Journal of Parenteral and Enteral Nutrition最新文献_第4页

Association between nutrition risk and oral mucosal membrane pressure injury in critically ill adults requiring endotracheal tube placement: A prospective cohort study 营养风险与需要气管内插管的危重成人口腔黏膜压力损伤之间的关系：一项前瞻性队列研究。

IF 4.1 3区医学 Q2 NUTRITION & DIETETICS

Journal of Parenteral and Enteral Nutrition

Pub Date : 2025-08-12 DOI: 10.1002/jpen.70004

Xiaohua Ai MD, Yuchun Deng RN, Bolan Wang RN, Hua Deng RN, Dongmei Tang RN, Linying Zeng RN, Yuping Jin RN, Yurong Liu RN, Lingli Jia RN

Background

Oral mucosal membrane pressure injuries are common yet underrecognized complications in critically ill patients with endotracheal tubes. This study investigated the association between nutrition risk and oral mucosal membrane pressure injuries.

Methods

This multicenter prospective cohort study enrolled 1533 intensive care unit patients with endotracheal tubes between April and December 2023. The primary model examined the association between nutrition risk and oral mucosal membrane pressure injuries. Additional analyses evaluated associations of medical nutrition therapy and inflammatory biomarkers (procalcitonin and C-reactive protein) with the outcome. Cox proportional hazards regression models were used, and five sequential models adjusted for confounders.

Results

Overall, 551 patients (36.3%) developed oral mucosal membrane pressure injuries. Nutrition risk was independently associated with an increased risk (hazard ratio [HR] = 1.37; 95% CI, 1.07–1.75). Medical nutrition therapy, including enteral nutrition, parenteral nutrition, and combined therapy, was associated with a reduced risk compared with suspended diet, with longer durations conferring greater benefit (HR = 0.77; 95% CI, 0.74–0.80). Additionally, elevated procalcitonin levels were associated with an increased risk of oral mucosal membrane pressure injuries (HR = 1.35; 95% CI, 1.09–1.68), whereas high C-reactive protein levels, although not statistically significant (HR = 1.09; 95% CI, 0.91–1.30), suggested a potential promoting effect.

Conclusion

Nutrition risk was an independent risk factor for oral mucosal membrane pressure injuries in critically ill patients with endotracheal tubes. Medical nutrition therapy reduced this risk, particularly with longer durations. Additionally, elevated procalcitonin levels were associated with a higher risk, highlighting the role of inflammation in pressure injury development.

背景：口腔粘膜压力损伤是气管插管危重患者常见但未被充分认识的并发症。本研究探讨营养风险与口腔粘膜压力损伤的关系。方法：该多中心前瞻性队列研究于2023年4月至12月期间纳入1533例重症监护病房气管插管患者。初级模型检验了营养风险与口腔粘膜压力损伤之间的关系。其他分析评估了医学营养治疗和炎症生物标志物（降钙素原和c反应蛋白）与结果的关联。采用Cox比例风险回归模型，并对5个序列模型进行混杂因素调整。结果：551例（36.3%）患者发生口腔粘膜压力损伤。营养风险与风险增加独立相关(风险比[HR] = 1.37；95% ci, 1.07-1.75)。与暂停饮食相比，包括肠内营养、肠外营养和联合治疗在内的医疗营养治疗与降低风险相关，持续时间越长，获益越大(HR = 0.77；95% ci, 0.74-0.80)。此外，降钙素原水平升高与口腔粘膜压力损伤的风险增加相关(HR = 1.35；95% CI, 1.09-1.68)，而c反应蛋白水平高，虽然没有统计学意义(HR = 1.09；95% CI, 0.91-1.30)，提示有潜在的促进作用。结论：营养风险是气管插管危重患者口腔黏膜压力损伤的独立危险因素。医学营养疗法降低了这种风险，特别是在持续时间较长的情况下。此外，降钙素原水平升高与较高的风险相关，强调了炎症在压力损伤发展中的作用。

