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Advances in Enteral Nutrition
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Advances in Enteral Nutrition

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

Deadline for manuscript submissions: closed (30 November 2020) | Viewed by 29542

Special Issue Editor

Prof. Dr. Marta Stelmach-Mardas

E-Mail Website
Guest Editor
Department of Obesity Treatment, Metabolic Disorders and Clinical Dietetics, Poznan University of Medical Sciences, 60-569 Poznan, Poland
Interests: diet-related diseases; gut microbiota; life quality assessment tools
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

This Special Issue on “Advances in Enteral Nutrition” aims to provide an overview of the importance of enteral nutrition (elemental or polymeric formulas) in malnourished and/or at risk of malnutrition patients, who on one hand have functional guts but on the other hand are not able to meet the nutritional requirements for energy and nutrients by a standard diet.
Enteral access requires an interdisciplinary approach to determine the best options and placement procedure for the patient. The estimated duration of treatment and the intended location of feeding are important considerations when selecting the type of feeding tube to place. Recent evidence has shown that an enteral nutrition may modify the composition of intestinal microbiome, being important in the pathogenesis of, e.g., inflammatory bowel diseases and cancer development/treatment. Taking into account patient health, quality of life, and the reduction of cost in the health care system, home enteral nutrition may also be of high importance. Finally, it seems that patients’ and their caregivers’ education in the management of enteral nutrition may be key to improving the adherence to enteral nutrition.
This issue will open a space for the discussion of different approaches and challenges related to enteral nutrition for professionals. You are welcome to share with readers your research results that will bring us closer to personalized nutrition in severely ill patients.

Dr. Marta Stelmach-Mardas
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Nutrients is an international peer-reviewed open access semimonthly journal published by MDPI.

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

  • Inflammatory bowel diseases
  • Cancer
  • Patiative care patients
  • Oral supplements
  • Quality of life
  • Feeding tube
  • Education
  • Economic aspect
  • Ethical aspect

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Published Papers (5 papers)

