Search

The modular nutrients are mixtures or isolated macronutrients that can be enriched with micronutrients. Modules are generally added in pediatrics, to the formula or to enteral preparations, to increase the energy intake or some specific nutrient. The existing carbohydrate modules are: maltodextrins, cereals, corn starch. The protein modules comprise; the formula concentration as well as the addition of fortifiers and finally, the lipid modules are made up of vegetable oil, medium chain triglycerides and mixed mixtures. The osmolarity must be considered depending on the type of formula and module to be used, carbohydrate modules are generally the ones that increase osmolarity the most. The usefulness of adding nutritional modules in current pediatrics persists and is a beneficial tool in various pathologies and nutritional status. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To determine the frequency and clinical features of the late preterm infants with feeding intolerance. MATERIASL AND METHODS: Medical records of 426 infants with gestational age of 340/7- 366/7 weeks were retrospectively reviewed for the study. Clinical and demographic features of late preterm infants and episodes of feeding intolerance were recorded. RESULTS: A total of 54 late preterm infants with feeding intolerance were evaluated and compared with 178 infants without feeding intolerance. Baseline demographics were similar between groups. Mean duration of intolerance period was 2.3 ± 1.2 days. Time to full enteral feeding was significantly longer in late preterm infants with feeding intolerance when compared with infants without feeding intolerance (8 ± 2.3 vs 5.2 ± 1.7 days, respectively, p<0.001). Breastfeeding rates were similar between the groups. Rate of prokinetic use in the feeding intolerance group was 37%. There were no differences between the time to full enteral feeding and the duration of parenteral nutrition between prokinetic users and non-users. CONCLUSIONS: Although the gestational ages of late preterm infants are close to term and their size is relatively large, they are not like term infants. These infants should be followed closely in terms of feeding problems as well as many morbidities. [ABSTRACT FROM AUTHOR]

Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: medical nutritional treatment (MNT) can be complex and may be associated with potential metabolic complications, which has been recently described as nutritrauma. Objective: the aim of our work is to describe whether the application of the nutritrauma concept in real life is feasible and useful to detect the metabolic complications associated with the prescription of MNT. Material and methods: in this descriptive, prospective study at a single center we enrolled 30 consecutive critically ill patients in a 14-bed medical-surgical intensive care unit. The nutritrauma strategy implementation was based in four "M" steps: Metabolic screening, MNT prescription, biochemical Monitoring, and nutritional Management. Results: we analyzed 28 patients (mean age, 69.7 ± 11.3 years; APACHE II, 18.1 ± 8.1; SOFA, 7.5 ± 3.7; Nutric Score, modified, 4.3 ± 2.01, and mean BMI, 27.2 ± 3.8). The main cause of admission was sepsis (46.4 %). Length of ICU stay was 20.6 ± 15.1 days; 39.3 % of subjects died during their ICU stay. Enteral nutrition (82.1 %) was more frequent than parenteral nutrition (17.9 %). During nutritional monitoring, 54 specific laboratory determinations were made. Hyperglycemia was the most frequent metabolic alteration (83.3 % of measurements). Electrolyte disturbances included hypocalcemia (50 %), hypophosphatemia (29.6 %) and hypokalemia (27.8 %). The most frequent lipid profile abnormalities were hypocholesterolemia (64.8 %) and hypertriglyceridemia (27.8 %). Furthermore, nutritional prescription was modified for 53.6 % of patients: increased protein dosage (25 %), increased calorie dosage (21.4 %) and change to organ-specific diet (17.8 %). Conclusions: in conclusion, the application of the nutritrauma approach facilitates detection of metabolic complications and an evaluation of the appropriate prescription of MNT. [ABSTRACT FROM AUTHOR]

Introduction: the objective of the study was to assess the efficacy of an individualized dietary adaptation to achieve nutritional requirements in patients undergoing hematopoietic stem cell transplantation (HSCT). Methodology: a pilot study of a nutritional intervention in patients undergoing HSCT. A nutritional assessment was performed the first 24 hours of admission and every 48-72 hours until discharge, or + 40 days after the transplant, making dietary adaptations. Results: 25 patients were recruited. According to MUST, 92.0 % (n = 23) were well nourished at the initial visit, with a loss of 2.1 (3.8) kg and a BMI of 26.4 kg/m2 (4.2). Before HSCT, there was already a decrease in intake of 15.4 (23.5) % and in body weight of 0.2 (3.2) kg; after the HSCT, the weight loss was 3.4 (5.0) kg and the decrease in intake was 6.5 (30.4) %. The predominant symptoms were mucositis (60 %), nausea (60 %), and diarrhea (44 %). The diet was adapted in 100 % of the patients, 52 % received oral nutritional support (ONS) (n = 13); enteral nutrition (EN) and parenteral nutrition (PN) were used only once. Conclusion: the nutritional status of patients undergoing HSCT is normal on admission but deteriorates during transplantation and prior conditioning. Dietary intervention is key to maintaining oral intake and reducing the risk of malnutrition. [ABSTRACT FROM AUTHOR]

