• Journal of Trauma and Injury
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• 제34권1호
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• pp.13-20
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• 2021

Purpose: Nutritional therapy in the intensive care unit is an essential factor for patient progress. The purpose of this study was to compare resting energy expenditure (REE) calculated by prediction equations (PEs) to the REE measured by indirect calorimetry (IC) in trauma patients. Methods: Patients admitted to the trauma intensive care unit who received mechanical ventilation between January and December 2015 were enrolled. REE was measured by IC (CCM Express, MGC Diagnostics) and calculated by the following PEs: Harris-Benedict, Fleisch, Robertson and Reid, Ireton-Jones, and the maximum value (25 kcal/kg/day) of the European Society for Clinical Nutrition and Metabolism (ESPEN). All patients were ventilated at a fraction of inspired oxygen (FiO2) below 60%. Results: Of the 31 patients included in this study, 24 (77.4%) were men and seven (22.6%) were women. The mean age of the patients was 49.7±13.2 years, their mean weight was 68.1±9.6 kg, and their mean Injury Severity Score was 26.1±11.3. The mean respiratory quotient on IC was 0.93±0.19, and their mean FiO2 was 38.72%±6.97%. The mean REE measured by IC was 2,146±444.36 kcal/day, and the mean REE values calculated by the PEs were 1,509.39±205.34 kcal/day by the Harris and Benedict equation, 1,509.39±154.33 kcal/day by the Fleisch equation, and 1,443.39±159.61 kcal/day by the Robertson and Reid equation. The Ireton-Jones equation yielded a higher value (2,278.90±202.35 kcal/day), which was not significantly different from the value measured using IC (p=0.53). The ESPEN maximum value (1,704.03±449.36 kcal/day) was lower, but this difference was likewise not significant (p=0.127). Conclusions: The REE measured by IC was somewhat higher than that calculated using PEs. Further studies are needed to determine the proper nutritional support for trauma patients.

• 한국식생활문화학회지
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• 제22권1호
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• pp.149-156
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• 2007

This study was performed to evaluate the effectiveness of food commodity supplementary program for low-income, living alone elderly people. The subjects were 57 low income aged females who lived alone in Bucheon city. The food commodity supplementary program lasted for 6 months, supplying one meal per day consisting with grains, meat, vegetables, dairy and fruit. Dietary intake, anthropometric measurements, and blood profiles were assessed. After 6 months of food commodity supplemented period, dietary intakes of protein(p<0.05), calcium(p<0.05), iron(p<0.05) and vitamin B(p<0.001) were significantly increased. The mean weight(p<0.05) and BMI(p<0.05) were increased, and the frequency of BMI over 25kg/m$^2$ was also raised from 54.4% to 59.7%. Serum concentrations of total protein(p<0.001) and albumin(p<0.001) were significantly increased, indicating improvement of protein status. The frequency of anemia was decreased from 45.6% to 26.3%. However, the proportion of dyslipidemia was increased. In general the stable food commodity supplementary program was effective to improve general nutritional status of the poor aged who lived alone, however, nutrient intakes still did not meet RDA for the elderly and the rates of obesity and dyslipidemia were increased. Therefore, local government should provide more active food support program and the selection of food items for commodity should be evaluated at regular intervals.

• Asian Pacific Journal of Cancer Prevention
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• 제15권6호
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• pp.2547-2554
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• 2014

Background: To evaluate the perception of cancer patients toward treatment services and influencing factors and to inquire about the use of complementary alternative medicine (CAM). Materials and Methods: Information was obtained through pre-tested structured questionnaires completed by cancer patients during treatment at King Abdulaziz University Hospital, Jeddah, Saudi Arabia. Results: Of 242 patients, 137 (64.6%) accepted to enter this study. Most were Saudi (n=93, 68%), female (n=80, 58%), educated at university (n=71, 52%), married (n=97, 72%) and with breast cancer (n=36, 26%). One-hundred (73%) patients were satisfied with the services provided; 61% were Saudi. Ninety-four (68%) respondents were satisfied with the explanation of their cancer. Twenty-eight (21.6%) patients received CAM, of them 54.0% received herbal followed by rakia (21.0%), nutritional supplements/vitamins (7.0%) and Zamam water (18.0%), with significant differences among them (p =0.004). Seven (5%) patients believed this therapy could be used alone; 34 (25%) patients believed it could be used with other treatments, regardless of whether they themselves used this therapy. Fifty-three (53%) satisfied patients felt they received enough support; 31 (58%) patients received support from family and friends; 22 (41.6%) patients received support from the health-care team. Patients who received information about their disease from their physicians and those who felt they had enough support were more satisfied. The patients who took alternative treatment were older age, mostly female and highly educated but values did not reach significance. Conclusions: We stress enhancing the educational and supportive aspects of cancer-patient services to improve their treatment satisfaction and emphasize the need for increasing the educational and awareness programs offered to these patients.

