Influence of Inflammatory State on the Need to Customize Parenteral Nutrition in Adolescents.

IF 4.8 2区医学 Q1 NUTRITION & DIETETICS Nutrients Pub Date : 2024-11-04 DOI:10.3390/nu16213782

Jéssica Lavanholi Pinho, Renata Germano Borges de Oliveira Nascimento Freitas, Tiago Henrique de Souza, Roberto José Negrão Nogueira

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Abstract

Background/objectives: Parenteral nutrition (PN) can be standardized or customized according to a patient's individual needs, including clinical, metabolic, nutritional, and inflammatory conditions. The influence of inflammation on the indication of standard or customized PN for adolescents hospitalized in a quaternary hospital in the southeastern of Brazil was evaluated.

Methods: A historical cohort study of 61 adolescents admitted to the hospital was conducted. Nutritional, clinical, and biochemical data from the first 7 days of PN use were analyzed. Elevated serum mineral and triglyceride levels, as well as renal or liver failure (grade III or IV), were considered unequivocal reasons for PN customization, while restoring energy-protein adequacy and low serum mineral levels were considered questionable reasons. Inflammatory status was analyzed during the study period.

Results: A total of 128 PN solutions were prescribed, comprising 55 standardized and 73 customized. Overall, 40/61 patients required customized PN. The main reason for customization was to restore energy-protein adequacy (n = 48), while 24.7% (n = 18) of individualizations were for unequivocal reasons. Restoring energy-protein adequacy in the first 48 h was shown to have contributed to high transthyretin, which reduced the need for additional customized PN (r = -0.544; p = 0.044). A positive correlation was found between the total number of PN readjustments and C-Reactive Protein levels (r = 0.509; p = 0.044).

Conclusions: Conditions such as malnutrition or an inflammatory state in adolescents presenting metabolic changes are indications for the use of customized PN.

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炎症状态对青少年定制肠外营养需求的影响。

背景/目的：肠外营养（PN）可根据患者的个体需求（包括临床、代谢、营养和炎症状况）进行标准化或定制。本研究评估了炎症对巴西东南部一家四级医院住院青少年使用标准或定制肠外营养的适应症的影响：方法：对该医院收治的 61 名青少年进行了历史队列研究。分析了使用 PN 头 7 天的营养、临床和生化数据。血清矿物质和甘油三酯水平升高以及肾或肝功能衰竭（III级或IV级）被认为是定制PN的明确原因，而恢复能量-蛋白质充足性和血清矿物质水平低被认为是值得商榷的原因。研究期间对炎症状态进行了分析：共开出 128 种 PN 溶液，其中 55 种为标准化溶液，73 种为定制溶液。总体而言，40/61 名患者需要定制 PN。定制的主要原因是为了恢复能量-蛋白质的充足性（48 人），而 24.7% 的个性化定制（18 人）是出于明确的原因。在最初的 48 小时内恢复能量-蛋白质的充足性被证明是转甲状腺素偏高的原因之一，从而减少了对额外定制 PN 的需求（r = -0.544；p = 0.044）。PN 重新调整的总次数与 C 反应蛋白水平之间呈正相关（r = 0.509；p = 0.044）：结论：青少年出现营养不良或炎症状态等新陈代谢变化时，是使用定制 PN 的指征。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Nutrients NUTRITION & DIETETICS-

CiteScore

9.20

自引率

15.30%

发文量

4599

审稿时长

16.74 days

期刊介绍： Nutrients (ISSN 2072-6643) is an international, peer-reviewed open access advanced forum for studies related to Human Nutrition. It publishes reviews, regular research papers and short communications. Our aim is to encourage scientists to publish their experimental and theoretical results in as much detail as possible. There is no restriction on the length of the papers. The full experimental details must be provided so that the results can be reproduced.