Journal of Parenteral and Enteral Nutrition最新文献_第3页

Association between a 6-h feeding protocol and postprocedure hospital length of stay following percutaneous endoscopic gastrostomy in hospitalized adults: A before-and-after cohort study 住院成人经皮内镜胃造口术后6小时喂养方案与术后住院时间的关系：一项前后队列研究

IF 3.2 3区医学 Q2 NUTRITION & DIETETICS

Journal of Parenteral and Enteral Nutrition

Pub Date : 2024-12-23 DOI: 10.1002/jpen.2718

Jeffrey L. Roberson MD, MBA, Jesse E. Passman MD, MPH, Marianne Aloupis MS, RD, Yessenia Caballero-Tilleria MA, Anthony Audia MA, Melissa R. Ramirez MA, Patricia Martinez Quinones MD, PhD, Patrick Kim MD, MHCI, Elinore J. Kaufman MD, MSHP, Catherine E. Sharoky MD, MSCE

Background

Tolerance of enteral nutrition following percutaneous endoscopic gastrostomy is a barrier to discharge. This study investigated the impact of an expedited feeding protocol following percutaneous endoscopic gastrostomy on postprocedure length of stay (LOS).

Methods

We performed a before-and-after cohort study on hospitalized adults in whom percutaneous endoscopic gastrostomy was placed by surgeons following the implementation of a standardized feeding protocol in which enteral feeds were resumed at the preoperative rate 6 h later.

Results

Enteral feeding resumed within 6 h postoperatively in 93% of patients after protocol initiation. The mean ± SD time to the goal enteral rate after percutaneous endoscopic gastrostomy was significantly shorter following protocol implementation (15 ± 10 vs 50 ± 26 h, P ≤ 0.0001). Compared with the preprotocol cohort, there was no change in postoperative aspiration at 1 week (6% vs 4%, P = 0.531) or rates of tube dislodgement (10% vs 9%, P = 0.89), return to the operating room (10% vs 6%, P = 0.36), and surgical-site infection (9% vs 8%, P = 0.92) at 1 month in the protocol implementation cohort. On multivariable regression, an expedited feeding protocol generated a significantly shorter postprocedure LOS for patients remaining in the hospital for ≤1 week (β = −2.14, 95% CI, −2.98 to −1.30; P < 0.001).

Conclusion

An expedited feeding protocol following percutaneous endoscopic gastrostomy placement had a high degree of provider uptake without any significant change in safety outcomes. Beginning enteral nutrition within 6 h postoperatively at the preoperative rate reduced LOS by >2 days, suggesting that these protocols can address common delays to discharge.

背景：经皮内镜胃造口术后肠内营养耐受性是排泄障碍。本研究探讨了经皮内镜胃造口术后加速喂养方案对术后住院时间（LOS）的影响。方法：我们对住院的成年人进行了一项前后队列研究，这些成年人在实施标准化喂养方案后经皮内镜胃造口术，6小时后按术前率恢复肠内喂养。结果：93%的患者在方案启动后6小时内恢复肠内喂养。经皮内镜胃造口术后达到目标肠内率的平均±SD时间在方案实施后显著缩短（15±10 vs 50±26 h, P≤0.0001）。与方案前队列相比，方案实施队列中术后1周的抽吸率（6%对4%，P = 0.531）、1个月的管脱位率（10%对9%，P = 0.89）、返回手术室率（10%对6%，P = 0.36）和手术部位感染率（9%对8%，P = 0.92）均无变化。在多变量回归中，对于住院≤1周的患者，加速喂养方案显著缩短了术后LOS (β = -2.14, 95% CI, -2.98至-1.30；结论：经皮内窥镜胃造口置入后的加速喂养方案具有高度的提供者摄取，而安全性结果没有任何显着变化。在术前6小时内开始肠内营养可使LOS减少60 ~ 2天，这表明这些方案可以解决常见的延迟出院问题。

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引用次数: 0

Fish oil lipid emulsion compared with soybean oil lipid emulsion in pediatric patients with parenteral nutrition-associated cholestasis: A cost-effectiveness study 鱼油脂乳剂与大豆油脂乳剂在小儿肠外营养相关性胆汁淤积症患者中的比较：一项成本-效果研究

