University Hospital, a 428-bed tertiary care teaching hospital, treats approximately 150 patients annually with TPN. Currently used are three standard TPN base formulae which are ordered by physicians using preprinted TPN order forms. A concurrent Drug Utilization Review (DUR) was conducted on TPN treatment of 30 patients, to examine adherence to the current TPN protocol. Criteria for evaluation included ruling out enteral feeding, indications for TPN use, duration of therapy, monitoring of laboratory values, and caloric delivery. Physician and dietician estimation of caloric needs were compared to calories actually ordered by the physician. The number of pharmacist interventions and TPN bags wasted were also determined. Results could not be obtained with respect to ruling out enteral feeding and indications for TPN therapy due to inadequate information. The five-day minimum for duration of TPN therapy established in the DUR criteria was not attained in 23 percent (7/30) of patients. Seventy-seven percent of laboratory monitoring tests were completed. Results indicate wide disparities in caloric calculation and delivery; only 45 percent (10/22) of the patients who were ordered TPN met the physician's caloric goal. A number of recommendations were made to improve the TPN protocol and TPN therapy.
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Surg Pract Sci
March 2024
Department of Pharmacy, University of Kentucky HealthCare, Lexington, KY, USA.
Introduction: Neuromuscular blockers (NMB) are used in surgical procedures to facilitate muscle relaxation and intubation. NMBs are then reversed at the end of the surgery with either an acetylcholinesterase inhibitor, such as neostigmine, or a modified cyclodextrin compound, such as sugammadex. Neostigmine and glycopyrrolate elicit counteracting cholinergic effects, potentially impairing postoperative gastrointestinal motility.
View Article and Find Full Text PDFMicrobiome
January 2025
Department of Experimental Vascular Medicine, Amsterdam UMC, Amsterdam, the Netherlands.
Background: The human gut microbiome strongly influences host metabolism by fermenting dietary components into metabolites that signal to the host. Our previous work has shown that Intestinimonas butyriciproducens is a prevalent commensal bacterium with the unique ability to convert dietary fructoselysine to butyrate, a well-known signaling molecule with proven health benefits. Dietary fructoselysine is an abundant Amadori product formed in foods during thermal treatment and is part of foods rich in dietary advanced glycation end products which have been associated with cardiometabolic disease.
View Article and Find Full Text PDFAnn Surg Treat Res
January 2025
Division of Pediatric Surgery, Department of Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Purpose: We aimed to evaluate health-related quality of life (HRQoL) in intestinal failure (IF) patients after different modes of intestinal rehabilitation.
Methods: HRQoL was assessed using the generic 36-item Short Form Survey (SF-36, ver. 2) and visual analogue scale (VAS) in 6 different areas: diet, sleep, gastrointestinal (GI) symptoms, diarrhea, musculoskeletal pain, and other symptoms.
Narra J
December 2024
Department Pediatrics, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia.
The achievement of recommended calorie targets for parenteral nutrition in pediatric patients receiving treatment in the pediatric intensive care unit (PICU) in Indonesia remains suboptimal, necessitating cautious implementation of this nutritional intervention alone. The aim of this study was to compare the effectiveness of total parenteral nutrition (TPN) and partial parenteral nutrition (PPN) in achieving the calorie requirements of pediatric patients receiving treatments in the PICU. A cross-sectional study was conducted in the PICU at H.
View Article and Find Full Text PDFJ Pediatr Surg
December 2024
Rady Children's Hospital San Diego, 3020 Children's Way, San Diego, CA 92123, USA; University of California San Diego School of Medicine, Department of Surgery, 9500 Gilman Dr., La Jolla, CA 92093, USA. Electronic address:
Background: Thoracoscopic repair of esophageal atresia with tracheoesophageal fistula (EA/TEF) has been reported to have superior outcomes to the open approach. We sought to evaluate adoption of thoracoscopic repair at US children's hospitals and compare outcomes to open repair.
Methods: The Pediatric Health Information System database was used to identify patients with EA/TEF who underwent repair between 2016 and 2023.
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