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Nutritional Support

Nutritional Support: A comprehensive approach to providing essential nutrients and energy to individuals with compromised nutritional status.
This may include enteral or parenteral feeding, dietary modifications, and the use of specialized supplements or formulas.
Nutritional support aims to prevent or treat malnutrition, promote wound healing, and support overall health and recovery.
Effective nutritional support requires careful assessment of an individual's needs and the selection of appropriate interventions to optimize clinical outcomes.

Most cited protocols related to «Nutritional Support»

1
Pediatric CRRT and Fluid Overload Assessment
Cited 10 times
Data collection included demographic data, comorbidity data, laboratory data, indication for CRRT defined by the pediatric nephrology note, and characteristics of each subject’s hospital and ICU course (e.g., length of stay, requirement for vasoactive agents, requirement for mechanical ventilation, etc.). Pediatric Risk of Mortality (PRISM) III scores were calculated at ICU admission [27 (link)].
AKI was classified by the RIFLE and pRIFLE criteria based on serum creatinine, estimated creatinine clearance (eCCl), and urine output in the 24 h prior to initiation of CRRT [28 (link)] [29 (link)]. The pRIFLE was modified slightly to exclude the “failure” component of eCCl < 35 ml/min/1.73 m2 for children ≤14 days. Estimated glomerular filtration rate (GFR) was calculated using the Schwartz equation in patients <18 years old [30 (link)] and the Modification of Diet in Renal Disease (MDRD) formula in patients >18 years old [31 (link)].
For fluid status determination we recorded weight upon hospital admission, weight at ICU admission, weight upon CRRT initiation, fluid intake from ICU admission until CRRT initiation, and fluid output from ICU admission until CRRT initiation. It is standard of care at our institution to weigh patients on ECLS daily. Fluid intake included blood products, intravenous fluids and flushes, medications, and all forms of nutritional support. Fluid output included urine output, drain output, blood loss, nasogastric tube output, stool volume, and wound drainage. For each patient, the daily flow charts were reviewed and 24 h totals of fluid intake and output were recorded for each patient for every day on the intensive care unit prior to CRRT initiation. These daily totals were then used to calculate the degree of fluid overload as described by Goldstein et al. [16 (link)]:
Method 1:%FO=Sum of daily(fluid in − fluid out)ICU admission weight×100.
This method was then compared with two weight-based formulas. These formulas calculated fluid overload based upon ICU admission weight and hospital admission weight:
Method 2:%FO=CRRT initiation weight − ICU admission weightICU admission weight×100,
Method 3:%FO=CRRT initiation weight − Hospital admission weightHospital admission weight×100.
The primary outcome was all-cause ICU mortality.
Selewski D.T., Cornell T.T., Lombel R.M., Blatt N.B., Han Y.Y., Mottes T., Kommareddi M., Kershaw D.B., Shanley T.P, & Heung M. (2011). Weight-based determination of fluid overload status and mortality in pediatric intensive care unit patients requiring continuous renal replacement therapy. Intensive Care Medicine, 37(7), 1166-1173.
Publication 2011
BLOOD Child Creatinine Day Care, Medical Diet, Formula Dietary Modification Drainage Feces Flushing Glomerular Filtration Rate Hemorrhage Kidney Diseases Mechanical Ventilation Nutritional Support Patients Pharmaceutical Preparations Serum Urine Wounds
2
Technique for Endoscopic Tube Placement
Cited 8 times
Patients underwent the procedure under anesthesia. All patients need this mid-gut tube for frequent fecal microbiota transplantation and/or enteral nutrition support. Two to three mL of liquid paraffin oil (medical use level) was injected into TET tube and then the matched guide wire was inserted into the tube (FMT-DT-N-27/1350, FMT Medical, Nanjing, China). Then the tube was coated with paraffin oil by medical gauze and was inserted into the esophagus through nasal orifice under gastroscopic vision in oral cavity (Fig. 1a, b). The endoscope was then synchronously advanced to the stomach following the tube. The tube should be advanced into the distal duodenum with or without assistant of grasping forceps. As shown in Additional file 1: Video 1, the tube was fixed on the pylorus wall by one titanium clip (Fig. 1c) when the targeting circle (25 cm or 20 cm to the distal tip of the tube) for fixation was located at the pylorus. The endoscopy assistant must hold the tube for avoiding any migration while the endoscope is being slowly withdrawn. After the fixation, the guide-wire should be pulled out partially until the tip of the guide wire within the tube was pulled into the stomach (almost 25–30 cm), which could be confirmed under endoscopic vision. The endoscope should be inserted into duodenum for confirming no buckling changes of the soft tube within the intestinal cavity. The endoscope could be taken out of the body with the stable controlling of the tube from the assistant. The guide wire was required to be taken out of the tube slowly after the endoscope was out of mouth. Finally, the medical tape was used to fix the tube on nose. According to our pilot study, the 100% (total 10 cases) of the distal tube could arrive at the target location (jejunum or distal duodenum) during the development of this device and technique. Therefore, there was no necessary to confirm the location of the distal tip of the tube under fluoroscopy (Fig. 1d). The endoscopic procedure was well-shown from the (Additional file 1: Video 1).

