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Parenteral Nutrition 2016
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Parenteral Nutrition 2016

A special issue of Nutrients (ISSN 2072-6643).

Deadline for manuscript submissions: closed (15 February 2017) | Viewed by 61909

Special Issue Editors

Prof. Dr. Leah Gramlich

E-Mail Website
Guest Editor
Department of Medicine, Division of Gastroenterology, University of Alberta, Edmonton, AB T6G 2R3, Canada；Royal Alexandra Hosipital, Alberta Health Services, Edmonton, AB T5H 3V9, Canada.
Interests: nutrition; gastroenterology; ERAS; implementation; cancer
Special Issues, Collections and Topics in MDPI journals
Prof. Dr. Johane Allard

E-Mail Website
Guest Editor
Division of Clinical Investigation & Human Physiology, Toronto General Research Institute, University of Toronto, 27 King's College Cir, Toronto, ON M5S, Canada

Special Issue Information

Dear Colleagues,

This Special Issue of Nutrients will include a variety of topical discussions related to current research and practice as they relate to Parenteral Nutrition (PN). It will include a discussion of the components of PN, including both macronutrients and micronutrients. It will review the use of PN in unique patient populations, such as the critically ill, and in pediatrics. It will also provide insight into optimizing the benefits of PN and minimizing the risks of PN from the perspective of the value of using pre-mx solutions vs. compounded, a discussion of catheter related blood stream infections and a discussion of other complications of PN including metabolic bone disease and PN associated liver disease (PNALD).

Dr. Leah Gramlich
Prof. Johane Allard
Guest Editors

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

  • Parenteral Nutrition
  • Lipids
  • Intestinal Failure
  • Protein
  • Micronutrients
  • Critical Illness
  • Cancer

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Published Papers (6 papers)

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Research

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216 KiB  
Article
The Prevalence of Vitamin D Insufficiency and Deficiency and Their Relationship with Bone Mineral Density and Fracture Risk in Adults Receiving Long-Term Home Parenteral Nutrition
by Navaporn Napartivaumnuay and Leah Gramlich
Nutrients 2017, 9(5), 481; https://doi.org/10.3390/nu9050481 - 10 May 2017
Cited by 18 | Viewed by 4346
Abstract
It has been demonstrated that low bone mass and vitamin D deficiency occur in adult patients receiving home parenteral nutrition (HPN). The aim of this study is to determine the prevalence of vitamin D insufficiency and deficiency and its relationship with bone mineral [...] Read more.
It has been demonstrated that low bone mass and vitamin D deficiency occur in adult patients receiving home parenteral nutrition (HPN). The aim of this study is to determine the prevalence of vitamin D insufficiency and deficiency and its relationship with bone mineral density (BMD) and fracture risk in long-term HPN patients. Methods: A retrospective chart review of all 186 patients in the HPN registry followed by the Northern Alberta Home Parenteral Nutrition Program receiving HPN therapy >6 months with a 25 (OH) D level and BMD reported were studied. Results: The mean age at the initiation of HPN was 53.8 (20–79) years and 23 (37%) were male. The mean HPN duration was 56 (6–323) months and the most common diagnosis was short bowel syndrome. Based on a total of 186 patients, 62 patients were categorized based on serum vitamin D status as follows: 1 (24.2%) sufficient, 31 (50%) insufficient and 16 (25.8%) deficient. Despite an average of 1891 IU/day orally and 181 IU/day intravenously vitamin D, the mean vitamin D level was 25.6 ng/mL (insufficiency) and 26.2 ± 11.9 ng/mL in patients with the highest 10-year fracture risk. Conclusion: Suboptimal vitamin D levels are common among patients on long-term HPN despite nutrient intake that should meet requirements. Full article
(This article belongs to the Special Issue Parenteral Nutrition 2016)
1942 KiB  
Article
Inadequacy of Body Weight-Based Recommendations for Individual Protein Intake—Lessons from Body Composition Analysis
by Corinna Geisler, Carla M. Prado and Manfred J. Müller
Nutrients 2017, 9(1), 23; https://doi.org/10.3390/nu9010023 - 31 Dec 2016
Cited by 20 | Viewed by 8067
Abstract
Current body weight-based protein recommendations are ignoring the large variability in body composition, particularly lean mass (LM), which drives protein requirements. We explored and highlighted the inter-individual variability of weight versus body composition-adjusted protein intakes by secondary analysis in three cohorts of (1) [...] Read more.
Current body weight-based protein recommendations are ignoring the large variability in body composition, particularly lean mass (LM), which drives protein requirements. We explored and highlighted the inter-individual variability of weight versus body composition-adjusted protein intakes by secondary analysis in three cohorts of (1) 574 healthy adults (mean ± SD age: 41.4 ± 15.2 years); (2) 403 cirrhotic patients (age: 44.7 ± 12.3 years) and (3) 547 patients with lung cancer (age: 61.3 ± 8.2 years). LM was assessed using different devices (magnetic resonance imaging, dual-energy X-ray absorptiometry, computer tomography, total body potassium and bioelectrical impedance), body weight-based protein intake, its ratio (per kg LM) and mean protein requirement were calculated. Variability in protein intake in all cohorts ranged from 0.83 to 1.77 g protein per kg LM per day using (theoretical protein intake of 60 g protein per day). Calculated mean protein requirement was 1.63 g protein per kg LM per day; consequently, 95.3% of healthy subjects, 100% of cirrhotic and 97.4% of cancer patients would present with a low protein intake per kg LM. Weight-adjusted recommendations are inadequate to address the LM specific differences in protein needs of healthy subjects or clinical populations. Absolute protein intake seems to be more relevant compared to the relative proportion of protein, which in turn changes with different energy needs. Full article
(This article belongs to the Special Issue Parenteral Nutrition 2016)
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Review