Background: the development of specialised nutritional support techniques allows the maintenance of an adequate supply of nutrients in those patients in whom oral feeding is not possible or is insufficient in relation to their requirements, trying to improve the quality of life, especially in those with chronic diseases. Methods: single-center clinical study carried out in a clinical-nutritional center consisting of a medically supervised nasogastric-duodenal tube feeding treatment for overweight, obesity and increased body fat percentage in patients requiring it by means of duodeno-enteral feeding, expecting losses of more than 10 %. Results: twenty-nine patients completed the protocol (20.4 % male and 79.6 % female) with a mean age of 38 years (SD: 12.4); 87.2 kg (SD: 18.5) mean weight; 37.9 kg (SD: 4.8) mean iFat%; 32.4 (SD: 5.4) iMean body mass index (BMI); 100 cm (SD: 16.0) iMean waist; 113.6 cm (SD: 10.4) iMean hip; 33.8 cm (SD: 3.9) iMean upper arm circumference; 65.5 cm (SD: 7.5) iMean thigh circumference; 9.7 (SD: 4.8) iVisceral fat index; and 22.9 days (SD: 13.9) mean treatment. A mean of 22.9 (SD: 13.9) days of MESUDEFT influences weight loss, fat loss, visceral fat loss and decreased arm, hip and thigh circumferences (p < 0.05) (i: initial). Conclusions: MESUDEFT is shown to be an effective alternative as a sole treatment or as an adjunct prior to bariatric surgery for obesity or overweight treatment with a minimum of 10 % loss of BMI and fat mass at completion and 3-6 months follow-up. [ABSTRACT FROM AUTHOR]

Copyright of Medicina (Buenos Aires) is the property of Medicina (Buenos Aires) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

La pancreatitis aguda es una patología cuyo manejo primario abarca medidas con el fin de asegurar el reposo gastrointestinal, la presente revisión sistemática tiene como fin valorar los beneficios obtenidos tras iniciarse una dieta oral inmediata en pacientes con pancreatitis aguda. Se realizó una revisión sistemática, bajo lineamentos PRISMA, que incluyó ensayos clínicos controlados aleatorizados, la búsqueda fue realizada en PubMed, ScienceDirect y Cochrane, se usaron los términos de búsqueda: “Acute pancreatitis”, “Enteral nutrition” "Oral refeed" y "randomized controlado trial", obteniendo 393 artículos. Tras aplicar criterios de inclusión y exclusión, un total de 6 estudios se incluyeron en la revisión, se valoró: complicaciones o eventos adversos, gravedad del cuadro, requerimiento de analgesia, estancia hospitalaria, tolerancia a la dieta y gastos generados, encontrando beneficios estadísticamente significativos, sobre todo en los últimos tres aspectos. Se concluyó que la alimentación oral inmediata es segura en pacientes con pancreatitis aguda, pese a ello, es imprescindible generar más estudios multicéntricos con el fin de generar evidencia de mayor peso.

Introduction: during COVID-19 pandemic, international societies released guidelines and recommendations for patients requiring nutritional support according to previous similar respiratory diseases. Objectives: the aim of the study was to evaluate the nutritional support provided by enteral nutrition (EN) in patients with COVID-19 infection, identify if the recommendations from international societies were met and their impact on mortality rate. Methods: a cohort study was conducted on adult patients with COVID-19 admitted to a tertiary hospital. Demographic, clinical, biochemical, and nutritional variables were obtained. A random-effect parametric survival-time model was performed to quantify the risk of death for each variable, and the Hausman test was used to confirm the model. Results: two hundred and twenty-nine patients were enrolled. The delivered energy was > 80 % of adequacy in the first two days, as suggested by international guidelines (11.7 ± 4.9 kcal/kg); however, an adequacy rate less than 60 % was achieved on day 14 (25.4 ± 7.4 kcal/kg). The protein adequacy was > 75 % on the first days of infusion (1.3 ± 0.3 g/kg); however, the infusion was < 50 % (1.5 ± 0.4 g/kg) after being extubated. Age, sex, and nutritional risk were related to higher mortality in patients with EN, whereas the infused energy and protein, the percentage of protein adequacy, arginine, and n-3 PUFA were associated with lower mortality. Conclusion: achieving at least 80 % of the energy and protein requirements, as well as n-3 PUFA and arginine supplementation could be associated with lower mortality in COVID-19 patients. More studies are needed to confirm the role of these nutrients on the mortality rate. [ABSTRACT FROM AUTHOR]

Copyright of Revista Nutrición Clínica y Dietética Hospitalaria is the property of Sociedad Espanola de Dietetica y Ciencias de la Alimentacion and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: This article summarizes the clinical practice guideline (CPG) for the management of enteral nutrition in premature newborns with very low birth weight in the Social Security of Peru (EsSalud). Objective: Provide evidence-based clinical recommendations for the management of premature newborns with very low birth weight in EsSalud. Methods: A guideline development group (GDG) was formed that included medical specialists and methodologists. The GDG formulated 5 clinical questions to be answered by this CPG. Systematic searches were carried out for systematic reviews and - when considered relevant - primary studies in Medline and CENTRAL during 2021. The evidence was selected to answer each of the clinical questions posed. The certainty of the evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology. In periodic working meetings, the GDG used the GRADE methodology to review the evidence and formulate recommendations, good clinical practice points, and the management flowchart. Finally, the CPG was approved with Resolution No. 071-IETSI-ESSALUD-2022. Results: This CPG addressed 5 clinical questions, all referring to the management of enteral nutrition in premature newborns with very low birth weight. Based on these questions, 5 recommendations were formulated (1 strong recommendation and 4 conditional recommendations), 5 GCP, and 1 flow chart. Conclusion: This article summarizes the methodology and evidence-based conclusions of the CPG for the management of enteral nutrition in premature newborns with very low birth weight in EsSalud. [ABSTRACT FROM AUTHOR]