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引用次数: 0

Small intestinal bacterial overgrowth and dysbiosis in children with intestinal failure: A descriptive cohort study 肠衰竭儿童的小肠细菌过度生长和生态失调：一项描述性队列研究。

IF 4.1 3区医学 Q2 NUTRITION & DIETETICS

Journal of Parenteral and Enteral Nutrition

Pub Date : 2025-07-28 DOI: 10.1002/jpen.2808

Johannes Hilberath MD, Andreas Busch MD, Ulrich Schoppmeier PhD, Kristina Schmauder MD, Philipp Oberhettinger MD, Matthias Marschal MD, Christoph Slavetinsky MD, PhD, Ekkehard Sturm MD, PhD, Silke Peter MD, Paul D'Alvise PhD

Background

Small intestinal bacterial overgrowth (SIBO) is a clinical and diagnostic challenge in pediatric intestinal failure. This study aimed to assess SIBO and dysbiosis in children with intestinal failure and to analyze clinical characteristics as well as cultural and metagenomic sequencing results from different sampling methods.

Methods

Descriptive, single-center cohort study in intestinal failure patients with prospective collection of intraluminal aspirate, epithelial brush swab, mucosal biopsy, and small bowel stoma stool for SIBO diagnosis, defined as ≥10³ CFU/ml of enteric, colonic-type bacteria, and microbiome analysis via whole-genome sequencing. Statistical testing included receiver operating characteristic analysis, chi-square test, and independent samples t test.

Results

Forty-four children with intestinal failure were analyzed (median age 58 months; female 48%; short bowel syndrome 70%). Sixty-six percent of samples were positive for SIBO. In 93%, all three endoscopic sampling methods showed congruent results. SIBO-positive cases were associated (P < 0.05) with small bowel dilatation, proton pump inhibitor use, intestinal inflammation, elevated direct bilirubin and hepatocellular enzyme levels, and a history of liver fibrosis and central venous catheter infections. Metagenomic sequencing revealed microbial dysbiosis in intestinal failure patients, with SIBO-positive cases showing higher microbial reads, lower alpha diversity, and increased abundance of Enterobacteriaceae and enteric anaerobes.

Conclusion

SIBO and dysbiosis are common in children with intestinal failure and associated with liver injury, central line–associated bloodstream infections, and intestinal inflammation. Cultural diagnosis of SIBO using mucosal biopsies or brush swabs are alternatives to small bowel aspirates. Metagenomic sequencing is feasible, and high microbial read numbers are indicative of SIBO.

背景：小肠细菌过度生长（SIBO）是儿童肠衰竭的临床和诊断挑战。本研究旨在评估肠衰竭儿童SIBO和生态失调，分析临床特征以及不同采样方法的培养和宏基因组测序结果。方法：对肠衰竭患者进行描述性单中心队列研究，前瞻性收集腔内抽吸、上皮刷拭子、粘膜活检和小肠造口粪便进行SIBO诊断，定义为≥103 CFU/ml的肠道、结肠型细菌和微生物组分析，通过全基因组测序。统计检验包括受试者工作特征分析、卡方检验和独立样本t检验。结果：分析了44例肠衰竭患儿(中位年龄58个月；女性的48%;短肠综合征70%)。66%的样本SIBO呈阳性。在93%的情况下，三种内镜取样方法的结果一致。结论：SIBO和生态失调在肠衰竭儿童中很常见，并与肝损伤、中央线相关性血流感染和肠道炎症有关。SIBO的培养诊断使用粘膜活检或刷拭子是小肠吸痰的替代方法。宏基因组测序是可行的，高微生物读数表明SIBO。

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引用次数: 0

Association between the composite dietary antioxidant index and vascular age among United States adults: A cross-sectional study 美国成年人膳食复合抗氧化指数与血管年龄的关系：一项横断面研究。

IF 4.1 3区医学 Q2 NUTRITION & DIETETICS

Journal of Parenteral and Enteral Nutrition

Pub Date : 2025-07-27 DOI: 10.1002/jpen.70001

Zhihao Zhao MM, Diya Qi MM, Fengyun Zhang MD, Ying Gao MM

Background

The composite dietary antioxidant index (CDAI) is a useful tool for evaluating antioxidant consumption and has been shown to effectively lower the risk of age-related diseases. However, the exact relationship between the CDAI and vascular age has yet to be established.

