Lipid and lipid-free total parenteral nutrition: differential effects on macrophage phagocytosis in rats

Cukier, Celso; Waitzberg, Dan Linetzky; Logullo, Ângela Flávia; Bacchi, Carlos E.; Travassos, Victor H.; Torrinhas, Raquel Susana; Soares, Sandra Regina; Saldiva, Paulo Hilário Nascimento; Oliveira, Telmi S.; Heymsfield, Stefan

doi:10.1016/s0899-9007(99)00186-0

Cited by 34 publications

(25 citation statements)

References 17 publications

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“…In vivo experimental studies of perfused rat lungs have demonstrated such endothelial damage induced by the intravenous infusion of lipids. 25,26 Another study has demonstrated an increase in thromboxane production in the lungs of patients who received lipid infusion in TPN, which favors thrombosis. 27 There are other aspects of the present study that should also be taken into account.…”

Section: Discussionmentioning

confidence: 99%

Lesões pulmonares e nutrição parenteral total em crianças internadas em unidade de terapia intensiva pediátrica

Silva¹,

Castello²,

Motta³

et al. 2005

J. Pediatr. (Rio J.)

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Suggested citation: Ramos-Silva V, Castello JS, da Motta LL, Pereira FE, Oliveira NS, Lamounier JA. Pulmonary lesions and total parenteral nutrition in children admitted to a pediatric intensive care unit. J Pediatr (Rio J). 2005;81:155-61. AbstractObjective: To describe lung injuries in autopsied pediatric patients (neonates through 15 years old) subjected or not to total parenteral nutrition, in an intensive care unit. Methods:Sections from six paraffin-embedded lung fragments, from 114 children were studied by routine staining. Demographic, clinical and therapeutic data were retrieved from the records. Statistical analysis was performed using Statistical Package for the Social Sciences.Results: The 114 patients were divided in two groups: 50 who were treated with total parenteral nutrition with lipid emulsion and 64 who did not receive total parenteral nutrition. The two groups did not differ in gender (p = 0.654), age (p = 0.682) or body weight (p = 0.175), but duration of hospital stay (p = 0.000), prematurity (p = 0.008) and treatment with blood products (p=0.009) were all higher in the group treated with total parenteral nutrition. All patients received mechanical ventilation during hospitalization. Chi-square comparisons showed that diffuse alveolar injury (p=0.022), pulmonary fibrosis (p = 0.019), pneumocyte hyperplasia (p = 0.004), microthromboembolism (p = 0.047) and thrombophlebitis (0.033) all exhibited a significant relationship with total parenteral nutrition. However, a multivariate analysis by logistic regression, taking into account prematurity and duration of hospital stay, demonstrated that total parenteral nutrition was an independent factor only with respect of pulmonary fibrosis. Conclusion:Although lung injuries were significantly more frequent in children who had received total parenteral nutrition, it was impossible to conclude that the lipid infusion had a direct relationship with these injuries, because prematurity and duration of hospital stay were significant co-factors.

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Section: Discussionmentioning

confidence: 99%

Lesões pulmonares e nutrição parenteral total em crianças internadas em unidade de terapia intensiva pediátrica

Silva¹,

Castello²,

Motta³

et al. 2005

J. Pediatr. (Rio J.)

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“…long-chain triglycerides derived from soybean oil-based emulsions 27,28 ; leukocyte functions, as well as local and systemic inflammatory mediators, are sensitive to infusions of lipids, and a better outcome is achieved with fish oil lipid emulsions, a source of ω-3 fatty acids, especially in association with MCTenriched lipid emulsions. [29][30][31][32] When the influence of fish oil parenteral lipid emulsions was evaluated on human monocyte/macrophage (Mphi)-expressing HLA-DR without activation (control group) vs HLA-DR in distinct activation states, the emulsions did not affect the expression of these molecules on the former. Yet, they affected the expression of these molecules in a dosedependent manner on the latter.…”

