Use of Bedside Ultrasound to Assess Muscle Changes in the Critically Ill Surgical Patient.

Background: Critical illness causes hypercatabolism, loss of lean body mass (LBM), and poor outcomes. Evaluating LBM in the critically ill is challenging, and it is uncertain whether nutrition support (NS) impacts LBM. This study measured quadriceps muscle layer thickness (QMLT) by bedside ultrasound (US) to estimate LBM changes in surgical intensive care unit (SICU) patients and healthy controls (HCs).

Reducing Blood Glucose Testing Is Safe in Patients Receiving Parenteral Nutrition.

Background: Hyperglycemia is a common adverse event associated with parenteral nutrition (PN); however, there is no consensus on optimal glucose monitoring. Unnecessary point-of-care (POC) blood glucose (BG) testing can result in additional healthcare cost and discomfort to the patient. This study's aim was to determine whether decreasing the frequency of POC glucose testing in patients receiving PN can reduce costs without increasing the frequency of glycemic events.

Thirty-Day Readmission Rate Is High for Hospitalized Patients Discharged With Home Parenteral Nutrition or Intravenous Fluids.

Background: Reducing hospital readmissions decreases healthcare costs and improves quality of care. There are no published studies examining the rate of, and risk factors for, 30-day readmissions for patients discharged with home parenteral support (HPS).

Objective: Determine the rate of 30-day readmissions for patients discharged with HPS and whether malnutrition and other demographic or clinical factors increase the risk.

Expediting Transition to Home Parenteral Nutrition With Fast-Track Cycling.

Background: Delivery of home parenteral nutrition (PN) is typically cycled over 12 hours. Discharge to home on PN is often delayed due to potential adverse events (AEs) associated with cycling PN. The purpose was to determine whether patients requiring long-term PN can be cycled from 24 hours to 12 hours in 1 day instead of 2 days without increasing the risk of PN-related AEs.

Fish oil-based lipid emulsion: current updates on a promising novel therapy for the management of parenteral nutrition-associated liver disease.

Intestinal failure is characterized by loss of enteral function to absorb necessary nutrients and water to sustain life. Parenteral nutrition (PN) is a lifesaving therapeutic modality for patients with intestinal failure. Lifelong PN is also needed for patients who have short bowel syndrome due to extensive resection or a dysmotility disorder with malabsorption.

Comparison Between Handgrip Dynamometry and Manual Muscle Testing Performed by Registered Dietitians in Measuring Muscle Strength and Function of Hospitalized Patients.

Background: The Academy of Nutrition and Dietetics and American Society the Parenteral and Enteral Nutrition (ASPEN) Consensus Statement recommends a standardized set of diagnostic characteristics to identify adult malnutrition. Due to lack of a consensus definition and challenges with measurements, physical function or performance has traditionally been difficult to assess. The purpose of this study was to determine whether manual muscle testing (MMT) performed by registered dietitians (RDs) can be used as a surrogate measurement of muscle strength and function in hospitalized patients.

Type and prevalence of adverse events during the parenteral nutrition cycling process in patients being prepared for discharge.

Background: The mechanism for cycling parenteral nutrition (PN) varies from institution to institution. However, the types and frequency of adverse events (AEs) involved with this process are not well understood.

Purpose: To determine the type and prevalence of AE in patients during PN cycling and identify factors associated with the occurrence of AEs.

Ethanol lock therapy in reducing catheter-related bloodstream infections in adult home parenteral nutrition patients: results of a retrospective study.

Background: Equivocal data demonstrate the efficacy of ethanol lock therapy (ELT) in preventing catheter-related bloodstream infections (CRBSIs) in home parenteral nutrition (HPN) patients, but it is not currently a standard of practice. The objective of this study is to investigate the efficacy of ELT in reducing the incidence of CRBSIs in HPN patients.

Methods: Medical records from the Cleveland Clinic database of adult HPN patients with CRBSIs placed on prophylactic ELT were retrospectively studied from January 2006 to August 2009 (n = 31).

Developing an education program for nutrition support teams.

Focused training and continuing medical education are necessary for nutrition support clinicians to acquire new skills, maintain competence, and keep abreast of advancements in the field. Unfortunately, there is a lack of physician-nutrition specialists to act as teachers and role models. One solution is to have members of a multidisciplinary nutrition support team, regardless of discipline, share their expertise with others.

Tip position of long-term central venous access devices used for parenteral nutrition.

Background: Venous thrombosis is a potential postplacement complication of a central venous access device (VAD). Improper catheter tip position is a predisposing factor, especially when the device is used to administer parenteral nutrition (PN). American Society for Parenteral and Enteral Nutrition (A.

Perioperative nutrition support: who and how.

Perioperative nutrition support can reduce postoperative complications in some malnourished patients, but there are risks, such as a greater risk of infection. The decision to use nutrition support--either total parenteral nutrition or enteral feedings--before and after surgery depends on how severely the patient is malnourished, the type of surgical procedure, and whether the surgery is elective.