IF 3.2 3区医学 Q2 NUTRITION & DIETETICS

Journal of Parenteral and Enteral Nutrition

Pub Date : 2024-12-21 DOI: 10.1002/jpen.2713

Massimiliano Povero PhD, Kathleen M. Gura PharmD, Muralidhar H. Premkumar MBBS, Lorenzo Pradelli MD, Mark Puder MD, PhD, Kara L. Calkins MD, MS

Objectives

Evidence indicates that, in pediatric patients with parenteral nutrition–associated cholestasis (PNAC), the use of a 100% fish oil lipid emulsion (FOLE) increased the likelihood of PNAC resolution and reduced the likelihood of liver transplantation compared with a 100% soybean oil lipid emulsion (SOLE). To evaluate the potential economic benefit, we conducted a cost-effectiveness analysis comparing FOLE with SOLE.

Study Design

A discrete event simulation model evaluated cost-effectiveness by simulating clinical outcomes and estimating associated healthcare costs in pediatric patients with PNAC receiving parenteral nutrition (PN) with FOLE (1 g/kg) or SOLE (1.9 g/kg) over a time horizon of 6 years. Model inputs for clinical outcomes were derived from the integrated analysis of two US Phase 3 trials (NCT00910104 and NCT00738101). Cost estimates were estimated from the perspective of the US payer including the cost of PN, transplantation, and adverse events.

Results

The total cost associated with FOLE was $69,847 USD vs $141,605 USD for SOLE. The cost reduction of $71,757 USD was attributable to the avoidance of liver transplantation (−15.7%) and reduction in adverse events (−4.8%). Life-years and the quality-adjusted life-years were increased with FOLE compared with SOLE (by 0.248 and 0.295, respectively).

Conclusion

By reducing the need for liver transplant and providing time to transition to full enteral nutrition, FOLE leads to cost-savings, compared with SOLE, in pediatric patients with PNAC in the perspective of the US payer. These findings support the use of FOLE in pediatric patients with PNAC who require PN.

目的：有证据表明，在肠外营养相关性胆汁淤积症（PNAC）的儿科患者中，与100%大豆油脂质乳（SOLE）相比，使用100%鱼油脂质乳（FOLE）增加了PNAC消退的可能性，降低了肝移植的可能性。为了评估潜在的经济效益，我们对FOLE和SOLE进行了成本-效果分析。研究设计：一个离散事件模拟模型通过模拟临床结果和估计在6年的时间范围内接受肠外营养（PN）与FOLE （1 g/kg）或SOLE （1.9 g/kg）的儿科PNAC患者的相关医疗成本来评估成本效益。临床结果的模型输入来自两项美国3期试验（NCT00910104和NCT00738101）的综合分析。从美国支付方的角度估计成本，包括PN、移植和不良事件的成本。结果：FOLE相关的总成本为69,847美元，而SOLE为141,605美元。由于避免了肝移植（-15.7%）和不良事件减少（-4.8%），成本减少了71,757美元。与SOLE相比，FOLE增加了寿命年和质量调整寿命年（分别增加0.248和0.295）。结论：从美国付款人的角度来看，通过减少肝移植的需求并提供过渡到完全肠内营养的时间，与SOLE相比，FOLE可以节省PNAC儿科患者的成本。这些发现支持在需要PN的PNAC患儿中使用FOLE。

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引用次数: 0

Nutrition provision over time in longer stay critically ill patients: A post hoc analysis of The Augmented vs Routine Approach to Giving Energy Trial 长期住院危重病人的营养供应：增强与常规方法给予能量试验的事后分析

IF 3.2 3区医学 Q2 NUTRITION & DIETETICS

Journal of Parenteral and Enteral Nutrition

Pub Date : 2024-12-20 DOI: 10.1002/jpen.2717

Elizabeth Viner Smith BND(Hons), Kylie Lange BSc(Ma&CompSci)(Hons), Sandra Peake PhD, Marianne J. Chapman PhD, Emma J. Ridley PhD, Christopher K. Rayner PhD, Lee-anne S. Chapple PhD

Background

Limited literature exists on nutrition practices for long-stay patients in the intensive care unit (ICU). We aimed to compare nutrition practices in the first and second weeks of an ICU admission.

