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Zhang WW, Wang XF, Yu HY, Wang LF. Influence of a diet meal plan on pepsinogen I and II, gastrin-17, and nutritional status in gastric ulcer patients. World J Clin Cases 2024; 12:4574-4581. [PMID: 39070811 PMCID: PMC11235480 DOI: 10.12998/wjcc.v12.i21.4574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Revised: 05/18/2024] [Accepted: 06/13/2024] [Indexed: 06/30/2024] Open
Abstract
BACKGROUND Gastric ulcers (GUs) have a high risk of clinical morbidity and recurrence, and further exploration is needed for the prevention, diagnosis, and treatment of the disease. AIM To investigated the effects of a diet plan on pepsinogen (PG) I, PG II, gastrin-17 (G-17) levels and nutritional status in patients with GUs. METHODS A total of 100 patients with GUs treated between May 2022 and May 2023 were enrolled, with 47 patients in the control group receiving routine nursing and 53 patients in the experimental group receiving dietary nursing intervention based on a diet plan. The study compared the two groups in terms of nursing efficacy, adverse events (vomiting, acid reflux, and celialgia), time to symptom improvement (burning sensation, acid reflux, and celialgia), gastric function (PG I, PG II, and G-17 levels), and nutritional status [prealbumin (PA) and albumin (ALB) levels]. RESULTS The experimental group showed a markedly higher total effective rate of nursing, a significantly lower incidence of adverse events, and a shorter time to symptom improvement than the control group. Additionally, the experimental group's post-intervention PG I, PG II, and G-17 levels were significantly lower than pre-intervention or control group levels, whereas PA and ALB levels were significantly higher. CONCLUSION The diet plan significantly reduced PG I, PG II, and G-17 levels in patients with GUs and significantly improved their nutritional status.
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Affiliation(s)
- Wei-Wei Zhang
- Department of Gastroenterology, Lujiang County Hospital of Traditional Chinese Medicine, Hefei 231500, Anhui Province, China
| | - Xiao-Fei Wang
- Department of Gastroenterology, Lujiang County Hospital of Traditional Chinese Medicine, Hefei 231500, Anhui Province, China
| | - Hai-Yan Yu
- Department of Anorectal Surgery, Lujiang County Hospital of Traditional Chinese Medicine, Hefei 231500, Anhui Province, China
| | - Ling-Fang Wang
- Department of Gastroenterology, Lujiang County Hospital of Traditional Chinese Medicine, Hefei 231500, Anhui Province, China
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Gu Y, Solomon OM, Wei Y. Investigating key factors of feeding intolerance in severe acute pancreatitis: A scoping review. Nurs Crit Care 2024. [PMID: 38828838 DOI: 10.1111/nicc.13093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 05/15/2024] [Accepted: 05/15/2024] [Indexed: 06/05/2024]
Abstract
BACKGROUND The complexity of severe acute pancreatitis (SAP) and the stress caused by the disease is associated with a high incidence of feeding intolerance. However, the factors influencing feeding incontinence in patients with SAP are diverse. AIMS To systematically analyse relevant studies that investigate the occurrence of feeding intolerance in patients with SAP, identify the relevant factors of feeding intolerance in such patients and provide a reference for nursing staff to develop relevant intervention measures. DESIGN AND METHODS This scoping review followed the approach proposed by Arksey and O'Malley. Seven electronic databases were searched from their establishment until August 2023. This included research on the factors influencing feeding intolerance in patients with SAP, determining research questions, completing literature screening and quality evaluation, extracting data and summarizing and analysing the data. The PRISMA extension for scoping reviews (PRISMA-ScR) statement has also been included. RESULTS A total of 23 articles were included. The factors influencing feeding intolerance in patients with SAP included the patient's condition, disease, treatment, feeding management and follow-up care. CONCLUSIONS The factors affecting feeding intolerance in patients with SAP are multifaceted. A personalized nursing care plan should be developed based on relevant risk factors to improve feeding tolerance and comfort in patients with SAP and shorten hospitalization time. RELEVANCE TO CLINICAL PRACTICE Intensive care nurses should identify the risk factors for feeding intolerance in patients with SAP and implement appropriate interventions. To identify the risk factors, nurses must be updated with courses and training. Moreover, a systematic feeding intolerance prediction program can help intensive care nurses effectively identify the risk factors for feeding.
