Journal ArticleDOI
Benefits of early enteral nutrition with glutamine and probiotics in brain injury patients
TLDR
It is concluded that the enteral formula containing glutamine and probiotics decreased the infection rate and shortened the stay in the intensive care unit of brain injury patients.Abstract:
Brain injury patients have higher energy and protein expenditures and are prone to infections. The aim of the present study was to evaluate the results of early enteral feeding with glutamine and probiotics in brain injury patients. Twenty-three brain injury patients (Glasgow score between 5-12 and therapeutic intervention scoring system>20) were studied. Three patients were excluded to leave 20 remaining patients. Patients were randomized to receive either an early enteral diet (control group, n=10) or the same formula with glutamine and probiotics added (study group, n=10) for a minimum of 5 days (range, 5-14 days). The diets were isocaloric and isonitrogenous [35 kcal.kg(-1).day(-1) (where 1 kcal approximately 4.184 kJ) and 1.5 g of protein.kg(-1).day(-1)]. Main outcome measures were the incidence of infection, the length of stay in the intensive care unit and the number of days requiring mechanical ventilation. The two groups were homogeneous in gender, age, nutritional status and severity of trauma. There was no mortality during the study period. The infection rate was higher in controls (100%) when compared with the study group (50%; P=0.03) and the median (range) number of infections per patient was significantly greater (P<0.01) in the control group [3 (1-5)] compared with the study group [1 (0-3)]. Both the critical care unit stay [22 (7-57) compared with 10 (5-20) days; P<0.01; median (range)] and days of mechanical ventilation [14 (3-53) compared with 7 (1-15) days; P=0.04; median (range)] were higher in the patients in the control group than in the study group. We conclude that the enteral formula containing glutamine and probiotics decreased the infection rate and shortened the stay in the intensive care unit of brain injury patients.read more
Citations
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Journal ArticleDOI
Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Adult Critically Ill Patient Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.)
Nilesh M. Mehta,Heather E. Skillman,Sharon Y. Irving,Jorge A. Coss-Bu,Sarah Vermilyea,Elizabeth Anne Farrington,Liam McKeever,Amber M. Hall,Praveen S. Goday,Carol L. Braunschweig +9 more
TL;DR: The guidelines reiterate the importance of nutrition assessment-particularly, the detection of malnourished patients who are most vulnerable and therefore may benefit from timely intervention and there is a need for renewed focus on accurate estimation of energy needs and attention to optimizing protein intake.
Journal ArticleDOI
The Microbiota-Gut-Brain Axis
John F. Cryan,Kenneth J. O’Riordan,Caitlin S. M. Cowan,Kiran V. Sandhu,Thomaz F.S. Bastiaanssen,Marcus Boehme,Martín Gabriel Codagnone,Sofia Cussotto,Christine Fülling,Anna V. Golubeva,Katherine E. Guzzetta,Minal Jaggar,Caitriona M. Long-Smith,Joshua M. Lyte,Jason A. Martin,Alicia Molinero-Perez,Gerard M. Moloney,Emanuela Morelli,Enrique Morillas,Rory C. O'Connor,Joana S Cruz-Pereira,Veronica L. Peterson,Kieran Rea,Nathaniel L. Ritz,Eoin Sherwin,Simon Spichak,Emily M. Teichman,Marcel van de Wouw,Ana Paula Ventura-Silva,Shauna E. Wallace-Fitzsimons,Niall P. Hyland,Gerard Clarke,Timothy G. Dinan +32 more
TL;DR: Future studies will focus on understanding the mechanisms underlying the microbiota-gut-brain axis and attempt to elucidate microbial-based intervention and therapeutic strategies for neuropsychiatric disorders.
Journal ArticleDOI
Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Adult Critically Ill Patient: Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.).
Robert G. Martindale,Stephen A. McClave,Vincent W. Vanek,Mary McCarthy,Pamela R. Roberts,Beth Taylor,Juan B. Ochoa,Lena M. Napolitano,Gail Cresci +8 more
TL;DR: These guidelines offer basic recommendations that are supported by review and analysis of the current literature, other national and international guidelines, and a blend of expert opinion and clinical practicality that are directed toward generalized patient populations.