Copyright of Revista Nutrición Clínica y Dietética Hospitalaria is the property of Sociedad Espanola de Dietetica y Ciencias de la Alimentacion and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: enteral nutrition is an effective method for restoring the nutritional status in patients unable to eat or fulfil nutritional requirements orally. Objectives: the ECONES study aimed to describe the treatment of patients requiring home enteral nutrition (HEN) in routine practice and the experience of specialists with the high-protein hypercaloric formula 2.0 with fiber IS50 (HP/HC 2.0). Methods: Spanish specialists answered a 38-questions survey about their last six patients with HEN and their treatment with HP/HC 2.0 formula. Results: the formulas were chosen based on the patients' requirements. HP/HC 2.0 was administered in a mean of 31.5 % of patients, and for a mean of 42.2 % of those, it was selected since the beginning of treatment. According to 92.4 % of specialists, the HP/HC 2.0 was considered as adequate based on nutritional requirements. Among adverse reactions, specialists reported diarrhea, bloating and constipation. Specialists reported that caregivers (90.6 %) stated that HP/HC 2.0 was well tolerated by patients (90.6 %) and expressed comfort with the frequency (75.3 %) and administration time (82.9 %). Conclusions: according to the specialists, formulas are chosen based on patients' characteristics. Patients with high nutritional needs benefit from the HP/HC 2.0 formula as it allows volume restriction, presents few adverse events, and improves the quality of life of the patients. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Nursing & Health is the property of Journal of Nursing & Health (JONAH) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Enfermería Neonatal is the property of Fundacion para la Salud Materno Infantil (FUNDASAMIN) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: the administration of enteral nutrition through a nasogastric tube can cause potentially serious complications. We present a case of esophageal obstruction due to an enteral nutrition bezoar. Case report: the 77-year-old patient was admitted to our center in the intensive care unit for COVID pneumonia. The patient received enteral nutrition through a nasogastric tube (NGT), presenting difficulty passing it after a month of follow-up. After removal of the tube and attached to it, an esophageal mold for enteral nutrition was extracted. Later, a solvent solution is administered through a new SNG and the formula is modified for a hydrolyzed one. Discussion: enteral nutrition bezoars are a rare but can be a life-threatening complication. [ABSTRACT FROM AUTHOR]

Introduction: Enteral feeding in patients with dementia poses an ethical-clinical challenge. This article presents the validation process of a questionnaire to know doctors' opinions on the matter and its preliminary results. Materials and methods: An anonymous questionnaire was prepared to obtain doctors' views about enteral feeding. I was aimed at palliative care, geriatrics, internal medicine, and neurology specialists from public and private care centers attending to three clinical cases of patients with dementia at different stages of evolution. The questions addressed four fields: motivations for starting or stopping enteral feeding, therapeutic adequacy, euthanasia, and decision-making. Results: A response rate of 64 % was attained. The questionnaire turned out to be a tool with acceptable validity and reliability. Palliative care and geriatrics specialists were more likely to adapt therapeutic efforts and integrate the family into decisions. Internal medicine and neurology professionals tended to be more invasive in their treatments. Conclusion: The results allow us to recommend the questionnaire to assess professionals' attitudes toward the most relevant bioethical issues in the care of patients with dementia. [ABSTRACT FROM AUTHOR]

Nutritional support in adult patients receiving extracorporeal membrane oxygenation (ECMO) therapy is controversial. Althou-gh there are guidelines for the NS (Nutritional support) in pediatric patients with ECMO, in adults these guidelines are not available for the use, type, route and timing of nutritional therapy. In critically ill patients it is well known that early enteral nutrition is beneficial, however there is the possibility that in patients with ECMO early enteral nutrition leads to gastrointes-tinal complications. Likewise, there have not been established caloric targets, proteins and doses or types of micronutrients to use for this specific population being a challenge for the clinician. In addition, patients with ECMO are some of the most seriously ill in intensive care units, where malnutrition is associated with increased morbidity and mortality. Regarding the use of parenteral nutrition (NP) it has not been described if it implies a risk of circuit failure at the time of introducing lipids to the oxygenator. Therefore, a correct evaluation and specific nutritional intervention by experts in the field is imperative to impro-ve the prognosis and quality of life in this population, which is a primary goal in the care of adult patients receiving extracor-poreal membrane oxygen. [ABSTRACT FROM AUTHOR]

Background: immunonutrition has been introduced and proposed to have positive modulating effects on inflammatory and immune responses in surgical patients. This meta-analysis aimed to assess whether perioperative enteral immunonutrition (EIN) can reduce postoperative complications or reduce inflammatory responses in esophageal cancer (EC) patients undergoing esophagectomy. Methods: PubMed, Embase, Web of science, EBSCO, and Cochrane library databases were systematically searched. Randomized controlled trials (RCTs) assessing the effect of EIN before and/or after surgery in EC patients undergoing esophagectomy were identified. Two investigators independently searched articles, extracted data, and assessed the quality of included studies. Results: ten RCTs involving 1,052 patients were included in the meta-analysis, including 573 patients in the EIN group and 479 patients in the enteral nutrition (EN) group. Overall, no significant difference was observed between the two groups in the incidence of postoperative pneumonia, surgical site infection, intra-abdominal abscess, septicemia, and urinary tract infection. No significant incidence of postoperative anastomotic leakage, acute respiratory distress syndrome (ARDS), and in-hospital mortality was found. Conclusions: perioperative enteral immunonutrition did not reduce the incidence of infectious complications and anastomotic leakage in EC patients undergoing esophagectomy, nor did it reduce postoperative CRP and IL-6, but did not increase in-hospital mortality. [ABSTRACT FROM AUTHOR]