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Affiliation(s)
- Yujia Gu
- College of Nursing, Zhejiang Chinese Medical University, Hangzhou, China
| | - O Mensah Solomon
- College of Nursing, Zhejiang Chinese Medical University, Hangzhou, China
| | - Yehong Wei
- Department of Intensive Care, The Second Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
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López-Gómez JJ, Delgado García E, Primo-Martín D, Simón de la Fuente M, Gómez-Hoyos E, Jiménez-Sahagún R, Torres-Torres B, Ortolá-Buigues A, Gómez-Vicente B, Arenillas-Lara JF, De Luis Román DA. Effect of a diabetes-specific formula in non-diabetic inpatients with stroke: a randomized controlled trial. Nutr Diabetes 2024; 14:34. [PMID: 38816400 PMCID: PMC11139872 DOI: 10.1038/s41387-024-00292-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 05/02/2024] [Accepted: 05/08/2024] [Indexed: 06/01/2024] Open
Abstract
BACKGROUND/OBJECTIVES In patients with acute stroke, the presence of hyperglycaemia has been associated with higher morbidity and less neurological recovery. The aim of the study was to evaluate the impact of a diabetes specific enteral nutrition (EN) formula on glycaemia, comorbidities and mortality in patients admitted with a first episode of stroke who received complete EN. METHODS This was a prospective randomised controlled trial. Patients with acute stroke did not have diagnosis of diabetes mellitus and required nasogastric tube feeding. This study has been registered with code NCT03422900. The patients were randomised into two arms: an isocaloric isoprotein formula (control group (CG), 27 patients) vs a diabetes-specific formula (low glycaemic index carbohydrates, fibre (80% soluble) and higher lipid content) (experimental group (EG), 25 patients). Pre-EN blood glucose, hyperglycaemia during EN treatment, HbA1c, insulin use, oral route recovery, length of stay (LOS) and mortality at 30 days were collected. The complications of enteral nutrition during admission were collected as well. RESULTS 52 patients were included, 50% females, with an age of 77.44(11.48) years; 34 (65.4%) had ischaemic stroke, with a Rankin score of 0(0-2), and a National Institute of Health Stroke Scale (NIHSS) of 19 (15-22). In CG, there were more cases of hyperglycaemia on the 5th day post-NE (13(65%) vs7(35%), p < 0.01). CG showed an OR of 7.58(1.49-39.16) (p = 0.02) for the development of hyperglycaemia. There were no differences in LOS between groups (12(8.5) days vs 14(23) days, p = 0.19) or in the death rate (10(37%) vs 10(40%), p = 0.8), although differences were found in terms of oral route recovery (EG: 11(44%) patients vs CG: 5(18.5%) patients, p = 0.04) (OR (EG): 5.53(1.25-24.47); p = 0.02). CONCLUSIONS The use of a diabetes-specific enteral formula in non-diabetic patients admitted with acute stroke reduced the risk of developing hyperglycaemia and improved the rate of oral route recovery. Registered under ClinicalTrials.gov Identifier no. NCT03422900.
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Affiliation(s)
- Juan J López-Gómez
- Servicio de Endocrinología y Nutrición, Hospital Clínico Universitario de Valladolid, Valladolid, Spain.
- Centro de Investigación en Endocrinología y Nutrición (IENVA), Universidad de Valladolid, Valladolid, Spain.
- Department of Medicine, Universidad de Valladolid, Universidad de Valladolid, Valladolid, Spain.
