• 대한영양사협회학술지
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• 제10권4호
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• pp.442-451
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• 2004

Protein-calories malnutrition is common among patients in the hospital. In particular, elderly patients with neurologic disorders has more risk of nutritional deficiency due to swallowing difficulty. Enteral tube feeding is more economical, physiological and immunological than parenteral nutrition for patients who have adequate gastrointestinal function. This study was conducted patients with neurologic disorders who received enteral nutrition at Asan Medical Center from February 1 to October 10, 2002. The control group (48 patients) were given traditional feeding methods 4 times a day while the treatment group (45 patients) were given improved feeding methods 3 times a day. We assessed nutritional status of patients and compared to both groups. We investigated body weight, serum albumin, hemoglobin, total lymphocyte count by means of nutrition markers. The objectives of this study is to reduce the time needed for nutritional requirement of patients without an increase in gastrointestinal intolerances. The results of this study are as follows: 1. Nutritional status of many patients in both groups were either malnourished or at risk for malnutrition. 2. The time to arrive to the nutritional requirements were 6.21 $\pm$ 0.35 days for the control group and 4.24 $\pm$ 0.52 days for the treatment group. The treatment group showed a significantly shorter amount of time. 3. The changes of the nutritional marker in the control group showed a significant drop in body weight, serum albumin and serum hemoglobin while the treatment group experienced a significant increase in body weight, serum albumin and total lymphocyte count. 4. Feeding intolerane such as diarrhea, high residual volume, ileus, nausea and vomiting were investigated. Diarrhea found in 25.1% (12 patients) of the control group and 22.2% (10 patients) of the treatment group and these findings are not significant.

• 대한영양사협회학술지
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• 제1권1호
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• pp.21-30
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• 1995

Critically ill patients admitted in ICU and NCU were studied with respect to their nutritional status and support to them at initial period, and the effect of nutritional support after 3 weeks. The nutritional support was supplied to these patients with the enteral and parenteral nutrition. The results of biochemical test and status of nutritional support on 52(29 males, 23 females) critically ill patients were based on medical records and the anthropometry was measured on 28 patients. The subjects were in mild malnutrition. Their initial calorie intakes were 85% of BEE, 57% of total energy requirements and 49% of protein requirement were provided. Two groups, one group of serum albumin level more than 3.5g/dl and the other group of serum albumin level less than 3.5g/dl, were significant different in total calorie and protein intakes. After 3 weeks, inappropriate nutritional support in the group of normal nutrition results in significant decreasing of serum albumin level but, there were no changes in the group of malnutrition. Nutritional support is one of the mainstays in the management of these critically ill patients and is aimed at preventing malnutrition. Therefore, timely nutritional support is heavily required in cases of critically ill patients whether their initial nutritional status is normal or not.

• 중환자간호학회지
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• 제11권3호
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• pp.108-119
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• 2018

Purpose : This study evaluated the nutritional status and effect of nutritional support team (NST) management in critically ill patients. Methods : From January 2015 to August 2017, the study retrospectively investigated 128 patients aged above 19 years admitted to a medical intensive care unit (MICU). The patients were divided into two groups: NST (n=65) and non-NST (n=63) groups. Nutritional status, classification of bedsore risks, incidence rate of bedsore and clinical outcomes were compared. Results : The study found a higher rate of the use of enteral nutrition in the NST group (${\chi}^2=45.60$, p < .001). The prescription rate of parenteral nutrition (PN) was found to be lower in the NST group (4.6%) compared to the non-NST group (60.3%). There was a higher PN of total delivered/required caloric ratio in the NST, compared to the non-NST, group (${\chi}^2=3.33$, p=.025). There were significant differences for higher albumin levels (t=2.50, p=.014), higher total protein levels (t=2.94, p=.004), and higher proportion of discharge with survival rates (${\chi}^2=18.26$, p < .001) in the NST group. Conclusions : Providing NST management to critically ill patients showed an increase in the nutrition support. Further, to achieve effective clinical outcomes, measures such as nutrition education and continuous monitoring and management for the provision of nutritional support by the systemic administration of a nutritional support team should be considered.