Method

A post hoc exploratory analysis of The Augmented vs Routine Approach to Giving Energy Trial (TARGET) randomized controlled trial (RCT) was undertaken. Inclusion criteria were: enrolled in TARGET on day 1 or 2 of ICU admission and ICU length of stay (LOS) >14 days. Clinical characteristics are described, and nutrition delivery and management compared between days 1–7 and 8–14. Data are n (%), mean ± SD, median (interquartile range [IQR]), or mean difference (MD) and 95% confidence interval (95% CI), with P < 0.05 considered significant.

Results

Data from 664 patients were analyzed (56.2 ± 16.3 years; 61% male; body mass index 29.2 ± 7.5 kg/m² and APACHE II 21.9 ± 8.1). When comparing days 1–7 to 8–14: (1) energy delivery was greater (all sources: 1826 ± 603 vs 1729 ± 689 (MD: 97 [95% CI: 52–140] kcal/day, P < 0.001) and nonnutrition sources: 317 ± 230 vs 192 ± 197 (MD 125 [95% CI: 111–139] kcal/day; P < 0.001); (2) protein delivery was similar (66 ± 20 vs 68 ± 24 (MD: −1.4 [95% CI: −3.2 to 0.4] g/day; P = 0.125]); and (3) fewer patients received parenteral nutrition (PN) (5% vs 9%, P < 0.001) or small intestine feeding (3% vs 8%; P < 0.001).

Conclusion

In this post hoc analysis, patients with an ICU LOS >14 days had greater energy delivery and fewer patients received PN or small intestine feeding during days 1–7 than days 8–14. Uncertainty remains regarding whether these data reflect usual practice and the clinical implications of this.

背景：关于重症监护病房（ICU）长期住院患者营养实践的文献有限。我们的目的是比较ICU入院第一周和第二周的营养实践。方法：采用随机对照试验（RCT）对增强法与常规法给予能量试验（TARGET）进行事后探索性分析。纳入标准为：ICU入院第1天或第2天入组TARGET， ICU住院时间(LOS)≥14天。描述临床特征，并比较1-7天和8-14天的营养输送和管理。数据为n（%）、mean±SD、median （intertile range [IQR]）或mean difference （MD）和95% confidence interval (95% CI)， P。结果：分析了664例患者的数据(56.2±16.3年；男性61%;体质指数29.2±7.5 kg/m2， APACHEⅱ指数21.9±8.1)。当比较第1-7天和第8-14天时：(1)能量输送更大(所有来源：1826±603 vs 1729±689 （MD: 97 [95% CI: 52-140] kcal/天，P）结论：在这项事后分析中，ICU LOS bb0 14天的患者能量输送更大，1-7天比8-14天接受PN或小肠喂养的患者更少。这些数据是否反映了常规做法及其临床意义仍不确定。

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引用次数: 0

Association between timing of maternal energy consumption and adiposity in breastfeeding infants: A prospective cohort study 母亲能量消耗时间与母乳喂养婴儿脂肪含量之间的关系：前瞻性队列研究

IF 3.2 3区医学 Q2 NUTRITION & DIETETICS

Journal of Parenteral and Enteral Nutrition

Pub Date : 2024-12-20 DOI: 10.1002/jpen.2714

Deniz Yaprak MD, Mina Mısırlıgil MD, Nüket Ünsal PhD, Necati Balamtekin MD, Belma Saygılı Karagöl MD, Ebru Dumlupınar PhD

Background

Lactating women's food intake timing may play a critical role in maternal and infant nutrition health. We aimed to examine associations of breastfeeding mothers' diet quantity and circadian timing of food intake with subsequent weight status of exclusively breastfed infants over a 6-month period.

Methods

This prospective observational study comprised pairs of healthy singleton breastfed infants and their corresponding healthy lactating mothers. Reported food intake times and diet content were used to define maternal eating patterns infant body mass index-for-age z scores (BAZs) at birth, 2 and 6 months. Association of maternal eating pattern with alterations in infant BAZ gain and nutritional status at age 6 months were investigated in multiple regression analyses.

Results

Compared with maternal daytime eating, maternal nighttime eating was linked to a greater increase in infantile BAZ from ages 2 to 6 months (adjusted β = 0.49; 95% CI, 0.05–0.92; P = 0.03) and a heightened likelihood of being overweight at age 6 months (adjusted odds ratio = 3.81; 95% CI, 1.41–6.63; P = 0.01) after adjusting for factors including maternal age, education level, household income, parity, pregestational body mass index, BAZ at 2 months, total daily energy consumption, and the percentages of energy derived from macronutrients.

