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Enteral/Parenteral Nutrition and Infections

A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Clinical Nutrition".

Deadline for manuscript submissions: closed (20 October 2023) | Viewed by 10825

Special Issue Editor


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Guest Editor
Department of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
Interests: chronic disease self-management; symptom management; lifestyle intervention; health promotion for cancer survivorship; adult nursing; critical care nursing
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Nutritional support is a complex aspect of patient care with global implications for delivering benefits to patients and reducing the impact on healthcare resources. When patients have feeding or digestive problems, enteral or parenteral nutrition is sometimes required.

Some patients receive enteral or parenteral feeding while recovering from surgery or serious illness, while others require long-term feeding. In general, enteral nutrition is favored over parenteral nutrition because it is more physiological and less expensive. Current guidelines also recommend the use of EN rather than PN, suggesting a reduced risk of infectious complications. However, evidence contradicts these recommendations. Whether, how, and when nutritional support can help improve patient outcomes has been debated. The choice between enteral and parenteral nutrition is sometimes difficult, and patients may require different types and amounts of artificial nutritional support at different stages of the disease. The feeding route, caloric intake, and timing of initiation are also important considerations.

For this Special Issue, we invite submissions of original studies, reviews, or meta-analyses focusing on enteral/parenteral nutrition and infections. Publications on artificial nutritional support for patient populations are welcome.

Dr. Tsae-Jyy Wang
Guest Editor

Manuscript Submission Information

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Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • nutritional support
  • enteral nutrition
  • parenteral nutrition
  • infections
  • feeding route
  • artificial nutritional support

Published Papers (5 papers)

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Research

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11 pages, 621 KiB  
Article
Prior Evaluation of Nutritional Status and Mortality in Patients with Sepsis in South Korea
by Tak Kyu Oh and In-Ae Song
Nutrients 2023, 15(24), 5040; https://doi.org/10.3390/nu15245040 - 8 Dec 2023
Viewed by 833
Abstract
Our objective was to determine whether nutritional status correlates with mortality in sepsis patients. Data from a nationwide registration database were utilized for this population-based cohort study. The study subjects comprised adults who received standard health examinations before being admitted to the hospital [...] Read more.
Our objective was to determine whether nutritional status correlates with mortality in sepsis patients. Data from a nationwide registration database were utilized for this population-based cohort study. The study subjects comprised adults who received standard health examinations before being admitted to the hospital for sepsis and were diagnosed with sepsis between 2018 and 2020. Nutrition scores were evaluated using the Nutritional Lifestyle Assessment Tool in South Korea. Overall, 2482 patients with sepsis were included in this study. The 90-day and 1-year mortality rates in patients with sepsis were 26.8% (664/2482) and 34.2% (848/2482), respectively. In the covariate-adjusted multivariable logistic regression model, a 1-point increase in nutrition score was associated with a decrease in 90-day mortality in patients with sepsis (odds ratio [OR]: 0.98, 95% confidence interval [CI]: 0.97, 0.98; p = 0.025). In the covariate-adjusted multivariable Cox regression model, a 1-point increase in nutrition score was associated with a decrease in 1-year mortality in patients with sepsis (hazard ratio [H.R.]: 0.99, 95% CI: 0.98, 0.99; p = 0.035). Our results suggest that adequate dietary intake and healthy eating habits might protect against mortality among sepsis patients. Full article
(This article belongs to the Special Issue Enteral/Parenteral Nutrition and Infections)
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11 pages, 429 KiB  
Article
Risk of Malnutrition in Adults Who Have Undergone Sleeve Gastrectomy: A Retrospective Study
by Wan-Chun Liao, Tsae-Jyy Wang, Chieh-Yu Liu, Tsang-Pai Liu, Shu-Yuan Liang and Ko-Shih Chang
Nutrients 2023, 15(17), 3858; https://doi.org/10.3390/nu15173858 - 4 Sep 2023
Viewed by 1248
Abstract
Sleeve gastrectomy achieves long-term weight control by reducing gastric volume. However, postoperative gastrointestinal symptoms and insufficient nutritional intake are likely to occur, which are not conducive to physical health. A retrospective study aimed to investigate changes in nutritional status and associated factors in [...] Read more.
Sleeve gastrectomy achieves long-term weight control by reducing gastric volume. However, postoperative gastrointestinal symptoms and insufficient nutritional intake are likely to occur, which are not conducive to physical health. A retrospective study aimed to investigate changes in nutritional status and associated factors in patients after sleeve gastrectomy. Data were collected from the medical records of patients who underwent sleeve gastrectomy at a teaching hospital in Taiwan. Data from 120 patients who met the eligibility criteria were included in the analysis. The results show that sleeve gastrectomy has a strong weight loss effect. Within 12 months, the average body mass index of the patients decreased by 13.47 kg/m2. The number of morbidly obese patients decreased from 62 (51.7%) to 3 (2.5%). However, surgery is also associated with gastrointestinal symptoms and the threat of malnutrition. The number of patients with moderate to severe nutritional risk increased from 4 (3.3%) before surgery to 24 (20%) at 12-month follow-up. Likewise, the number of patients with anemia increased from 11 (9.2%) to 29 (24.17%). Gender, constipation, and diarrhea affected postoperative nutritional status. These findings suggest that patients after sleeve gastrectomy are at risk of malnutrition and require regular monitoring. Special attention should be given to women and patients with constipation or diarrhea, as they are at a particularly high risk of malnutrition. Full article
(This article belongs to the Special Issue Enteral/Parenteral Nutrition and Infections)
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18 pages, 1237 KiB  
Article
Using Body Composition Analysis for Improved Nutritional Intervention in Septic Patients: A Prospective Interventional Study
by Kai-Yin Hung, Tzu-Hsiu Chen, Ya-Fen Lee and Wen-Feng Fang
Nutrients 2023, 15(17), 3814; https://doi.org/10.3390/nu15173814 - 31 Aug 2023
Cited by 1 | Viewed by 1215
Abstract
The study aimed to determine whether using body composition data acquired through bio-electrical impedance analysis (BIA) to adjust diet formulas could improve outcomes in septic patients. There were 132 septic patients in medical intensive care units enrolled in the prospective, randomized, double-blind, interventional [...] Read more.
The study aimed to determine whether using body composition data acquired through bio-electrical impedance analysis (BIA) to adjust diet formulas could improve outcomes in septic patients. There were 132 septic patients in medical intensive care units enrolled in the prospective, randomized, double-blind, interventional study. For the intervention group, dietitians had access to BIA data for adjusting diet formulas according to body composition variables on days 1, 3, and 8. The patients were also stratified based on nutritional risk using the modified Nutrition Risk in Critically ill (mNUTRIC) score. Patients with intervention were more likely to achieve caloric and protein intake goals compared to the control group, especially in the low-risk group. The intervention did not significantly affect mortality, but the survival curves suggested potential benefits. The high-risk group had longer ICU stays and mechanical ventilation duration, which were mitigated by the intervention. Certain body composition variables (e.g., extracellular water to total body water ratio and phase angle) showed differences between high-risk and low-risk groups and may be related to patient outcomes. Non-invasive body composition assessment using BIA can help dietitians adjust diet formulas for critically ill septic patients. Body composition variables may be associated with sepsis outcomes, but further research with larger patient numbers is needed to confirm these findings. Full article
(This article belongs to the Special Issue Enteral/Parenteral Nutrition and Infections)
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12 pages, 12033 KiB  
Article
Extensively Hydrolyzed Formula Improves Allergic Symptoms in the Short Term in Infants with Suspected Cow’s Milk Protein Allergy
by Michael J. Wilsey, Jared Florio, Jesse Beacker, Luke Lamos, Jessica V. Baran, Lea Oliveros, Panida Sriaroon, Jerry M. Brown and Jon A. Vanderhoof
Nutrients 2023, 15(7), 1677; https://doi.org/10.3390/nu15071677 - 30 Mar 2023
Cited by 7 | Viewed by 3698
Abstract
Although extensively hydrolyzed formula is widely accepted for managing cow’s milk protein allergy (CMPA) long-term, there is a lack of evidence on its short-term efficacy. This study’s objective was to investigate the short-term symptom changes (within 3–6 weeks) of infants diagnosed with CMPA [...] Read more.
Although extensively hydrolyzed formula is widely accepted for managing cow’s milk protein allergy (CMPA) long-term, there is a lack of evidence on its short-term efficacy. This study’s objective was to investigate the short-term symptom changes (within 3–6 weeks) of infants diagnosed with CMPA and managed with extensively hydrolyzed formula containing Lactobacillus rhamnosus at their subsequent physician visit. Healthcare providers treating 202 patients diagnosed with CMPA under six months old completed de-identified surveys, which were then analyzed in this prospective study. After their first visit, the patients were started on extensively hydrolyzed formula, and their baseline symptoms were scored on a severity scale of 0–3. Patients were then reevaluated at their next follow-up visit to assess changes in symptom severity. The study found statistically significant improvements in gastrointestinal (93%), skin (83%), respiratory (73%), and uncategorized symptoms (90%). These symptom improvements were consistent across different follow-up visit durations. This study is the largest prospective analysis conducted in the United States evaluating short-term change in CMPA symptoms severity in infants under six months old using extensively hydrolyzed formula. These findings suggest that extensively hydrolyzed formula is associated with clinical symptom relief, which is often noticeable by the next follow-up visit. However, additional randomized control trials are needed to validate these results. Full article
(This article belongs to the Special Issue Enteral/Parenteral Nutrition and Infections)
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Review

