The knowledge of intensive care professionals about diarrhea

Lordani, Cláudia Regina Felicetti; Eckert, Raquel Goreti; Tozetto, Altevir Garcia; Lordani, Tarcísio Vítor Augusto; Duarte, Péricles Almeida Delfino

doi:10.5935/0103-507x.20140042

Cited by 9 publications

(7 citation statements)

References 24 publications

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“…Children who require nutrition support from feeding tubes routinely report feeding intolerances. 4 Our national multicenter, retrospective study found that children who had switched to an "enteral formula with food-derived ingredients" reported a significant improvement in gastrointestinal symptoms, including a reduction in retching, flatulence, and vomiting. Dietitians reported clinical improvements within the first week of switching to the new enteral formula that were sustained throughout the study period.…”

Section: Discussionmentioning

confidence: 97%

“…3 The frequency of diarrhea in enterally fed patients ranges from 29% to 72%. 4,5 The management of persistent feed intolerances results in repeated feed withdrawal to allow for gut rest, contributing to malnutrition through a reduction in nutrition intake, a decrease in nutrient absorption, and an increase in nutrient reserve catabolism. 6 In the pediatric population interest is growing in the use of a blended diet for the management of feeding intolerances.…”

Section: Introductionmentioning

confidence: 99%

“…Clinical manifestations of enteral feeding intolerances, such as abdominal distension and diarrhea, are some of the complications that can occur in patients 3 . The frequency of diarrhea in enterally fed patients ranges from 29% to 72% 4,5 . The management of persistent feed intolerances results in repeated feed withdrawal to allow for gut rest, contributing to malnutrition through a reduction in nutrition intake, a decrease in nutrient absorption, and an increase in nutrient reserve catabolism 6 …”

Section: Introductionmentioning

confidence: 99%

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Monitor gastrointestinal tolerance in children who have switched to an “enteral formula with food‐derived ingredients”: A national, multicenter retrospective chart review (RICIMIX study)

et al. 2021

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Background Enteral tube feeding intolerances, such as diarrhea, are commonly reported in children. In the pediatric population, interest is growing in the use of blended diets for the management of enteral feeding intolerances. Fiber within a blended diet stimulates the growth of beneficial gut bacteria, which in turn produce short‐chain fatty acids, which are utilized as energy substrates for enterocytes. Enteral formula manufacturers have responded to this trend towards “real‐food” blended diets and developed an enteral formula with food‐derived ingredients. The aim of this study was to collect data relating to feed tolerance in children who had switched to an “enteral formula with food‐derived ingredients.” Methods A national multicenter retrospective study. Results Dietitians collected data from 43 medically unwell children between March 2021 and July 2021. Significant improvements were reported in children who had switched to an “enteral formula with food‐derived ingredients” in retching 17 of 18 children (95%), flatulence 6 of 8 children (85%), loose stools 10 of 11 children (90%), and constipation 10 of 11 children (90%). These improvements in gastrointestinal symptoms were reflected in weight change during the one month period measurements were collected (baseline, 19.5 kg [SD, 9]; 1 month, 20.1 kg [SD, 9]; P = 0.002). Conclusion We have observed beneficial outcomes in medically complex children who have switched to an “enteral formula with food‐derived ingredients.” Our data should motivate healthcare professionals to implement more research to better evaluate the clinical impact and mechanisms of action of blended diets and enteral formulas with food‐derived ingredients.

