Parenteral Nutrition and Cardiotoxicity

Nispen, Johan van; Voigt, Mark M.; Song, Eric; Armstrong, Austin; Fedorova, Margarita; Murali, Vidul; Krebs, Joseph; Samaddar, Ashish; Manithody, Chandrashekhara; Jain, Ajay K.

doi:10.1007/s12012-021-09638-1

Cited by 5 publications

(4 citation statements)

References 78 publications

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“…The DRP “Carbohydrate rate > necessary” (1.96%) (2 mg/kg/min) denotes that the suggested maximum oxidation rate was exceeded and can cause hyperglycemia (with water retention), risk of cardiotoxicity, hepatic steatosis, hypertriglyceridemia, increased CO 2 production, and other respiratory problems, associated or not, and mechanical ventilation could increase [ 12 , 26 , 27 ]. Although other pediatric PN guidelines suggest 16 mg/kg/min (23 g/kg/day) as a maximum intake for LPN (L) and 13 mg/kg/min (18 g/kg/day) in TN, the health unit handles 12.5 mg/kg/min as the maximum limit [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

Negative Outcomes Associated with Medication in Neonates on Parenteral Nutrition Therapy

Dı́az¹,

Barros

Reyna

et al. 2023

Pediatric Reports

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Objective: In Ecuador, studies on clinical daily practice problems focused on parenteral nutrition in neonates are scarce. Therefore, this research aimed to identify negative results associated with medications (NRAM) in neonates with parenteral nutrition (PN) in a third-level hospital in Ecuador. Material and methods: An observational, prospective, descriptive study was designed in the neonatology area of a tertiary-level public hospital, where, for over four months, the medical records, PN prescriptions, and pharmacy-managed databases of 78 patients were analyzed. Drug-related problems (DRPs) as possible causes of NRAM were classified through administrative, physicochemical, and clinical validation. Results: DRPs classified as follows were found: 78.81% by physicochemical, 17.62% by clinical, and 3.57% by administrative validation. The NRAM were 72% quantitatively uncertain, 16% needed, and 11% quantitatively ineffective. Conclusion: The NRAM associated with DRPs were statistically related to prematurity condition, APGAR score, PN time, and the number of medications administered, which suggests the need to create a nutritional therapy committee at the health facility.

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Section: Discussionmentioning

confidence: 99%

Negative Outcomes Associated with Medication in Neonates on Parenteral Nutrition Therapy

Dı́az¹,

Barros

Reyna

et al. 2023

Pediatric Reports

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“…In the United States, there are approximately 20,000 reported cases [10,11]. The prevalence of SBS in children has been reported to occur in 24.5 out of 100,000 live births [12][13][14].…”

Section: Introductionmentioning

confidence: 99%

Gut Microbiota Modulation of Short Bowel Syndrome and the Gut–Brain Axis

Carter,

Bettag,

Morfin

et al. 2023

Nutrients

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Short bowel syndrome (SBS) is a condition that results from a reduction in the length of the intestine or its functional capacity. SBS patients can have significant side effects and complications, the etiology of which remains ill-defined. Thus, facilitating intestinal adaptation in SBS remains a major research focus. Emerging data supports the role of the gut microbiome in modulating disease progression. There has been ongoing debate on defining a “healthy” gut microbiome, which has led to many studies analyzing the bacterial composition and shifts that occur in gastrointestinal disease states such as SBS and the resulting systemic effects. In SBS, it has also been found that microbial shifts are highly variable and dependent on many factors, including the anatomical location of bowel resection, length, and structure of the remnant bowel, as well as associated small intestinal bacterial overgrowth (SIBO). Recent data also notes a bidirectional communication that occurs between enteric and central nervous systems called the gut–brain axis (GBA), which is regulated by the gut microbes. Ultimately, the role of the microbiome in disease states such as SBS have many clinical implications and warrant further investigation. The focus of this review is to characterize the role of the gut microbiota in short bowel syndrome and its impact on the GBA, as well as the therapeutic potential of altering the microbiome.

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“…8 To ensure nutrition intake, early parenteral nutrition (PN; <24 h after admission) is often selected during TH in clinical practice, 9 but some scholars worry that it may introduce multiple complications, such as catheter-related bloodstream infection (CRBSI), PN-related liver disease, and cardiotoxicity. [10][11][12] Postpyloric feeding (PPF) refers to a special EN mode that directly delivers nutrients from the position beyond the gastric pylorus into the duodenum or jejunum of the small intestine. PPF is applicable to other patients with severe disease, but there are few studies on its early application in TH.…”

Section: Introductionmentioning

confidence: 99%

“…Severe pulmonary infection can easily become complicated with sepsis, prolonging mechanical ventilation (MV), and can lead to adverse outcomes 8 . To ensure nutrition intake, early parenteral nutrition (PN; <24 h after admission) is often selected during TH in clinical practice, 9 but some scholars worry that it may introduce multiple complications, such as catheter‐related bloodstream infection (CRBSI), PN‐related liver disease, and cardiotoxicity 10–12 . Postpyloric feeding (PPF) refers to a special EN mode that directly delivers nutrients from the position beyond the gastric pylorus into the duodenum or jejunum of the small intestine.…”

Section: Introductionmentioning

confidence: 99%

Effectiveness and safety of early postpyloric feeding during therapeutic hypothermia in patients with large hemispheric infarction: A retrospective cohort study

Cao

Chang

et al. 2023

Nut in Clin Prac

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BackgroundWhat kind of feeding should be provided during therapeutic hypothermia (TH) in patients with large hemispheric infarction (LHI) is not clear. Therefore, we conducted a retrospective observational study to determine whether providing early postpyloric feeding (PPF) (<24 h after admission) is beneficial or harmful for patients with this condition.MethodsThis study retrospectively screened 78 patients with LHI who were treated with TH from one neurological intensive care unit (ICU). The patients were receiving either early PPF (n = 52) or early parenteral nutrition (PN) (n = 26). Data regarding 30‐day mortality, neurological outcome, nutrition‐related laboratory indicators, ICU hospitalization time, mechanical ventilation (MV) duration, and complications were collected.ResultsA greater number of patients who received early PPF had favorable neurologic outcome than those who received early PN (57.7% vs 30.7%, P = 0.025). The early PPF group had a lower severity of pulmonary infection than the early PN group, as measured by the Clinical Pulmonary Infection Score (7.33 ± 0.96 vs 9.42 ± 2.11, P = 0.006). The total protein and hemoglobin levels in the early PPF group were higher than those in the early PN group (59.56 ± 5.09 vs 56.52 ± 7.94 g/L, P = 0.046; 131.06 ± 19.58 vs 122.07 ± 17.72 g/L, P = 0.045). The MV duration and ICU hospitalization time were shorter in the early PPF group (13 [9;21] vs 21 [14;30] days, P = 0.006; 28 [22;36] vs 34 [33;51] days, P = 0.014). There were no significant differences in the incidence of catheter‐related bloodstream infections, 30‐day mortality, or nutrition intolerance between the two groups.ConclusionEarly PPF is an effective and safe enteral nutrition method for patients with LHI receiving TH.

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Parenteral Nutrition and Cardiotoxicity

Cited by 5 publications

References 78 publications

Negative Outcomes Associated with Medication in Neonates on Parenteral Nutrition Therapy

Negative Outcomes Associated with Medication in Neonates on Parenteral Nutrition Therapy

Gut Microbiota Modulation of Short Bowel Syndrome and the Gut–Brain Axis

Effectiveness and safety of early postpyloric feeding during therapeutic hypothermia in patients with large hemispheric infarction: A retrospective cohort study

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