Copyright of Revista de Gastroenterología del Perú is the property of Sociedad de Gastroenterologia del Peru and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista de Gastroenterología del Perú is the property of Sociedad de Gastroenterologia del Peru and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction and aim: Acute pancreatitis (AP) is the most common cause of pancreatic disease in children. Previous studies have described factors related to days of hospital length of stay (LOS) in children. Our aim was to identify factors associated with LOS in AP. Materials and methods: A retrospective study was conducted at the Hospital Infantil de México Federico Gómez in Mexico City, encompassing the time frame of January 1, 2017 and March 31, 2019. AP was confirmed by medical chart review, according to the INSPPIRE criteria at the time of hospital admission, in patients below 18 years of age. AP grade was classified, following the NASPGHAN guidelines. Demographic, clinical, biochemical, nutritional, and treatment data were collected. Prolonged hospital LOS was considered that which lasted 7 days or longer. Results: Fifty-one events (32 patients) were registered. Median LOS was 8 days (IQR 4–14 days). Antibiotic use was significantly associated with longer LOS (OR 31.71; 95% CI: 2.71–370.65; p = 0.006) and early feeding (EF) (within 72 h of admission) was associated with shorter LOS (OR 0.05; 95% CI: 0.001–0.63; p = 0.02). There was no association between LOS and the variables of age, recurrence, grade, etiology, comorbidities, complications, fluid resuscitation, parenteral nutrition, or biochemical characteristics upon admission. Conclusion: Our study, like others, corroborated the fact that EF in the management of AP was associated with fewer days of hospital LOS. Resumen: Introducción y objetivo: La pancreatitis aguda (PA) es la causa más común de enfermedad pancreática en niños. Estudios previos exponen factores relacionados con los días de estancia hospitalaria (EH) en niños. Nuestro objetivo fue identificar factores asociados con EH en PA. Material y métodos: Se realizó un estudio retrospectivo en el Hospital Infantil de México Federico Gómez de la Ciudad de México, del 1 de enero de 2017 al 31 de marzo de 2019. Se confirmó PA por revisión del expediente clínico, de acuerdo con los criterios INSPPIRE en pacientes menores de 18 años de edad al tiempo de su admisión. El grado de PA se clasificó de acuerdo con los lineamientos de la NASPGHAN. Se recabó información demográfica, clínica, bioquímica, nutricional y de tratamiento. Se consideró estancia hospitalaria prolongada (EHP) aquella mayor o igual a 7 días. Resultados: Se registraron 51 eventos (32 pacientes). La mediana de EH fue de 8 días (RIQ 4–14 días). El uso de antibióticos estuvo asociado significativamente con una mayor EH (RM 31.71; IC 95%: 2.71–370.65; p = 0.006) y la alimentación temprana (AT) (dentro de 72 horas del ingreso) se asoció con una disminución de EH (RM 0.05; IC 95%: 0.001-0.63; p = 0.02). No se encontró asociación entre edad, recurrencia, grado, etiología, comorbilidades, complicaciones, reanimación hídrica, uso de nutrición parenteral y características bioquímicas al ingreso y EH. Conclusión: En nuestro estudio, como en algunos otros, se corrobora que, en el manejo de la PA, la AT está asociada con una disminución de los días de EH.

Introduction and objectives: Digestive disorders are one of the most common comorbidities among children with cerebral palsy (CP). The aim of this study is to examine the nutritional status of patients with CP, the prevalence of dysphagia by degree of motor impairment, and the impact of digestive disorders on quality of life. Material and methods: We conducted a descriptive, cross-sectional, open-label study of out-patients with CP from a tertiary hospital in the Region of Madrid using a structured interview, classifying dysphagia using the Eating and Drinking Ability Classification System (EDACS). We gathered demographical and anthropometric data, and analysed the correlation between severity of dysphagia and functional status as measured with the Gross Motor Function Classification System (GMFCS). Results: Our sample included 44 patients (65.9% boys), with a mean (standard deviation) age of 9.34 (5) years and a mean BMI of 18.5 (4.9). Forty-three percent presented safety and efficiency limitations (EDACS level > II). Safety and efficiency limitations were associated with more extensive motor involvement (60% had tetraparesis), more varied clinical manifestations (87% had mixed forms) and poorer functional capacity (100% on GMFCS V). The impact on nutritional status increased with higher EDACS and GMFCS scores. Conclusions: This is the first study into the usefulness of the EDACS scale in a representative sample of Spanish children and adolescents with CP. Our findings underscore the importance of screening for dysphagia in these patients, regardless of the level of motor impairment, and the need for early treatment to prevent the potential consequences: malnutrition (impaired growth, micronutrient deficiencies, osteopaenia, etc.), microaspiration, or recurrent infections that may worsen patients’ neurological status. Resumen: Introducción y objetivos: La enfermedad digestiva es una de las comorbilidades más frecuentes en niños con parálisis cerebral infantil (PCI). Nuestro objetivo es analizar el estado nutricional de los pacientes PCI, la prevalencia de disfagia según afectación motriz (GMFCS) y su repercusión en la calidad de vida. Material y métodos: Estudio descriptivo transversal y abierto en pacientes con PCI seguidos en un Hospital Terciario de la Comunidad de Madrid mediante entrevista estructurada y clasificación de disfagia según la escala Eating and Drinking Ability Classification System (EDACS). Recogimos datos demográficos y antropométricos y relacionamos el nivel de disfagia con el nivel funcional según el Gross Motor Function Classification System (GMFCS). Resultados: La muestra incluyó 44 pacientes (65,9% varones), con una edad media de 9,34 ± 5 años y un IMC de 18,5 ± 4,9. El 43% tenía limitaciones en seguridad y/o eficiencia (EDACS > II). El porcentaje de pacientes afectados fue mayor cuanto más extensa desde el punto de vista topográfico (tetraparesia 60%), más variada semiología clínica (87% en formas mixtas) y peor nivel funcional (100% en GMFCS V). La repercusión nutricional fue mayor cuanto mayor nivel EDACS y GMFCS. Conclusiones: Presentamos el primer estudio sobre la utilidad de la escala EDACS en una muestra representativa de niños y adolescentes españoles con PCI. Los resultados deben hacernos reflexionar sobre la importancia del screening de disfagia en estos pacientes, independientemente del grado de afectación motriz y la necesidad de una intervención precoz para evitar sus principales consecuencias: desnutrición (hipocrecimiento, déficit de micronutrientes, osteopenia, etc.), microaspiraciones o infecciones de repetición que empeoran el estado neurológico.

