Journal Detail Information

1

Cite

Share

Effects of a Nutrition Support Team with Parenteral Nutrition on Gastrointestinal Cancer Patients Who Underwent Surgery.

Hyun Jung LEE ; Jung Tae KIM ; Byung Koo LEE

Journal of Clinical Nutrition.2014;6(2):79-86. doi:10.15747/jcn.2014.6.2.79

PURPOSE: Cancer patients are frequently malnourished, and malnutrition can increase morbidity and mortality. Postoperative malnutrition can cause poor wound healing and failure of the immune response. Administration of parenteral nutrition (PN) after surgery may decrease complication and hospital length of stay. Intervention of a Nutrition Support Team (NST) improves patient outcomes through nutritional assessment and proper nutrition support. In this study we investigated effects of NST intervention with PN on gastrointestinal cancer patients who underwent surgery. METHODS: This retrospective study was conducted at Kyung Hee University Hospital at Gangdong from 2012 January to 2013 December. This study reviewed gastrointestinal cancer patients who were administered PN for more than seven days. The patients were divided into two groups: NST group versus non-NST group. RESULTS: In this study, 53 patients with malnutrition were administered PN for more than seven days. Nutrition support between the NST group and non-NST group was not statistically significant, except multivitamin and trace element. Changes in nutritional index were not statistically significant. No difference in incidence of complication, monitoring performance rate was observed between the two groups. CONCLUSION: Due to a small number of patients and lack of severity of disease in this study, no significant difference in improvement of nutritional index was observed between the NST group and non-NST group. For safe and effective PN, conduct of additional study is necessary in order to determine the effects of NST.
Gastrointestinal Neoplasms* ; Humans ; Incidence ; Length of Stay ; Malnutrition ; Mortality ; Nutrition Assessment ; Parenteral Nutrition* ; Retrospective Studies ; Wound Healing

2

Cite

Share

Nutritional Status of Korean Hospitalized Patients: A Multi-Center Preliminary Survey.

Yeon Mi LEE ; Seon Hyeong KIM ; Young Shin KIM ; Eun Mee KIM ; Jung Yeon KIM ; Min Ae KEUM ; Jae Young MOON ; Su Jin PARK ; Dong Woo SHIN ; Hong Yup AHN ; Young Ran LEE ; Hae Jun YIM ; Suk Kyung HONG ; Hyun Wook BAIK

Journal of Clinical Nutrition.2014;6(2):71-78. doi:10.15747/jcn.2014.6.2.71

PURPOSE: The purpose of this study is to examine the prevalence of malnutrition in hospitalized patients aged 18 years old or older at the time of admission in Korea. METHODS: This multi-center, preliminary survey included patients over 18 years old who were admitted on a given day from six hospitals in Korea. Nutritional status was assessed using Subjective Global Assessment tool. Data collected included hospital characteristics, patient characteristics, nutrition screening, and nutrition assessment. RESULTS: Among the 99 patients recruited (47 males, 47.5%), 18 (18.2%) and 2 (2.0%) patients were moderately malnourished and severely malnourished, respectively. The mean age of the malnourished group was older than that of the well-nourished group (49.7+/-17.1 vs. 60.5+/-13.6 years old, P-value=0.010). Patients admitted for medical treatment were more malnourished than those admitted for surgical treatment. CONCLUSION: Results of the multi-center preliminary survey showed 20.2% prevalence of malnutrition on admission. A national survey was piloted and will be followed by full implementation.
Humans ; Inpatients ; Korea ; Male ; Malnutrition ; Mass Screening ; Nutrition Assessment ; Nutritional Status* ; Prevalence

3

Cite

Share

A Prospective Observational Study Evaluating the Change of Nutritional Status and the Incidence of Dumping Syndrome after Gastrectomy.