Section: Nutrition Care Per Sementioning

confidence: 99%

Strategies for High‐Quality Nutrition Therapy in Brazil

Waitzberg

Correia

2015

J Parenter Enteral Nutr

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It is a great honor to present the 2015 Rhoads Lecture and to discuss strategies for high-quality nutrition therapy (NT), as well as to address the problem of malnutrition in Brazilian hospitals.Dr Rhoads is known for his outstanding achievements in nutrition care, and his unquestionable legacy is demonstrated by the translation of his many scientific papers and books into several languages. The importance of artificial nutrition in the overall care of a patient is reflected in Dr Rhoads's own words: "intravenous feeding is one of the rare things in Medicine that has turned out to be better than its sponsors anticipated." Moreover, when Dr Rhoads was awarded for his contributions and leadership in the field of nutrition, in his speech, he referred to a quote by Nobel laureate economist Milton Friedman: "success lies on the degree to which one's ideas and contributions become embedded in the body of knowledge that comprised one's discipline."1 Indeed, we are here to confirm the veracity of this statement regarding Dr Rhoads's scientific contributions.Accumulating evidence supports the utmost relevancy of artificial nutrition, including oral nutrition, enteral nutrition (EN), and parenteral nutrition (PN), as one of the cornerstones of patient care. Nonetheless, for the full success of NT to be achieved, it is imperative that standardized procedures be followed to prevent life-threatening associated complications and, above all, to avoid the "one-size-fits-all" practice of nutrition, which should be condemned by those following the evidence behind science. History of NT in BrazilHere, the steps that have helped Brazil implement an NT practice are presented and discussed. The statements herein are based on the experience and data of the authors, although we also acknowledge and cite the work of other professionals who have contributed to the development of NT practice in Brazil. In combination, these scientific data highlight the importance of applying advances in laboratory research to the clinical setting to improve patient care. First, we review the history of clinical nutrition in Brazil, with a particular emphasis on the role of nutrition screening and nutrition assessment as demonstrated by a malnutrition prevalence study that encompassed 4000 patients.2 Next follows a discussion of to whom, when, and what NT should be administered, particularly regarding immunonutrition and parenteral lipid emulsions. Finally, strategies that have been used to implement hospital clinical nutrition are presented, with a focus on patients with short bowel syndrome (SBS) and obesity. The outcomes, costs, quality control, and education in clinical practice that are currently involved with these strategies are also presented, as well as how these strategies have the potential to affect perspectives.Very briefly, Brazil is a country that has approximately 200 million inhabitants, 10% of whom are elderly. Life expectancy AbstractStrategies for improving nutrition therapy (NT) are of utmost importance in any healthcare system. The ...

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“…Isso porque, experimentalmente e em estudos clínicos, AGPI tipo n-6 podem inibir certas funções de linfócitos, neutrófilos e macrófagos, prejudicar funções do sistema reticuloendotelial e diminuir o clareamento plasmático de lípides (Nordenstrom et al, 1979;Hamawy et al, 1985;Sobrado et al, 1985;Jensen et al, 1990;Sedman et al, 1990;Waitzberg et al, 1992;Cukier et al, 1999).…”

Section: Implicações Imunológicas Das Emulsões Lipídicasunclassified

Efeitos de diferentes emulsões lipídicas sobre a expressão de moléculas de superfície envolvidas no processo de apresentação de antígenos em células mononucleares humanas in vitro

Jacintho¹

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Lipid and lipid-free total parenteral nutrition: differential effects on macrophage phagocytosis in rats

Cited by 34 publications

References 17 publications

Lesões pulmonares e nutrição parenteral total em crianças internadas em unidade de terapia intensiva pediátrica

Lesões pulmonares e nutrição parenteral total em crianças internadas em unidade de terapia intensiva pediátrica

Strategies for High‐Quality Nutrition Therapy in Brazil

Efeitos de diferentes emulsões lipídicas sobre a expressão de moléculas de superfície envolvidas no processo de apresentação de antígenos em células mononucleares humanas in vitro

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