Journal of Parenteral and Enteral Nutrition最新文献

{"title":"Association between enteral essential fatty acids and plasma phospholipid essential fatty acids related immune response in critically ill adults with COVID-19: A prospective cohort study","authors":"Vera C. Mazurak PhD,&nbsp;Irma Magaly Rivas-Serna PhD,&nbsp;Sarah R. Parsons RD,&nbsp;Md Monirujjaman PhD,&nbsp;Krista E. Maybank RD,&nbsp;Oleksa G. Rewa MD,&nbsp;Andrew J. Cave MD,&nbsp;Caroline Richard RD, PhD,&nbsp;M. Thomas Clandinin PhD","doi":"10.1002/jpen.2783","DOIUrl":"10.1002/jpen.2783","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Coronavirus disease 2019 (COVID-19) is a complicated disease with widely varying outcomes. Up to 20% of unvaccinated, hospitalized patients infected with COVID-19 may die during the initial three weeks. Our research shows that COVID-19 infection results in rapid, remarkable change in the balance between essential fatty acid constituents of plasma phospholipids that are substrates for synthesis of signals that regulate immunity, inflammation, and thrombosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We assessed if enteral feeding of EPA (eicosapentaenoic acid, 20:5n-3) and DHA (docosahexaenoic acid; 22:6n-3) normalizes remodeling of plasma phospholipid essential fatty acid content caused by COVID-19 viral infection and modifies immune response. Blood samples were taken on day 1 of hospital admission. From the patient record, patients were categorized into two groups based on enteral formula fed by day 5 after admission: enteral feeds that contained EPA + DHA or not. These two groups were compared at 1 week and 3 weeks postadmission for plasma phospholipid fatty acids, cytokines, and chemokines.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Feeding EPA + DHA increases plasma content of these fatty acids in specific species of plasma phosphatidylcholine. Change in essential fatty acid status was associated with downregulation of the inflammatory signal macrophage inflammatory protein-1β and increase in interleukin-17, monocyte chemoattractant protein (MCP)-4, macrophage-derived chemokine and thymus- and activation-regulated chemokine signals. Plasma arachidonic acid content correlated with chemoattractant protein MCP-4 during early stages of infection.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>We conclude that feeding COVID-19 infected intensive care unit patients enteral formulas containing EPA and DHA may alter response to infection; however, the potential benefit to clinical outcome is not clear.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16668,"journal":{"name":"Journal of Parenteral and Enteral Nutrition","volume":"49 7","pages":"875-882"},"PeriodicalIF":4.1,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://aspenjournals.onlinelibrary.wiley.com/doi/epdf/10.1002/jpen.2783","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144532832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of home-based methods to defat human milk for infants with chylothorax: An experimental study","authors":"Kaitlin Berris RD,&nbsp;Kendall Plant BSc,&nbsp;Frances Jones IBCLC,&nbsp;Diego Marquez MD,&nbsp;Vicki Hsieh RN,&nbsp;Rajavel Elango PhD","doi":"10.1002/jpen.2782","DOIUrl":"10.1002/jpen.2782","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Chylothorax is a postoperative complication for infants with congenital heart defects; with high nutrition risk. Defatted human milk is recommended; however, refrigerated centrifugation to process milk poses accessibility barriers for many hospitals and families at home. Creation of a simplified home-based defatted milk protocol allows infants with chylothorax to be provided the immunological benefits of human milk postoperatively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Milk from 20 mothers was tested to compare refrigerated centrifugation as the standard defatting technique against gravity-based methods: syringe tip-down and gravy separator. Two timeframes, 24 h and 48 h, were tested to determine if additional time had a significant impact on fat reduction. The MIRIS human milk analyzer provided results for fat, true protein, carbohydrate, and energy content. One-way analysis of variance was used to determine a significant difference on fat content among methods.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>All methods had a significant reduction in fat content, with centrifugation having the largest mean decline from 3.4 to 0.5 g/100 ml (<i>P</i> &lt; 0.0001). The second most effective method to defat milk was 48-h gravy separator with a mean decline to 0.7 g/100 ml (<i>P</i> &lt; 0.0001). Postpartum age of milk impacted the degree of fat removal in all methods. True protein content remained the same as baseline in all methods.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>A simplified home-based gravity separation method over 48 h reduced human milk fat by 80%. This is the first protocol to defat human milk without use of the more resource-intensive centrifugation method, that shows significant fat reduction with easy-to-use and accessible equipment for management of infants with chylothorax.