Concept and procedure of administration through mid-gut tubing. a The concept of administration through mid-gut tubing; b The endoscopic view at mouth cavity when the soft tube tip from nasal cavity was inserted into hypopharynx close to esophagus; c One tiny endoscopic clip was used for fixation of the tube at gastric antrum before the guide wire within the tube was removed out; d The location of mid-gut tube could be confirmed by X-Ray and contrast agent, but is not necessary using this TET technique and device

The endoscopic procedure was well-shown from the video 1. (AVI 18990 kb)

The primary aim of the study was rate of success on the tubing procedure. The secondary aim was rate of adverse events. The end point was 1 month after procedure. The duration of the procedure from nasal intubation to fixation of the titanium clip on the gastric wall was recorded as tubing time. Two endoscopists with different training experience performed the endoscopic procedures in this study. One endoscopist was at advanced level and another one was an endoscopist at general level who had finished about 300 case of endoscopy. In order to evaluate the difficulty of training for TET. The mean time of procedure were compared between and within the two endoscopists. After the fixation, further scanning of the stomach and esophagus or possible biopsy could be performed, but the time was not included. Procedure-related and tube-related adverse events, patient-reported discomfort and satisfaction on TET placement were also recorded. The grade of satisfaction was clarified as yes or no.
Long C., Yu Y., Cui B., Jagessar S.A., Zhang J., Ji G., Huang G, & Zhang F. (2018). A novel quick transendoscopic enteral tubing in mid-gut: technique and training with video. BMC Gastroenterology, 18, 37.
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Publication 2018
Anesthesia Biopsy Clip Contrast Media Dental Caries Duodenum Endoscopes Endoscopy Esophagus Fluoroscopy Forceps Gastroscopy Human Body Hypopharynx Intestines Intestines, Small Intubation Jejunum Medical Devices Nasal Cavity Nose Nutritional Support Oral Cavity paraffin oils Patients Pyloric Antrum Pylorus Radiography Satisfaction Stomach Surgical Endoscopy Titanium Vision
3
Glycemic Control in ICU Patients
Cited 8 times
The BG target range during the study period was 90 to 120 mg/dl for all patients admitted to the ICU, a modest upward revision of the target range shown to improve mortality and morbidity of populations of critically ill patients in previously published interventional trials [5 (link),6 (link)] (Additional file 1). This target was chosen explicitly to maximize the percentage of values within a broader 70 to 140 mg/dl range, a range that the ICU nurses felt that they could achieve. We chose this range because (1) <70 mg/dl is a widely used definition of hypoglycemia and (2) ≥140 mg/dl is a widely accepted threshold for hyperglycemia. Nurses performed BG monitoring using ACCU-CHEK Inform II glucose meters (Roche Diagnostics, Indianapolis, IN, USA) to test capillary, venous or arterial blood. Monitoring guidelines precluded use of capillary blood in the setting of shock or marked peripheral edema. The measurement frequency was every 3 hours at a minimum for all patients. Sustained hyperglycemia—two consecutive BG readings ≥180 mg/dl—triggered the institution of continuous intravenous regular insulin infusion and hourly BG measurement. The nurses treated lesser degrees of hyperglycemia with subcutaneous insulin aspart at an interval of every 3 hours. It is the standard of care in the ICU to initiate nutritional support in the first 24 to 48 hours of admission. Patients requiring more than 10 U/day of insulin who were receiving a continuous source of calories were typically administered insulin glargine to supply a portion of their daily insulin requirement. The typical starting dose of insulin glargine was one-third to one-half of the previous 24-hour insulin requirement.
Krinsley J.S, & Preiser J.C. (2015). Time in blood glucose range 70 to 140 mg/dl >80% is strongly associated with increased survival in non-diabetic critically ill adults. Critical Care, 19(1), 179.
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Publication 2015
Arteries Capillaries Critical Illness Diagnosis Edema Feelings Glucose Hyperglycemia Hypoglycemia Insulin Insulin Aspart Insulin Glargine Intravenous Infusion Nurses Nutritional Support Patients Population Group Shock Veins
4
Comprehensive Costs of HIV Care and Treatment
Cited 5 times
For the purpose of this study, care and treatment were defined as the full range of facility-level, HIV-related medical services provided to the patient from the time the patient is enrolled on ART. Specifically, this included the costs of antiretroviral medications (ARVs), opportunistic infection medications (OIs), laboratory costs, nutritional support, direct and indirect personnel, facility-level training, equipment, clinical and non-clinical supplies, building maintenance and other administrative support costs. Equipment, building and supply costs were amortized. The costs of adherence and other support programs were captured where they were incurred at the facility (e.g., community health workers were paid through the facility). Treatment-related costs incurred outside of primary facilities, such as lab costs at tertiary facilities associated with diagnosis of opportunistic infections or patient monitoring, were also included.