• 치위생과학회지
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• 제8권2호
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• pp.73-80
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• 2008

본 연구는 치위생과 재학생들의 건강증진행위를 조사하여 대학생의 건강증진을 도모하기 위한 기초자료를 제공하고자 경기도에 소재한 4개 대학의 치위생과 재학생 687명을 대상으로 2007년 9월부터 10월까지 설문조사를 실시하였다. SPSS 12.0 program을 이용한 분석한 결과는 다음과 같다. 1. 구강관리행위는 1학년 학생($3.11{\pm}.57$)이 가장 낮은것으로 조사되었으며, 통계적으로 유의한 차이를 보였다(p < .001). 2. 건강증진행위는 건강상태가 나쁘다고 인식하는 경우 영양관리($3.63{\pm}.63$), 사회적지지($2.43{\pm}.60$), 건강에 대한 책임($2.40{\pm}.68$), 자신의 삶에 대한 존중($2.33{\pm}.51$)에서 관리행위정도가 낮은 것으로 조사되었으며, 통계적으로 유의한 차이를 보였다(p < .001, p < 0.01). 3. 부모님의 교육정도에 따른 건강증진행위는 아버지가 중졸이하인 경우($3.62{\pm}.52$) 영양관리가 가장 낮았으며(p < .001), 어머니가 중졸인 경우($2.52{\pm}.52$) 사회적 지지가 낮은 것으로 조사되었으며, 통계적으로 유의한 차이를 보였다(p < .05). 4. 자취를 하는 경우 영양관리($3.66{\pm}.57$)가 가장 낮았으며, 통계적으로 유의한 차이를 보였다(p < .001). 5. 월평균 가계 수입이 100만원 이하에서($2.42{\pm}.62$) 삶의 존중행위가 가장 낮게 조사되었으며, 통계적으로 유의한 차이를 보였다(p < .05). 6. 건강증진행위와 관련 변인간의 상관관계는 건강증진행위가 사회적 지지가 높을수록 삶의 존중이 높았으며, 삶의 존중이 높을수록 스트레스 관리가 잘되고 있는 것으로 조사되었으며, 통계적으로 유의한 차이가 보였다(p < .01).

• Clinical and Experimental Pediatrics
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• 제51권3호
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• pp.329-334
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• 2008

Kwashiorkor는 단백질 결핍으로 인한 영양실조로 저알부민혈증, 설사, 피부염, 부종을 증상으로 나타낸다. 단백질-열량 결핍은 면역결핍을 초래하고 이는 감염에 대한 감수성을 높임으로써 생명을 위협하는 상태가 될 수 있다. 치료는 조기 영양공급, 감염증 치료가 주이며, 치료 경과 중 확장성 심근증이 나타날 수 있으며 이 경우 예후가 안 좋다. Kwashiorkor는 주로 빈곤한 나라에서 생긴다고 알려져 왔으며, 기술적으로 진보한 나라에서 치명적인 결과까지 낳은 예는 보고된 바가 없었다. 치명적인 kwashiorkor 1례를 경험하였기에 보고하는 바이다. 환아는 가난때문이 아니라 부모의 잘못된 생각으로 2개월 동안 곡물에 태운 곡식가루만 먹었으며, 설사, 전신 부종, 홍반, 저체온증 등을 주소로 입원하였다. 면역 결핍이 있는 상태였으며, 혈액 배양 검사상 Alcaligenes Xylosoxidans가 동정되었다. 단백질 보충식이 및 항생제 치료, 정주용 면역글로불린치료, 미세영양소 보충하였으나 확장성 심근병증, 다발성 장기 부전으로 사망하였다.