Objective: the aim of this study was to compare the incidence rate of feeding intolerance (FI) during supine (SP) or prone positioning (PP) in critically ill COVID-19 patients. Methods: this was a retrospective cohort study of critically ill patients with overweight or obesity who received enteral nutrition (EN) in prone or supine positioning continuously during the first five days of mechanical ventilation. Nutritional risk, anthropometric measurements and body composition were assessed at the first 24 hours upon Intensive Care Unit (ICU) admission. Biochemical and clinical variables (Sequential Organ Failure Assessment [SOFA], Acute Physiology and Chronic Health Evaluation II [APACHE II], Acute Kidney Injury [AKI] or comorbidities diagnosis) were collected. Pharmacotherapy (prokinetics, sedatives or neuromuscular blocking agents) and FI incidence (gastric residual volume [GRV] = 200 ml or = 500 ml, vomiting or diarrhea) were daily recorded. Constipation was defined as the absence of evacuation for five consecutive days. Results: eighty-two patients were included. Higher rate of prophylactic prokinetic prescription was observed in PP (42.8 vs 12.5 %, p = 0.002). GRV = 200 in supine position was not different when compared to PP (p = 0.47). Vomiting episodes in supine compared to PP showed no difference between groups (15 % vs 24 %, p = 0.31). No differences in diarrhea events were detected (10 % vs 4.7 %, p = 0.36). Constipation was common in both groups (95 % vs 82 %, p = 0.06). Conclusion: FI during prone position was not different in comparison to supine position. Routinely use of prokinetics in continuous prone position may help to prevent FI incidence. Algorithm development is necessary for FI prevention and treatment so to avoid EN interruptions and adverse clinical outcomes. [ABSTRACT FROM AUTHOR]

El presente artículo se orientará en el estudio de todos aquellos casos que han presentado diagnóstico de Neumonía en el grupo etario desde el nacimiento hasta los 28 días de vida, contemplando los factores que predisponen para el desarrollo de la patología. Estudio retrospectivo, analítico, de cohorte transversal sobre todos los casos de síndrome de dificultad respiratoria registrados en el Servicio de Neonatología del Hospital General IESS Ambato en el período Enero 2018 – Diciembre 2021. Se realizó el estudio en una población de 600 neonatos con cuadro de dificultad respiratoria de los cuales los afectados por neumonía fueron el 84 %, que corresponde al síndrome de dificultad respiratoria tipo II y el 16 % al tipo I. Y del porcentual de casos del SDR del tipo II, el 95 % corresponde a neumonía connatal. Entre los factores de riesgo maternos prevalentes son las infecciones de vías urinarias (55%), vulvovaginitis (24%), ruptura prematura de membranas (12%) y corioamnionitis (9 %).

Introducción: La herramienta mNUTRIC fue diseñada para identificar a los pacientes internados en las Unidades de Cuidados Intensivos (UCI) con una intervención nutricional optimizada e intensiva. Según diversas guías de práctica clínica, el riesgo nutricional se relaciona con la mortalidad y estancia hospitalaria. Objetivos: analizar la asociación entre la sobrevida a los 30 días y la estancia en las UCI con el puntaje de mNUTRIC Score, ajustado por el aporte calórico-proteico. Métodos: Se incluyeron 110 pacientes internados en tres salas de UCI de un hospital público de Buenos Aires. A través de un diseño observacional, longitudinal, analítico y ambispectivo, se realizó un análisis de sobrevida y modelos de regresión Cox. Resultados: Según los modelos múltiples, el riesgo de muerte aumentó en promedio un 4% por cada año que aumentaba la edad (p= 0,002) y se redujo en promedio un 79% por cada gramo adicional de proteína por kilo de peso corporal aportada (p=0,021). La probabilidad de egreso de la UCI se redujo a mayor edad (p=0,002). El mNUTRIC, sexo, aporte calórico, la obesidad y la infección por COVID-19 no se asociaron a las variables resultado. Conclusiones: El mNUTRIC no se asoció a la mortalidad y a la estancia en la UCI, pudiendo la infección por COVID atenuar su impacto. El aporte proteico fue un factor protector para la mortalidad, por lo que se deben implementar estrategias adicionales para optimizarlo.

Introduction: physiotherapy intervention consisting of oral, perioral, and non-nutritive suction stimulation is a tool applied in preterm new-borns to accelerate the achievement of full oral feeding (tube removal). Objectives: to describe the postmenstrual age of acquisition of full oral feeding through orofacial intervention in preterm neonates and to associate it to their degree of prematurity and early treatment initiation. Material and methods: prospective, longitudinal, descriptive and correlational study carried out in the Neonatal Unit of Hospital Universitario Miguel Servet in Zaragoza, in premature infants with tube. The inclusion criterion was being premature and using nasogastric tube feeding. The exclusion criteria were the presence of serious associated pathology and the existence of different syndromes. Results: the sample included 145 preterm infants, of which 20 % were extremely premature (n = 29), 51.70 % very premature (n = 75) and 28.30 % moderately premature (n = 41). The mean number of weeks of postmenstrual age at which they achieved full oral feeding was 35.90 ± 2.03 (n =145). A very strong positive correlation (rho = 0.774) was observed between the age of initiation of treatment and the age at which full oral feeding was achieved, especially in the moderately preterm group (rho = 0.841). Conclusion: the application of the suction and swallow protocol allows preterm infants to achieve full oral feeding before term birth. This intervention, if carried out early shortens the times for its achievement, especially in the moderately premature group. [ABSTRACT FROM AUTHOR]

