Publications by authors named "Lyn Gillanders"
Background: This practical guideline is based on the ESPEN Guidelines on Chronic Intestinal Failure in Adults.
Methodology: ESPEN guidelines have been shortened and transformed into flow charts for easier use in clinical practice. The practical guideline is dedicated to all professionals including physicians, dieticians, nutritionists, and nurses working with patients with chronic intestinal failure.
Background & Aims: The safety and effectiveness of a home parenteral nutrition (HPN) program depends both on the expertise and the management approach of the HPN center. We aimed to evaluate both the approaches of different international HPN-centers in their provision of HPN and the types of intravenous supplementation (IVS)-admixtures prescribed to patients with chronic intestinal failure (CIF).
Methods: In March 2015, 65 centers from 22 countries enrolled 3239 patients (benign disease 90.
Background: Preoperative supplementation with immunonutrients, including arginine and n-3 fatty acids, has been shown in a number of systematic reviews to reduce infectious complications in patients who have undergone gastrointestinal surgery. Limited information, however, is available on the benefits of nutritional supplementation enriched with arginine and n-3 fatty acids in patients undergoing liver resection.
Aim: To evaluate the effects of preoperative nutritional supplementation enriched with arginine and -3 fatty acids on inflammatory and immunologic markers and clinical outcome in patients undergoing liver resection.
Background & Aims: Home parenteral nutrition-quality of life (HPN-QOL) is a self-assessment tool for the measurement of QOL in patients on HPN. The aims of this study were: to re-assess the basic psychometric properties of the HPN-QOL in a multinational sample of adult patients; to provide a description of QOL dimensions by short and long HPN treatment duration; to explore clinical factors potentially associated to QOL scores.
Methods: Patients (n = 699) from 14 countries completed the HPN-QOL.
Background: In the critically ill, energy delivery from enteral nutrition (EN) is often less than the estimated energy requirement. Parenteral nutrition (PN) as a supplement to EN may increase energy delivery. We aimed to determine if an individually titrated supplemental PN strategy commenced 48-72 hours following ICU admission and continued for up to 7 days would increase energy delivery to critically ill adults compared to usual care EN delivery.
View Article and Find Full Text PDFArticle Synopsis
- Dietary copper restriction has traditionally been part of Wilson's disease (WD) treatment, but evidence for its effectiveness is limited, with no randomized controlled trials available.
- Research shows that as dietary copper intake increases, the body's absorption of copper decreases, suggesting that avoiding "high copper" foods doesn't significantly impact overall absorption in WD patients.
- For stable WD patients on medical therapy, dietary copper restrictions may not be required, except for two specific food groups: shellfish and liver, as they pose higher risks for copper accumulation.
Background & Aims: The aim of the study was to evaluate the applicability of the ESPEN 16-category clinical classification of chronic intestinal failure, based on patients' intravenous supplementation (IVS) requirements for energy and fluids, and to evaluate factors associated with those requirements.
Methods: ESPEN members were invited to participate through ESPEN Council representatives. Participating centers enrolled adult patients requiring home parenteral nutrition for chronic intestinal failure on March 1st 2015.
Background And Objectives: This work represents the second part of a progressive review of AuSPEN's 1999 Guidelines for Provision of Micronutrient Supplementation in adult patients receiving parenteral nutrition.
Methods And Study Design: A systematic literature review was undertaken and recommendations made based on the available evidence and with consideration to specific elements of the Australian and New Zealand (NZ) practice environment. The strength of evidence underpinning each recommendation was assessed.
Background & Aims: Chronic Intestinal Failure (CIF) is the long-lasting reduction of gut function, below the minimum necessary for the absorption of macronutrients and/or water and electrolytes, such that intravenous supplementation is required to maintain health and/or growth. CIF is the rarest organ failure. Home parenteral nutrition (HPN) is the primary treatment for CIF.
View Article and Find Full Text PDFBackground: Nutrition is one of the fundamentals of care provided to critically ill adults. The volume of enteral nutrition received, however, is often much less than prescribed due to multiple functional and process issues. To deliver the prescribed volume and correct the energy deficit associated with enteral nutrition alone, parenteral nutrition can be used in combination (termed "supplemental parenteral nutrition"), but benefits of this method have not been firmly established.
View Article and Find Full Text PDFBackground: This work represents the first part of a progressive review of AuSPEN's 1999 Guidelines for Provision of Micronutrient Supplementation in Adult Patients receiving Parenteral Nutrition, in recognition of the developments in the literature on this topic since that time.