• Journal of Nutrition and Health
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• 제45권3호
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• pp.264-273
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• 2012

This study analyzes the food frequency for the elderly regarding different family types and finds the factors for nutritional risk, offers a basic reference for providing nutritional support for them. The study referred to the dietary behavioral survey data of 3,680 elderly people (1652 male and 2028 female) from 21 regions in the northern Kyeonggi province. The data was collected through the method of one-to-one interviews and was a part of the Community Health Survey for 2008 by the Korea Centers for Disease Control and Prevention (KCDC). We classified family types as a household for elderly people living alone, a household of elderly people with a spouse, a household of the elderly with unmarried children and a household of the elderly with married children, and as for intakes of foods, the frequencies of taking fruits, vegetables, kimchi, rice with mixed cereals, meat, fish, bean tofu soymilk, milk and dairy products, as well as sweet beverages are calculated on a daily basis and skipped meals are calculated on a weekly basis. Elderly women showed lower income, lower education level, higher unemployment rates, and a higher rate of government healthcare subsidies than elderly men. Elderly women tend to live alone and with their children while elderly men tend to live with their spouse. In both males and females, the intake of fruits and vegetables were the least in the elderly living alone, while the elderly with married children ate the most. In both males and females, the household of the elderly living alone ate significantly less amounts of Kimchi than other family types. Elderly people living alone tended to have significantly less meat and fish, especially women. In the case of rice with mixed cereals, the elderly men living alone and the elderly men with unmarried children ate significantly less amounts than the elderly men living with a spouse. The elderly men living alone took significantly less milk and dairy products than the elderly men with unmarried children while the elderly women living with a spouse took significantly less milk and dairy products than the elderly women with married children. With regards to the frequency of meal-skipping, the elderly living alone had the highest frequency for skipping meals. From this result, having various foods is difficult for the elderly living alone. Furthermore, the elderly living with unmarried children demonstrated a low quality of dietary life compared to those of married children. Hence, it can be concluded that social support is important in order for the elderly to have a balanced diet.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제11권2호
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• pp.122-129
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• 2008

목 적: 만성 설사, 흡수 장애 등의 소화기 질환에서 경구 영양 공급이 불충분할 경우 미량원소 결핍 발생의 빈도가 높으나, 이러한 환아에서 미량원소 결핍 증상에도 불구하고 혈액 검사 결과 정상으로 나타나기도 한다. 따라서 미량원소 결핍 고위험군 환아에서 결핍된 미량원소를 확인하고, 적절한 공급 및 추적 관찰 지표로서 모발 검사의 유용성을 알아보고자 하였다. 방 법: 서울대학교 어린이병원에 내원하여 만성 소화기 질환으로 경구 영양 장애 또는 성장 발육 부전을 보였던 13명을 대상으로 모발과 혈액의 미량원소 검사를 시행하여, 결핍 소견을 보인 모발과 혈액의 미량원소에 대해 장기 정맥영양군과 경구영양군, 그리고 증상군과 무증상군으로 나누어 비교, 분석하였다. 결 과: 전체 13명 중 11명에서 모발 또는 혈액 검사에서 미량원소 결핍이 있었으며, 결핍된 미량원소는 아연, 셀레늄, 구리였다. 모발 내 아연 결핍은 8명(62%), 모발 내 셀레늄 결핍은 6명(46%)이었고, 혈액 내 아연농도가 정상인 환자의 67% (8/12명), 혈액 내 셀레늄 농도가 정상 환자의 57% (4/7명)에서 각각 모발 내 아연, 모발 내 셀레늄 결핍을 보였다. 모발 내 아연 농도는 장기 정맥영양군에서 경구영양군에 비해 유의하게 낮았으며(p=0.015) 결핍 발생 빈도 또한 유의하게 높았다(Fisher's exact test, p=0.032). 모발 내 셀레늄 농도는 증상군에서 무증상군에 비해 유의하게 낮았다(p=0.034). 결 론: 만성 소화기 질환으로 경구 영양 장애 또는 성장 발육 부전이 있을 경우 증상 여부에 상관없이 혈액검사와 함께 모발 미네랄 검사로 결핍 여부를 평가하는 것이 필요할 것으로 보인다.

