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Clinical nutrition
About: Clinical nutrition is a research topic. Over the lifetime, 2762 publications have been published within this topic receiving 66901 citations. The topic is also known as: nutrology.
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TL;DR: Malnutrition remains a largely unrecognised problem in hospital and highlights the need for education on clinical nutrition in different clinical units.
Abstract: Objectives : To determine incidence of malnutrition among patients on admission to hospital, to monitor their changes in nutritional status during stay, and to determine awareness of nutrition in different clinical units. Design : Prospective study of consecutive admissions. Setting : Acute teaching hospital. Subjects : 500 patients admitted to hospital: 100 each from general surgery, general medicine, respiratory medicine, orthopaedic surgery, and medicine for the elderly. Main outcome measures: Nutritional status of patients on admission and reassessment on discharge, review of case notes for information about nutritional status. Results : On admission, 200 of the 500 patients were undernourished (body mass index less than 20) and 34% were overweight (body mass index >25). The 112 patients reassessed on discharge had mean weight loss of 5.4% with greatest weight loss in those initially most undernourished. But the 10 patients referred for nutritional support showed mean weight gain of 7.9%. Review of case notes revealed that, of the 200 undernourished patients, only 96 had any nutritional information documented. Conclusion : Malnutrition remains a largely unrecognised problem in hospital and highlights the need for education on clinical nutrition.
1,480 citations
Uppsala University1, University of Trieste2, University of Oxford3, University Hospital Southampton NHS Foundation Trust4, Winterthur Museum, Garden and Library5, University of Hohenheim6, University of Pennsylvania7, Universidade Federal de Minas Gerais8, Fujita Health University9, Aalborg University10, University of Vermont11, Mount Carmel Health12, Sapienza University of Rome13, Kristianstad University College14, Medical University of Vienna15, University of Nice Sophia Antipolis16, VU University Medical Center17, HAN University of Applied Sciences18, University of Erlangen-Nuremberg19, Peking Union Medical College20, Université libre de Bruxelles21, Rabin Medical Center22
TL;DR: An agreement of basic nutritional terminology to be used in clinical practice, research, and the ESPEN guideline developments has been established and may help to support future global consensus efforts and updates of classification systems such as the International Classification of Disease.
1,294 citations
TL;DR: These Guidelines for Paediatric Parenteral Nutrition have been developed as a mutual project of the European Society for paediatric Gastroenterology, Hepatology and Nutrition and the European society for Clinical Nutrition and Metabolism.
Abstract: BACKGROUNDThese Guidelines for Paediatric Parenteral Nutrition have been developed as a mutual project of the European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN; www.espghan.org) and the European Society for Clinical Nutrition and Metabolism (ESPEN; www.espen.org). T
1,281 citations
TL;DR: Late initiation of parenteral nutrition was associated with faster recovery and fewer complications, as compared with early initiation.
Abstract: A b s t r ac t Background Controversy exists about the timing of the initiation of parenteral nutrition in critically ill adults in whom caloric targets cannot be met by enteral nutrition alone. Methods In this randomized, multicenter trial, we compared early initiation of parenteral nutrition (European guidelines) with late initiation (American and Canadian guidelines) in adults in the intensive care unit (ICU) to supplement insufficient enteral nutrition. In 2312 patients, parenteral nutrition was initiated within 48 hours after ICU admission (early-initiation group), whereas in 2328 patients, parenteral nutrition was not initiated before day 8 (late-initiation group). A protocol for the early initiation of enteral nutrition was applied to both groups, and insulin was infused to achieve normoglycemia. Results Patients in the late-initiation group had a relative increase of 6.3% in the likelihood of being discharged alive earlier from the ICU (hazard ratio, 1.06; 95% confidence interval [CI], 1.00 to 1.13; P = 0.04) and from the hospital (hazard ratio, 1.06; 95% CI, 1.00 to 1.13; P = 0.04), without evidence of decreased functional status at hospital discharge. Rates of death in the ICU and in the hospital and rates of survival at 90 days were similar in the two groups. Patients in the late-initiation group, as compared with the early-initiation group, had fewer ICU infections (22.8% vs. 26.2%, P = 0.008) and a lower incidence of cholestasis (P<0.001). The late-initiation group had a relative reduction of 9.7% in the proportion of patients requiring more than 2 days of mechanical ventilation (P = 0.006), a median reduction of 3 days in the duration of renalreplacement therapy (P = 0.008), and a mean reduction in health care costs of €1,110 (about $1,600) (P = 0.04). Conclusions Late initiation of parenteral nutrition was associated with faster recovery and fewer complications, as compared with early initiation. (Funded by the Methusalem program of the Flemish government and others; EPaNIC ClinicalTrials.gov number, NCT00512122.)
1,151 citations
Klinikum St. Georg1, Vita-Salute San Raffaele University2, Montreal General Hospital3, Fujita Health University4, University Hospital of Lausanne5, Memorial Hospital of South Bend6, Sapienza University of Rome7, Örebro University8, National Institute for Health Research9, Oregon Health & Science University10, University of São Paulo11, University of Hohenheim12, Rabin Medical Center13
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.
1,096 citations