Ju Ri NA ; Yuhn Suk SUH ; Seong Ho KONG ; Jeong Hyun LIM ; Dal Lae JU ; Han Kwang YANG ; Hyuk Joon LEE

Journal of Clinical Nutrition.2014;6(2):59-70. doi:10.15747/jcn.2014.6.2.59

PURPOSE: The aim of this study was to investigate the change of nutritional status and the incidence of dumping syndrome after gastrectomy for gastric cancer. METHODS: From January 2013 to May 2014, 36 patients who underwent gastrectomy for gastric cancer were prospectively investigated in terms of nutritional status by body weight, anthropometric measurements, biochemical data, and Patient-Generated Subjective Global Assessment (PG-SGA). Dumping syndrome was assessed using a newly developed questionnaire based on the Japanese Society of Gastroenterological Surgery survey and Sigstad's scoring system. RESULTS: Body weight losses were 4.6%, 8.1%, and 6.9% at discharge, six months, and one year after discharge, respectively. Triceps skinfold thickness had no significance, however, mid-arm muscle circumference showed significant loss after gastrectomy. A part of the biochemical data showed significant change after gastrectomy, but almost indicated a restoring tendency within two months after discharge. In terms of PG-SGA, 33 patients (91.7%) were classified as A (well-nourished) before surgery, however, the number of well-nourished patients showed a sharp decrease to 1 (2.8%) at two weeks after discharge, and then gradually increased to 25 (69.4%) at one year. The main obstacles against diet intake were reported as 'early satiety' and 'anxiety'. The number of patients who had experience in at least one dumping syndrome related symptom was 21 (58.3%) at discharge, 26 (72.2%) at two months after discharge, and 11 (30.6%) at one year after discharge. CONCLUSION: Nutritional deficit as well as dumping syndrome is encountered in a large number of gastric cancer patients after gastrectomy. Postoperative nutritional support and personalized education seem to be very important during the postoperative period.
Asian Continental Ancestry Group ; Body Weight ; Diet ; Dumping Syndrome* ; Education ; Gastrectomy* ; Humans ; Incidence* ; Nutritional Status* ; Nutritional Support ; Observational Study* ; Postoperative Period ; Prospective Studies* ; Skinfold Thickness ; Stomach Neoplasms ; Surveys and Questionnaires

4

Cite

Share

Protein Metabolism and Glutamine Supplementation in Stress Condition.

Sook Hee AN

Journal of Clinical Nutrition.2014;6(2):56-58. doi:10.15747/jcn.2014.6.2.56

Stress conditions such as sepsis, trauma, burn, fracture, and major surgery are associated with hypermetabolism and hypercatabolism. Protein is mobilized for energy and uptake of amino acids by muscle tissue is decreased in stress conditions. The metabolic response to stress causes movement of amino acids (predominantly alanine and glutamine) from peripheral reserves to metabolically active tissues. Glutamine is a conditionally essential amino acid during stress. Glutamine plays a role in maintenance of intestinal immune function and reinforcement of wound repair. Supplementation of parenteral glutamine (0.3~0.5 g/kg/day) as a component of nutrition support may improve clinical outcomes in appropriate patients. In patients with multiorgan failure, supplementation with a high dose of glutamine (>0.5 g/kg/day) in the acute phase of critical illness is not recommended. In stress conditions, provision of adequate protein is essential and glutamine supplementation should be considered in patients without specific contraindications.
Alanine ; Amino Acids ; Burns ; Critical Illness ; Glutamine* ; Humans ; Metabolism* ; Sepsis ; Wounds and Injuries

5

Cite

Share

Parenteral Nutrition Support in Preterm Infants.

Ji Hye YOON

Journal of Clinical Nutrition.2014;6(2):51-55. doi:10.15747/jcn.2014.6.2.51

Nutrition support for preterm infants is important to achievement of a postnatal growth rate optimizing normal fetal intrauterine growth rates and for improvement of patient outcome. However, sufficient nutrient delivery is not easy because of underlying illness. Although enteral nutrition (EN) is preferred over parenteral nutrition (PN), immature gastrointestinal features and inability to suck and swallow until 33 weeks' gestation disrupt. In patients with inability to tolerate adequate EN for more than 2 or 3 days, to optimize nutrition support and minimize complications, PN should begin within 24 hours after birth. The purpose of this study is to review the PN in preterm infants for the most appropriate nutritional support to meet each patient's requirement.
Enteral Nutrition ; Humans ; Infant, Newborn ; Infant, Premature* ; Nutritional Support ; Parenteral Nutrition* ; Parturition ; Pregnancy

6

Cite

Share

Nutrition Therapy in Major Burns.