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16668,"journal":{"name":"Journal of Parenteral and Enteral Nutrition","volume":"49 6","pages":"724-731"},"PeriodicalIF":4.1,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jpen.2782","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144478543","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between insulin dose and hyperglycemia in hospitalized adults with ischemic stroke receiving continuous enteral nutrition: A retrospective cohort study","authors":"Heather M. Wallhauser PharmD,&nbsp;Leslie A. Hamilton PharmD,&nbsp;Skyler R. Brown PharmD,&nbsp;Thomas J. Christianson MD,&nbsp;Brian F. Wiseman MD,&nbsp;Olivia N. Bray PharmD,&nbsp;Hayden W. Caldwell PharmD,&nbsp;A. Shaun Rowe PharmD","doi":"10.1002/jpen.2787","DOIUrl":"10.1002/jpen.2787","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Hyperglycemia following an acute ischemic stroke has been linked to increased morbidity and mortality. Because of changes in a hospital-wide sliding-scale insulin protocol to incorporate half-doses at midnight due to hypoglycemia risk, we aimed to evaluate the safety and efficacy of half-dose sliding-scale insulin at midnight compared with full doses in patients with acute ischemic stroke receiving enteral nutrition.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This single-center, retrospective cohort study involved 151 patients with acute ischemic stroke and receiving enteral nutrition in a neurocritical care unit between January 1, 2014, and December 31, 2021. The exposure of interest was half-dose sliding-scale insulin at midnight compared with full-dose sliding-scale insulin at midnight. The primary outcome was the incidence of hyperglycemia for a 48-h period after stability while receiving enteral nutrition. Secondary outcomes were new infections, incidence of hypoglycemia, and incidence of delirium.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In the full-dose group, 52 patients experienced hyperglycemia compared with 60 patients in the half-dose group; however, after propensity matching for carbohydrate content in enteral nutrition and hemoglobin A1c, the results are not noninferior (risk difference, 3.9%; 95% CI, −21.2% to 13.3%; <i>P</i> = 0.1041). Delirium was significantly higher in the full-dose group, whereas the half-dose group had a higher rate of suspected bacterial infections.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The study indicates that administering half-dose sliding-scale insulin at midnight in patients with acute ischemic stroke receiving enteral nutrition is not noninferior to full doses in controlling hyperglycemia. However, differences in delirium and infection rates suggest that glycemic changes may influence other outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16668,"journal":{"name":"Journal of Parenteral and Enteral Nutrition","volume":"49 6","pages":"752-757"},"PeriodicalIF":4.1,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144370066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic evaluation of GLIM-defined severe malnutrition via skeletal muscle mass index in critically ill adults: A comparative analysis","authors":"Tomoka Miyagi RD,&nbsp;Minoru Yoshida MD, PhD,&nbsp;Shinya Suganuma MD,&nbsp;Kensuke Nakamura MD, PhD,&nbsp;Shunsuke Takaki MD, PhD","doi":"10.1002/jpen.2789","DOIUrl":"10.1002/jpen.2789","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The Global Leadership Initiative on Malnutrition (GLIM) criteria are recommended by major academic societies; however, their application to critically ill patients is limited because of the difficulties associated with assessing muscle mass and the lack of standardized methods and cutoff values. We herein applied GLIM criteria to intensive care unit (ICU) patients by accurately assessing total skeletal muscle volume using computed tomography (CT) with sarcopenia diagnostic cutoff values.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We included consecutive adult patients admitted to our ICU who underwent CT of the trunk. Total skeletal muscle area at the third lumbar vertebra was measured, and the skeletal muscle index was calculated. Reduced muscle mass was defined with Iritani criteria. A positive result in any of the phenotypic criteria was regarded as severe malnutrition. The primary outcome was in-hospital mortality. We also examined the agreement with the Subjective Global Assessment (SGA) using Cohen kappa coefficient.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 147 patients, 38 had weight loss, 39 had a low body mass index (BMI), and 41 had reduced muscle mass. In-hospital mortality was associated with reduced muscle mass (13.2% vs 43.9%, <i>P</i> &lt; 0.001) and low BMI (15.7% vs 38.5%, <i>P</i> = 0.003). The concordance of individual and sole phenotypic criteria with SGA was low, whereas concordance was the highest at κ = 0.70 when all three criteria were combined.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>GLIM criteria with accurate muscle mass evaluation using sarcopenia diagnostic cutoffs by CT may facilitate the identification of ICU patients with malnutrition whose prognosis is poor.