Jpen Parenter Enter
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Jpen Parenter Enter · Sep 2013
Review Meta AnalysisClinical evidence for pharmaconutrition in major elective surgery.
In recent years, standard nutrition preparations have been modified by adding specific nutrients, such as arginine, ω-3 fatty acids, glutamine, and others, which have been shown to upregulate host immune response, modulate inflammatory response, and improve protein synthesis after surgery. Most randomized trials and several meta-analyses have shown that perioperative administration of enteral arginine, ω-3 fatty acids, and nucleotides (immunonutrition) reduced infection rate and length of hospital stay in patients with upper and lower gastrointestinal (GI) cancer. The most pronounced benefits of immunonutrition were found in subgroups of high-risk and malnourished patients. ⋯ Conflicting results on the real benefit of parenteral glutamine supplementation in patients undergoing elective major surgery have been published. In conclusion, enteral diets supplemented with specific nutrients significantly improved short-term outcome in patients with cancer undergoing elective GI surgery. Future research should investigate a molecular signaling pathway and identify specific mechanisms of action of immune-enhancing substrates.
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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 · Mar 2013
Meta AnalysisA meta-analysis of probiotic and synbiotic use in elective surgery: does nutrition modulation of the gut microbiome improve clinical outcome?
Perioperative nutrition modulation of gut microbiota is increasingly used as a strategy for reducing the infective complications of elective surgery. This meta-analysis assessed the effect of probiotic and synbiotic preparations on the incidence of postoperative sepsis. ⋯ Probiotic and synbiotic nutrition strategies reduce the incidence of postoperative sepsis in the elective general surgery setting. These effects appear more pronounced with the use of synbiotics. High-powered, mechanistic studies are now required for the optimization of pro- and prebiotic regimens to further improve their efficacy.
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Jpen Parenter Enter · Jul 2011
Meta Analysis Comparative StudyEarly versus traditional postoperative feeding in patients undergoing resectional gastrointestinal surgery: a meta-analysis.
A meta-analysis evaluating surgical outcomes following nutritional provision provided proximal to the anastomosis within 24 hours of gastrointestinal surgery compared with traditional postoperative management was conducted. ⋯ Early postoperative nutrition is associated with significant reductions in total complications compared with traditional postoperative feeding practices and does not negatively affect outcomes such as mortality, anastomotic dehiscence, resumption of bowel function, or hospital length of stay.
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Jpen Parenter Enter · Sep 2010
Meta AnalysisThe impact of glutamine dipeptide-supplemented parenteral nutrition on outcomes of surgical patients: a meta-analysis of randomized clinical trials.
To evaluate the impact of glutamine dipeptide-supplemented parenteral nutrition (GLN-PN) on clinical outcomes in surgical patients. ⋯ GLN-PN was beneficial to postoperative patients by shortening the length of hospital stay and reducing the morbidity of postoperative infectious complications.