Nutritional support is essential for improving the outcome in critically ill patients. Enteral nutrition possesses advantages over total parenteral nutrition in that it maintains the physiologic barrier function of the gastrointestinal mucosa. Short-term enteral nutrition can be achieved through transnasal feeding tubes. Traditionally, feeding tubes have been placed at bedside in a blind fashion. However, blind tube placement is unreliable as it may result in improper positioning of the tubes. Numerous complications arising from misplacement have been reported in the literature. A number of modalities may be used in order to improve the accuracy and safety of transnasal feeding tube placement. Fluoroscopy is widely accepted for this purpose. Together with the use of water-soluble contrast media and over-the-wire technique, fluoroscopy-guided placement of nasogastric or nasojejunal feeding tubes offers a higher rate of technical success while decreasing procedure time as well as the incidence of procedure-related complications.
Contrast Media ; Critical Illness ; Enteral Nutrition ; Fluoroscopy* ; Humans ; Incidence ; Mucous Membrane ; Nutritional Support ; Parenteral Nutrition, Total

Extrauterine growth restriction is much popular in China and it is still challenge job for pediatricians. This article described the benefits for PICC in route of PN choice. New fat emulsions were appeared recently years, however they are no strong evidence for using in premature infants and need do more clinical trial. Parenteral nutrition associated with liver damage still is a serious complication of TPN and we encourage early enteral feeding, appropriate calore intake, anti sepsis for prevention.
Enteral Nutrition ; Humans ; Infant, Newborn ; Infant, Premature ; Nutritional Support ; Parenteral Nutrition, Total ; adverse effects

A 69-year-old man was consulted to our Home Health Care department for home parenteral enteral nutrition. He was diagnosed with Kennedy disease. He had swallowing difficulty and bowel ischemia. We provided nutritional support in a variety of ways in order to suit his condition. The role of the home care nurse involves training methods depending on changes in the nutritional support to patient and care giver. However, in the case of Kennedy disease, increasing the target patient's nutritional requirements as calculated was difficult.
Aged ; Bulbo-Spinal Atrophy, X-Linked* ; Caregivers ; Deglutition ; Delivery of Health Care ; Enteral Nutrition* ; Home Care Services ; Humans ; Ischemia ; Nutritional Requirements ; Nutritional Support ; Parenteral Nutrition

Clinicians should assume the responsibility of nutritional therapy for satisfactory outcomes. They should master knowledge on nutritional metabolism, and participate in the administration of nutritional support. Clinicians should be acquainted with new concepts and standardized techniques in this field, such as different requirement of energy, understanding of early nutritional support, and optimal regimens of enteral or parenteral nutrition.
China ; Enteral Nutrition ; Humans ; Nutritional Support ; Parenteral Nutrition

PURPOSE: The effectiveness of enteral nutrition for patients with anastomotic leakage after gastric cancer surgery is controversial. The purpose of this study is to compare effectiveness between combined enteral nutrition with parenteral nutrition (EPN) and total parenteral nutrition (TPN). METHODS: Patients who underwent gastric cancer surgery for primary gastric cancer from April 2010 to August 2012 were reviewed. Clinicopathologic characteristics, complication, laboratory tests, and body weight (Bwt) were compared between EPN and PN. RESULTS: Among patients with postoperative leakage within postoperative 1 month (n=43), 13 patients were supported by EPN and 23 patients by TPN. Clinicopathologic characteristics, including preoperative Bwt, body mass index, nutritional status, other complications, and TNM stage were similar. Preoperative serum albumin and Bwt were similar between EPN and TPN. However, after 1 week of nutritional support, albumin at EPN was significantly higher than that of PN (3.52+/-0.3 and 3.25+/-0.3; P=0.010). Adjusted by preoperative Bwt, preoperative nutritional status, and difference in Bwt between preoperative and pre-nutritional support period, decrease of Bwt between pre-nutritional support and discharge was significantly less at EPN than at TPN (-4.5+/-5.4% and -6.3+/-4.1%; P=0.001). CONCLUSION: In terms of the maintenance of serum albumin and Bwt during nutritional support, EPN may be a better supportive option than TPN for patients with anastomotic leakage after gastric cancer surgery.
Anastomotic Leak* ; Body Mass Index ; Body Weight ; Enteral Nutrition ; Gastrectomy ; Humans ; Nutritional Status ; Nutritional Support ; Parenteral Nutrition* ; Parenteral Nutrition, Total ; Serum Albumin ; Stomach Neoplasms*