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16668,"journal":{"name":"Journal of Parenteral and Enteral Nutrition","volume":"49 7","pages":"865-874"},"PeriodicalIF":4.1,"publicationDate":"2025-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144370068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence of catheter-related bloodstream infections with sodium citrate lock therapy in adult patients receiving home parenteral nutrition: A descriptive cohort study","authors":"Rachel Leong PharmD,&nbsp;Nisha J. Dave PharmD,&nbsp;Daniel P. Griffith RPh,&nbsp;Anna Guo MS,&nbsp;Kirk A. Easley MS,&nbsp;John R. Galloway MD,&nbsp;Thomas R. Ziegler MD,&nbsp;Vivian M. Zhao PharmD","doi":"10.1002/jpen.2788","DOIUrl":"10.1002/jpen.2788","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>We determined the incidence of catheter-related bloodstream infections in adult patients requiring home parenteral nutrition (HPN) while receiving sodium citrate locks.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a single-center descriptive cohort study involving 38 adults who required HPN from January 1, 2020, to August 31, 2022. The exact method, assuming a Poisson distribution, was used to estimate the incidence rate of catheter-related bloodstream infections per 1000 catheter days among patients receiving sodium citrate locks. Univariate and multivariate analyses using Poisson regression and frailty models were employed to evaluate predictive factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Thirty-eight patients received sodium citrate locks, with 65.8% women (mean age, 50.2 ± 14.5 years). The average length of HPN was 3.6 years. Forty-six catheter-related bloodstream infections occurred during 20,085 catheter days, demonstrating an incidence rate of 2.3 (95% confidence interval, 1.7–3.1) per 1000 catheter days. Peripheral-inserted central catheters had a higher incidence rate (3.9 per 1000 catheter days) than Hickman catheters (2.2 per 1000 catheter days), with a hazard ratio of 1.27, indicating a 27% increased risk of catheter-related bloodstream infections. Univariate and multivariate Poisson regression analyses revealed that for every 1-h increase in HPN infusion duration (h/day), the incidence rate of catheter-related bloodstream infections is expected to increase by 10%.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Catheter-related bloodstream infections are common in adult patients requiring HPN. Sodium citrate locks may help prevent these infections. Recognizing predictive factors, such as the duration of parenteral infusion, can help healthcare providers develop more effective prevention strategies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16668,"journal":{"name":"Journal of Parenteral and Enteral Nutrition","volume":"49 6","pages":"783-790"},"PeriodicalIF":4.1,"publicationDate":"2025-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144370067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Essential fatty acid deficiency in children treated with long-term 100% fish-oil lipid injectable emulsion: A longitudinal descriptive cohort study","authors":"Kathleen M. Gura PharmD,&nbsp;Muralidhar H. Premkumar MBBS,&nbsp;Kara L. Calkins MD,&nbsp;Mark Puder MD, PhD","doi":"10.1002/jpen.2785","DOIUrl":"10.1002/jpen.2785","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>To assess severity and risk of an essential fatty acid deficiency in children &lt;2 years with parenteral nutrition–associated cholestasis on long-term 100% fish-oil lipid injectable emulsion.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This longitudinal descriptive cohort study included patients receiving fish-oil lipid injectable emulsion (1 g/kg/day). Triene: tetraene ratios were monitored for up to 4 years and classified as mildly elevated (≥0.05 and &lt;0.2) or essential fatty acid deficiency (≥0.2).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>One hundred and twenty-seven patients with a baseline median age of 14 weeks were included. Serum docosahexaenoic acid and eicosapentaenoic acid levels markedly increased, whereas arachidonic acid, linoleic acid, and α-linolenic acid levels decreased before stabilizing. Median triene: tetraene ratios peaked at 0.027 at week 8 and then stabilized within a range of 0.015 and 0.020 from week 16 until the end of the study. Seven patients had mildly elevated triene: tetraene ratio at the end of the study. Three infants had an essential fatty acid deficiency, but none demonstrated clinical signs consistent with this deficiency. One deficiency was attributed to a laboratory error; two were associated with adverse events. All patients resolved with the continuation of fish-oil lipid injectable emulsion.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Children with parenteral nutrition–associated cholestasis on long-term fish-oil lipid injectable emulsion are at low risk for a clinical or biochemical essential fatty acid deficiency. These findings indicate that despite its low content of linoleic acid and α-linolenic acid, long-term 1 g/kg/day of 100% fish-oil lipid injectable emulsion is not associated with an essential fatty acid deficiency.