| | - Esther Delgado García
- Servicio de Endocrinología y Nutrición, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
- Centro de Investigación en Endocrinología y Nutrición (IENVA), Universidad de Valladolid, Valladolid, Spain
- Department of Medicine, Universidad de Valladolid, Universidad de Valladolid, Valladolid, Spain
| | - David Primo-Martín
- Servicio de Endocrinología y Nutrición, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
- Centro de Investigación en Endocrinología y Nutrición (IENVA), Universidad de Valladolid, Valladolid, Spain
| | | | - Emilia Gómez-Hoyos
- Servicio de Endocrinología y Nutrición, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
- Centro de Investigación en Endocrinología y Nutrición (IENVA), Universidad de Valladolid, Valladolid, Spain
- Department of Medicine, Universidad de Valladolid, Universidad de Valladolid, Valladolid, Spain
| | - Rebeca Jiménez-Sahagún
- Servicio de Endocrinología y Nutrición, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
- Centro de Investigación en Endocrinología y Nutrición (IENVA), Universidad de Valladolid, Valladolid, Spain
| | - Beatriz Torres-Torres
- Servicio de Endocrinología y Nutrición, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
- Centro de Investigación en Endocrinología y Nutrición (IENVA), Universidad de Valladolid, Valladolid, Spain
- Department of Medicine, Universidad de Valladolid, Universidad de Valladolid, Valladolid, Spain
| | - Ana Ortolá-Buigues
- Servicio de Endocrinología y Nutrición, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
- Centro de Investigación en Endocrinología y Nutrición (IENVA), Universidad de Valladolid, Valladolid, Spain
- Department of Medicine, Universidad de Valladolid, Universidad de Valladolid, Valladolid, Spain
| | - Beatriz Gómez-Vicente
- Department of Medicine, Universidad de Valladolid, Universidad de Valladolid, Valladolid, Spain
- Stroke Program, Department of Neurology, HCUV, Valladolid, Spain
| | - Juan F Arenillas-Lara
- Department of Medicine, Universidad de Valladolid, Universidad de Valladolid, Valladolid, Spain
- Stroke Program, Department of Neurology, HCUV, Valladolid, Spain
| | - Daniel A De Luis Román
- Servicio de Endocrinología y Nutrición, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
- Centro de Investigación en Endocrinología y Nutrición (IENVA), Universidad de Valladolid, Valladolid, Spain
- Department of Medicine, Universidad de Valladolid, Universidad de Valladolid, Valladolid, Spain
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Zhang X, Du M, He M, Wang M, Jiang M, Cai Y, Cui M, Wang Y. Prevention and management of enteral nutrition-related diarrhea among adult inpatients: a best practice implementation project. JBI Evid Implement 2024:02205615-990000000-00082. [PMID: 38470610 DOI: 10.1097/xeb.0000000000000412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/14/2024]
Abstract
INTRODUCTION Diarrhea, the most common complication for patients during enteral nutrition, poses a range of risks and care burdens. Medical staff are aware of the importance of proactively preventing and managing enteral nutrition-related diarrhea. However, clinical prevention and management methods are not standardized, and the scientific basis and effectiveness of these methods need to be further verified. OBJECTIVES This project aimed to promote evidence-based practices for the prevention and management of enteral nutrition-related diarrhea among adult inpatients in a public tertiary hospital in China. METHODS This project was guided by the JBI Evidence Implementation Framework and used the JBI Practical Application of Clinical Evidence System (PACES) and the JBI Getting Research into Practice (GRiP) tools. Twelve audit criteria were developed to conduct a baseline audit to measure compliance with best practices. A barrier analysis was conducted, and strategies were implemented to overcome the barriers. The project was finalized with a follow-up audit to determine any changes in compliance with best practices. RESULTS The overall compliance rate for the audit criteria increased from 27.37% at baseline to 89.62% in the follow-up audit, with six criteria achieving a compliance rate of 100%. CONCLUSIONS The implementation of evidence-based practices can effectively narrow the gap between current practice and best practice. This project improved the ability of medical staff to prevent and manage enteral nutrition-related diarrhea, as well as promoting evidence-based practice in the hospital. SPANISH ABSTRACT http://links.lww.com/IJEBH/A168.