Conclusion

Disruption of rhythmic physiology from irregular eating habits can lead to circadian misalignment, which may result in abnormal weight gain in infants and an increased likelihood of being overweight in the early postnatal period. Circadian alignment is fundamental for regulating women-infant dyads health.

背景：哺乳期妇女的食物摄入时间可能在母婴营养健康中起关键作用。我们的目的是研究母乳喂养母亲的饮食量和食物摄入的昼夜节律时间与6个月期间纯母乳喂养婴儿随后的体重状况之间的关系。方法：这项前瞻性观察研究包括一对健康的单胎母乳喂养婴儿及其相应的健康哺乳母亲。报告的食物摄入时间和饮食含量被用来定义母亲的饮食模式，婴儿出生时、2个月和6个月的体重指数年龄z分数（baz）。采用多元回归分析研究了母亲饮食方式与婴儿6月龄时BAZ增加和营养状况变化的关系。结果：与母亲白天进食相比，母亲夜间进食与2 - 6个月婴儿BAZ增加有关(调整后β = 0.49；95% ci, 0.05-0.92；P = 0.03)， 6个月大时超重的可能性增加(校正优势比= 3.81；95% ci, 1.41-6.63；P = 0.01)，校正了产妇年龄、受教育程度、家庭收入、胎次、孕前体重指数、2月龄BAZ、每日总能量消耗和来自常量营养素的能量百分比。结论：不规则饮食习惯对节律生理的破坏可能导致昼夜节律失调，这可能导致婴儿体重异常增加，并增加出生后早期超重的可能性。昼夜节律一致性是调节母婴健康的基础。

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引用次数: 0

Factors associated with accelerated parenteral weaning in children with intestinal failure: A descriptive cohort study 肠衰竭儿童肠外加速断奶相关因素：一项描述性队列研究。

IF 3.2 3区医学 Q2 NUTRITION & DIETETICS

Journal of Parenteral and Enteral Nutrition

Pub Date : 2024-12-17 DOI: 10.1002/jpen.2711

Hadar Moran-Lev MD, Samuel A. Kocoshis MD, Isabel Córdova Amador BS, Mariah Mukasa, Stephanie B. Oliveira MD, Michael Helmrath MD, Conrad R. Cole MD

Background

The goal of intestinal rehabilitation in children is to wean from parenteral nutrition (PN). The aim of this study was to identify factors associated with accelerated weaning and to evaluate long-term outcomes of children receiving long-term PN.

Methods

This was a retrospective study of children managed by the Intestinal Rehabilitation Center at Cincinnati Children's Hospital. Medical history data were retrieved. The outcomes of children receiving long-term chronic PN (>2 years) were compared with those of children receiving short-term chronic PN regimen (<2 years).

Results

The cohort consisted of 112 children (58% boys, median [IQR] age of 6.0 [3.7–9.5] years). The group treated with a long-term PN regimen had significantly shorter residual small bowel and large bowel compared with the group treated with a short-term PN regimen (20% vs 60% and 75% vs 100%, respectively; P < 0.05). The lapse of time between PN and enteral feed initiation was longer in the group undergoing long-term PN regimen than in the short-term group (71 vs 32.5 days; P = 0.012). More episodes of central line–associated bloodstream infection (CLABSI) and a higher percentage of feeding aversion was demonstrated in the long-term PN group (2 [1–3] vs 1 [0–2] episodes and 36% vs 0%, respectively).

Conclusion

Small bowel, colon length, enteral feed initiation, and frequency of CLABSI are factors associated with duration of PN regimen. A long-term chronic PN regimen is associated with a higher risk of food aversion.