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8659 KiB  
Review
Parenteral Nutrition and Intestinal Failure
by Barbara Bielawska and Johane P. Allard
Nutrients 2017, 9(5), 466; https://doi.org/10.3390/nu9050466 - 6 May 2017
Cited by 75 | Viewed by 14689
Abstract
Severe short bowel syndrome (SBS) is a major cause of chronic (Type 3) intestinal failure (IF) where structural and functional changes contribute to malabsorption and risk of micronutrient deficiencies. Chronic IF may be reversible, depending on anatomy and intestinal adaptation, but most patients [...] Read more.
Severe short bowel syndrome (SBS) is a major cause of chronic (Type 3) intestinal failure (IF) where structural and functional changes contribute to malabsorption and risk of micronutrient deficiencies. Chronic IF may be reversible, depending on anatomy and intestinal adaptation, but most patients require long-term nutritional support, generally in the form of parenteral nutrition (PN). SBS management begins with dietary changes and pharmacologic therapies taking into account individual anatomy and physiology, but these are rarely sufficient to avoid PN. New hormonal therapies targeting intestinal adaptation hold promise. Surgical options for SBS including intestinal transplant are available, but have significant limitations. Home PN (HPN) is therefore the mainstay of treatment for severe SBS. HPN involves chronic administration of macronutrients, micronutrients, fluid, and electrolytes via central venous access in the patient’s home. HPN requires careful clinical and biochemical monitoring. Main complications of HPN are related to venous access (infection, thrombosis) and metabolic complications including intestinal failure associated liver disease (IFALD). Although HPN significantly impacts quality of life, outcomes are generally good and survival is mostly determined by the underlying disease. As chronic intestinal failure is a rare disease, registries are a promising strategy for studying HPN patients to improve outcomes. Full article
(This article belongs to the Special Issue Parenteral Nutrition 2016)
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241 KiB  
Review
Trace Elements in Parenteral Nutrition: Considerations for the Prescribing Clinician
by Jennifer Jin, Leanne Mulesa and Mariana Carrilero Rouillet
Nutrients 2017, 9(5), 440; https://doi.org/10.3390/nu9050440 - 28 Apr 2017
Cited by 53 | Viewed by 10376
Abstract
Trace elements (TEs) are an essential component of parenteral nutrition (PN). Over the last few decades, there has been increased experience with PN, and with this knowledge more information about the management of trace elements has become available. There is increasing awareness of [...] Read more.
Trace elements (TEs) are an essential component of parenteral nutrition (PN). Over the last few decades, there has been increased experience with PN, and with this knowledge more information about the management of trace elements has become available. There is increasing awareness of the effects of deficiencies and toxicities of certain trace elements. Despite this heightened awareness, much is still unknown in terms of trace element monitoring, the accuracy of different assays, and current TE contamination of solutions. The supplementation of TEs is a complex and important part of the PN prescription. Understanding the role of different disease states and the need for reduced or increased doses is essential. Given the heterogeneity of the PN patients, supplementation should be individualized. Full article
(This article belongs to the Special Issue Parenteral Nutrition 2016)
215 KiB  
Review
Parenteral Nutrition and Lipids
by Maitreyi Raman, Abdulelah Almutairdi, Leanne Mulesa, Cathy Alberda, Colleen Beattie and Leah Gramlich
Nutrients 2017, 9(4), 388; https://doi.org/10.3390/nu9040388 - 14 Apr 2017
Cited by 107 | Viewed by 13133
Abstract
Lipids have multiple physiological roles that are biologically vital. Soybean oil lipid emulsions have been the mainstay of parenteral nutrition lipid formulations for decades in North America. Utilizing intravenous lipid emulsions in parenteral nutrition has minimized the dependence on dextrose as a major [...] Read more.
Lipids have multiple physiological roles that are biologically vital. Soybean oil lipid emulsions have been the mainstay of parenteral nutrition lipid formulations for decades in North America. Utilizing intravenous lipid emulsions in parenteral nutrition has minimized the dependence on dextrose as a major source of nonprotein calories and prevents the clinical consequences of essential fatty acid deficiency. Emerging literature has indicated that there are benefits to utilizing alternative lipids such as olive/soy-based formulations, and combination lipids such as soy/MCT/olive/fish oil, compared with soybean based lipids, as they have less inflammatory properties, are immune modulating, have higher antioxidant content, decrease risk of cholestasis, and improve clinical outcomes in certain subgroups of patients. The objective of this article is to review the history of IVLE, their composition, the different generations of widely available IVLE, the variables to consider when selecting lipids, and the complications of IVLE and how to minimize them. Full article
(This article belongs to the Special Issue Parenteral Nutrition 2016)
482 KiB  
Review
Parenteral Nutrition: Amino Acids
by Leonard John Hoffer
Nutrients 2017, 9(3), 257; https://doi.org/10.3390/nu9030257 - 10 Mar 2017
Cited by 18 | Viewed by 10515
Abstract
There is growing interest in nutrition therapies that deliver a generous amount of protein, but not a toxic amount of energy, to protein-catabolic critically ill patients. Parenteral amino acids can achieve this goal. This article summarizes the biochemical and nutritional principles that guide [...] Read more.
There is growing interest in nutrition therapies that deliver a generous amount of protein, but not a toxic amount of energy, to protein-catabolic critically ill patients. Parenteral amino acids can achieve this goal. This article summarizes the biochemical and nutritional principles that guide parenteral amino acid therapy, explains how parenteral amino acid solutions are formulated, and compares the advantages and disadvantages of different parenteral amino acid products with enterally-delivered whole protein products in the context of protein-catabolic critical illness. Full article
(This article belongs to the Special Issue Parenteral Nutrition 2016)
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