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16668,"journal":{"name":"Journal of Parenteral and Enteral Nutrition","volume":"49 6","pages":"732-740"},"PeriodicalIF":4.1,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144334822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Parenteral nutrition weaning in pediatric intestinal failure patients enrolled in remote patient monitoring: A descriptive study","authors":"Stephanie B. Oliveira MD,&nbsp;Julia D. Thomas BA,&nbsp;Conrad Cole MD,&nbsp;Michael Helmrath MD,&nbsp;Samuel Kocoshis MD,&nbsp;Paul W. Wales MD","doi":"10.1002/jpen.2784","DOIUrl":"10.1002/jpen.2784","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Remote patient monitoring (RPM) enhances patient surveillance. This study describes our initial experience with RPM in pediatric intestinal failure patients and its preliminary impact on parenteral nutrition (PN) reduction in an outpatient setting.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We performed a descriptive cohort study on pediatric patients with intestinal failure receiving home PN and enrolled in an RPM program managed by our intestinal rehabilitation team. Initiated in March 2021, the study compared PN energy and volume reduction rates before and after RPM implementation. We calculated the rate of PN decrease per day and the time to achieve a 20% reduction in PN volume. Paired <i>t</i> tests were used for comparisons. Statistical significance was set at <i>P</i> &lt; 0.05. The study received institutional review board approval.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Seventeen patients were included (52% male; mean age: 44 months). The most common etiology of short bowel syndrome was necrotizing enterocolitis (NEC), with a mean residual small bowel length of 15.5% ± 12.5%. Post-RPM, there was a greater reduction in PN energy and volume (0.22 ± 0.28 and 0.17 ± 0.24) compared with pre-RPM (0.08 ± 0.10 and 0.07 ± 0.08), though not statistically significant (<i>P</i> = 0.11 and <i>P</i> = 0.17). Time to achieve a 20% reduction in PN was shorter post RPM but not statistically significant (<i>P</i> = 0.06 and <i>P</i> = 0.20 for energy and volume, respectively).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Remote patient monitoring appears safe for pediatric intestinal failure patients, with potential for higher PN reduction and shorter time to achieve it. Further research is needed to fully assess RPM's impact on this population.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16668,"journal":{"name":"Journal of Parenteral and Enteral Nutrition","volume":"49 6","pages":"768-772"},"PeriodicalIF":4.1,"publicationDate":"2025-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jpen.2784","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144304409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Teduglutide in adults with short bowel syndrome and intestinal failure: A descriptive cohort study","authors":"Elizabeth S. L. Low MBBS,&nbsp;Kathryn Burrell GradDip,&nbsp;Katrina Tan MBBS,&nbsp;Brooke Chapman PhD,&nbsp;Adam Testro PhD,&nbsp;Darren Wong PhD","doi":"10.1002/jpen.2786","DOIUrl":"10.1002/jpen.2786","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>International evidence supports the efficacy of teduglutide in reducing parenteral support requirements, or achieving enteral autonomy, in patients with short bowel syndrome–intestinal failure. This is a multicenter observational study presenting the real-world experience with teduglutide in Australia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>11 of 12 Australian intestinal rehabilitation units submitted data for 19 adult patients with short bowel syndrome–intestinal failure prescribed teduglutide from November 2020 to August 2023. Patient and clinical characteristics, including teduglutide dosing and parenteral support prescriptions, were collected at 3-month intervals for 12 months from teduglutide initiation and finally at study termination. Univariate analysis was conducted and results presented as medians with interquartile ranges (IQRs).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Seventy-four percent of the cohort (median age 58 [IQR 44–67] years) were female. The median residual small bowel length was 85 cm (IQR 60–118), with 53% having colon in continuity. Prior to teduglutide commencement, median parenteral support duration was 3.8 (IQR 1.1–11.0) years, with weekly parenteral support volumes of 11.5 (IQR 6.2–15.3) L/week. Seven patients (37%) achieved enteral autonomy, with five weaned off by 12 months and the remaining between 12–42 months from teduglutide initiation. 79% achieved ≥20% parenteral support volume reductions, with overall median parenteral support volume reductions of 28% after 12 months. Baseline quality-of-life assessments suggested that sexual function, travel ability, and sleep patterns were areas of greatest disease burden.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Within an Australian cohort, teduglutide is effective at reducing parenteral support requirements in patients with short bowel syndrome–intestinal failure, although the effect onset and range remains heterogenous.