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Research

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16 pages, 917 KiB  
Article
Complex Enterally Tube-Fed Community Patients Display Stable Tolerance, Improved Compliance and Better Achieve Energy and Protein Targets with a High-Energy, High-Protein Peptide-Based Enteral Tube Feed: Results from a Multi-Centre Pilot Study
by Benjamin Green, Katy Sorensen, Mary Phillips, Lisa Green, Rachel Watson, Adrienne McCallum, Sarah Brook, Siobhan Oldham, Michelle Barry, Lyndsey Tomlinson, Alice Williams, Sam Crease, Carrie Wills, Rose Talbot, Rourke Thomas, Julie Barker, Annalisa Owen, Judith Davies, Carys Robinson, Anna Lumsdon, Samm Morris, Chloé McMurray, Nicola Cunningham, Lily Miller, Carolyn Day, Kristina Stanley, Susan Price, Susan Duff, Anna Julian, Jennifer Thomas, Carole-Anne Fleming, Gary Hubbard and Rebecca Strattonadd Show full author list remove Hide full author list
Nutrients 2020, 12(11), 3538; https://doi.org/10.3390/nu12113538 - 18 Nov 2020
Cited by 6 | Viewed by 9845
Abstract
This pilot study evaluated a high-energy, high-protein, peptide-based, (medium-chain triglycerides) MCT-containing enteral tube feed (Nutrison Peptisorb Plus HEHP®, Nutricia Ltd., Trowbridge, BA14 0XQ, UK.) containing 1.5 kcal/mL and 7.5 g protein/100 mL. Fifteen community-based, enterally tube-fed adults (42 (SD 16.3) years) [...] Read more.
This pilot study evaluated a high-energy, high-protein, peptide-based, (medium-chain triglycerides) MCT-containing enteral tube feed (Nutrison Peptisorb Plus HEHP®, Nutricia Ltd., Trowbridge, BA14 0XQ, UK.) containing 1.5 kcal/mL and 7.5 g protein/100 mL. Fifteen community-based, enterally tube-fed adults (42 (SD 16.3) years) received the intervention feed daily for 28 days, with gastrointestinal tolerance, compliance and nutrient intake assessed at baseline and after the intervention period. Incidence and intensity of constipation (p = 0.496), nausea (p = 1.000), abdominal pain (p = 0.366) and bloating (p = 0.250) remained statistically unchanged, yet the incidence and intensity of diarrhoea improved significantly after receiving the intervention feed (Z = −2.271, p = 0.023). Compliance with the intervention feed was significantly greater compared to the patient’s baseline regimens (99% vs. 87%, p = 0.038). Compared to baseline, use of the intervention feed enabled patients to significantly increase total energy (1676 kcal/day (SD 449) to 1884 kcal/day (SD 537), p = 0.039) and protein intake (73 g/day (SD 17) to 89 g/day (SD 23), p = 0.001), allowing patients to better achieve energy (from 88% to 99%, p = 0.038) and protein (from 101% to 121%, p < 0.001) requirements. This pilot study demonstrates that a high-energy, high-protein, peptide-based, MCT-containing enteral tube feed maintains gastrointestinal tolerance and improves compliance, energy and protein intake in complex, enterally tube-fed, community-based adult patients, though more work is recommended to confirm this. Full article
(This article belongs to the Special Issue Advances in Enteral Nutrition)
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9 pages, 448 KiB  
Article
Home Enteral Nutrition in Adults—Nationwide Multicenter Survey
by Marcin Folwarski, Stanisław Kłęk, Agata Zoubek-Wójcik, Waldemar Szafrański, Lidia Bartoszewska, Krzysztof Figuła, Marlena Jakubczyk, Anna Jurczuk, Zbigniew Kamocki, Karolina Kaźmierczak-Siedlecka, Tomasz Kowalczyk, Bogna Kwella, Przemysław Matras, Karolina Skonieczna-Żydecka, Joanna Sonsala-Wołczyk, Jacek Szopiński, Krystyna Urbanowicz and Anna Zmarzły
Nutrients 2020, 12(7), 2087; https://doi.org/10.3390/nu12072087 - 14 Jul 2020
Cited by 21 | Viewed by 5443
Abstract
Home enteral nutrition (HEN) is an important part of the health care system, with a growing population of patients around the world. The aim of our study was to analyze one of the largest cohorts of HEN patients to provide the most recent [...] Read more.
Home enteral nutrition (HEN) is an important part of the health care system, with a growing population of patients around the world. The aim of our study was to analyze one of the largest cohorts of HEN patients to provide the most recent data available in European literature. A multicenter, nation-wide survey in the period of 1 January 2018–1 January 2019 was performed in Poland. Data concerning adult patients on HEN in 2018 during 1 year of observation time were analyzed: demographic characteristics, primary disease, technique of enteral feeding, diet formulation and amount of energy provided. A total of 4586 HEN patients (F: 46.7%, M: 53.3%) were included in the study. The primary diseases were: 54.5% neurological (17.4%—neurovascular, 13.7%—neurodegenerative), 33.9% cancer (20.2%—head and neck, 11.7%—gastrointestinal cancer), 2.5%—gastroenterology, 1.5%—inherited diseases. Of new registrations in 2018—cancer patients 46.3%, neurological patients 45.1%. The median age overall was: 64 yr., BMI-20.2 kg/m2, NRS 2002 score—4.28. A total of 65% of patients were treated with PEG, 11.6% with surgical gastrostomy, 14.3% with naso-gastric tube and 7% with jejunostomy. Boluses were the most common method of feeding (74.4%). Gravity flow was used in 17.6% and peristaltic pump was used in 8% patients. The median energy provision was 1278 kcal/day and 24 kcal/kg/day. The most commonly used diets were: isocaloric (28.1%), protein-enriched isocaloric (20%) and protein-enriched hypercaloric (12%). The median overall duration of HEN was 354 days, 615 days for neurological and 209 days for cancer patients. A number of new registrations of cancer patients was significant and long duration of HEN in this group is encouraging. A developing spectrum of enteral formulas available enables more specified nutritional interventions. Full article
(This article belongs to the Special Issue Advances in Enteral Nutrition)
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12 pages, 767 KiB  
Article
Comparison of Feeding Efficiency and Hospital Mortality between Small Bowel and Nasogastric Tube Feeding in Critically Ill Patients at High Nutritional Risk
by Wei-Ning Wang, Chen-Yu Wang, Chiann-Yi Hsu and Pin-Kuei Fu
Nutrients 2020, 12(7), 2009; https://doi.org/10.3390/nu12072009 - 6 Jul 2020
Cited by 3 | Viewed by 2658
Abstract
Nasogastric tube enteral nutrition (NGEN) should be initiated within 48 h for patients at high nutritional risk. However, whether small bowel enteral nutrition (SBEN) should be routinely used instead of NGEN to improve hospital mortality remains unclear. We retrospectively analyzed 113 critically ill [...] Read more.
Nasogastric tube enteral nutrition (NGEN) should be initiated within 48 h for patients at high nutritional risk. However, whether small bowel enteral nutrition (SBEN) should be routinely used instead of NGEN to improve hospital mortality remains unclear. We retrospectively analyzed 113 critically ill patients with modified Nutrition Risk in Critically Ill (mNUTRIC) score ≥ 5 and feeding volume < 750 mL/day in the first week of their stay in the intensive care unit (ICU). Age, sex, mNUTRIC score, and Acute Physiology and Chronic Health Evaluation II (APACHE II) score were matched in the SBEN (n = 48) and NGEN (n = 65) groups. Through a univariate analysis, factors associated with hospital mortality were SBEN group (hazard ratio (HR), 0.56; 95% confidence interval (CI), 0.31–1.00), Simplified Organ Failure Assessment (SOFA) score on day 7 (HR, 1.12; 95% CI, 1.03–1.22), and energy intake achievement rate < 65% (HR, 2.53; 95% CI, 1.25–5.11). A multivariate analysis indicated that energy intake achievement rate < 65% on the third follow-up day (HR, 2.29; 95% CI, 1.12–4.69) was the only factor independently associated with mortality. We suggest initiation of SBEN on the seventh ICU day before parenteral nutrition initiation for critically ill patients at high nutrition risk. Full article
(This article belongs to the Special Issue Advances in Enteral Nutrition)
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Review