Yong Suk CHO

Journal of Clinical Nutrition.2014;6(2):45-50. doi:10.15747/jcn.2014.6.2.45

Major burns lead to a hypermetabolic response that is more dramatic than that observed in any other disease or injury. In addition, major burns increase the metabolic demands of the body and can lead to severe loss of body weight and increased risk of mortality. The hyper-metabolic response is accompanied by severe catabolism and a loss of lean body mass and by a progressive decline of host defenses, which results in impairment of the immunological response. The protective functions of intact skin are lost, leading to increased risk of infection and protein loss. Therefore, adequate and timely provision of nutritional support is an essential component of care of the critically ill burn patient. Nutrition therapy is also important in burn care from the early resuscitation phase until the end of rehabilitation. Careful assessment of the nutritional state of the burn patient is also important to reducing infection, recovery time, and long-term results. Nutritional therapy in severe burns has evidence-based specificities that contribute to improve clinical outcomes.
Body Weight ; Burns* ; Critical Illness ; Humans ; Metabolism ; Mortality ; Nutrition Therapy* ; Nutritional Support ; Rehabilitation ; Resuscitation ; Skin

7

Cite

Share

Letter from Editor.

Hyuk Joon LEE

Journal of Clinical Nutrition.2014;6(2):43-44. doi:10.15747/jcn.2014.6.2.43

No abstract available.

8

Cite

Share

The Effects of Early Enteral Nutrition in Patients: A Role of Nutrition Support Team.

Kye Wol PARK ; Hee Ryoung SON ; Ji Hoon KIM ; Myoung Hee KIM ; Eun Jin CHOI

Journal of Clinical Nutrition.2016;8(2):66-70. doi:10.15747/jcn.2016.8.2.66

PURPOSE: The study examined the effects of early enteral nutrition on the patients' length of stay in an intensive care unit (ICU), length of stay and mortality rate. METHODS: A retrospective design was employed with a total of 461 patients (mean age=69.9±15.6 years; 253 males; 208 females). They were divided into two groups according to when they received enteral feeding: an "early enteral nutrition" (EEN) group of 148 patients (32.1%) who received enteral feeding within 48 hours of their arrival at the hospital and a "delayed enteral nutrition" (DEN) group of 313 patients (67.9%) who received enteral feeding at some point after 48 hours of their arrival at the hospital. The EEN group and control group were similar in terms of age, sex, body mass index, and underlying diseases. RESULTS: The EEN group's total length of stay in hospital was shorter (23.29±27.19 days) than that of the control group (36.74±32.24 days); the difference was significant (P<0.001). The EEN group also showed a shorter length of stay in the ICU (13.67±22.77 days) than the DEN group (17.46±21.02 days) and a lower mortality rate (17.6%) than the control group (18.8%), but these differences were not significant. CONCLUSION: The study found that early enteral nutrition treatment reduced total length of stay in hospital significantly. The findings suggest that early enteral nutrition treatment plays an important role in the patients' recovery and prognosis.
Body Mass Index ; Enteral Nutrition* ; Humans ; Intensive Care Units ; Length of Stay ; Male ; Mortality ; Nutritional Support ; Prognosis ; Retrospective Studies

9

Cite

Share

Characteristics and Clinical Course of Patients Who Received Enteral or Parenteral Nutrition in Tertiary Referral Hospitals in Korea.