背景：儿童肠道康复的目标是摆脱肠外营养（PN）。本研究的目的是确定与加速断奶相关的因素，并评估接受长期PN的儿童的长期结果。方法：这是一项由辛辛那提儿童医院肠道康复中心管理的儿童的回顾性研究。检索病史数据。将接受长期慢性PN方案（> ~ 2年）的儿童与接受短期慢性PN方案的儿童的结局进行比较(结果：该队列包括112名儿童（58%为男孩，中位[IQR]年龄为6.0[3.7 ~ 9.5]岁）。与短期PN治疗组相比，长期PN治疗组的残余小肠和大肠明显更短(分别为20% vs 60%和75% vs 100%；结论：小肠、结肠长度、肠内喂养起始和CLABSI频率是影响PN方案持续时间的因素。长期慢性PN方案与较高的食物厌恶风险相关。

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引用次数: 0

Hunger and the transition from parenteral nutrition in hospitalized adults: A descriptive cohort study 住院成人的饥饿和肠外营养的转变：一项描述性队列研究。

IF 3.2 3区医学 Q2 NUTRITION & DIETETICS

Journal of Parenteral and Enteral Nutrition

Pub Date : 2024-12-16 DOI: 10.1002/jpen.2710

Sergio Henrique Loss MD, PhD, Klara Muller Alves RD, Aline Camargo Nunes RN, Joel Stefani MD, Giovanna Peres Loureiro RD, Adriana Píscopo MD, Luciana Verçoza Viana MD, PhD

Background

Parenteral nutrition (PN) provides nutrition to patients who cannot use the digestive tract. Some patients experience delayed appetite recovery after PN, but the factors contributing to this remain unclear. This study aimed to investigate whether hospitalized patients receiving PN experience reduced hunger or appetite.

Methods

A descriptive cohort study was conducted on adults who underwent PN between April 2022 and July 2023. Data on patient characteristics and nutritional support were collected from medical records. Hunger and satiety were assessed using a validated tool during three phases: clinical stability with calorie-protein targets on PN, transition to oral/enteral feeding, and PN withdrawal. The primary outcome was the absence of hunger assessed by the tool.

Results

Of 231 screened patients, 102 were included. Among these, 62.7% reported hunger during PN. Lipid doses and energy reduction strategies did not affect hunger or satiety. Transition success to oral/enteral nutrition was 2.38 times higher in patients who experienced hunger compared to those who did not (95% CI: 1.59–3.54). Poisson regression identified higher age, inflammation, and metastatic cancer as independent factors associated with the absence of hunger.

Conclusion

This study suggests that PN does not suppress hunger and that factors other than nutritional therapy (age, inflammation, and cancer) could explain the absence of appetite. Considering individual conditions and needs, these findings could guide decision-making strategies regarding the transition from PN to oral/enteral feeding.

背景：肠外营养（PN）为不能使用消化道的患者提供营养。一些患者在PN后经历延迟的食欲恢复，但导致这种情况的因素尚不清楚。本研究旨在调查住院患者接受PN治疗是否会减少饥饿感或食欲。方法：对2022年4月至2023年7月期间接受PN治疗的成年人进行描述性队列研究。从医疗记录中收集患者特征和营养支持的数据。饥饿感和饱腹感是通过一种经过验证的工具在三个阶段进行评估的：临床稳定，以卡路里-蛋白质为目标的PN，过渡到口服/肠内喂养，PN戒断。该工具评估的主要结果是饥饿的消失。结果：231例筛查患者中，102例纳入。其中，62.7%的人在PN期间报告饥饿。脂质剂量和能量减少策略对饥饿感和饱腹感没有影响。经历过饥饿的患者过渡到口服/肠内营养的成功率是没有经历过饥饿的患者的2.38倍（95% CI: 1.59-3.54）。泊松回归发现，年龄增大、炎症和转移性癌症是与饥饿缺失相关的独立因素。结论：本研究提示PN不能抑制饥饿感，营养治疗以外的因素（年龄、炎症和癌症）可以解释食欲不振。考虑到个体情况和需求，这些发现可以指导从PN过渡到口服/肠内喂养的决策策略。

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引用次数: 0

JPEN Journal Club 89. Signal-finding studies. 日本笔会杂志俱乐部Signal-finding研究。

IF 3.2 3区医学 Q2 NUTRITION & DIETETICS

Journal of Parenteral and Enteral Nutrition

Pub Date : 2024-12-10 DOI: 10.1002/jpen.2709

Ronald L Koretz

引用次数: 0

Associations between the Dietary Inflammatory Index and fractional exhaled nitric oxide among United States adults: A cross-sectional study 美国成年人饮食炎症指数与呼出一氧化氮分数之间的关系：一项横断面研究。