Methods

We performed a cross-sectional study examining the association between dietary antioxidants, as measured by the CDAI, and estimated pulse wave velocity (ePWV) and heart vascular age in 41,380 adults based in the United States using data from the National Health and Nutrition Examination Survey from 1999 to 2018. Multivariable linear regression models, restricted cubic splines, and subgroup analysis were used to examine the associations between the CDAI and ePWV and heart vascular age.

Results

This study included 41,380 participants with a mean ± SD age of 50 ± 18 years. After adjusting for confounding factors, multiple linear regression analysis revealed that higher CDAI scores were independently associated with lower ePWV (β = −0.008, P < 0.001) and lower heart vascular age (β = −0.080, P = 0.033). Restricted cubic spline analysis showed that the CDAI was negatively associated with ePWV and heart vascular age. No statistical interaction was observed within any subgroups of the CDAI and ePWV and heart vascular age.

Conclusion

Higher CDAI scores were associated with lower ePWV and heart vascular age in US adults.

背景：复合膳食抗氧化指数（CDAI）是评估抗氧化剂消耗的有用工具，已被证明可以有效降低与年龄有关的疾病的风险。然而，CDAI与血管年龄之间的确切关系尚未确定。方法：我们进行了一项横断面研究，利用1999年至2018年国家健康与营养检查调查的数据，研究了CDAI测量的膳食抗氧化剂与美国41,380名成年人的估计脉搏波速度（ePWV）和心血管年龄之间的关系。采用多变量线性回归模型、受限三次样条和亚组分析来检验CDAI和ePWV与心脏血管年龄之间的关系。结果：本研究纳入41,380名参与者，平均±SD年龄为50±18岁。在校正混杂因素后，多元线性回归分析显示，较高的CDAI评分与较低的ePWV独立相关（β = -0.008， P）。结论：较高的CDAI评分与美国成年人较低的ePWV和心血管年龄相关。

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引用次数: 0

Correction to “Measured energy expenditure according to the phases of critical illness: A descriptive cohort study” 更正“根据危重疾病阶段测量的能量消耗：一项描述性队列研究”。

IF 4.1 3区医学 Q2 NUTRITION & DIETETICS

Journal of Parenteral and Enteral Nutrition

Pub Date : 2025-07-21 DOI: 10.1002/jpen.70003

Tatucu-Babet OA, King SJ, Zhang AY, et al. Measured energy expenditure according to the phases of critical illness: a descriptive cohort study. J Parenter Enteral Nutr. 2025;49(3):314-323. doi:10.1002/jpen.2721

In the abstract, results, and conclusion, we erroneously described the energy expenditure in our cohort as corresponding to a median [interquartile range] of 135 [117–155]% increase above the predicted basal metabolic rate.

However, the correct description is that measured energy expenditure corresponded to a median [interquartile range] of 135 [117–155]% of the predicted basal metabolic rate, meaning it was a median of 35% above the predicted value.

We apologize for this error.

塔图库-巴贝特OA， King SJ，张艾，等。根据危重疾病阶段测量能量消耗：一项描述性队列研究。[J]中华儿科杂志，2015;49(3):314-323。doi: 10.1002 / jpen。2721在摘要、结果和结论中，我们错误地将我们队列中的能量消耗描述为高于预测基础代谢率的中位数[四分位数范围]增加了135[117-155]%。然而，正确的描述是，测量的能量消耗对应于预测基础代谢率的中位数[四分位数范围]为135[117-155]%，这意味着它比预测值高35%。我们为这个错误道歉。

引用次数: 0

Correction to “Variations in adverse events associated with different infusion modalities of parenteral nutrition: A pharmacovigilance study” 更正“与肠外营养的不同输注方式相关的不良事件的变化：一项药物警戒研究”。

IF 4.1 3区医学 Q2 NUTRITION & DIETETICS

Journal of Parenteral and Enteral Nutrition

Pub Date : 2025-07-18 DOI: 10.1002/jpen.70002

Jing Z, Zhengli J, Ying S, et al. Variations in adverse events associated with different infusion modalities of parenteral nutrition: a pharmacovigilance study. J Parenter Enteral Nutr. 2025; 49(5):659–669. doi:10.1002/jpen.2763

In the article cited above, extraneous text was included in the AUTHOR CONTRIBUTIONS section. The corrected section is reprinted below.