Methods: A systematic literature review was undertaken and recommendations were made based on the available evidence and with consideration to specific elements of the Australian and New Zealand practice environment. The strength of evidence underpinning each recommendation was assessed.
Background & Aims: Intestinal failure (IF) is not included in the list of PubMed Mesh terms, as failure is the term describing a state of non functioning of other organs, and as such is not well recognized. No scientific society has yet devised a formal definition and classification of IF. The European Society for Clinical Nutrition and Metabolism guideline committee endorsed its "home artificial nutrition and chronic IF" and "acute IF" special interest groups to write recommendations on these issues.
View Article and Find Full Text PDFUnlabelled: Preliminary work suggested that perioperative immunonutrition (IMN) enriched in n-3 fatty acids, arginine, and nucleotides may improve preoperative nutritional status, enhance postoperative recovery, and reduce postoperative infectious complications in patients undergoing liver transplantation (LT). The current study examined these outcomes in a double-blind, randomized, controlled trial. Patients wait-listed for LT (n = 120) were randomized to either supplemental (0.
View Article and Find Full Text PDFBackground & Aims: Central venous access device (CVAD)-related complications such as catheter-related sepsis, occlusion and breakage contribute to both mortality and morbidity in home parenteral nutrition (HPN) patients. Prospectively collected data in these patients are scarce.
Methods: Data on all CVAD-related complications in four tertiary referral centres in Australia and New Zealand were prospectively collected between 01/01/2009 and 31/12/2009 together with costs of each episode that required admission.
Aim: To summarise and evaluate data on the use of total parenteral nutrition (TPN) and associated septic complications at Auckland City Hospital (Auckland, New Zealand) over a 6-year period beginning with appointment of a specialist TPN nurse.
Methods: For each adult patient requiring TPN on an inpatient basis (excluding those in critical care) between January 1998 and December 2003 demographic data, reason for TPN requirement, number of days of TPN administration, type of central venous line used for administration, and frequency of infectious complications were collected prospectively.
Results: 498 episodes of TPN were recorded in 484 patients (202 male, median age 60, range 15-89 y).
Aim: Home parenteral nutrition (HPN) remains the treatment of choice for severe intestinal failure. These patients are few in number but consume significant resource in funding and personnel. Patients receiving HPN in Scotland and New Zealand (NZ) are both tracked through HPN registers which enable clinical audit for identifying important variations in practice.
View Article and Find Full Text PDFObjective: Evidence based guidelines for home parenteral nutrition (HPN) were commissioned by the Australasian Society of Parenteral and Enteral Nutrition (AuSPEN) and developed by a multidisciplinary group. The guidelines make recommendations in four domains: patient selection, patient training, formulation and monitoring regimens, and preventing and managing complications.
Methods: The Appraisal of Guidelines Research and Evaluation guideline process was used to focus questions and identify evidence by systematic literature reviews of meta-analyses and randomized control trials in the Cochrane Library, Medline, Embase, and Cinahl to mid-2007.
Unlabelled: Patients with liver cirrhosis exhibit early onset of gluconeogenesis after short-term fasting. This accelerated metabolic reaction to starvation may underlie their increased protein requirements and muscle depletion. A randomized controlled trial was conducted to test the hypothesis that provision of a late-evening nutritional supplement over a 12-month period would improve body protein stores in patients with cirrhosis.
View Article and Find Full Text PDFIs manganese an essential supplement for parenteral nutrition?
Curr Opin Clin Nutr Metab Care
May 2008
Article Synopsis
- - The review highlights the importance of manganese, an essential trace element, while addressing potential toxicity and the need for better monitoring methods and dosage recommendations for nutrition support.
- - Recent findings show that fixed concentration multiple trace element supplements in parenteral nutrition can lead to toxic symptoms, particularly in pediatric and long-term home patients, due to impaired elimination and unpredictable individual responses.
- - The study suggests that routine addition of manganese to parenteral nutrition should be reconsidered, as high doses can cause neurotoxicity, emphasizing the need for revised dosage guidelines and frequent monitoring to track tissue accumulation.
Background: Data describing the nutritional status of patients with liver cirrhosis of diverse origin, as assessed by direct body-composition methods, are limited.
Objective: We sought to provide a comprehensive assessment of nutritional status and metabolic activity in patients with liver cirrhosis by using the most accurate direct methods available.
Design: Two hundred sixty-eight patients (179 M, 89 F; x +/- SEM age: 50.