Background: The National Board of Nutrition Support Certification credentials healthcare professionals and certifies that holders of the Certified Nutrition Support Clinician (CNSC) credential have specialized knowledge of safe and effective nutrition support therapy. The purpose of this pilot study was to survey healthcare professionals affiliated with the American Society for Parenteral and Enteral Nutrition (A.S.
View Article and Find Full Text PDFThe development of intravenous fat emulsion (IVFE) is the culmination of physiological, biochemical, nutritional, and medical scientific advancements. IVFEs have the ability to deliver critical nutritional substrates to the patient. Recent literature purports that they may also play roles in modulation of immune functionality and pulmonary physiology, but data supporting these potential benefits are limited.
View Article and Find Full Text PDFParenteral nutrition lipid emulsions made from various plant oils contain steroidal compounds, called phytosterols. During parenteral administration of lipid emulsions, phytosterols can reach levels in the blood that are many fold higher than during enteral administration. The elevated phytosterol levels have been associated with the development of liver dysfunction and the rare development of liver failure.
View Article and Find Full Text PDFJPEN J Parenter Enteral Nutr
January 2013
Background: For 40 years, parenteral nutrition (PN) has provided therapeutic benefits to patients unable to receive oral/enteral nutrition. Very limited published evidence exists to describe modern PN practices or characteristics of patients receiving PN. The aim of this article was to describe the characteristics of hospitalized patients receiving PN in 196 U.
View Article and Find Full Text PDFBackground & Aims: The ratio of energy expenditure to nitrogen loss respectively of energy to nitrogen provision (E/N) is considered a valuable tool in the creation of an enteral or parenteral formulation. Specific E/N ratios for parenteral nutrition (PN) have not yet been clearly defined. To determine the range of energy expenditure, nitrogen (protein) losses, and E/N ratios for various patient groups, we performed a systematic review of the literature.
View Article and Find Full Text PDFBackground: This study compared overall bacterial and bloodstream infection rates in patients receiving premixed parenteral nutrition (PN) with vs without lipid emulsion.
Methods: Data from hospitalized patients who were ≥18 years of age and receiving premixed PN between 2005 and 2007 were extracted from the Premier Perspective database. Data were categorized into 2 groups: patients who received premixed PN only and those receiving premixed PN with lipids.
Saturated fatty acids (SFAs), significant components of both enteral/parenteral nutritional formulations (including diet), are linked to cardiovascular disease complications, such as atherosclerosis. We investigated whether oleic acid (C18:1n-9) reduces the growth inhibitory and pro-inflammatory effects of the stearic acid (C18:0) in human aortic endothelial cells (HAEC). Stearic acid induced growth inhibition at concentrations less than 50 μM, whereas higher concentrations invoked cytotoxicity.
View Article and Find Full Text PDFJPEN J Parenter Enteral Nutr
October 2008
Background: While the prevalence of obesity continues to increase in our society, outdated resting energy expenditure (REE) prediction equations may overpredict energy requirements in obese patients. Accurate feeding is essential since overfeeding has been demonstrated to adversely affect outcomes.
Objectives: The first objective was to compare REE calculated by prediction equations to the measured REE in obese trauma and burn patients.
Individuals who have sustained intestinal failure due to trauma or disease are able to survive through the use of parenteral nutrition (PN). Although home PN (HPN) is a lifesaving therapy, patients may, over the long term, be at risk for liver, bone, and immune dysfunction. A limited number of human studies and a large number of animal studies suggest that there may be a chronic inflammatory condition and additionally a potentially lower T-lymphocyte immune function associated with PN administration.
View Article and Find Full Text PDFMetabolic rate is generally assessed by use of equations in critically ill patients, but evidence pertaining to the validity of these equations in this population has not been systematically evaluated. This paper represents the first such systematic analysis in adult patients. A work group created by the American Dietetic Association identified pertinent peer-reviewed articles.
View Article and Find Full Text PDFObjective: The quantity of nutrition that is provided to intensive care unit (ICU) patients has recently come under more scrutiny in relation to clinical outcomes. The primary objective of this study was to assess energy intake in severely ill ICU patients and to evaluate the relationship of energy intake with clinical outcomes.
Design: Prospective cohort study.
JPEN J Parenter Enteral Nutr
May 2007
Background: A proinflammatory state has been described in patients with intestinal failure. The prevalence of metabolic bone disease in this group is considerable. It is not known whether this proinflammatory state is related to bone parameters, though bone disease is recognized as a proinflammatory process in postmenopausal women.
View Article and Find Full Text PDFThe objective of this study was to evaluate the evidence behind specific but common patient care decisions in support of enteral feedings for patients admitted to intensive care units. Six specific questions were developed and refined to address clinical outcomes specific to clinical practice decisions pertinent to enteral feeding of critically ill patients. The data sources consisted of an intensive literature review from five databases, using standardized search terms.
View Article and Find Full Text PDFObjectives: Patients who used home parenteral nutrition (HPN) and healthy, volunteer control subjects were examined to assess relative immune potential and inflammatory marker expression and to investigate the association between HPN and immune parameters.
Methods: Subjective Global Assessments were performed on all subjects. The peripheral blood concentration of C-reactive protein was determined by enzyme-linked immunosorbent assay.
Evidence-based practice merges the best and most relevant clinical research data with clinician experience, pathophysiology of disease state, and the specifics of individual patient care. Currently, there is a significant gap between the best research evidence in healthcare and application of this evidence to clinician practices. Consistent with this finding, nutrition support is not always applied effectively or consistently, despite available scientific evidence that could be used to enhance a given treatment protocol.
View Article and Find Full Text PDFDietary studies are often conducted as longitudinal intervention or crossover trials using multiple days of measurement on each subject during each of several measurement periods, and determining the required numbers of days and subjects is important in designing these studies. Linear mixed statistical models were used to derive equations for precision, statistical power and sample size (number of days and number of subjects) and to obtain estimates of between-subject, period-to-period, and day-to-day variation needed to apply the equations. Two cohorts of an on-going exercise intervention study, and a crossover study of Olestra, each with 14 d of measurement/subject per period, were used to obtain estimates of variability for energy and macronutrient intake.
View Article and Find Full Text PDFBackground: In light of the current obesity epidemic, treatment models are needed that can prevent weight gain or provide weight loss. We examined the long-term effects of a supervised program of moderate-intensity exercise on body weight and composition in previously sedentary, overweight and moderately obese men and women. We hypothesized that a 16-month program of verified exercise would prevent weight gain or provide weight loss in the exercise group compared with controls.
View Article and Find Full Text PDFBackground: Measurements of dietary intake in obese and overweight populations are often inaccurate because food intakes are underestimated.
Objective: The purpose of this study was to evaluate the validity of the combined use of observer-recorded weighed-food records and 24-h snack recalls in estimating energy intakes in overweight and obese individuals.
Design: Subjects were 32 healthy women and 22 healthy men with mean body mass indexes (in kg/m(2)) of 29.