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Nutrition Support Blog: Abstract Perusal of the Week

Posted by SF8N at Aug 04, 2011 09:15 AM |
August 4, 2011

In sweeping the Tables of Contents this week here are some items that stood out.  Some of these articles will likely be fodder for future journal clubs with commentary on our E-journal Club summary.  Keep in mind that any comments are strictly preliminary based on a glance at the abstract and opinions expressed herein are subject to change once we read the whole article.  I did not include titles from NCP and JPEN because most clinicians keep on eye on the core journals even if they are not an ASPEN member.

The clinical guidelines for vitamin D supplementation from the Endocrine Society are certainly worth reviewing – keeping in mind that the expert consensus is based on the limited available intervention studies with vitamin D. 

  • Holick MF, Binkley NC, Bischoff-Ferrari HA, et al.  Evaluation, treatment, and prevention of vitamin D deficiency: an endocrine society clinical practice guideline.  J Clin Endocrinol Metab. 2011;96(7):1911-1930.

Energy intake and expenditure in ALS is of particular interest to us because of our team’s involvement in the UVA multidisciplinary ALS clinic.  There is very limited nutrition support data with ALS patients. Available research raises concerns about hypermetabolism, however, our clinic experience suggests that due to limited physical activity some patients are at risk for excessive abdominal fat accumulation while providing nutrition support. 

  • Genton L, Viatte V, Janssens JP. et al.  Nutritional state, energy intakes and energy expenditure of amyotrophic lateral sclerosis (ALS) patients.  Clinical Nutrition, Vol. 30, In Press, Corrected Proof, Available online 27 July 2011.

This next abstract from Clinical Nutrition suggests that postoperative patients that received early (within 12 hours of surgery) needle catheter jejunostomy feeding had significantly shortened length of hospital stay and improved clinical outcomes (fewer wound infections, chest infections and anastomotic leaks).

  • Barlow R, Price P, Reid TD, et al.  Prospective multicentre randomised controlled trial of early enteral nutrition for patients undergoing major upper gastrointestinal surgical resection.  Clin Nutr. 2011 May 19. [Epub ahead of print]

The next study will need to be put on the fast track to journal club here.  A diet enriched with EPA, GLA, and anti-oxidants was compared with an enteral formula with “normal” lipid content (30% of calories) in ALI/ARDS.  The specialized formula did not improve gas exchange or decrease the incidence of new organ failures in critically ill septic patients with ALI/ARDS.

  •  Grau-Carmona T, Morán-García V, García-de-Lorenzo A, et al.  Effect of an enteral diet enriched with eicosapentaenoic acid, gamma-linolenic acid and anti-oxidants on the outcome of mechanically ventilated, critically ill, septic patients.  Clin Nutr. 2011 Apr 5. [Epub ahead of print].

If you have an interest in following the ongoing saga of the potential role of antioxidant supplementation in critically ill patients I recommend reading this recent editorial in Critical Care Medicine.

·         Bar-Or D, Garrett RE.  Is low plasma selenium concentration a true reflection of selenium deficiency and redox status in critically ill patients?  Crit Care Med. 2011;39(8):2000-1.

"Read, every day, something no one else is reading.  Think, every day, something no one else is thinking.  Do, every day, something no one else would be silly enough to do. It is bad for the mind to continually be part of unanimity."                                                 - Christopher Morley

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