Jpen Parenter Enter
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Jpen Parenter Enter · Jul 2013
Role of peripherally inserted central catheters in home parenteral nutrition: a 5-year prospective study.
Home parenteral nutrition (HPN) has become a common therapy, with tunneled central venous catheters (CVCs) being preferred for its administration. Peripherally inserted central catheters (PICCs) are not currently recommended for long-term HPN, although evidence to support this statement is scarce. The authors aimed to evaluate the outcomes of HPN, focusing on CVC-related complications. ⋯ PICCs are similar in terms of catheter-related complications to other CVCs for the administration of HPN, especially for oncology patients with HPN lasting <6 months.
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Jpen Parenter Enter · Jul 2013
Transitional NPH insulin therapy for critically ill patients receiving continuous enteral nutrition and intravenous regular human insulin.
The intent of this study was to evaluate the efficacy and safety of transitioning from a continuous intravenous (IV) regular human insulin (RHI) or intermittent IV RHI therapy to subcutaneous neutral protamine Hagedorn (NPH) insulin with intermittent corrective IV RHI for critically ill patients receiving continuous enteral nutrition (EN). ⋯ Transitional NPH therapy with intermittent corrective IV RHI was effective for achieving BG concentrations within 70-149 mg/dL for the majority of the day. NPH therapy should be implemented with caution for those who are older, have erratic daily BG control, or have poor preadmission glycemic control.
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Jpen Parenter Enter · May 2013
Review Meta AnalysisThe effects of probiotics in early enteral nutrition on the outcomes of trauma: a meta-analysis of randomized controlled trials.
The role of probiotics in trauma patients remains unclear. We undertook a meta-analysis of published randomized controlled trials (RCTs) to assess the effects of probiotics on the clinical outcomes of trauma patients. ⋯ The use of probiotics is associated with a reduction in the incidence of nosocomial infections, VAP, and length of ICU stay but is not associated with an overall mortality advantage. However, the results should be interpreted cautiously due to the heterogeneity among study designs. Further large-scale, well-designed RCTs are needed.
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Jpen Parenter Enter · May 2013
The effect of body mass index on the outcome of critically ill surgical patients.
The incidence of obesity is rising, and an increasing number of obese patients are admitted to surgical intensive care units (SICUs). However, it is not clear whether obesity is an independent risk factor for increased morbidity and mortality in SICU patients. We examined the effect of obesity on morbidity and mortality in patients admitted to the SICU in this study. ⋯ Obesity does not affect the mortality of patients admitted to the SICU. We conclude that obesity cannot be used as an independent predictive mortality outcome variable in patients admitted to the SICU.
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Jpen Parenter Enter · May 2013
Observational StudyMalnutrition may worsen the prognosis of critically ill children with hyperglycemia and hypoglycemia.
To determine whether hyperglycemia and hypoglycemia are associated with higher mortality, longer length of intensive care unit (ICU) stay, and fewer ventilator-free days in critically ill children while taking into account the clinical severity and nutrition status. ⋯ Compared with the well nourished, malnourished patients with hyperglycemia are at a greater risk of mortality, independent of clinical severity. Hypoglycemia was shown to be associated with mortality, longer length of ICU stay, and fewer ventilator-free days only in malnourished patients.