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16668,"journal":{"name":"Journal of Parenteral and Enteral Nutrition","volume":"49 7","pages":"912-918"},"PeriodicalIF":4.1,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Donor human milk storage and gastrointestinal morbidities in preterm infants: A case-control study","authors":"Terence James M. Camilon MS,&nbsp;Mary Galemmo BS,&nbsp;Whitney Savino NNP,&nbsp;Allison Rohrer RD,&nbsp;Mathew J. Gregoski PhD,&nbsp;Aaron P. Lesher MD,&nbsp;Katherine E. Chetta MD","doi":"10.1002/jpen.2780","DOIUrl":"10.1002/jpen.2780","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Prolonged storage of donor human milk may alter its bioactive components, potentially affecting preterm infant outcomes. No prior studies have examined the impact of donor human milk storage duration on necrotizing enterocolitis or spontaneous intestinal perforation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In a retrospective case-control study (February 2022 to January 2024) at a single neonatal intensive care unit, we evaluated preterm infants (&lt;32 weeks' gestational age or birth weight &lt;1700 g) receiving donor human milk. Cases (<i>n</i> = 36) had necrotizing enterocolitis (Bell stage ≥2A) or spontaneous intestinal perforation; controls (<i>n</i> = 226) were disease free. Donor human milk storage duration (days from expression to consumption) was calculated using lot expiration dates. Logistic regression assessed associations, adjusting for gestational age, birth weight, and other confounders.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 262 infants, 36 developed necrotizing enterocolitis (<i>n</i> = 28) or spontaneous intestinal perforation (<i>n</i> = 8). Mean donor human milk storage duration was 258.6 (SD, 29.9) days in cases and 244.5 (SD, 21.7) days in controls (<i>P</i> = 0.01). Each additional storage day increased the adjusted odds of necrotizing enterocolitis or spontaneous intestinal perforation by 3.6% (95% confidence interval, 1.17–5.5; <i>P</i> &lt; 0.001), after accounting for maternal and infant comorbidities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Prolonged donor human milk storage is associated with necrotizing enterocolitis and spontaneous intestinal perforation in preterm infants, particularly those &lt;750 g. These findings suggest a need to reevaluate donor human milk storage guidelines for high-risk neonates, pending multicenter validation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16668,"journal":{"name":"Journal of Parenteral and Enteral Nutrition","volume":"49 6","pages":"717-723"},"PeriodicalIF":4.1,"publicationDate":"2025-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jpen.2780","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between parenteral nutrition and length of stay in late preterm and term infants: A retrospective cohort study","authors":"Katrina A. Savioli MD,&nbsp;Carl E. Hunt MD,&nbsp;Anwar E. Ahmed PhD,&nbsp;Cara H. Olsen MS, PhD,&nbsp;Reese H. Clark MD,&nbsp;Nicole R. Dobson MD","doi":"10.1002/jpen.2781","DOIUrl":"10.1002/jpen.2781","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>We aimed to determine how the use of parenteral nutrition in late preterm and term infants admitted to the neonatal intensive care unit (NICU) affects outcomes, specifically length of stay.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This is a retrospective cohort study that included infants ≥35 weeks gestation admitted to a Pediatrix Medical Group–affiliated NICU on day of life 0–2 in 2009–2019. Propensity score matching was used to control for demographics, delivery characteristics, and severity of illness. Infants were excluded if they received comfort or palliative care in the delivery room or transferred before discharge home. The primary outcome was length of stay. Secondary outcomes were duration of conventional and high-frequency ventilation, late-onset sepsis, and mortality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The total cohort had 470,433 neonates; of the 259,495 infants who met inclusion criteria and survived to discharge, 97,577 (37.6%) received parenteral nutrition. Of 59,580 propensity-matched neonates comparing parenteral nutrition vs no parenteral nutrition, those receiving parenteral nutrition (<i>n</i> = 29,790) had a longer median length of stay (10 vs 9 days, <i>P</i> &lt; 0.0001). Analysis of secondary outcomes revealed a higher mean number of conventional ventilation days, higher odds of late-onset sepsis, and higher odds of mortality in neonates receiving parenteral nutrition vs no parenteral nutrition.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Parenteral nutrition in late preterm and term neonates is associated with increased length of stay, duration of conventional ventilation, and odds of late-onset sepsis and mortality. Prospective clinical trials are needed to better understand the optimal use and timing of parenteral nutrition and associated morbidities in this population.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16668,"journal":{"name":"Journal of Parenteral and Enteral Nutrition","volume":"49 7","pages":"837-845"},"PeriodicalIF":4.1,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144236749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}