Clinical nutrition : official journal of the European Society of Parenteral and Enteral Nutrition
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Recent studies have demonstrated mixed results on the effects of soy intake in patients with CKD, and this have not been systematically analyzed. We conducted this meta-analysis to identify and evaluate the effects of soy protein intake in patients with CKD. ⋯ Soy protein containing isoflavones intake significantly decreased serum creatinine, serum phosphorus, CRP and proteinura in predialysis patients, while no significant change was found in creatinine clearance and glomerular filtration rate. We also found that soy protein intake could maintain the nutritional status in dialysis patients, though no significant change in CRP, BUN, and serum phosphorus was detected. Future large, long-term RCTs are still needed to clarify the effects of soy protein intake in patients with CKD.
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Accurate assessment of resting energy expenditure (REE) and metabolic state is essential to optimize nutrient intake in critically ill patients. We aimed to examine the accuracy of a simplified equation for predicting REE using carbon dioxide elimination (VCO2) values. ⋯ A simplified metabolic equation using VCO2 values was superior to the standard equation in estimating REE, and provided a reasonably accurate metabolic classification in mechanically ventilated children. In the absence of indirect calorimetry, bedside VCO2 monitoring could provide valuable continuous metabolic information to guide optimal nutrient intake.
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Indirect calorimetry (IC) is the gold standard to measure energy expenditure (EE) in hospitalized patients. The popular 30 year-old Deltatrac II(®) (Datex) IC is no more commercialized, but other manufacturers have developed new devices. This study aims at comparing for the first time simultaneously, two new IC, the CCM express(®) (Medgraphics) and the Quark RMR(®) (Cosmed) with the Deltatrac II(®) to assess their potential use in intensive care unit (ICU) patients. ⋯ Quark RMR(®) compares better with Deltatrac II(®) than CCM express(®), but it suffers an EE variance of 441 kcal, which is not acceptable for clinical practice. New indirect IC should be further improved before recommending their clinical use in ICU.
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Multicenter Study
The Geriatric Nutritional Risk Index predicts hospital length of stay and in-hospital weight loss in elderly patients.
Nutritional derangements are common in elderly patients, but how nutritional risk affects outcome in this subset of hospital inpatients deserves further investigation. We evaluated the impact of nutritional risk on length of stay (LOS) and in-hospital weight loss (WL) in elderly patients (>65 yrs). ⋯ Nutritional risk assessed by the GNRI on admission, predicts LOS and in-hospital WL in elderly patients.
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Early enteral feeding following surgery can be given orally, via a jejunostomy or via a nasojejunal tube. However, the best feeding route following esophagectomy is unclear. ⋯ International prospective register of systematic reviews, CRD42013004032.