ISSN:0884-5336    

DOI:10.1177/011542659501000243

出版商:Sage Publications    

年代:1995

数据来源: WILEY

摘要:

Nutrition support in patients with pancreatitis has created a challenge for clinicians. Because the pancreas is normally stimulated by the ingestion of food, particularly fat, patients are often denied oral nutrition. This reduction in the ingestion of food, together with the increased metabolic demands of this disease, often results in a negative energy balance and occasionally undernutrition or malnutrition. This review summarizes the etiologies and methods for staging pancreatitis, the physiology of pancreatic exocrine secretion and the response of the pancreas to different methods of nutrition support. The results of clinical trials, which examine both parenteral and enteral nutrition in animals and humans with this disease, are reviewed. Recommendations for nutrition management of patients with acute and chronic pancreatitis and areas for future research are discussed.

ISSN:0884-5336    

DOI:10.1177/011542659501000245

出版商:Sage Publications    

年代:1995

数据来源: WILEY

摘要:

The diversity of nutritional needs within the pediatric population makes ordering parenteral nutrition (PN) for infants and children a difficult task for inexperienced clinicians. A well designed PN order form can simplify this task. Standard PN solutions, tables with age‐specific nutrient requirements, and guidelines for advancing substrate may improve PN prescriptions and serve as an educational tool. The development of an optimal PN order form for an institution requires consideration of many factors, including the patient population, requirements of the institution, and the needs of the staff and students. One nutrition support team's experience in developing pediatric PN order forms is described.

ISSN:0884-5336    

DOI:10.1177/011542659501000254

出版商:Sage Publications    

年代:1995

数据来源: WILEY

摘要:

Central venous access for the administration of total parenteral nutrition is usually achieved via the subclavian or internal jugular veins. Although a high incidence of complications has been reported with the use of femoral catheters for central venous access, this route has been used when traditional central venous access is contraindicated. We retrospectively reviewed 171 patients who received total parenteral nutrition via a central venous triple‐lumen catheter and compared the rates of infections in femoral vs nonfemoral access. A literature review was performed to identify associated complications of and appropriate indications for femoral catheter use. In the 171 patients studied, 355 triple‐lumen catheters were placed; these included 331 nonfemoral catheters and 24 femoral catheters. Femoral catheters were placed in nine patients. Femoral catheters had a greater incidence of positive tips (42%vs6.9%, p<.001) and related bacteremia (16.7%vs1.8%, p = .002) than did nonfemoral catheters. The organisms most commonly isolated from the blood and catheter tips of both catheter access sites were methicillin‐resistantStaphylococcus epidermidisandCandida.The use of femoral catheters for central venous access for total parenteral nutrition administration results in an increased risk of infectious complications.

ISSN:0884-5336    

DOI:10.1177/011542659501000260

出版商:Sage Publications    

年代:1995

数据来源: WILEY

摘要:

Cystic fibrosis (CF) is the most common lethal genetic disease in the white population. The pulmonary infections and pancreatic insufficiency make CF a medically challenging disease. Although the importance of nutrition in the CF patient is known, approximately 50% of CF patients are in less than the 10th percentile for weight and height as reported by the 1991 CF Foundation Registry of 114 CF Centers in the United States. This paper addresses the nutritional status of 10 pediatric CF patients who underwent double lung transplant at Children's Hospital of Pittsburgh between August 1991 and May 1993. Patients who survived beyond 1 year gained a significant amount of weight sooner after transplant than those who survived less than 1 year. Gastrostomy tube feedings were more effective than oral intake for weight gain after transplant. CF patients with pancreatic insufficiency have more difficulty with adjustment of doses of immunosuppressive agents for reasons that are not clearly understood.

ISSN:0884-5336    

DOI:10.1177/011542659501000267

出版商:Sage Publications    

年代:1995

数据来源: WILEY

摘要:

To evaluate the clinical impact of prolonged parenteral nutritional (PN) therapy on patients with advanced cystic fibrosis, we conducted a retrospective chart review of 25 cystic fibrosis patients who underwent prolonged PN (median course 295 days) at our institution between August 1988 and May 1992. The patients' survival status, change in percentage of ideal body weight, need for ongoing nutritional intervention, pulmonary function test changes, IV antibiotic use, and complication rates were assessed. Patients gained significant weight while receiving PN, but they lost weight when PN was discontinued. PN did not clearly improve pulmonary status. IV antibiotic therapy nearly doubled during PN. Central venous catheter sepsis rates rose from 1.29 to 3.45 per 1000 catheter days during PN therapy. In conclusion, prolonged PN promotes weight gain in cystic fibrosis patients with severe disease; however, the effect is transient and involves a significantly increased risk of sepsis.

ISSN:0884-5336    

DOI:10.1177/011542659501000273

出版商:Sage Publications    

年代:1995

数据来源: WILEY

ISSN:0884-5336    

DOI:10.1177/088453369501000207

出版商:Sage Publications    

年代:1995

数据来源: WILEY

ISSN:0884-5336    

DOI:10.1177/088453369501000208

出版商:Sage Publications    

年代:1995

数据来源: WILEY

ISSN:0884-5336    

DOI:10.1177/088453369501000210

出版商:Sage Publications    

年代:1995

数据来源: WILEY

ISSN:0884-5336    

DOI:10.1177/088453369501000211

出版商:Sage Publications    

年代:1995

数据来源: WILEY