Jpen Parenter Enter
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Jpen Parenter Enter · Aug 2017
Review Meta AnalysisEffect of Perioperative Probiotics and Synbiotics on Postoperative Infections After Gastrointestinal Surgery: A Systematic Review With Meta-Analysis.
Bacterial infection following gastrointestinal surgery remains a common morbidity. The aim of this study was to estimate the effect of the perioperative use of probiotics and synbiotics on postoperative infections. ⋯ Probiotics and synbiotics may prevent postoperative infections in patients undergoing gastrointestinal surgery. However, the results need to be interpreted with caution due to the risk of bias in the included studies and the potential publication bias.
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Jpen Parenter Enter · Nov 2016
ReviewPractice Guideline Recommendations on Perioperative Fasting: A Systematic Review.
Traditionally, perioperative fasting consisted of being nil by mouth (NBM) from midnight before surgery and fasting postoperatively until recovery of bowel function. These outdated practices persist despite emerging evidence revealing that excessive fasting results in negative outcomes and delayed recovery. Various evidence-based, multimodal, enhanced recovery protocols incorporating minimized perioperative fasting have arisen to improve patient outcomes and streamline recovery, but implementation remains limited. This article aims to review current fasting guidelines, assess their quality, summarize relevant recommendations, and identify gaps in evidence. ⋯ This article presents several high-level recommendations ready for immediate implementation, while poorly graded and inconsistent recommendations reveal key areas for future research. Meanwhile, guideline quality requires improvement, especially regarding rigor of development and applicability, through systematic methodology, reporting transparency, and implementation strategies.
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Jpen Parenter Enter · Sep 2015
Review Meta AnalysisModulation of Dietary Lipid Composition During Acute Respiratory Distress Syndrome: Systematic Review and Meta-Analysis.
Pharmaconutrition including omega-3 and competitive analogs of omega-6 fatty acids has been used to modulate the inflammatory response during acute respiratory distress syndrome (ARDS). The clinical benefit of this approach when assessed in prospective randomized clinical trials has been inconsistent. We tried to assess the reasons for the conflicting results, including the possible influence of the composition of the control solution. ⋯ Use of enteral pharmaconutrition in patients with ARDS was associated with decreased mortality only when the comparator solution contained a greater amount of lipid than is currently recommended. Hence, there is insufficient evidence to support the use of enteral pharmaconutrition in ARDS.
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Jpen Parenter Enter · Sep 2015
Review Meta AnalysisModulation of Dietary Lipid Composition During Acute Respiratory Distress Syndrome: Systematic Review and Meta-Analysis.
Pharmaconutrition including omega-3 and competitive analogs of omega-6 fatty acids has been used to modulate the inflammatory response during acute respiratory distress syndrome (ARDS). The clinical benefit of this approach when assessed in prospective randomized clinical trials has been inconsistent. We tried to assess the reasons for the conflicting results, including the possible influence of the composition of the control solution. ⋯ Use of enteral pharmaconutrition in patients with ARDS was associated with decreased mortality only when the comparator solution contained a greater amount of lipid than is currently recommended. Hence, there is insufficient evidence to support the use of enteral pharmaconutrition in ARDS.
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Jpen Parenter Enter · Aug 2015
Review Meta AnalysisImpact of Providing a Combination Lipid Emulsion Compared With a Standard Soybean Oil Lipid Emulsion in Children Receiving Parenteral Nutrition: A Systematic Review and Meta-Analysis.
Soybean oil lipid emulsion may compromise immune function and promote hepatic damage due to its composition of long-chain fatty acids, phytosterols, high proportion of ω-6 fatty acids, and low α-tocopherol levels. Combination lipid emulsions have been developed using medium-chain triglyceride oil, fish oil, and/or olive oil, which provide adequate essential fatty acids, a smaller concentration of ω-6 fatty acids, and lower levels of phytosterols. The purpose of this systematic review is to determine if combination lipid emulsions have a more favorable impact on bilirubin levels, triglyceride levels, and incidence of infection compared with soybean oil lipid emulsions in children receiving parenteral nutrition. ⋯ There is inadequate evidence that combination lipid emulsions offer any benefit regarding bilirubin levels, triglyceride levels, or incidence of infection compared with soybean oil lipid emulsions.