IF 3.2 3区医学 Q2 NUTRITION & DIETETICS

Journal of Parenteral and Enteral Nutrition

Pub Date : 2024-12-05 DOI: 10.1002/jpen.2708

Yinghong Wang MD, Xiaolian Song MD, PhD, Min Tan MD, PhD

Background

Fractional exhaled nitric oxide (FeNo) is a convenient and noninvasive test that measures the concentration of nitric oxide in exhalation as a surrogate biomarker of airway inflammation. This cross-sectional study aimed to determine the associations between Dietary Inflammatory Index (DII) and FeNo in US adults.

Methods

Adults participating in the 2007–2012 cycles of the US National Health and Nutrition Examination Survey with complete information and available measurement data of DII and FeNo were included. Associations between DII and FeNo were assessed using univariable and multivariable logistic regression models, restricted cubic spline analysis, stratified analysis, and sensitivity analysis.

Results

A total of 7677 participants (mean age 45.68 years, 53.03% men) with a mean DII of 1.28 and FeNo of 17.33 ppb were included. The multivariable-adjusted linear regression analysis showed that a one-unit increase in DII was associated with a 0.283-ppb reduction in FeNo level. The beta and 95% CI for the second, third, and fourth DII quartile groups were −1.19 (−2.04 to −0.35), −1.07 (−2.26 to 0.12), and −1.60 (−2.85 to −0.36), respectively (P for trend = 0.04), with the lowest quartile group as the reference. The restricted cubic spline curve showed an inversely linear relationship between DII and FeNo. The study result is robust and did not appear to be affected by the participant's age, sex, race, body mass index, physical activity, diabetes status, or white blood cell or eosinophil counts.

Conclusion

A proinflammatory diet, as indicated by a higher DII, is cross-sectionally associated with lower FeNo levels in US adults.

背景：呼气一氧化氮分数（FeNo）是一种方便且无创的检测方法，可测量呼气中一氧化氮的浓度，作为气道炎症的替代生物标志物。本横断面研究旨在确定美国成年人饮食炎症指数（DII）和FeNo之间的关系。方法：纳入2007-2012年美国国家健康与营养调查周期中具有完整信息和可获得的DII和FeNo测量数据的成年人。采用单变量和多变量logistic回归模型、受限三次样条分析、分层分析和敏感性分析评估DII和FeNo之间的相关性。结果：共纳入7677名参与者（平均年龄45.68岁，男性53.03%），平均DII为1.28，FeNo为17.33 ppb。多变量调整线性回归分析显示，DII增加1个单位与FeNo水平降低0.283 ppb相关。第二、第三、第四个DII四分位数组的beta和95% CI分别为-1.19（-2.04 ~ -0.35）、-1.07（-2.26 ~ 0.12）和-1.60 (-2.85 ~ -0.36)(P为趋势= 0.04)，以最低四分位数组为参考。限制三次样条曲线显示DII与FeNo呈反线性关系。研究结果是可靠的，似乎不受参与者的年龄、性别、种族、体重指数、身体活动、糖尿病状况、白细胞或嗜酸性粒细胞计数的影响。结论：促炎饮食，如较高的DII所示，与美国成年人较低的FeNo水平横断面相关。

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引用次数: 0

The ASPEN Rhoads Research Foundation: Supporting and advancing clinical nutrition research 阿斯彭路德斯研究基金会：支持和推进临床营养研究。

IF 3.2 3区医学 Q2 NUTRITION & DIETETICS

Journal of Parenteral and Enteral Nutrition

Pub Date : 2024-12-05 DOI: 10.1002/jpen.2707

Marion Winkler PhD, RD, Kelly A. Tappenden PhD, RD, M. Molly McMahon MD, Michelle Spangenburg MS, RD, Charlene Compher PhD, RD

The vision of the ASPEN Rhoads Research Foundation is to promote innovation and research discovery to improve nutrition care and health. The Foundation was launched in 1993, incorporated in 2002, and established as a nonprofit 501(c)(3) organization in 2007. On the occasion of American Society for Parenteral and Enteral Nutrition (ASPEN)'s 50th anniversary, this article examines the creation of the Foundation, the state of clinical nutrition research funding, the Foundation's philanthropic mission, and the return on investment of Foundation grant support. To date, 114 investigators have received 2.78 million dollars in funding. The article examines the success of ASPEN research programs and Foundation grant support in career development, leadership, and mentorship. It is important to document a historical account of the ASPEN Rhoads Research Foundation and encourage innovation and discovery and ongoing financial support.