Objective: The recording of data referring to Enteral Nutrition Therapy (ENT) is important to ensure the procedure and systematic communication of care. The objective was to analyze the nursing records regarding the insertion of nasogastric (CNG) and nasoenteral (CNE) catheters, considering the under-recording and non-conformities found in medical records and during patient observation. Methods: observational, cross-sectional study with a quantitative approach, through the application of an instrument to collect data from patients admitted to a University Hospital in Pará between August 2019 and July 2020. Results: 191 insertions of catheters by nurses were identified, of which 43 (22.52%) underreported reinsertion and 148 (77.48%) presented non-conformities. Discussion: Under-registration and non-compliance interfere with the quality of nursing care, weaken patient safety actions, in addition to having legal repercussions. Conclusion: The data presented in this article were essential for the detection of gaps in nursing care. [ABSTRACT FROM AUTHOR]

Introduction: fistuloclysis is a technique described by Teubner et al. whereby a fistula is used as a route of nutritional administration. This procedure is an alternative to the management of patients with intestinal failure receiving parenteral nutritional support. Case reports: we present two clinical cases of patients with different medical histories but who coincided in malnutrition, abdominal sepsis with fistulas, and their awaiting intestinal reconnection. In both cases nutritional support was administered with parenteral nutrition and enteral nutrition through fistuloclysis. Discussion: enteral nutrition through fistuloclysis improves function of the intestinal barrier, reduces the rate of intrahospital infection in critically ill patients, improves immune function, prevents atrophy of the intestinal mucosa, and that is why as soon as an enteral access is located we must take advantage of this route so that our patients may experience the benefits of fistuloclysis regardless of caloric intake. [ABSTRACT FROM AUTHOR]

Background: anorexia nervosa (AN) is a severe psychiatric pathology that has one of the highest mortality rates among mental illnesses, estimated at 5.1 deaths per 1,000 people/year, and is associated with high comorbidity, both psychiatric and somatic. Aim: to characterize hospitalized adolescents and their nutritional rehabilitation using a standardized protocol. Methods: a descriptive-retrospective study of adolescent patients hospitalized at the San Carlos of Apoquindo Clinic with a diagnosis of AN, hemodynamically stable and without refeeding syndrome criteria, between 2015 and 2021. Epidemiological, clinical, and nutritional data of the patients were analyzed. Results: of 46 patients studied, 37 were female; the average length of stay was 45.4 (SD ± 36.1) days; 53.8 % of the patients had mood disorder as psychiatric comorbidity, and the most common personality trait was obsessive-compulsive (36.9 %); the most frequent somatic comorbidity was thyroid pathology (19.2 %). The initial oral caloric intake was 1467 (SD ± 479) kcal, with an average weekly increase of 400 kcal, reaching 2430 (SD ± 457) kcal at discharge. An average percentage median body mass index (BMI%) of 7.8 % (SD ± 6.1) was obtained. Conclusions: this is the first study done in Chilean adolescents hospitalized with AN that describes nutritional rehabilitation and length of stay. [ABSTRACT FROM AUTHOR]

Copyright of QhaliKay: Revista de Ciencias de la Salud is the property of QhaliKay Revista de Ciencias de la Salud and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Gaucha de Enfermagem is the property of Revista Gaucha de Enfermagem and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Dilemas Contemporáneos: Educación, Política y Valores is the property of Dilemas Contemporaneos: Educacion, Politica y Valores and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Cirugía y Cirujanos is the property of Publicidad Permanyer SLU and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Texto & Contexto Enfermagem is the property of Universidade Federal de Santa Catarina, Programa de Pos-Graduacao de Enfermagem and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objectives: the study describes the evolution over the years of the use of artificial nutrition, in particular after the introduction of a dedicated Clinical Nutrition and Dietetic Service. Methods: a single-center, retrospective observational study performed with data collected from 2014 to 2019 at the Regional Hospital of Locarno, Switzerland. Results: from 2014 to 2019, there has been an increase in the number of patients identified as being at risk of malnutrition. We observed a reduction in the use of parenteral nutrition in all services, especially after the introduction of the dedicated Clinical Nutrition and Dietetic Service. There would seem to be a switch from enteral to oral nutrition with increased use of oral nutritional supplements. Conclusions: the introduction of a dedicated Clinical Nutrition and Dietetic Service in the care of patients with nutritional issues would seem to reduce the use of artificial invasive nutrition, despite an increase in the number of patients identified as being at risk of malnutrition. [ABSTRACT FROM AUTHOR]

Introduction: Objectives: the study describes the evolution over the years of the use of artificial nutrition, in particular after the introduction of a dedicated Clinical Nutrition and Dietetic Service. Methods: a single-center, retrospective observational study performed with data collected from 2014 to 2019 at the Regional Hospital of Locarno, Switzerland. Results: from 2014 to 2019, there has been an increase in the number of patients identified as being at risk of malnutrition. We observed a reduction in the use of parenteral nutrition in all services, especially after the introduction of the dedicated Clinical Nutrition and Dietetic Service. There would seem to be a switch from enteral to oral nutrition with increased use of oral nutritional supplements. Conclusions: the introduction of a dedicated Clinical Nutrition and Dietetic Service in the care of patients with nutritional issues would seem to reduce the use of artificial invasive nutrition, despite an increase in the number of patients identified as being at risk of malnutrition. [ABSTRACT FROM AUTHOR]

