• 제목/요약/키워드: Enteral nutrition

검색결과 114건 처리시간 0.03초

(+)-Catechin is a Potent Inhibitor of Intestinal Absorption of Cholesterol in Rats

  • Noh, Sang K.;Koo, Sung I.;Jiang, Yongzhi
    • Preventive Nutrition and Food Science
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    • 제8권1호
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    • pp.1-6
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    • 2003
  • Catechins exhibit a hypocholesterolemic effect in cholesterol-fed animals. The present study was conducted to examine whether (+)-catechin influences the absorption of cholesterol in rats. Male Sprague-Dawley rats were fed ad libitum an AIN-93G diet containing soybean oil for 5 wk. Rats with lymph cannulae were infused at 3.0 mL/h for 8 h via a duodenal catheter with a lipid emulsion containing radiolabeled cholesterol with or without (+)-catechin. Lymph was collected hourly for 8 h. The enteral infusion of (+)-catechin significantly lowered the lymphatic absorption of $^{14}$ C-cholesterol (21.1 $\pm$ 3.6% dose/B h) compared with controls infused with the lipid emulsion devoid of (+)-catechin (38.2 $\pm$ 1.2% dose/8 h). The intestinal absorption of $\alpha$-tocopherol (24.2$\pm$3.0% dose/8 h) also was significantly decreased by (+)-catechin infusion, relative to controls (32.2$\pm$2.2% dose/8 h). However, the lymphatic outputs of oleic acid and phospholipid were not affected by enteral (+)-catechin infusion. The results indicate that (+)-catechin has a profound inhibitory effect on the intestinal absorption of cholesterol and $\alpha$-tocopherol without affecting the absorption of fat.

신생아 중환자실 영양요법치료에서 약사의 역할과 영향 (Neonatal Total Nutritional Pharmacy Service at Intensive Care Unit at a University Hospital in Korea)

  • 오윤경;이광섭;이정연
    • 한국임상약학회지
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    • 제23권2호
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    • pp.167-174
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    • 2013
  • Objective: The study evaluated the impact of pharmacist inventions with the implementation of pharmacistinvolved nutritional support service at neonate intensive care unit in a tertiary teaching hospital. Method: A retrospective and observational study was carried out. The total of 58 infants in neonate intensive care unit was enrolled between January 2011 and October 2012. The pharmacist-involved total parenteral nutritional program was initiated in June of 2012. During the program, pharmacist actively participated in the multidisciplinary round with performing the interventions from reviewing the amount of combined total parenteral nutrition and enteral fluid intakes, the amount of total calories, the glucose infusion rate, and the amounts of proteins per weight in kilogram. The outcome was compared with the results from the control group which reflected the prior period of the program initiation. Result: The number of days of regaining birth weight was significantly shorter (14.5 vs. 19 days, p=0.049) and the percentage of total calorie days with >90 kcal/kg/day was increased significantly (40 vs. 13%, p=0.008) in intervention group compared to the values in control group. In addition, the total mean daily caloric intakes ($84.78{\pm}13.8$ vs. $74.86{\pm}15.36$ kcal/kg/day, p=0.018) was significantly higher in intervention group than those results in control group. There were no significant differences in safety parameters between two groups related to nutritional services of necrotizing enterocolitis, intraventricular hemorrhage, proven sepsis, and also parenteral nutrition-induced hepatotoxicity. Conclusion: Pharmacist-involved total parenteral nutrition managed program was successfully implemented. The outcome showed the improved effectiveness of total parenteral nutrition with pharmacist interventions and no differences in adverse reactions. This could prove the positive effects of pharmacist involvement on nutritional therapy for neonate population.

3차병원에서의 TPN 사용의 적정성 점토 (Evaluation of Total Parenteral Nutrition in Tertiary Hospital)

  • 민경아;손기호;서옥경;최경업
    • 한국임상약학회지
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    • 제8권1호
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    • pp.35-46
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    • 1998
  • A retrospective study was conducted to evaluate the appropriateness of total parenteral nutrition (TPN) for 200 hospitalized adult patients in Samsung Medical Center from January 1st in 1995 to June 31st in 1997. Standard criteria were modified and determined from those stated by AJHP (American Journal of Health System Pharmacy) and ASPEN (American Society of Parenteral and Enteral Nutrition). The justification for indications was appropriate in $35\%,\;44\%,\;and\;32\%$ of the patient's in 1995, 1996, and 1997, respectively, without significant improvement over the last two and half years. Before and during the administration of TPN, several monitoring indicators were well documented, and monitoring frequencies were increased over two and half years period. However, the majority of the monitoring indicators were not found in the standard criteria range of $90\%$. The monitoring indicators for electrolyte balance, $PO_4$ and Mg, were not measured appropriately and resulted in the complications which could have been prevented. The indicator for lipid tolerance, triglyceride and the indicator for hemorrhagic incidence, prothrombin time (PT), were not well documented in comparison with other indicators. The indicators for the improvement in nutritional status, albumin and total protein, were appropriate in $90\%$ of the patients. Determination of TPN formula was based on the laboratory data and chart reviews, and it was appropriate in $98\%$. But the administration of lipid and vitamin K for the prevention of essential fatty acid deficiency and hemorrhage, respectively, was not carried out appropriately when the administration of TPN was prolonged, lasting more than 7 days. When a patient returned to oral or enteral feeding, TPN was terminated. However, increase in albumin level or weight was rarely observed. In conclusion, healthcare professionals should all work as a team and active participation to provide optimized nutrition support for partners.