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Affiliation(s)
- Xinyue Zhang
- Nursing Department, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Meijie Du
- Nursing Department, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Mei He
- Nursing Department, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Mei Wang
- Comprehensive Department, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Mengyao Jiang
- Nursing Department, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yue Cai
- Nursing Department, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Mengying Cui
- Nursing Department, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ying Wang
- Nursing Department, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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da Costa RL, Medeiros CO, da Cunha DT, Stangarlin-Fiori L. Checklist to assess food safety when handling home enteral nutrition. Nutr Clin Pract 2023; 38:1309-1323. [PMID: 36822676 DOI: 10.1002/ncp.10962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 01/04/2023] [Accepted: 01/20/2023] [Indexed: 02/25/2023] Open
Abstract
BACKGROUND Identifying food safety risks when handling enteral formulations at home is important to restore and maintain the health of patients. Therefore, this study developed and validated a food safety assessment checklist for handling home enteral nutrition (HEN). METHODS This methodological study developed a checklist based on a literature review and interviews with food safety professionals. The content validation, which was conducted by food safety and enteral feeding experts, assessed the relevance, clarity, and simplicity of the checklist using the content validity index of items (CVI-I), categories (CVI-C), and the entire instrument (CVI-EI). Each item was rated as either essential, necessary, or recommended according to the risk in relation to foodborne diseases. RESULTS The Food Safety for Handling Home Enteral Nutrition checklist (FSHEN checklist) that was developed includes 40 items and the following eight categories: physical structure; cleaning of facilities, equipment, furniture, and utensils; pests and waste; water supply; food handlers; ingredients and packaging; handling of enteral formulations; and the bottling and storage of enteral formulations. The CVI-EI was above the recommendation (≥0.93) for the three assessed criteria, as was the CVI-C in terms of clarity (≥0.95), relevance (≥0.98), and simplicity (≥0.84). A total of 52.5% of the items were rated as essential, 32.5% as necessary, and 15% as recommended. CONCLUSION The FSHEN checklist is relevant, clear, and easy to use. It can help health professionals and individuals working in the field to assess and prioritize items to improve food safety in the management of HEN.
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Affiliation(s)
- Rayane Luizi da Costa
- Postgraduate Program in Food and Nutrition, Federal University of Parana (UFPR), Curitiba, Brazil
| | - Caroline Opolski Medeiros
- Postgraduate Program in Food and Nutrition, Department of Nutrition, Federal University of Parana (UFPR), Curitiba, Brazil
| | - Diogo Thimoteo da Cunha
- Multidisciplinary Laboratory of Food and Health, School of Applied Sciences, State University of Campinas, Limeira, Brazil
| | - Lize Stangarlin-Fiori
- Postgraduate Program in Food and Nutrition, Department of Nutrition, Federal University of Parana (UFPR), Curitiba, Brazil
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Pelizzari L, Antoniono E, Giraudo D, Ciardi G, Lamberti G. Fecal Incontinence after Severe Brain Injury: A Barrier to Discharge after Inpatient Rehabilitation? Neurol Int 2023; 15:1339-1351. [PMID: 37987457 PMCID: PMC10660697 DOI: 10.3390/neurolint15040084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Revised: 10/18/2023] [Accepted: 10/25/2023] [Indexed: 11/22/2023] Open
Abstract
BACKGROUND In this study, we aimed to investigate the incidence of fecal incontinence (FI) after severe acquired brain injuries (sABIs) and to determine whether this symptom can lead to an inability to return home after rehabilitation. METHODS This was a retrospective observational cohort study. In total, 521 acute sABI inpatients were enrolled from the Department of Neurorehabilitation at an academic tertiary care hospital. Patients were divided into two groups, with and without FI, at the end of the rehabilitation phase. The primary and secondary endpoints were the incidence of persistent FI and any difference in the discharge destination. RESULTS Upon admission, new-onset FI was found in 443 (85%) patients, of which 38% had traumatic sABI. Moreover, 62.7% of all patients had FI upon admission. At discharge, 53.3% (264/495) of patients still had FI. Of these, 75.4% (199/264) had a Rancho Level of Cognitive Functioning Scale (LCFS) ≥3. A statistically significant correlation between FI at discharge and the presence of frontal lesions, autonomic crises, and increased LCFS scores was noted. Among the patients discharged to their homes, the proportion with persistent FI was lower (34% vs. 53.3). CONCLUSIONS FI was significantly persistent after sABI, even after recovery from unconsciousness, and must be considered as a consequence of, rather than an independent risk factor for, unfavorable outcomes.