Journal ArticleDOI
ESPEN guideline: Clinical nutrition in surgery
Arved Weimann,Marco Braga,Franco Carli,Takashi Higashiguchi,Martin Hübner,Stanislaw Klek,Alessandro Laviano,Olle Ljungqvist,Dileep N. Lobo,Robert G. Martindale,Dan Linetzky Waitzberg,Stephan C. Bischoff,Pierre Singer +12 more
TL;DR: The focus of this guideline is to cover nutritional aspects of the Enhanced Recovery After Surgery (ERAS) concept and the special nutritional needs of patients undergoing major surgery, e.g. for cancer, and of those developing severe complications despite best perioperative care.
Journal ArticleDOI
ESPEN Guidelines on Enteral Nutrition: Surgery including Organ Transplantation
Arved Weimann,Marco Braga,László Harsányi,Alessandro Laviano,Olle Ljungqvist,Peter B. Soeters,Karl-Walter Jauch,M. Kemen,J. M. Hiesmayr,T. Horbach,E. R. Kuse,K. H. Vestweber +11 more
TL;DR: These guidelines are intended to give evidence-based recommendations for the use of ONS and TF in surgical patients and it is strongly recommended not to wait until severe undernutrition has developed, but to start EN therapy early, as soon as a nutritional risk becomes apparent.
References
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Journal ArticleDOI
Probiotics: effects on immunity
TL;DR: The data show that probiotics can be used as innovative tools to alleviate intestinal inflammation, normalize gut mucosal dysfunction, and down-regulate hypersensitivity reactions and suggest that specific immunomodulatory properties of probiotic bacteria should be characterized when developing clinical applications for extended target populations.
Journal ArticleDOI
Randomised trial of glutamine-enriched enteral nutrition on infectious morbidity in patients with multiple trauma
Alexander P. J. Houdijk,Emmy R Rijnsburger,Jaap Jansen,R. I. C. Wesdorp,Jeffery K Weiss,Mark Anthony Mccamish,Tom Teerlink,Stephan Gm Meuwissen,H. J. T. M. Haarman,Lambertus G. Thijs,Paul A. M. van Leeuwen +10 more
TL;DR: There was a low frequency of pneumonia, sepsis, and bacteraemia in patients with multiple trauma who received glutamine-supplemented enteral nutrition.
Journal Article
The gut: a central organ after surgical stress.
Douglas W. Wilmore,Robert J. Smith,S. T. O'Dwyer,Danny O. Jacobs,Thomas R. Ziegler,Xian-Dong Wang +5 more
TL;DR: It is anticipated that a combination of hormones and specific nutrients will provide optimal support of the gut mucosa in the severely ill patient and glutamine-containing parenteral feedings are associated with increased mucosal cellularity and improved survival after gut injury.
Journal ArticleDOI
Early enteral administration of a formula (Impact) supplemented with arginine, nucleotides, and fish oil in intensive care unit patients: results of a multicenter, prospective, randomized, clinical trial.
R. H. Bower,Frank B. Cerra,B. Bershadsky,Jerome J Licari,David B. Hoyt,Gordon L. Jensen,C. T. Van Buren,M. M. Rothkopf,John M. Daly,B. R. Adelsberg +9 more
TL;DR: Early enteral feeding of the experimental formula was safe and well tolerated in ICU patients and a substantial reduction in hospital length of stay was observed, along with a significant reduction in the frequency of acquired infections.
Journal Article
Enteral nutrition with supplemental arginine, RNA, and omega-3 fatty acids in patients after operation: immunologic, metabolic, and clinical outcome.
TL;DR: It is suggested that postoperative enteral nutrition with supplemental arginine, RNA, and omega-3 fatty acids instead of a standard enteral diet significantly improved immunologic, metabolic, and clinical outcomes in patients with upper gastrointestinal malignancies who were undergoing major elective surgery.
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