• 대한영양사협회학술지
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• 제15권4호
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• pp.335-342
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• 2009

Forty-two percent of the patients with renal failure that requires continuous renal replacement therapy (CRRT) have been reported to have severe malnutrition, and preexisting malnutrition is a statistically significant and independent predictor of negative hospital outcomes. We performed this study to evaluate the appropriateness of the calorie and protein provided for the critically ill patients who require CRRT. One hundred forty-nine patients who received CRRT were enrolled. The demographic data, the length of the ICU stay and the mortality were recorded. The calorie/protein intake and the blood urea nitrogen (BUN), albumin and creatinine levels were used as nutritional parameters. The mean daily calorie intake during CRRT was 16.1${\pm}$7.4 kcal/kg, which was 64% of the recommended intake. Only 10% of the patients received the recommended caloric intake and the ratio of the enteral and parenteral calories was 26%/74%. The mean protein intake was 0.58${\pm}$0.34 g/kg, which was 38% of the recommended intake. The calorie and protein intakes at the termination of CRRT were significantly increased compared to the initial day of treatment, but they stayed under the recommended intake. The BUN, creatinine and albumin levels were significantly increased in the survival group (odds ratio for albumin: 2.73; creatinine: 2.43). A strategy to increase the nutrition provision is needed to improve the nutritional statuses and clinical outcomes of the critically ill patients who require CRRT.

• 대한소화기학회지
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• 제72권6호
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• pp.308-312
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• 2018

Percutaneous endoscopic gastrostomy (PEG) is widely used to provide nutritional support for patients with dysphagia and/or disturbed consciousness preventing oral ingestion, and PEG tube placement is a relatively safe and convenient non-surgical procedure performed under local anesthesia. However, the prevention of PEG-insertion-related complications is important. A 64-year-old man with recurrent pneumonia underwent tracheostomy and nasogastric tube placement for nutritional support and opted for PEG tube insertion for long-term nutrition. However, during the insertion procedure, needle puncture had to be attempted twice before successful PEG tube placement was achieved, and a day after the procedure his hemoglobin had fallen and he developed hypotension. Abdominal computed tomography revealed injury to a pancreatic branch of the superior mesenteric artery (SMA) associated with bleeding, hemoperitoneum, and pancreatitis. Transarterial embolization was performed using a microcatheter to treat hemorrhage from the injured branch of the SMA, and the acute pancreatitis was treated using antibiotics and supportive care. The patient was discharged after an uneventful recovery. Clinicians should be mindful of possible pancreatic injury and bleeding after PEG tube insertion. Possible complications, such as visceral injuries or bleeding, should be considered in patients requiring multiple puncture attempts during a PEG procedure.

• Journal of Nutrition and Health
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• 제55권1호
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• pp.85-100
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• 2022

본 연구에서는 다발성 외상 중환자에게 있어 급성 단계에서의 이화학적 상태 및 경장영양 공급 수준이 임상적 예후에 미치는 영향을 알아보고자 하였다. 먼저 조사 대상자 302명의 특성을 분석한 결과, 남성의 비율이 높으며 다른 중환자실에 비해 연령이 낮게 나타났으며 과체중의 체격을 가지고 있었다. 입원 후 7일간의 경장영양 공급 수준에 따라 일반적 결과와 합병증 발생률, 영양 관련 생화학적 지표를 비교한 결과, 초기 경장영양이 가장 적극적으로 공급되었던 High EN 그룹에서 사망률, CRP에서 유의적으로 감소하였다. 질소 평형을 기준으로 이화상태가 양호한 그룹에서는 경장영양 공급 기간이 길수록 HAIs 발생률이 높았으나, 이화상태가 불량한 그룹에서는 적극적인 경장영양 공급에도 여러 합병증 발생이 증가하지 않았다. 생화학적 검사 결과에서는 그룹 간 유의적인 차이가 없었으며, 경장영양 공급 수준에 따른 사망률 감소 추세는 두 그룹 모두에서 유지되었다. 결론적으로, 본 연구에서는 사망률 감소, 염증 수치의 감소 등에서 초기 경장영양 공급 일수가 증가할수록 긍정적인 효과를 확인하였다. 단, 후향적 관찰연구라는 제한점을 미루어 보아 향후 연속적으로 이화상태를 모니터링 및 평가하며 기본 특성의 차이가 없는 그룹 간에서 경장영양 공급 수준을 차별화한 전향적 코호트 연구가 필요하겠다.