Introduction: Introduction: the nasal bridle (NB) is one of the strategies to avoid the displacement of tubes for enteral nutrition (EN) used during a nutritional intervention. Objectives: to review the efficacy and safety of NB placement in a patient population requiring EN by tube feeding. To analyze their clinical characteristics and identify complications related to this procedure. Methods: a retrospective observational study in usual clinical practice including patients admitted to a second-level hospital with EN catheters who required the use of a commercial NB-CORGRIP NG/NI TFEEDING TUBE RETENTION SYSTEM. Results: 51 patients with a mean age of 73 years (37-96) were analyzed; 64.7 % were men. Oropharyngeal dysphagia (OPD) was the fundamental indication for placement of an EN tube (54.9 %) followed by refusal to ingest (17.6 %), and orotracheal intubation (7.8 %), among others. NB was withdrawn in 7.8 % of cases due to change in digestive access (gastrostomy), in 21.6 % because of transition to the oral route, and in 9.8 % due to ignorance on how to use it. We found significant differences between accidental removal and self-withdrawal of probes before and after BN placement (2.59 ± 1.512 vs 0.24 ± 0.596; p < 0.05). No related complications were recorded except for only one case of skin ulcer. Conclusions: NB is a safe and effective retention system for the prevention of probe displacement and withdrawal in patients with a wide variety of pathologies. Training health professionals is essential for proper use. [ABSTRACT FROM AUTHOR]

Conocer cómo se realiza la terapia nutricional domiciliario (TND) en los países miembros de FELANPE.

Introduction: Introduction: amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease. Its symptoms include dysphagia that may make it necessary to place a percutaneous endoscopic gastrostomy (PEG) for feeding. The administration of drugs by PEG can obstruct it, decrease the effectiveness of treatment, and increase the risk of toxicity by altering the original pharmaceutical form. Objective: to describe and analyze the degree of adequacy of the prescription of drugs administered by PEG in patients with ALS and with enteral nutrition (EN). Material and methods: the prescription of pharmacological treatment for patients with ALS who were admitted for placement of a PEG was reviewed. The degree of adequacy of the prescribed drugs was analyzed according to criteria of loss of efficacy, toxicity, risk for handler, and compatibility with EN by consulting the available scientific evidence. Results: the medical prescriptions of the treatments of 34 patients were reviewed, with a total of 307 medications (median of 9 drugs per patient, range 2-17). Via PEG 267 oral medications (median 8 per patient, range 2-15) were prescribed; 81.65 % were solid forms, and the pharmaceutical form was modified in 43 %, due to the risk of catheter occlusion, toxicity or loss of efficacy, affecting 97 % of the patients. Conclusions: patients with ALS and PEG are at risk of presenting safety problems and loss of treatment efficacy related to alteration of the original pharmaceutical form and the interaction with EN. [ABSTRACT FROM AUTHOR]

Introduction: Introduction: hyponatremia is the most frequent disturbance in hospitalized patients. This situation may influence the therapeutic approach in patients with total enteral tube feeding (TEN). Objective: to study the prevalence of hyponatremia and the clinical factors that are associated with increased risk in a population with TEN. Methods: a retrospective study from January 2014 to January 2020; 1,651 non-critically ill patients receiving TEN were included who were assessed by the Department of Endocrinology and Nutrition. Data collected included sex, age, body mass index (BMI) (kg/m2), and nutritional status by Mini Nutritional Assessment (MNA); main disease diagnosis and development of hyponatremia at onset or during TEN were also included. Results: in all, 53.9 % of the total sample were males aged 76.8 [65.7-85.3] years. Neurological pathology was the most frequent primary diagnosis on admission (37.3 %). We found hyponatremia in 26.1 % -11.0 % at onset and 16.7 % during TEN-. Hyponatremia was more frequent in patients with digestive disease (28.7 %) and infectious disease (27.65 %). According to the MNA questionnaire 41.1 % were malnourished and nutritional status was worse in patients with hyponatremia (76.3 % vs. 55.8 %; p < 0.001). By multivariate analysis, malnutrition was only associated with hyponatremia status; OR, 2.86 [95 % CI: 1.5-4.88]. Conclusions: in this study, hyponatremia was detected in a third of patients. This was up to two more times as common in malnourished patients; however, age, sex, BMI, and baseline pathology were not related. [ABSTRACT FROM AUTHOR]

Copyright of Revista Argentina de Terapia Intensiva is the property of Sociedad Argentina de Terapia Intensiva (SATI) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Cirugía y Cirujanos is the property of Publicidad Permanyer SLU and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: the ESPEN Guideline offers a multidisciplinary focus on clinical nutrition in inflammatory bowel disease (IBD). Methodology: the guideline is based on a extensive systematic review of the literature, but relies on expert opinion when objective data are lacking or inconclusive. The conclusions and 64 recommendations have been subject to full peer review and a Delphi process, in which uniformly positive responses (agree or strongly agree) were required. Results: IBD is increasingly common and potential dietary factors in its etiology are briefly reviewed. Malnutrition is highly prevalent in IBD -- especially in Crohn's disease. Increased energy and protein requirements are observed in some patients. The management of malnutrition in IBD is considered within the general context of support for malnourished patients. Treatment of iron deficiency (parenterally, if necessary) is strongly recommended. Routine provision of a special diet in IBD is not, however, supported. Parenteral nutrition is indicated only when enteral nutrition has failed or is impossible. The recommended perioperative management of patients with IBD undergoing surgery accords with general ESPEN guidance for patients having abdominal surgery. Probiotics may be helpful in UC but not in Crohn's disease. Primary therapy using nutrition to treat IBD is not supported in ulcerative colitis but is moderately well supported in Crohn's disease, especially in children, where the adverse consequences of steroid therapy are proportionally greater. However, exclusion diets are generally not recommended and there is little evidence to support any particular formula feed when nutritional regimens are constructed. Conclusions: available objective data to guide nutritional support and primary nutritional therapy in IBD are presented as 64 recommendations, of which 9 are very strong recommendations (grade A), 22 are strong recommendations (grade B), and 12 are based only on sparse evidence (grade 0); 21 recommendations are good practice points (GPP). [ABSTRACT FROM AUTHOR]