AUTHOR CONTRIBUTIONS

Zhou Jing contributed to the conceptualization, methodology, project administration, review and editing, and investigation. Jiang Zhengli contributed to the software, data curation, formal analysis, methodology, and review and editing. Su Ying contributed to the software, data curation, and visualization. Man Shiyu contributed to the software, data curation, and visualization. Ma Jingjing contributed to the validation and formal analysis. Pang Mujuan contributed to the validation and formal analysis. Xu Hongyan contributed to the validation and visualization. Hu Yan contributed to the conceptualization, original draft, project administration, supervision, and resources.

We apologize for this error.

张静，金正利，应生，等。与肠外营养不同输注方式相关的不良事件的变化：一项药物警戒研究。[J]中华儿科杂志。2025；49(5): 659 - 669。doi: 10.1002 / jpen。在上面引用的文章中，作者贡献部分包含了多余的文本。更正后的部分转载如下。作者贡献：周静对论文的构思、研究方法、项目管理、审稿编辑、调研等工作均有贡献。蒋正立对软件、数据整理、形式分析、方法论以及审查和编辑做出了贡献。苏颖对软件、数据管理和可视化做出了贡献。满世宇对软件、数据管理和可视化做出了贡献。马晶晶对验证和形式分析做出了贡献。庞慕娟对验证和形式分析做出了贡献。徐红岩对验证和可视化做出了贡献。胡岩对项目的构思、原稿、项目管理、监督、资源等做出了贡献。我们为这个错误道歉。

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引用次数: 0

JPEN Journal Club 94. Qualitative systematic reviews 日本笔会杂志俱乐部1994。定性系统评价。

IF 4.1 3区医学 Q2 NUTRITION & DIETETICS

Journal of Parenteral and Enteral Nutrition

Pub Date : 2025-07-18 DOI: 10.1002/jpen.70000

Ronald L. Koretz MD

引用次数: 0

Fat-free mass index cutoff values for reduced muscle mass in older community-dwelling adults in Japan: A descriptive cohort study 日本老年社区居民肌肉量减少的无脂肪质量指数临界值：一项描述性队列研究。

IF 4.1 3区医学 Q2 NUTRITION & DIETETICS

Journal of Parenteral and Enteral Nutrition

Pub Date : 2025-07-11 DOI: 10.1002/jpen.2806

Sahoko Takagi RD, MSc, Keisuke Maeda MD, PhD, Shosuke Satake MD, PhD, Shuzo Miyahara MD, DDS, PhD, Yuria Ishida RD, PhD, Hiroyasu Akatsu MD, PhD, Hidenori Arai MD, PhD

Background

The Global Leadership Initiative on Malnutrition criteria emphasize the importance of assessing muscle mass, recommending the fat-free mass index (FFMI) as a key measure. This study aimed to establish FFMI cutoff values for Japanese individuals and examine the risk factors of falls using these values.

Methods

This descriptive cohort study included 696 older adults from a Japanese outpatient frailty clinic located within a hospital. FFMI was measured via bioelectrical impedance analysis, and the appendicular skeletal muscle index (ASMI) was measured using dual-energy X-ray absorptiometry. Receiver operating characteristic analysis identified optimal FFMI cut-offs against low ASMI (<7.0 kg/m² for men; <5.4 kg/m² for women). Logistic regression was used to analyze the relationship between reduced muscle mass and falls over 1 year.