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Affiliation(s)
- Laura Pelizzari
- Department of Rehabilitative Medicine, AUSL Piacenza, 29017 Fiorenzuola d’Arda, PC, Italy; (L.P.); (G.C.)
| | - Elena Antoniono
- Neurorehabilitation Unit, AUSL CN1, 12045 Fossano, CN, Italy;
| | - Donatella Giraudo
- Department of Urology, IRCCS San Raffaele Scientific Institute, 20127 Milano, MI, Italy;
| | - Gianluca Ciardi
- Department of Rehabilitative Medicine, AUSL Piacenza, 29017 Fiorenzuola d’Arda, PC, Italy; (L.P.); (G.C.)
| | - Gianfranco Lamberti
- Department of Rehabilitative Medicine, AUSL Piacenza, 29017 Fiorenzuola d’Arda, PC, Italy; (L.P.); (G.C.)
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Kaewdech A, Sripongpun P, Wetwittayakhlang P, Churuangsuk C. The effect of fiber supplementation on the prevention of diarrhea in hospitalized patients receiving enteral nutrition: A meta-analysis of randomized controlled trials with the GRADE assessment. Front Nutr 2022; 9:1008464. [PMID: 36505240 PMCID: PMC9733536 DOI: 10.3389/fnut.2022.1008464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Accepted: 10/27/2022] [Indexed: 11/27/2022] Open
Abstract
Introduction Enteral nutrition (EN) in hospitalized patients has several advantages. However, post-feeding diarrhea occurs frequently and has been linked to negative outcomes. The EN formula itself may have an impact on how diarrhea develops, and fiber supplements may theoretically help patients experience less diarrhea. This study aimed to thoroughly evaluate whether adding fiber to EN decreases the likelihood of developing diarrhea and whether different types of fibers pose different effects on diarrhea (PROSPERO CRD 42021279971). Methods We conducted a meta-analysis on fiber supplementation in hospitalized adult patients receiving EN. We thoroughly searched PubMed, Medline, Embase, Scopus, Web of Science, CENTRAL, and ClinicalTrials.gov databases from inception to 1 September 2022. Only randomized controlled trials (RCTs) were included. Pooled results on the incidence of diarrhea were calculated using a random-effects model. The Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach was applied. Only fiber types from soy polysaccharides (n = 4), psyllium (n = 3), mixed soluble/insoluble fiber (mixed fiber, n = 3), pectin (n = 2), and partially hydrolyzed guar gum (PHGG, n = 2) were examined in the sensitivity analysis. Results Among the 4,469 titles found, a total of 16 RCTs were included. Overall, compared to fiber-free formulas, fiber supplementation reduced the occurrence of diarrhea in patients receiving EN by 36% (pooled risk ratio [RR] of 0.64 [95% confidence interval (CI): 0.49-0.82, p = 0.005; I 2 = 45%]), with GRADE showing the evidence of moderate certainty. Only mixed fiber and PHGG significantly decreased the incidence of diarrhea according to the sensitivity analyses for fiber types (RR 0.54, 95%CI: 0.39-0.75, I 2 = 0% and RR 0.47, 95%CI: 0.27-0.83, I 2 = 0%, respectively). The results for the remaining fiber types were unclear. Conclusion According to a meta-analysis, fiber supplements help lessen post-feeding diarrhea in hospitalized patients receiving EN. However, not all fiber types produced successful outcomes. Diarrhea was significantly reduced by PHGG and mixed soluble/insoluble fiber. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=279971, identifier: PROSPERO CRD 42021279971.