Eunmi SEOL ; Yun Suhk SUH ; Dal Lae JU ; Hye Jung BAE ; Hyuk Joon LEE

Journal of Clinical Nutrition.2016;8(2):58-65. doi:10.15747/jcn.2016.8.2.58

PURPOSE: The purposes of this study are to evaluate clinical characteristics of malnourished patients who received nutritional therapy and to compare their clinical courses according to nutritional support team (NST) consultation in tertiary referral hospital in Korea. METHODS: From June 2014 to May 2015, 43,954 admitted patients who were more than 18 years old were retrospectively investigated. Characteristics of patients who received enteral nutrition (EN) or parenteral nutrition (PN) for more than 3 days (nutritional therapy group) were compared to the patients without nutritional therapy (control group). In addition, clinical courses according to NST consultation (NST group and non-NST group) were compared through propensity score matching (PSM). RESULTS: EN or PN was applied in 4,599 patients for more than 3 days (nutritional therapy group: 10.5%). For characteristics, there were significant differences between two groups (nutritional therapy group vs. control group) with age, male proportion, body weight, body mass index. All laboratory data at admission were significantly worse in nutritional therapy group. And for clinical courses, there were significant differences in length of stay (LOS), rate of intensive care unit (ICU) admission, LOS in ICU, Acute Physiology and Chronic Health Enquiry (APACHE II) score, days of nutritional therapy, mortality rate. NST consultation was made in 39% of nutritional therapy group. Among departments, Thoracic Surgery showed the highest rate of NST consultation (68.5%) otherwise Neurosurgery showed the lowest rate (18.7%). When PSM between NST group vs. non-NST group were made, significant differences was shown only in the rate of ICU admission, EN or PN support days, cholesterol at discharge. CONCLUSION: In tertiary referral hospital in Korea, more than 10% of patients still needed active nutritional therapy. NST consultation rate varies among departments. We failed to find significant differences between NST group and non-NST group.
Body Mass Index ; Body Weight ; Cholesterol ; Enteral Nutrition ; Humans ; Intensive Care Units ; Korea* ; Length of Stay ; Male ; Mortality ; Neurosurgery ; Nutrition Therapy ; Nutritional Support ; Parenteral Nutrition* ; Physiology ; Propensity Score ; Retrospective Studies ; Tertiary Care Centers* ; Thoracic Surgery ; Treatment Outcome

10

Cite

Share

Effects of Compliance with the Nutrition Support Team in Critically Ill Pediatric Patients.

Soo Jin PARK ; Ji Eun PARK ; Na Young KWON ; Jae Song KIM ; Eun Sun SON ; Hyun Ji YU ; Jae Yeon BANG ; Seung KIM ; Ho Seon EUN

Journal of Clinical Nutrition.2016;8(2):51-57. doi:10.15747/jcn.2016.8.2.51

PURPOSE: This study performed a comparative evaluation of nutritional condition's improvement and clinical effects in accordance with the Nutrition Support Team (NST) consultation compliance of critically ill pediatric patients. METHODS: The medical records of 64 critically ill pediatric patients (2 to 18 years old), who were officially referred to a NST consultant in pediatric intensive care unit from January to August 2015, were reviewed. The patients were divided into 2 groups according to the compliance of NST consultation answers. The total delivered/required caloric and protein ratio, weight, serum total protein, serum albumin, hemoglobin, and hematocrit were compared. RESULTS: According to the NST consultation answer, 'nutrition support increase' occupied the largest proportion at 38.5%; 'maintenance' and 'decrease' accounted for 35.7% and 18.2% respectively. The NST compliance group and non-compliance group were 20 and 14 patients, respectively. Although total delivered/required caloric ratio was significantly increased in the NST compliance group (19.7%, P=0.036), there was no significant difference in the NST non-compliance group (5.1%, P=0.692). The total delivered/required protein ratio was increased (15.1%, P=0.163) in the NST compliance group and decreased (-4.7%, P=0.774) in the NST non-compliance group. The NST non-compliance group (-8.6%, P=0.219) was further reduced weight than the NST compliance group (-1.0%, P=0.820). The serum albumin was significantly increased in the NST compliance group (13.1%, P=0.003), but there was no difference in the NST non-compliance group (7.1%, P=0.433). CONCLUSION: Although 56.7% of NST consultations were needed for nutritional interventions, a lower NST compliance (53.8%) is the limit of nutritional support. The NST compliance group was supplied adequately with more calories and protein than before consultation and a more improved nutritional status. Therefore, aggressive NST consultation can help increase the therapeutic effect by improving the nutritional status. This study will form the basis to seek ways to further enhance NST compliance.
Compliance* ; Consultants ; Critical Illness* ; Hematocrit ; Humans ; Intensive Care Units ; Medical Records ; Nutritional Status ; Nutritional Support ; Pediatrics ; Referral and Consultation ; Serum Albumin

DISPLAY OPTIONS

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share