Results

Participants (mean age 76.1 ± 7.4 years; 64.8% female) experienced falls in 180 cases (25.9%), with 244 participants (35.1%) exhibiting low ASMI. The optimal FFMI cut-offs were <17.5 kg/m² for men (area under the curve [AUC]: 0.926; 95% confidence interval [CI]: 0.893–0.958) and <14.4 kg/m² for women (AUC: 0.927; 95% CI: 0.902–0.953), yielding 84.0% sensitivity, 91.2% specificity, and 88.6% accuracy. Low ASMI was not significantly linked to falls (odds ratio [OR: 1.04; 95% CI: 0.70–1.53; P = 0.860), whereas low FFMI was predictive (OR: 1.49; 95% CI: 1.01–2.20; P = 0.044).

Conclusion

FFMI cut-offs of <17.5 kg/m² for men and <14.4 kg/m² for women effectively identified reduced muscle mass and predicted falls. The results suggest that FFMI may be a useful tool in malnutrition diagnosis.

背景：营养不良标准全球领导倡议强调评估肌肉质量的重要性，建议将无脂肪质量指数（FFMI）作为关键衡量标准。本研究旨在建立日本个体的FFMI临界值，并利用这些值检查跌倒的危险因素。方法：这项描述性队列研究包括来自日本一家医院门诊虚弱诊所的696名老年人。采用生物电阻抗法测定FFMI，双能x线吸收法测定阑尾骨骼肌指数（ASMI）。接受者工作特征分析确定了低ASMI的最佳FFMI截止值(男性为2；女性2个)。采用Logistic回归分析1年内肌肉量减少与跌倒之间的关系。结果：参与者(平均年龄76.1±7.4岁；其中180例（25.9%）出现跌倒，244例（35.1%）出现低ASMI。男性的最佳FFMI截点为2(曲线下面积[AUC]: 0.926；95%置信区间[CI]: 0.893-0.958)，女性为2 (AUC: 0.927；95% CI: 0.902-0.953)，敏感性84.0%，特异性91.2%，准确性88.6%。低ASMI与跌倒无显著关联(优势比[OR: 1.04；95% ci: 0.70-1.53；P = 0.860)，而低FFMI具有预测意义(OR: 1.49；95% ci: 1.01-2.20；p = 0.044)。结论：FFMI截断值男性为2，女性为2，可有效识别肌肉量减少并预测跌倒。结果表明FFMI可能是营养不良诊断的有用工具。

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引用次数: 0

Energy and protein intake adequacy in geriatric rehabilitation inpatients: A descriptive cohort study 老年康复住院患者的能量和蛋白质摄入充足性：一项描述性队列研究。

IF 4.1 3区医学 Q2 NUTRITION & DIETETICS

Journal of Parenteral and Enteral Nutrition

Pub Date : 2025-07-06 DOI: 10.1002/jpen.2804

Jeewanadee Hettiarachchi APD, PhD, Esmee M. Reijnierse PhD, Andrea B. Maier MD, PhD, Kate Fetterplace APD, PhD

Background

Indirect calorimetry (IC) provides an accurate measure of energy expenditure, which informs energy requirements. Achieving energy and protein requirements is fundamental in nutrition care. This study aims to determine if the energy requirements informed by IC and estimated protein requirements are met in geriatric rehabilitation inpatients receiving dietitian-led individualized nutrition care.

Methods

Geriatric rehabilitation inpatients referred to dietitians were included. Resting metabolic rate was measured using IC at inclusion in the study and within 48 h before discharge. Food intake was assessed using plate waste observation. The patient's energy requirement was calculated using the resting metabolic rate and physical activity factor and adjusted for the weight goal. Protein requirements were estimated by the dietitian. The energy and protein intake adequacy was calculated as a percentage of the individual requirement and defined “adequate” if ≥100%.

