Clinical nutrition : official journal of the European Society of Parenteral and Enteral Nutrition
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Randomized Controlled Trial Clinical Trial
The effect of glutamine-supplemented total parenteral nutrition on nitrogen economy depends on severity of diseases in surgical patients.
Gln is an important substrate for enterocyte and rapid proliferation cells. Studies have shown that parenteral supplementation of Gln maintains the intracellular Gln pool, improves nitrogen balance and shortens hospital stay. However, some studies showed Gln-supplemented TPN had no effect on restoring the Gln pool in critically ill patients. ⋯ TPN supplemented with Gln dipeptide had beneficial effect on enhancing the immune response. However, the effect of Ala-Gln administration on improving nitrogen economy was only observed in patients with low APACHE II scores. These results may indicate that Gln required for reversing the catabolic condition may depend on the characteristics and severity of the diseases.
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Randomized Controlled Trial Clinical Trial
The local vascular tolerance to an intravenous infusion of a concentrated glutamine solution in ICU patients.
The beneficial effects of glutamine is well-documented in ICU patients. However, the documentation and control of enteral administration of glutamine is still insufficient. As an adjunct to enteral nutrition, a concentrated dipeptide solution may be given in a central venous line, but administration via a peripheral vein would be preferable. Therefore, we systematically evaluated local vascular tolerance following a concentrated dipeptide infusion in ICU-patients. ⋯ Administration of a glutamine-containing dipeptide concentrate (20%) by peripheral veins is safe in terms of local tolerance, if a strict protocol is adapted for this purpose is used.
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Randomized Controlled Trial Clinical Trial
Should the food intake of patients admitted to acute hospital services be routinely supplemented? A randomized placebo controlled trial.
Many patients admitted to acute hospital services are underweight or harbour vitamin deficiencies. ⋯ No benefit was observed for sipfeed intervention although a small benefit of less than one day is not excluded. Vitamin supplementation may have slight but economically important benefit.
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Randomized Controlled Trial Clinical Trial
Inadequate fluid intakes in dysphagic acute stroke.
To investigate the fluid intakes of patients with dysphagic acute stroke and to evaluate the effect of disability, the ward speciality and the type of fluid given on oral intake. ⋯ Fluid intakes in this patient group are insufficient to achieve requirements. Hospital staff must ensure adequate fluid intakes in patients at risk of dehydration, which should include both an adequate prescription and provision of supplementary fluids. Pre-thickened drinks improve oral fluid intake in patients with dysphagic acute stroke on non-specialist wards.
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Randomized Controlled Trial Clinical Trial
Soluble fiber reduces the incidence of diarrhea in septic patients receiving total enteral nutrition: a prospective, double-blind, randomized, and controlled trial.
Attempts to control enteral nutrition associated diarrhea in the critically ill tube-fed patient by implementing feeding formulas enriched with fiber were mostly unsuccessful. Recently, it was shown that enteral feeding containing soluble partially hydrolyzed guar decreased the incidence of diarrhea in a cohort of non-critically ill medicosurgical patients. We investigated whether this type of enteral feed could also influence stool production in patients with severe sepsis, a population at risk for developing diarrhea. ⋯ Total enteral nutrition supplemented with soluble fiber is beneficial in reducing the incidence of diarrhea in tube-fed full-resuscitated and mechanically ventilated septic patients.