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18 pages, 1164 KiB  
Review
Novel Therapeutic Approaches for Mitigating Complications in Short Bowel Syndrome
by Jeffery Bettag, Loren Po, Cassius Cunningham, Rahul Tallam, Kento Kurashima, Aakash Nagarapu, Chelsea Hutchinson, Sylvia Morfin, Mustafa Nazzal, Chien-Jung Lin, Amit Mathur, Rajeev Aurora and Ajay K. Jain
Nutrients 2022, 14(21), 4660; https://doi.org/10.3390/nu14214660 - 4 Nov 2022
Cited by 4 | Viewed by 3095
Abstract
Short bowel syndrome (SBS) is a particularly serious condition in which the small intestine does not absorb sufficient nutrients for biological needs, resulting in severe illness and potentially death if not treated. Given the important role of the gut in many signaling cascades [...] Read more.
Short bowel syndrome (SBS) is a particularly serious condition in which the small intestine does not absorb sufficient nutrients for biological needs, resulting in severe illness and potentially death if not treated. Given the important role of the gut in many signaling cascades throughout the body, SBS results in disruption of many pathways and imbalances in various hormones. Due to the inability to meet sufficient nutritional needs, an intravenous form of nutrition, total parental nutrition (TPN), is administered. However, TPN presents difficulties such as severe liver injury and altered signaling secondary to the continued lack of luminal contents. This manuscript aims to summarize relevant studies into the systemic effects of TPN on systems such as the gut–brain, gut-lung, and gut-liver axis, as well as present novel therapeutics currently under use or investigation as mitigation strategies for TPN induced injury. Full article
(This article belongs to the Special Issue Enteral/Parenteral Nutrition and Infections)
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