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중환자를 위한 근거중심 영양지원 (Evidence-based Nutritional Support in the Intensive Care Unit)

  • 이영희;위미숙
    • 중환자간호학회지
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    • 제3권1호
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    • pp.79-88
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    • 2010
  • Optimal nutrition serves to maintain normal organ function and to preserve body energy stores to guarantee survival during times of shortage of food. Adequate nutrition of intensive care unit (ICU) patients improves outcome, while malnutrition is strongly associated with increased morbidity and mortality rates among critically ill patients. Previously published researches showed that trials of nutritional support in critical illness rarely fulfill basic quality requirements. Nutrition support plays a vital role in the prevention and treatment of nutritional deficiencies in at-risk, critically ill patients. This paper reviewed the challenges in determining critically ill patients' nutrition requirements including nutrition assessment, determination of caloric requirements then providing them with adequate nutrition support while in the ICU with the guidelines published by Society of Critical Care Medicine and American Society for Parenteral and Enteral Nutrition. Nutrition support can be effectively enhanced by using the guidelines.

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Enteral Infusion of Green Tea Extract Selectively Enhances the Biliary Secretion of 14C-Benzo[a]pyrene in Rats without Affecting Other Biliary Lipids

  • Noh, Sang-K.;Kim, Ju-Yeon
    • Preventive Nutrition and Food Science
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    • 제16권2호
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    • pp.104-109
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    • 2011
  • Recently, we have demonstrated that green tea extract (GTE) decreases the intestinal absorption of benzo[a]pyrene (BAP), which is an extremely lipophilic food contaminant. The present study was conducted to examine if an enteral infusion of GTE would influence the biliary secretion of BAP and lipids in rats. Female rats were fed an AIN-93G diet with or without (control) GTE at 5 g/kg diet for 4 week. Following the 4-week dietary treatment, rats with bile duct cannula were infused continuously for 8 hr at 3.0 mL/hr via a duodenal catheter with a lipid emulsion containing $4.0\;{\mu}mol$ BAP labeled with $^{14}C$ ($^{14}C$-BAP), $20.7\;{\mu}mol$ cholesterol, $452\;{\mu}mol$ triolein, and $3.1\;{\mu}mol$ ${\alpha}$-tocopherol, and $396.0\;{\mu}mol$ Na-taurocholate with or without 76.1 mg GTE powder in PBS buffer (pH, 6.4). Bile was collected hourly via bile cannula for an 8 hr period. Our results showed that bile flow did not differ between groups. However, the biliary secretion of $^{14}C$-BAP was significantly enhanced by GTE infusion, compared with those infused with the lipid emulsion alone. However, GTE did not affect the biliary outputs of cholesterol, fat, phospholipid and ${\alpha}$-tocopherol. These findings indicate that GTE has a profound stimulatory effect on the biliary excretion of BAP in rats, without affecting other biliary lipids. The mechanism(s) by which GTE enhances the biliary secretion of BAP remains to be investigated.

The Optimal Time for Initiating Probiotics for Preterm and Very-Low-Birth-Weight Infants: A 10-Year Experience in a Single Neonatal Intensive Care Unit

  • JeongHoon Park;Jae Young, Cho;Jung Sook Yeom;Jin Su Jun;Ji Sook Park;Eun Sil Park;Ji Hyun Seo;Jae Young Lim;Chan-Hoo Park;Hyang-Ok Woo
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제26권3호
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    • pp.146-155
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    • 2023
  • Purpose: The starting time for probiotic supplementation in preterm infants after birth varies widely. This study aimed to investigate the optimal time for initiating probiotics to reduce adverse outcomes in preterm or very low birth weight (VLBW) infants. Methods: Medical records of preterm infants born at a gestational age (GA) of <32 weeks or VLBW infants in 2011-2020 were reviewed respectively. The infants who received Saccharomyces boulardii probiotics within 7 days of birth were grouped into an early introduction (EI) group, and those who received supplemented probiotics after 7 days of birth were part of the late introduction (LI) group. Clinical characteristics were compared between the two groups and analyzed statistically. Results: A total of 370 infants were included. The mean GA (29.1 weeks vs. 31.2 weeks, p<0.001) and birth weight (1,235.9 g vs. 1491.4 g, p<0.001) were lower in the LI group (n=223) than in the EI group. The multivariate analysis indicated that factors affecting the LI of probiotics were GA at birth (odds ratio [OR], 1.52; p<0.001) and the enteral nutrition start day (OR, 1.47; p<0.001). The late probiotic introduction was associated with a risk of late-onset sepsis (OR, 2.85; p=0.020), delayed full enteral nutrition (OR, 5.44; p<0.001), and extrauterine growth restriction (OR, 1.67; p=0.033) on multivariate analyses after adjusting for GA. Conclusion: Early supplementation of probiotics within a week after birth may reduce adverse outcomes among preterm or VLBW infants.