Results

Fifty-three patients were included (mean age, 84.3 [standard deviation, 8.44] years; 22 [41.5%] women). The median energy and protein intake adequacy was 101.7% (interquartile range [IQR], 76.4–112.9) and 87.6% (IQR, 71.9–122.2) at the start of the nutrition care (n = 53) and 99.9% (IQR, 63.9–113.8) and 80.1% (IQR, 65.1–99.6) at discharge (n = 29), respectively. Only 15 of 53 (28.3%) patients at the start of nutition care and 6 of 29 (20.7%) patients at discharge achieved both energy and protein intake adequacy.

Conclusions

Energy requirements were met, but the protein requirements were not met in geriatric rehabilitation inpatients receiving nutrition care. However, less than one-third of patients achieved both energy and protein intake adequacy.

背景：间接量热法（IC）提供了一种准确的能量消耗测量方法，它可以告知能量需求。实现能量和蛋白质需求是营养保健的基础。本研究旨在确定在接受营养师主导的个性化营养护理的老年康复住院患者中，IC所告知的能量需求和估计的蛋白质需求是否满足。方法：纳入由营养师转诊的老年康复住院患者。静息代谢率在纳入研究时和出院前48小时内用IC测量。通过盘子剩余物观察评估食物摄取量。使用静息代谢率和体力活动因子计算患者的能量需求，并根据体重目标进行调整。蛋白质需要量由营养师估算。能量和蛋白质摄入充分性以个体需要量的百分比计算，如果≥100%则定义为“充足”。结果：纳入53例患者(平均年龄84.3岁[标准差8.44]岁；22[41.5%]女性)。营养护理开始时（n = 53）的能量和蛋白质摄入充足度中位数分别为101.7%（四分位数间距[IQR]， 76.4-112.9）和87.6% (IQR, 71.9-122.2)，出院时（n = 29）的能量和蛋白质摄入充足度中位数分别为99.9% （IQR, 63.9-113.8）和80.1% （IQR, 65.1-99.6）。53例患者中只有15例（28.3%）在开始营养护理时达到能量和蛋白质摄入充足，29例患者中只有6例（20.7%）在出院时达到能量和蛋白质摄入充足。结论：接受营养护理的老年康复住院患者能量需求满足，蛋白质需求不满足。然而，不到三分之一的患者达到了能量和蛋白质摄入充足。

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引用次数: 0

Association between late parenteral nutrition initiation and length of hospital stay in late preterm and term infants: A retrospective cohort study 晚期早产儿和足月婴儿肠外营养起始时间与住院时间的关系：一项回顾性队列研究。

IF 4.1 3区医学 Q2 NUTRITION & DIETETICS

Journal of Parenteral and Enteral Nutrition

Pub Date : 2025-07-06 DOI: 10.1002/jpen.2805

Katrina A. Savioli MD, Carl E. Hunt MD, Anwar E. Ahmed PhD, Cara H. Olsen MS, PhD, Reese H. Clark MD, Nicole R. Dobson MD

Background

We aimed to determine the association between timing of parenteral nutrition initiation and length of hospital stay in late preterm and term infants.

Methods

This retrospective cohort study includes infants ≥35 weeks gestation admitted to a Pediatrix Medical Group neonatal intensive care unit in 2009–2019. Propensity score matching was used to control for demographics, delivery characteristics, and severity of illness. The primary outcome was length of hospital stay. Secondary outcomes were duration of mechanical ventilation, late-onset sepsis, and mortality. Early parenteral nutrition was defined as initiation on the day of birth and late as initiation after.

Results

The total cohort has 475,708 infants; of 259,495 eligible infants, 97,577 (37.6%) received parenteral nutrition. After propensity score matching, outcomes were analyzed for 13,712 infants. Infants receiving late parenteral nutrition (n = 6856) have no difference in length of hospital stay compared with early. Analysis of secondary outcomes reveals no differences between groups. Negative binomial regression shows decreased length of hospital stay when parenteral nutrition is initiated on days of life 1–3 compared with day of birth or days 4–10.

Conclusion

Initiating parenteral nutrition on day 1 or later vs day of birth is not associated with increased length of hospital stay in late preterm and term infants. Exploratory analysis suggests that initiation of parenteral nutrition on days 1–3 instead of day of birth or days 4–10 is associated with decreased hospital stay. Prospective clinical trials are needed to better understand optimal timing of parenteral nutrition in this population.