• 약학회지
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• 제54권4호
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• pp.270-281
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• 2010

Total parenteral nutrition (TPN) is necessary to neonates in neonatal intensive care unit (NICU) for survival and growth because of impossible of enteral feeding. Long-term TPN can be associated with a broad spectrum of hepatobiliary disorder, ranging from mild hepatic dysfunction to severe end-stage liver disease. Cholestasis developed most commonly in neonate, ursodeoxycholic acid (UDCA) is widely used in adult with cholestatic and non-cholestatic liver diseases but there have been limited data on the effects in neonate with PNAC. This study was performed retrospectively to review all medical histories of the total 30 neonates with was administrated UDCA for treatment to parenteral nutrition associated cholestasis (PNAC) at Chungbuk National University Hospital NICU from April 2002 to December 2008. UDCA was administrated at bilirubin is over 2 mg/dl. The criterias for drug evaluation were included hepatic biochemical marker such as direct bilirubin, total bilirubin, AST, ALT, ALP and GGT, TPN therapy period, cholestasis development period, UDCA treatment period, UDCA dosage and adverse effect. In the results, Post-UDCA treatment significant was decreased direct bilirubin, total bilirubin, AST and ALP (p<0.05), and was decreased GGT (p>0.05) and slightly was increased ALT (p>0.05). Reffective timect biDCA was appear at mean $10.5{\pm}1.3$ days, iDCA administration period was mean $64.4{\pm}5.9$ days, cholestasis period was mean $71.9{\pm}6.4$ days and UDCA dosage was mean $22.9{\pm}0.9$ mg/kg/day. Common adverse effects is diarrhea, 5 patients arised mild diarrhea but it possible also related with increased enteral feeding. In conclusion, iDCA can decrease direct bilirubin that major parameter t bcholestasis and oher hepatic biochemical makers. UDCA is effective on PNAC without any serious side effect and cost-effective. Although no greatly shortening cholestasis period, but can protect to develop into severe liver disease and other complication or death. Based on these result, UDCA is recommended for treatment of cholestasis at direct bilirubin is over 2 mg/dl.

• 한국임상약학회지
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• 제3권2호
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• pp.125-130
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• 1993

The particle size distribution and physical stability of commercial lipid emulsion inject, $intralipos^R$ before and after mixture with total parenteral nutrition(TPN) was tested. Three TNAs were prepared by adding intralipos to P-TPN, Neo-TPN and IVH-2 respectively. Particle size of fat emulsion in three TNA preparations were measured by using LPA-3000 photon correlater. Each TNAs was stored for 48 hours at $4^{\circ}C\;and\;25^{\circ}C.$ During storage, three TNAs showed the particle size in the range of 40-1000nm(about $100\%$ of total fat) and in the range of 1000-8000nm(less than $0.005\%$ of total fat). All TNAs were stable in terms of pH and visual appearance. The results showed that added lipid emulsion was stable for 48 hours at $4^{\circ}C\;and\;25^{\circ}C$.

• Journal of Nutrition and Health
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• 제31권4호
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• pp.679-686
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• 1998

This study was performed to determine whether the infusion of nucleosides and a nucleotide mixture directly ito intestinal lumen can induce a regenerative effect on impaired intestinal mucosa. The effects of massive small bowel resention and also total parenteral nutrition were induced by surgical creation of Thirty-Vella fistual in male Sprague-Dawley rats. The rats received saline solution (Control group) or nucleosides and a nucleotide mixture(lower concentration group(Nucl) or higher concentration group (Nuc2) every two days into the fistula. Mucosal protein, DNA , ornithine decarboxylase(ODC) activity, and morphometry were evaluated at 9 or 21 days postoperation in the fistual and also in the residual ileal segment. On the 9th day, mucosal protein, DNA content, and villous surface area in the fistula and also in the residual ileum increased in rats that received nucleosides and a nucleotide mixture of lower concentration (Nuc 1). On the 21 th day, there were no significant differences in intestinal mucosa between the control group and the lower level nucleoside nucleotide mixture-treated group. The fistula villous height of the higher nucleosides and a nucleotide mixture group was higher than in the control rats. Fistula mucosal ODC activities were not significantly different between groups although the mucosal ODC activity of the residual ileal segment was increased on the 9th day. Our data suggests that this animal model is suitable for studying the effect of dietary factors on intestinal mucosal growth and regeneration after villous stropy , differentiating direct effects of diet on the intestine from systemic effects. It is also suggested that external nucleosides and nucleotides have supportive effects on intestinal mucosal regeneration.

