AIMS AND OBJECTIVES: This study sought to assess the impact of a standardized protocol to maintain nasoenteral tube (NET) patency in patients requiring fluid restriction and identify factors associated with tube patency. BACKGROUND: Nasoenteral tube obstruction may interrupt nutritional support and prohibit drug administration. Balancing NET patency in the context of fluid restriction can be a challenge. DESIGN AND METHODS: The impact of the standardized protocol was assessed by using a quasi-experimental design and an historical control.
We found eight randomized controlled trials (RCTs) of miscellaneous interventions that were designed to facilitate the process of weaning from mechanical ventilation. The two RCTs of high-fat/low-carbohydrate enteral nutrition found favorable physiologic effects on CO2 production and respiratory quotient, rendering this type of nutrition potentially useful in patients with impaired ventilatory reserve; however, no conclusions can be made about the outcomes of the duration of ventilation and weaning success.
Dietary manipulation may influence outcome after infection and injury by altering production of inflammatory mediators and disease activity. Restricted nutrient intake may have beneficial effects on life-span, development of degenerative disease, autoimmune processes, renal injury, susceptibility to infection, and survival rate after infection. Nutritional therapies that serve to maximize nitrogen balance may adversely affect the host response to injury, especially when given in excess of energy and protein needs.
This study reviewed the medical records of 19 patients with a diagnosis of Parkinson's disease listed on the death certificate who died between June 1985 and July 1990. The presence or absence of dementia separated the patients into two groups. The study examined the age at time of death, number and type of secondary diagnoses, frequency of dysphagia diagnosis, and therapeutic dietary differences. The presence of dementia did not influence the age at time of death. Dysphagia was a common diagnosis for each group.
Cystic fibrosis (CF) is a complex multisystem disorder affecting mainly the gastrointestinal tract and respiratory system. Intestinal malabsorption occurs in approximately 90% of patients. In the past, malnutrition was an inevitable consequence of disease progression, leading to poor growth, impaired respiratory muscle function, decreased exercise tolerance and immunological impairment. A positive association between body weight and height and survival has been widely reported. The energy requirements of patients with CF vary widely and generally increase with age and disease severity.
A wide range of medical, legal and ethical opinion regarding withholding or withdrawing medically assisted nutrition and hydration (ANH) from vegetative state (VS) and persistent vegetative state patients (PVS) has been presented in professional journals over the past twenty years. This article concerns the moral aspects of this debate as it has developed within the Catholic Church, especially in the United States.
European Journal of Cardio-Thoracic Surgery: Official Journal of the European Association for Cardio-Thoracic Surgery
OBJECTIVE: Fast-track rehabilitation is a group of simple measures that reduces morbidity, postoperative complication and accelerates postoperative rehabilitation reducing hospital stay. It can be applied to lung cancer lobectomy. Fast-track rehabilitation cornerstones are: minimally invasive surgical techniques using video-assisted and muscle sparring incisions, normovolemia, normothermia, good oxygenation, euglicemia, no unnecessary antibiotics, epidural patient-controlled analgesia, systemic opiods-free analgesia, early ambulation and oral feeding.
Because of the number of factors affecting the nutritional and metabolic status in patients with advanced chronic kidney disease or who are on maintenance dialysis, the prevention and treatment of protein-energy wasting (PEW) of chronic kidney disease should involve a comprehensive combination of maneuvers to diminish protein and energy depletion, in addition to therapies that will avoid further losses.
BACKGROUND: Sepsis and septic shock syndrome are the leading causes of death in critically ill patients. Lipopolysaccharide (LPS) released by the colonic microorganisms may translocate across a compromised lumen, leading to upregulated reactive oxidative stress, inflammation, and sepsis. The authors examined an enteral formula high in cysteine (antioxidant precursor), omega-3 fatty acids, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), and prebiotic fructooligosaccharides (FOS) against systemic inflammatory syndrome.
PURPOSE OF REVIEW: Patients on maintenance dialysis commonly develop protein-energy wasting (PEW), which is associated with poor survival. There have been several advances in anabolic interventions aimed at improving PEW in these patients in recent years. RECENT FINDINGS: Oral or parenteral nutritional supplementation, especially if administered during dialysis, improves net protein anabolism in chronic hemodialysis patients. These beneficial effects have been extended to long-term benefits in recent clinical trials.