Introduction: nasoenteral tube-related mechanical complications are feared and little is known about their incidence and the risk factors associated with them. Objective: to evaluate the incidence of nasoenteral tube-related mechanical complications and the risk factors associated with them. Methods: a prospective double cohort of adult patients who used nasoenteral tube and were inpatients in nursing wards at a Brazilian high-complexity hospital. Data were collected daily. Cox regression and Generalized Estimating Equations were applied in the statistical analysis. Results: the sample was 494 patients, or 3,676 patient days. Traction (33 %) and obstruction (3.4 %) were frequent. Inadequate positioning of the distal end of the device and bleeding in the nasal mucosa occurred once each (0.2 %). There was no bronchoaspiration. Traction was associated with a history of stroke (HR: 1.69; 95 % CI: 1.09 to 2.64; p = 0.020), a higher score on the Glasgow Coma Scale (RR: 1.09; 95 % CI: 1.03 to 1.15; p = 0.002), and older age (RR: 1.02; 95 % CI: 1.00 to 1.04; p = 0.049). Being admitted to hospital already with the tube on (HR: 3.56; 95 % CI: 1.31 to 9.66; p = 0.013) and having opioids administered in the form of pills (RR: 6.09; 95 % CI: 1.37 to 27.2; p = 0.018) were risk factors for obstruction. Conclusion: traction or removal and obstruction of the device were frequent. A history of stroke, higher score on the Glasgow Coma Scale, and older age were risk factors for traction, whereas obstruction was more common in patients who already had the tube on at admission to the nursing ward, and who had opioids in the form of pills administered via the tube. [ABSTRACT FROM AUTHOR]

Objective: the objective of this study was to demonstrate that implementation of enteral nutrition by gastrostomy tube by the Home Hospitalization Unit (HHU) in patients suffering from neurological diseases, significantly improves their nutritional status, both in terms of anthropometric and analytical parameters. Methods: data on admissions, days of hospital stay, emergency room visits and nutritional parameters were collected during the 6 months before and 6 months after placement of a percutaneous endoscopic gastrostomy (PEG) tube in 100 patients from the UHD at General University Hospital in Elda (Alicante). Results: a total of 100 neurological patients were included in the study; 58 % of them were women and with a mean age (standard deviation, SD) of 78.3 (13.3) years, with 60 % of the patients being > 80 years. The monitoring and home treatment of these patients by the HHU of General University Hospital in Elda led to improvement in quality of life and nutritional parameters (weight, body mass index, proteins, albumin, prealbumin, creatinine, and hemoglobin), as well as a decrease in the number of complications derived from the nutritional management of patients at their home, and a significant reduction in number of admissions (90.27 %) and days of hospital stay (94.05 %), as well as of visits to emergency services (79.47 %), with a consequent reduction in healthcare costs. Conclusions: the implementation of a home-based monitoring program for patients with PEG by a HHU improves their nutritional status and reduces healthcare costs. [ABSTRACT FROM AUTHOR]

Introduction: Head and neck cancer patients are a population at permanent nutritional risk. In addition to the presence of the tumour, the reason for this is the tumour's location, which affects all structures involved in the swallowing process. The side effects of the oncological treatments they must receive during the course of their illness-surgery, chemo-radiotherapy, etc.-only further burden an already precarious nutritional status. For all these reasons, it is essential that, from the diagnosis of their disease, a multidisciplinary team including specialists in dietetics and nutrition supervises them. [ABSTRACT FROM AUTHOR]

Introduction: Aim: to present the results of the Spanish home enteral nutrition (HEN) registry of the NADYA-SENPE group for the years 2018 and 2019. Material and methods: from January 1, 2018 to December 31, 2019 the home enteral nutrition registry was recorded, and afterwards a further descriptive and analytical analysis was done. Results: in 2018, 4756 active patients were registered and the prevalence was 101.79 patients per one million inhabitants; in 2019 there were 4633 patients with a prevalence of 98.51 patients per one million inhabitants. They originated in 46 hospitals: 51.3 % were male, and median age was 71.0 years in both periods. The most frequent diagnosis was a neurological disorder that presents with aphagia or severe dysphagia - 58.7 % and 58.2 %, respectively. The main cause of episode termination was death. A total of 116 pediatric patients were registered in 2018 and 115 in 2019. Females represented 57.8 % and 59.1 %, respectively, in each of the periods. Median age at the beginning of HEN was 5 and 7 months. The most commonly recordered diagnostic group (42.2 % and 42.6 %) was included within the other pathologies group, followed by neurological disorders that present with aphagia or severe dysphagia in 41.4 % and 41.7 % of children. The route of administration was gastrostomy in 46.6 % and 46.1 %, respectively, in each of the periods. Conclusions: the NED registry of the NADYA-SENPE group continues to operate uninterruptedly since its inception. The number of registered patients and the number of participating hospitals remained stable in the last biennium analyzed. [ABSTRACT FROM AUTHOR]