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11 pages, 712 KiB  
Review
Influence of Enteral Nutrition on Gut Microbiota Composition in Patients with Crohn’s Disease: A Systematic Review
by Paulina Horwat, Stanisław Kopeć, Aleksandra Garczyk, Iwona Kaliciak, Zuzanna Staręga, Konstanty Drogowski, Marcin Mardas and Marta Stelmach-Mardas
Nutrients 2020, 12(9), 2551; https://doi.org/10.3390/nu12092551 - 23 Aug 2020
Cited by 18 | Viewed by 4417
Abstract
The aim of the study was to systematically and comprehensively evaluate whether exclusive enteral nutrition (EEN) has impact on gut microbiota in patients with Crohn’s disease (CD). The databases PUBMED (MEDLINE), SCOPUS and WEB OF SCIENCE were searched. Out of 232 studies, 9 [...] Read more.
The aim of the study was to systematically and comprehensively evaluate whether exclusive enteral nutrition (EEN) has impact on gut microbiota in patients with Crohn’s disease (CD). The databases PUBMED (MEDLINE), SCOPUS and WEB OF SCIENCE were searched. Out of 232 studies, 9 met inclusion criteria. The combined analyzed population consists of 118 patients with CD and treated with EEN with a time of intervention of 2–12 weeks. Studies were conducted in children, with the exception of one study. All applied feeding formulas had similar energy value and composition. The microbiome analysis was based on 16S rRNA gene sequencing of faecal samples. In all studies, EEN treatment decreases inflammatory markers (i.e., hs-CRP and FCP). A change in abundance of numerous bacterial families (Clostridiaceae, Eubacteriaceae, Bacteroidaceae) was noticed, especially in Bacteroidaceae. An increase in families connected to the more severe clinical course (Fusobacteria, Prevotella, Lachnospiraceae) was observed in only 2.5% of CD patients. Our analyses suggest EEN has a beneficial influence on gut microbiome in patients with CD, which is interrelated with clinical patient’s improvement and time of disease remission. Full article
(This article belongs to the Special Issue Advances in Enteral Nutrition)
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16 pages, 3619 KiB  
Review
Semi-Solid Nutrients for Prevention of Enteral Tube Feeding-Related Complications in Japanese Population: A Systematic Review and Meta-Analysis
by Yoji Kokura, Chieko Suzuki, Hidetaka Wakabayashi, Keisuke Maeda, Kotomi Sakai and Ryo Momosaki
Nutrients 2020, 12(6), 1687; https://doi.org/10.3390/nu12061687 - 5 Jun 2020
Cited by 8 | Viewed by 6595
Abstract
The aim of this systematic review was to assess the best available evidence on semi-solid nutrients for prevention of complications associated with enteral tube feeding (ETF). PubMed (MEDLINE), EMBASE, Cochrane Central Register of Controlled Trial, Ichushi-web, and World Health Organization International Clinical Trials [...] Read more.
The aim of this systematic review was to assess the best available evidence on semi-solid nutrients for prevention of complications associated with enteral tube feeding (ETF). PubMed (MEDLINE), EMBASE, Cochrane Central Register of Controlled Trial, Ichushi-web, and World Health Organization International Clinical Trials Registry Platform databases were searched for relevant articles. Randomized controlled trials (RCTs), cluster RCTs, and crossover trials comparing the effects of semi-solid nutrients with those of control interventions in patients on ETF were included in the review. The primary outcome was development of gastroesophageal reflux (GER). Eight RCTs and five crossover trials involving 889 study participants in total were examined via meta-analysis. The meta-analysis showed that semi-solid nutrients significantly decreased the risk of GER (risk ratio 0.39; 95% confidence interval (CI) 0.21 to 0.73) and the GER index (mean difference −2.93; 95% CI −5.18 to −0.68). Dwell time in the stomach was significantly shortened (standardized mean difference (SMD) −0.50; 95% CI −0.99 to −0.02), as was care time defined as the time needed to prepare and administer the nutrient solution (SMD −8.02; 95% CI −10.94 to −5.10). Semi-solid nutrients significantly decrease the risk of GER and the dwell time in the stomach in adult patients. Full article
(This article belongs to the Special Issue Advances in Enteral Nutrition)
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