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Section: Discussionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Monitor gastrointestinal tolerance in children who have switched to an “enteral formula with food‐derived ingredients”: A national, multicenter retrospective chart review (RICIMIX study)

et al. 2021

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“…However, despite all pre-cautions, intestinal bowel material is "differentially diluted" among different patients, due to case dependent differential "biomass wash-outs", during presentation of acute diarrheal symptoms, the total bacterial load could vary up to few log values [3]. Whenever pre-analytical sampling variability is large [1,2,[4][5][6][7][8] and quantification is intended to establish the clinical status of the patient, normalization based on sample mass, or sample volume is not effective.…”

Section: Introductionmentioning

confidence: 99%

Absolute versus relative presentation of tcdB Clostridium difficile biomarker

Brukner¹,

Eintracht²,

Forgetta³

et al. 2019

Integr Mol Med

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Clostridium difficile infection is the major etiologic agent of antibiotic-associated pseudomembranous colitis, a disease that can be fatal if unrecognized, or untreated. On average, there are 15000 deaths and 500000 new cases per year, in the USA. Diagnostic biomarkers currently used are the tcdB gene, or its gene product (toxin B). Clinical interpretation of the assay is particularly challenging: (1) biomarker detection is possible without manifestation of symptoms and (2) missing biomarker due to assay sensitivity limitations can be fatal. To resolve clinical uncertainty, quantitative analysis has been considered. Despite multiple efforts, a quantitative tcdB/toxB threshold with a meaningful clinical impact has yet to be established. Herein we shed light as to why mass/volume-based normalisations were fruitless in the past. Specifically, measuring total bacterial flora (using "universal bacterial" 16S qPCR rDNA assay) to calculate relative abundance of C difficile, we demonstrate a strong and significant negative correlation between tcdB biomarker of C difficile (R 2 =0.73, N=227, P=10 -39 ) and the rest of gut microorganisms. The new parameter (Cq (toxB)-Cq (16SrDNA)) is calculated from two biomarkers, is independent of sampling variability and inherently incorporates the destructive character of C difficile on the rest of micro-flora. By incorporating relative abundance of tcdB (in context of the total bacterial flora), and correcting for "biomass wash-out/dilution effects of acute diarrhea , these biomarkers could collectively enhance the predictive value of CDI testing.

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“…Lordani et al(2014) mostram que dentre os fatores adversos mais corriqueiros que podem influenciar a descontinuidade da referida terapia são: resíduos gástricos excessivos, distensão abdominal, náuseas/vômitos, diarréia, constipação, doenças gastrointestinais, uso de sedação, opióides,…”

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Administração de terapia nutricional em crianças gravemente doentes: fatores que prejudicam a oferta de nutrientes

Tôrres¹

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Aos meus pais, Quitéria e José, a quem tanto estimo e que sempre torceram por mim, me incentivaram a estudar e a não desistir dos meus sonhos, que tanto se dedicaram à minha educação, mesmo nos momentos mais difíceis, em especial a minha mãe que apesar de distante, sempre esteve disposta a me ajudar, escutar e pelas palavras de carinho e conforto nos momentos de angústia e cansaço. Aos meus irmãos, tios, tias, primos, primas e amigos que sempre torceram por mim e pelo o meu crescimento profissional, que souberam compreender cada ausência minha, para que pudesse conciliar e me dedicar ao trabalho e ao mestrado. À minha tia Preta, pelas orações e apoio espiritual em todos os momentos da minha vida. Aos meus queridos sobrinhos, Pedro Henrique, Maysa, Davi e Miguel, que tanto tenho carinho. Esta dissertação está de acordo com as seguintes normas, em vigor no momento desta publicação: Referências: adaptado de International Committee of Medical Journals Editors (Vancouver).

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The knowledge of intensive care professionals about diarrhea

Cited by 9 publications

References 24 publications

Monitor gastrointestinal tolerance in children who have switched to an “enteral formula with food‐derived ingredients”: A national, multicenter retrospective chart review (RICIMIX study)

Monitor gastrointestinal tolerance in children who have switched to an “enteral formula with food‐derived ingredients”: A national, multicenter retrospective chart review (RICIMIX study)

Absolute versus relative presentation of tcdB Clostridium difficile biomarker

Administração de terapia nutricional em crianças gravemente doentes: fatores que prejudicam a oferta de nutrientes

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