• Journal of Chest Surgery
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• 제27권9호
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• pp.798-800
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• 1994

Chyloascities is an extravasation of milky chyle into the peritoneal cavity due to tumor , inflammation or rarely postoperative lymphatic trauma.It is an unusual complication that can lead to significant immunologic and nutritional consequences.We experienced one case of chyloascites after aorto-bifemoral bypass graft in a patient with aorto-iliac occlusive disease.The patient was a 62-year-old male, who suffered from severe progressive claudication for 5 months. A 16$\times$ 8mm gelsealed Dacron-Y shaped graft was used in arterial reconstruction. A bloody-milky fluid was drained through the operative wound from 3days after operation and evaluated biochemically.Diagnosis of chyloascites was made with repeated paracentesis and examination of the fluid.After Total parenteral nutrition[T.P.N] for 3 weeks from 6days after operation, chyloascites was controlled sufficiently and maintained a good graft-patency in abdominal sonogram.

• Neonatal Medicine
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• 제15권2호
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• pp.190-195
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• 2008

저자들은 항-E항체에 의한 신생아 동종 면역성 용혈성 질환 환아에서 생후 8일째 담낭내 오니가 있고 4개월, 9개월, 11개월 및 50개월 후 추적 초음파에서 담석을 보인 1례를 경험하였기에 보고하는 바이다

• 대한약학회:학술대회논문집
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• 대한약학회 2002년도 Proceedings of the Convention of the Pharmaceutical Society of Korea Vol.2
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• pp.275.2-275.2
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• 2002

There have been many changes in hospital pharmacy after division of medical practice and dispensing. Many pharmacist leave hospital pharmacy to drugstore. Because reduced number of pharmacist, many of hospital pharmacies are placed in difficulty. Restructuring of hospital pharmacy made us consider substitution hospital admixtured TPN(total parenteral nutrition) with industrial manufactured TPN. But we have no data established to support that, so we have sarried out the comparison of two kinds of TPn formulary. We have divided into groups receiving hospital admixtured TPN and industrial manufactured TPN patients in august. 2002. We have compared with each groups in nutritional related dose, parameters and complication before and after TPN administration and also invertigated the reason of formulary change in each groups. We expect that this study will be good data for selection TPN formulary and substitution hospital admixtured TPN with industrial manufactured TPN.

• Nutrition Research and Practice
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• 제12권3호
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• pp.215-221
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• 2018

BACKGROUND/OBJECTIVES: The prevalence of malnutrition among hospitalized children ranges between 12% and 24%. Although the consequences of hospital malnutrition are enormous, it is often unrecognized and untreated. The aim of this study was to identify the current status of in-hospital nutrition support for children in South Korea by carrying out a nationwide hospital-based survey. SUBJECTS/METHODS: Out of 345 general and tertiary hospitals in South Korea, a total of 53 institutes with pediatric gastroenterologists and more than 10 pediatric inpatients were selected. A questionnaire was developed by the nutrition committee of the Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition. The questionnaires were sent to pediatric gastroenterologists in each hospital. Survey was performed by e-mails. RESULTS: Forty hospitals (75.5%) responded to the survey; 23 of them were tertiary hospitals, and 17 of them were general hospitals. Only 21 hospitals (52.5%) had all the required nutritional support personnel (including pediatrician, nutritionist, pharmacist, and nurse) assigned to pediatric patients. Routine nutritional screening was performed in 22 (55.0%) hospitals on admission, which was lower than that in adult patients (65.8%). Nutritional screening tools varied among hospitals; 33 of 40 (82.5%) hospitals used their own screening tools. The most frequently used nutritional assessment parameters were weight, height, hemoglobin, and serum albumin levels. In our nationwide hospital-based survey, the most frequently reported main barriers of nutritional support in hospitals were lack of manpower and excessive workload, followed by insufficient knowledge and experience. CONCLUSIONS: Although this nationwide hospital-based survey targeted general and tertiary hospitals with pediatric gastroenterologists, manpower and medical resources for nutritional support were still insufficient for hospitalized children, and nutritional screening was not routinely performed in many hospitals. More attention to hospital malnutrition and additional national policies for nutritional support in hospitals are required to ensure appropriate nutritional management of hospitalized pediatric patients.