Nutritional Support Strategies for the Preterm Infant in the Neonatal Intensive Care Unit

  • Hay, William W. Jr.
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제21권4호
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    • pp.234-247
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    • 2018
  • The goal of nutrition of the preterm infant is to "provide nutrients to approximate the rate of growth and composition of weight gain for a normal fetus of the same postmenstrual age and to maintain normal concentrations of blood and tissue nutrients" (American Academy of Pediatrics 2014). Failure to provide the necessary amounts of all of the essential nutrients to preterm infants has produced not only growth failure, but also increased morbidity and less than optimal neurodevelopment. This continues to be true despite many efforts to increase nutrition of the preterm infants. In contrast, enhanced nutrition of very preterm infants, both intravenous and enteral, beginning right after birth, promotes positive energy and protein balance and improves longer term neurodevelopmental outcomes. The benefits are long lasting too, particularly for prevention of later life chronic diseases.

소아 영양지원팀 운영 및 관리의 실제 (Managing Pediatric Nutritional Support Team in Hospital)

  • 양혜란
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제12권sup1호
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    • pp.37-40
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    • 2009
  • Nutritional support team (NST) is a multidisciplinary group of nutrition professionals with interest and expertise in the evaluation and management of malnutrition and nutrition-related problems in hospital. The goal of NST is providing optimal nutrition to patients who need enteral and parenteral nutrition. Recently, NST is set up in some hospitals in Korea. However, until now, pediatric NST is not established in most hospitals. Because children admitted to hospital are at risk of malnutrition, NST is required to provide effective nutritional management for pediatric patients.

성인 단장증후군 환자의 다학제 장 재활: 국내 단일 기관 다학제 장재활 클리닉의 경험 (Multidisciplinary Intestinal Rehabilitation for Short Bowel Syndrome in Adults: Results in a Korean Intestinal Rehabilitation Team)

  • 윤소정;이상훈;박효정;김현정;윤지혜;민자경;서정민
    • Journal of Clinical Nutrition
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    • 제10권2호
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    • pp.45-50
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    • 2018
  • Purpose: Intense multidisciplinary team effort is required for the intestinal rehabilitation of patients afflicted with the short bowel syndrome (SBS). These include enteral and parenteral nutrition (PN) support, monitoring of complications related to treatment, and considering further medical or surgical options for intestinal adaptation. Methods: In the Intestinal Rehabilitation Team (IRT) at the Samsung Medical Center, we have experienced 20 cases of adult SBS requiring multidisciplinary intestinal rehabilitation. This study is a retrospective review of the collected medical records. Results: Of the 20 subjects treated, 12 patients were male and 8 patients were female. At the time of referral to the IRT, the mean age was 51.5 years, and the mean body weight was 50.1 kg, which was 90% of the usual body weight. The diseases or operative managements preceding massive bowel resection were malignancy in 11 cases, cardiac surgery in 2 cases, trauma in 2 cases and one case, each of tuberculosis, corrosive esophagitis, atrial fibrillation, simultaneous pancreas and kidney transplantation, and perforated appendicitis. Of these, there were 14 survivals and 6 mortalities. The fatalities were attributed to progression of disease, intestinal failure-associated liver disease, and sepsis (unrelated to intestinal failure) (2 cases each). Among the 14 surviving patients, 8 patients have been weaned off PN, whereas 6 are still dependent on PN (mean PN dependence 36%). Conclusion: This paper reports the results of multidisciplinary intestinal rehabilitation of adult short bowel patients treated at the Samsung Medical Center. Further studies are required to improve survival and enteral tolerance of these patients.

Evaluation and Treatment of Malnutrition and Associated Gastrointestinal Complications in Children with Cerebral Palsy

  • Trivic, Ivana;Hojsak, Iva
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제22권2호
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    • pp.122-131
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    • 2019
  • The majority of children with cerebral palsy (CP) have feeding difficulties and are especially prone to malnutrition. The early involvement of a multidisciplinary team should aim to prevent malnutrition and provide adequate nutritional support. Thorough nutritional assessment, including body composition, should be a prerequisite for the nutritional intervention. As in typically-developed children nutritional support should start with dietary advice and the modification of oral feeding, if safe and acceptable. However, for prolonged feeding, in the presence of unsafe swallowing and inadequate oral intake, enteral nutrition should be promptly initiated and early gastrostomy placement should be evaluated and discussed with parents/caregivers. Gastrointestinal problems (oropharyngeal dysfunction, gastroesophageal disease, and constipation) in children with CP are frequent and should be actively detected and adequately treated as they can further worsen the feeding process and nutritional status.