PURPOSE: To evaluate the effect of parenteral nutrition in early neonatal period on bone mineralization at the time of reaching 2 kg body weight in premature infants, bone mineral density(BMD) in infants who received long-term parenteral nutrition in the early neonatal period was measured and compared with infants who received enteral nutrition only. METHODS: Twenty low birth weight infants(those weighing 2 kg or less) were investigated in the Neonatal Intensive Care Units of Pusan National University Hospital between May 2000 and April 2001. Twelve infants received oral nutrition with preterm formula after birth(group A). Eight infants were supported with parenteral nutrition and intensive management in the early neonatal period due to respiratory distress syndrome and after a while they were also fed with preterm formula(group B). We measured the BMD of the whole body of all 20 infants using at the time reaching 2 kg body weight. RESULTS: The mean value of the BMD of total infants was 0.610+/-0.003 g/cm2. The BMD of group A and B was 0.615+/-0.002 g/cm2 and 0.603+/-0.006 g/cm2, respectively. There was no significant differences in the BMD between the two groups. CONCLUSION: Low birth weight infants who received appropriate nutritional supports such as total parenteral nutrition and preterm formula could achieve a catch-up in bone mineralization compared with the infants who were fed with preterm formula only and who had similar postconceptional age and weight.
Body Weight* ; Busan ; Calcification, Physiologic* ; Enteral Nutrition ; Humans ; Infant ; Infant, Low Birth Weight ; Infant, Newborn ; Infant, Premature* ; Intensive Care Units, Neonatal ; Nutritional Support ; Parenteral Nutrition* ; Parenteral Nutrition, Total

Most critically ill children are in a state of serious stress and tend to develop malnutrition, which may reduce the body's ability to fight against diseases and repair damaged tissues and thus aggravate their conditions. Reasonable and effective nutritional support for critically ill children can improve their nutritional status and prognosis, and so it is necessary to offer nutritional support for critically ill children. This article reviews the research on nutritional support for critically ill children and the current status of clinical application. It also introduces the main methods for nutritional support, including enteral nutrition and parenteral nutrition, and elaborates on the new methods for nutritional support, such as early enteral nutrition, enteral immunonutrition, and supplementary parenteral nutrition, in order to provide a reference for nutritional support for critically ill children.
Child ; Critical Illness ; Enteral Nutrition ; Humans ; Nutritional Status ; Nutritional Support ; Parenteral Nutrition