阿斯彭路德斯研究基金会的愿景是促进创新和研究发现，以改善营养保健和健康。基金会成立于1993年，成立于2002年，并于2007年成为一个非营利性的501(c)(3)组织。在美国肠外营养学会（ASPEN）成立50周年之际，本文考察了基金会的创建、临床营养研究经费的状况、基金会的慈善使命以及基金会赠款支持的投资回报。到目前为止，114名调查人员已经获得了278万美元的资助。本文考察了ASPEN研究项目的成功以及基金会在职业发展、领导力和指导方面的资助支持。重要的是要记录ASPEN路德斯研究基金会的历史记录，鼓励创新和发现以及持续的财政支持。

引用次数: 0

Dietetic-led interventions in critically ill adults that influence outcome: A scoping review 影响预后的危重成人饮食主导干预：范围综述

IF 3.2 3区医学 Q2 NUTRITION & DIETETICS

Journal of Parenteral and Enteral Nutrition

Pub Date : 2024-12-04 DOI: 10.1002/jpen.2705

Ella Terblanche PGDip Dietetics, MSc, Judith Merriweather PhD, Mina Bharal MRes, Rhiannon Lewis PGDip Dietetics, Liesl Wandrag PhD

Background

Critically ill patients face malnutrition risks, making nutrition management challenging. Dietitians play a crucial role in the intensive care unit (ICU) by applying their expertise to address these challenges. This review examines dietitian-led interventions and their impact on patient outcomes.

Methods

A scoping review of MEDLINE, Embase, CINAHL, EBSCO, Web of Science, and ProQuest databases from January 1995 to July 2023 was conducted. Studies involving dietitian-led interventions in adult critical care were included. Data extraction followed Joanna Briggs Institute methodology, focusing on study design, population, and interventions.

Results

Of 751 studies, 39 met the inclusion criteria. Most studies were observational, with only three interventional trials. Dietitian-led interventions included (1) guideline development and implementation, (2) individualized nutrition treatment, and (3) enteral nutrition tube insertion. Outcomes were classified into (1) patient clinical outcomes (ICU stay duration, mechanical ventilation, infections, cost savings, readmissions, mortality, adverse effects, and glycemic control) and (2) nutrition-related outcomes (nutrition initiation, energy and protein delivery, gastrointestinal tolerance, parenteral nutrition use, and appropriate dietetic referral).

Conclusion

Dietitian-led interventions improved nutrition outcomes and may have contributed to better clinical outcomes. Future research should prioritize reporting core outcomes, including nutrition status and physical function, to further quantify the effectiveness of dietitians in ICU care and enhance their recognition within the multiprofessional team.

背景：危重患者面临营养不良风险，使营养管理具有挑战性。营养师通过运用他们的专业知识来解决这些挑战，在重症监护病房（ICU）中发挥着至关重要的作用。本综述探讨了以营养师为主导的干预措施及其对患者预后的影响。方法：对1995年1月至2023年7月的MEDLINE、Embase、CINAHL、EBSCO、Web of Science和ProQuest数据库进行回顾性分析。包括在成人重症监护中以营养师为主导的干预研究。数据提取遵循乔安娜布里格斯研究所的方法，重点关注研究设计、人口和干预措施。结果：751项研究中，39项符合纳入标准。大多数研究是观察性的，只有三个干预性试验。营养师主导的干预措施包括(1)指南的制定和实施，(2)个体化营养治疗，(3)肠内营养管的插入。结果分为(1)患者临床结果（ICU住院时间、机械通气、感染、成本节约、再入院、死亡率、不良反应和血糖控制）和(2)营养相关结果（营养开始、能量和蛋白质输送、胃肠道耐受性、肠外营养使用和适当的饮食转诊）。结论：营养师主导的干预改善了营养结果，可能有助于更好的临床结果。未来的研究应优先报告核心结果，包括营养状况和身体功能，以进一步量化营养师在ICU护理中的有效性，并提高他们在多专业团队中的认可度。

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