背景：我们的目的是确定肠外营养开始时间与晚期早产儿和足月婴儿住院时间之间的关系。方法：本回顾性队列研究纳入2009-2019年儿科医疗集团新生儿重症监护室收治的妊娠≥35周的婴儿。倾向评分匹配用于控制人口统计学、分娩特征和疾病严重程度。主要观察指标为住院时间。次要结局是机械通气持续时间、迟发性败血症和死亡率。早期肠外营养定义为出生当天开始，晚为出生后开始。结果：总队列有475,708名婴儿；在259,495名符合条件的婴儿中，97,577名（37.6%）接受了肠外营养。倾向评分匹配后，对13712名婴儿的结果进行了分析。接受晚肠外营养的婴儿（n = 6856）在住院时间上与早期没有差异。次要结果分析显示两组间无差异。负二项回归显示，与出生当天或4-10天相比，在出生后1-3天开始肠外营养的住院时间缩短。结论：在出生第1天或更晚开始肠外营养与晚期早产儿和足月儿住院时间的增加无关。探索性分析表明，在1-3天而不是出生当天或4-10天开始肠外营养与住院时间缩短有关。需要前瞻性临床试验来更好地了解在这一人群中肠外营养的最佳时机。

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引用次数: 0

Roles, responsibilities, and opportunities for the nutrition support physician working with adults: A critical review 与成人一起工作的营养支持医师的角色、责任和机会：一个批判性的回顾。

IF 4.1 3区医学 Q2 NUTRITION & DIETETICS

Journal of Parenteral and Enteral Nutrition

Pub Date : 2025-07-02 DOI: 10.1002/jpen.2790

Manpreet S. Mundi MD, Jeffrey I. Mechanick MD, Jayshil Patel MD, Carolyn Newberry MD, Senthilkumar Sankararaman MBBS, Martin Rosenthal MD, Osman Mohamed Elfadil MBBS, Jamie Bering MD, Jennifer Katz MD, Christian Stoppe MD, Robert Martindale MD, PhD, Stephen McClave MD

The dual burden of undernutrition and overnutrition requires a greater understanding and commitment to physician training and specialization in nutrition support. Despite the significant healthcare need and existence of organizations focused on nutrition support such as the American Society for Parenteral and Enteral Nutrition (ASPEN), physician involvement in the nutrition care of high-risk patients remains low. In an ASPEN survey of members, inadequate training among physicians was reported along with significant barriers to involvement in nutrition support, such as insufficient protected time, reduced reimbursement and financial support, inadequate support from administrators or supervisors, as well as a nationwide reduction in number of nutrition support teams. These changes in the healthcare landscape prompted the ASPEN Physician Engagement Committee to develop a critical review focused on domains of nutrition risk assessment, enteral and parenteral access and support, scholarly activities, board certification, administrative responsibilities, education and training opportunities, coding, and reimbursement. The aim of this critical review is to capacitate physicians to engage in nutrition support and enhance their acumen in clinical nutrition to improve patient care and enrich personal and professional development.

营养不良和营养过剩的双重负担需要对营养支持方面的医生培训和专业化有更深入的了解和承诺。尽管有大量的医疗保健需求和组织的存在，如美国肠外和肠内营养协会（ASPEN），医生参与高危患者的营养护理仍然很低。在ASPEN对成员的调查中，医生的培训不足，以及参与营养支持的重大障碍，如保护时间不足，报销和财政支持减少，管理人员或主管的支持不足，以及全国范围内营养支持小组数量的减少。医疗保健领域的这些变化促使ASPEN医师参与委员会对营养风险评估、肠内和肠外获取和支持、学术活动、委员会认证、行政责任、教育和培训机会、编码和报销等领域进行了重要审查。这篇重要综述的目的是使医生能够从事营养支持，提高他们在临床营养方面的敏锐度，以改善患者护理，丰富个人和职业发展。

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引用次数: 0