Journal of Parenteral and Enteral Nutrition最新文献

Pre–coronavirus disease 2019 (COVID-19) critical care research underscored the importance of muscularity on patient outcomes. This study investigates the association between skeletal muscle mass and quality with clinical and physical function outcomes in critically ill patients with COVID-19. We systematically searched MEDLINE, EMBASE, and CINAHL from database inception to April 24, 2024, for studies using objective methods to evaluate muscularity in critically ill adults with COVID-19, without language restrictions. Co–primary outcomes were overall mortality and muscle strength. Random-effect meta-analyses were performed in RevMan 5.4.1. We included 20 studies (N = 1818), assessing muscularity via computed tomography (twelve studies), ultrasound (seven studies), and bioelectrical impedance analysis (one study); none had low risk of bias. In analyses of high vs low muscularity, high muscle mass was significantly associated with lower overall mortality (nine studies; risk ratio = 0.74; 95% CI, 0.57–0.98; P = 0.03). When muscularity was analyzed as a continuous variable, COVID-19 survivors had higher skeletal muscle area (SMA) (13 studies; mean difference [MD] = 1.18; 95% CI, 0.03–2.33; P = 0.05) confirmed by sensitivity analysis using standardized MD (0.23, 95% CI 0.05–0.42, P = 0.01) and significantly higher muscle quality (five studies; standardized MD = 0.45; 95% CI, 0.20–0.70; P = 0.0004). Muscle strength findings were inconsistent: one study showed significant correlations between muscle strength with muscle mass parameters (r = 0.365–0.375, P < 0.001) whereas another found no association. In critically ill adults with COVID-19, high muscle mass was associated with lower mortality risk. Survivors had significantly higher SMA and muscle quality. Findings on physical function outcomes remain inconclusive (PROSPERO ID: CRD42022384155).

There are inconsistent recommendations in available guidelines and uncertainty regarding the exact nutrient requirements for preterm infants, partly because of inconsistent outcome reporting in nutrition intervention studies. To support development of a minimum reporting set, we undertook a scoping review to identify measures of nutrition intake and growth outcomes reported in recent preterm nutrition studies. We searched for publications from 2018 to 2023 reporting individuals born preterm at any gestational age and study location whose nutrition intake was assessed before first hospital discharge and whose growth was assessed at any age. One reviewer screened articles and extracted the measures. Any uncertainties were resolved by a second reviewer. The results were tabulated and analyzed descriptively. We identified 6365 records, and included 250 studies. Only 10 of 236 studies (4%) reported how nutrition intake was calculated. There were five different ways of reporting weight and 13 of weight gain, each at many different time points. Furthermore, 27 of 105 studies (26%) did not report how weight gain was calculated, and those that did reported five different calculation methods. Our findings demonstrate significant variation and incomplete reporting of nutrition intake and growth outcomes in preterm nutrition studies. This lack of standardization limits the utility of existing evidence and highlights the need for a standardized reporting framework to improve comparability and support evidence-based guidelines in preterm nutrition.

With advancements in neonatal care, the viability of extremely low-birth-weight (ELBW) infants, especially those born extremely preterm, is increasing. However, specific recommendations for managing parenteral nutrition (PN) support in nanopreterm infants (<750 g or <25 weeks' gestation) are lacking. We aim to evaluate current recommendations and highlight considerations for applying them to nanopreterm infants. The author team used English-language articles related to nutrition in ELBW with emphasis on nanopreterm infants, along with studies on fetal growth and metabolism. Current PN support recommendations for ELBW infants may not suit nanopreterm infants due to physiological and developmental differences. Key considerations for nanopreterm infants include:

This review highlights the limitations of available PN support recommendations for nanopreterm infants. Further research is needed to establish precise guidelines that optimally meet their nutrition needs.