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Affiliation(s)
- Apichat Kaewdech
- Gastroenterology and Hepatology Unit, Division of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, Thailand
| | - Pimsiri Sripongpun
- Gastroenterology and Hepatology Unit, Division of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, Thailand
| | - Panu Wetwittayakhlang
- Gastroenterology and Hepatology Unit, Division of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, Thailand
| | - Chaitong Churuangsuk
- Clinical Nutrition and Obesity Medicine Unit, Division of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, Thailand,*Correspondence: Chaitong Churuangsuk
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Uniat KC, Stangarlin-Fiori L, Krüger JF, Schieferdecker MEM, Rabito EI. MICROBIOLOGICAL QUALITY OF ENTERAL FORMULATIONS HANDLED AT HOME: A SYSTEMATIC REVIEW. JPEN J Parenter Enteral Nutr 2022; 46:1787-1796. [PMID: 35809193 DOI: 10.1002/jpen.2432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 06/03/2022] [Accepted: 07/01/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND Studies have shown an increase in the number of patients who use enteral nutrition at home, and the benefits of this type of nutritional care. However, little is known about the risk of bacterial contamination of enteral formulations prepared at home. Therefore, the aim of the study was to assess the microbiological quality of home-prepared enteral formulations. METHODS This study is a systematic review, registered in PROSPERO. The search for articles was carried out in databases and gray literature. Eligible studies which microbiologically analyzed homemade enteral preparations (HEP), blended enteral preparations (BEP), and commercial enteral formulas (CEF) that were prepared at home were selected. The types and quantities of microorganisms, sources of contamination in the handling area, and the consequences of contamination (signs and symptoms) were the subjects extracted from the studies. RESULTS Five studies evaluated 217 enteral formulations. It was found that 72.81% of the enteral formulations exceeded the acceptable bacterial count in the case of at least one of the analyzed microorganisms. This result corresponded to 93.58% (n=73) of the HEP; 81.96% (n=50) of the BEP; and 44.87% (n=35) of the CEF. The presence of ten different microorganisms was identified in the enteral formulations, and total coliforms and mesophilic aerobics were the microorganisms found in the greatest quantity in the samples. CONCLUSION The three types of home-prepared enteral formulations showed unsatisfactory microbiological quality, indicating poor hygiene conditions during food handling. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Kelly Cristina Uniat
- Department of Nutrition, Federal University of Paraná (UFPR), Curitiba, Paraná, Brazil
| | - Lize Stangarlin-Fiori
- Department of Nutrition, Federal University of Paraná (UFPR), Curitiba, Paraná, Brazil
| | - Jenifer Faria Krüger
- Department of Nutrition, Federal University of Paraná (UFPR), Curitiba, Paraná, Brazil
| | | | - Estela Iraci Rabito
- Department of Nutrition, Federal University of Paraná (UFPR), Curitiba, Paraná, Brazil
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Huang Z, Zheng J, Huang W, Yan M, Hong L, Hong Y, Jin R, Huang X, Fan H, Chen H, Yang H, Su W, Huang X. The effects and safety of omega-3 fatty for acute lung injury: a systematic review and meta-analysis. World J Surg Oncol 2020; 18:235. [PMID: 32883303 PMCID: PMC7470437 DOI: 10.1186/s12957-020-01916-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 06/14/2020] [Indexed: 12/02/2022] Open
Abstract
Background Several randomized controlled trials (RCTs) have compared the treatment of acute lung injury (ALI) with omega-3 fatty, yet the results remained inconsistent. Therefore, we attempted this meta-analysis to analyze the role of omega-3 fatty in the treatment of ALI patients. Methods We searched PubMed databases from inception date to October 31, 2019, for RCTs that compared the treatment of ALI with or without omega-3 fatty. Two authors independently screened the studies and extracted data from the published articles. Summary mean differences (MD) with 95% confidence intervals (CI) were calculated for each outcome by fixed- or random-effects model. Results Six RCTs with a total of 277 patients were identified, of whom 142 patients with omega-3 fatty acid treatment and 135 patients without omega-3 fatty treatment. Omega-3 fatty treatments significantly improve the PaO2 (MD = 13.82, 95% CI 8.55–19.09), PaO2/FiO2 (MD = 33.47, 95% CI 24.22–42.72), total protein (MD = 2.02, 95% CI 0.43–3.62) in ALI patients, and omega-3 fatty acid treatments reduced the duration of mechanical ventilation (MD = − 1.72, 95% CI − 2.84 to − 0.60) and intensive care unit stay (MD = − 1.29, 95% CI − 2.14 to − 0.43) in ALI patients. Conclusions Omega-3 fatty can effectively improve the respiratory function and promote the recovery of ALI patients. Future studies focused on the long-term efficacy and safety of omega-3 fatty use for ALI are needed.
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