Short Bowel Syndrome (SBS) is a condition that causes malabsorption and nutrient deficiency because a large section of the small intestine is missing or has been surgically removed. SBS may develop congenitally or from gastroenterectomy, which often change the motility, digestive, and/or absorptive functions of the small bowel. The surgical procedure for SBS and the condition itself have high mortality rates and often lead to a range of complications associated with long-term parenteral nutrition (PN). Therefore, careful management and appropriate nutrition intervention are needed to prevent complications and to help maintain the physiologic integrity of the remaining intestinal functions. Initial postoperative care should provide adequate hydration, electrolyte support and total parenteral nutrition (TPN) to prevent fatal dehydration. Simultaneously, enteral nutrition should be gradually introduced, with the final goal of using only enteral nutrition support and/or oral intake and eliminating TPN from the diet. A patient should be considered for discharge when macro and micronutrients can be adequately supplied through enteral nutrition support or oral diet. Currently, there is more research on pediatric patients with SBS than on adult patient population. A 35-year-old man with no notable medical history was hospitalized and underwent a surgery for acute appendicitis at a local hospital. He was re-operated on the 8th day after the initial surgery due to complications and was under observation when he suddenly complained of severe abdominal pain and high fever. He was immediately transferred to a tertiary hospital where the medical team discovered free air in the abdomen. He was subsequently diagnosed with panperitonitis and underwent an emergency reoperation to explore the abdomen. Although the patient was expected to be at a high risk of malnutrition due to short bowel syndrome resulting from multiple surgeries, through intensive care under close cooperation between the medical and nutrition support team, his nutritional status improved significantly through continuous central and peripheral parenteral nutrition, enteral nutrition, and oral intake. The purpose of this paper is to report the process of the patient's recovery.
Abdomen ; Abdominal Pain ; Adult ; Appendicitis ; Dehydration ; Diet ; Emergencies ; Enteral Nutrition ; Fever ; Humans ; Critical Care ; Intestine, Small ; Malnutrition ; Micronutrients ; Mortality ; Nutritional Status ; Nutritional Support* ; Parenteral Nutrition ; Parenteral Nutrition, Total ; Postoperative Care ; Reoperation ; Short Bowel Syndrome* ; Tertiary Care Centers

Underweight and specific nutrient deficiencies are frequent in adult patients with inflammatory bowel disease (IBD). In addition, a significant number of children with IBD, particularly Crohn's disease (CD) have impaired linear growth. Nutritional support is important in patients with IBD and nutritional problems. Enteral nutrition (EN) can reduce CD activity and maintain remission in both adults and children. Given that the ultimate goal in the treatment of CD is mucosal healing, this advantage of EN over corticosteroid treatment is valuable in therapeutic decision-making. EN is indicated in active CD, in cases of steroid intolerance, in patient's refusal of steroids, in combination with steroids in undernourished individuals, and in patients with inflammatory stenosis of the small intestine. EN should be the first choice compared to total parenteral nutrition. However, EN does not have a primary therapeutic role in ulcerative colitis. In conclusion, it appears that the role of nutrition as supportive care in patients with IBD should not be underestimated. The aim of this comprehensive review is to provide the reader with an update on the role of nutritional support in IBD patients.
Adult ; Child ; Colitis, Ulcerative ; Constriction, Pathologic ; Crohn Disease ; Disulfiram ; Enteral Nutrition ; Humans ; Inflammatory Bowel Diseases* ; Intestine, Small ; Nutritional Support* ; Parenteral Nutrition, Total ; Steroids ; Thinness

Pancreatic necrosis is associated with complications and mortality if the necrotic tissue becomes infected. The development of necrosis is associated with hypovolemia, vascular spasm and hemoconcentration. Control of hypovolemia, use of antibiotics, nutritional support and endoscopic treatments are the nonsurgical options in the mamagement of necrotizing pancreatitis. The proper use of antibiotics in acute pancreatitis remains controversial, however, current evidence favors the use of prophylactic antibiotics in necrotizing pancreatitis. Enteral feeding is usually well tolerated, however, total parenteral nutrition may be necessary. Several studies have demonstrated that enteral feeding via a nasojejunal tube infused distal to the ligament of Treitz is associated with a decreased rate of complications, including infection, when compared to total parenteral nutrition. Infected pancreatic necrosis can be managed by percutaneous or endoscopic dranage. The choice of drainage routes depends on the disease status, availability of the interventional radiologist or gastroenterologist. For improvement of outcomes and reducing complications in the management of necrotizing pancreatitis, proper patient selection and technical expertise are required.
Anti-Bacterial Agents ; Drainage ; Enteral Nutrition ; Hypovolemia ; Ligaments ; Mortality ; Necrosis ; Nutritional Support ; Pancreatitis* ; Parenteral Nutrition, Total ; Patient Selection ; Professional Competence ; Spasm