in cancer patients receiving home parenteral nutrition (HPN). ⋯ PICCs had significantly better outcomes than tunneled-cuffed CICCs and were safe and durable as ports. Our extensive, long-term study suggests that PICCs can be successfully used as safe and long-lasting VADs for HPN in cancer patients.
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JPEN J Parenter Enteral Nutr · Jan 2021
Case ReportsUse of Continuous Glucose Monitoring to Assess Parenteral Nutrition-Induced Hyperglycemia in an Adult Patient With Severe COVID-19.
Many patients admitted to the intensive care unit (ICU) are acutely malnourished and often require aggressive and early nutrition support with parenteral nutrition (PN). However, PN-induced hyperglycemia is a predictor of hospital mortality and is associated with increased length of stay. Elevated blood glucose in hospitalized patients with coronavirus disease 2019 (COVID-19) is also associated with increased mortality. ⋯ We assessed the use of rtCGM data (Dexcom G6) in a 58-year-old male admitted to the ICU for severe COVID-19 infection, who developed PN-induced hyperglycemia with markedly elevated total daily insulin requirements as high as 128 units. rtCGM was used to safely titrate insulin infusion and monitor glucose levels. No episodes of hypoglycemia were observed, despite an extremely aggressive insulin regimen. This case demonstrates the potential utility of rtCGM in the critical care setting and highlights its potential to help conserve personal protective equipment and minimize unnecessary staff exposure in the setting of COVID-19.
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JPEN J Parenter Enteral Nutr · Jan 2021
Observational StudyEvaluation of Nutrition Risk and Its Association With Mortality Risk in Severely and Critically Ill COVID-19 Patients.
The nutrition status of coronavirus disease 2019 patients is unknown. This study evaluates clinical and nutrition characteristics of severely and critically ill patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and investigates the relationship between nutrition risk and clinical outcomes. ⋯ Most severely and critically ill patients infected with SARS-CoV-2 are at nutrition risk. The patients with higher nutrition risk have worse outcome and require nutrition therapy.