However, HIV testing before ART initiation and treatment-related costs outside of the facility were not captured. For example, medical care (e.g., inpatient care) delivered at referral sites would have required patient-level or cohort analysis. Laboratory sample transport and supply chain costs, which were not accounted for in commodity pricing, were excluded. The study did not capture the cost of supervision or other associated managerial and support for facilities implemented above the facility-level by the government, donors or implementing partners. Non-medical interventions such as outreach, income-generating activities and interventions for orphans and vulnerable children were also excluded.
Data sources included retrospective program records such as patient registers, account ledgers, pharmacy stock cards and other facility documentation. Once cost data was collected for the facility, the unit cost per patient-year was derived through the allocation described below:
This “top-down” allocation was replaced with a “bottom-up” or normative calculation of ARV costs where there were severe data limitations. ARV costs were generally measured by calculating facility consumption from initial and final stock on pharmacy stock cards, and then allocating total consumption to different patient types as described above. However, where stock card data was considered unreliable or of poor quality, the final ARV cost ppy was calculated using the site's regimen mix and a normative cost per patient-year by regimen. Therefore the facility-level expenditure after stock-outs and product expiry was not captured consistently.
Local currency was converted to US dollars using the average conversion rate during the survey period. Nominal costs for each cost data year are presented here.
Tagar E., Sundaram M., Condliffe K., Matatiyo B., Chimbwandira F., Chilima B., Mwanamanga R., Moyo C., Chitah B.M., Nyemazi J.P., Assefa Y., Pillay Y., Mayer S., Shear L., Dain M., Hurley R., Kumar R., McCarthy T., Batra P., Gwinnell D., Diamond S, & Over M. (2014). Multi-Country Analysis of Treatment Costs for HIV/AIDS (MATCH): Facility-Level ART Unit Cost Analysis in Ethiopia, Malawi, Rwanda, South Africa and Zambia. PLoS ONE, 9(11), e108304.
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Publication 2014
Child Community Health Workers Diagnosis Donors Hospitalization Nutritional Support Opportunistic Infections Orphaned Children Patients Pharmaceutical Preparations Supervision Treatment Protocols
5
Undernutrition and Feeding Practices in HIV-Positive Children
Cited 5 times
We employed a mixed method design for this study. First, we conducted a cross-sectional quantitative study to examine the magnitude and determinants of undernutrition and poor feeding practices among HIV-positive children in Tanga, Tanzania. Results of this study guided a qualitative study. Through seven focus group discussions (FGDs), we explored possible explanations of the findings and the key associations between various determinants and undernutrition among HIV-positive children. Finally, we triangulated results from both methods to help explain the causal relations of the associations between feeding practices and nutrition statuses among HIV-positive children in this food rich region. This study seeks to contribute to the operational research [29] (link), aiming to improve feeding practices and thus nutritional status of such vulnerable children.
In the Tanga region, a vast diversity of food is available and grown. It is the leading region in fruit and vegetable production in the country and supplies other regions with cereal, fruits, marine, and diary products. The presence of such quantity and diversity of foods is not correlated with consumption and nutrition statuses. Only 59.4% of 292 sampled under-five children in Tanga consumed foods rich in Vitamin A [19] . Tanga has the worst nutrition outcomes in the country despite the foods available. For example, stunting prevalence was the highest in the country with about 49% of 315 under-five sampled children, 12% were underweight, and 5.5% had wasting. Poor feeding practices could also be behind poor micronutrient markers among children. In the same population, 38.9% of children had Vitamin A deficiency, 36.5% had iron deficiency, and 52.2% had iron deficiency anemia [19] .
A total of 20,773 people living with HIV/AIDS were enrolled in care and treatment centers (CTCs) in the Tanga region in 2009. Although the magnitude of HIV/AIDS among children has not been reported for Tanga, about 1,800 HIV-positive children have been enrolled in the CTCs for care and treatment. The current study was a hospital-based study and conducted among participants who were attending CTCs in the region. We described the CTCs' organization and distribution in a separate article [29] (link).
After obtaining confirmatory test results using the standard algorithm [30] , HIV-positive children are usually enrolled in the CTCs to receive care. Such care includes treatment with Highly Active Antiretroviral Therapy (HAART), follow up, adherence counseling, and treatment of other associated opportunistic infections [30] . They are also supposed to receive nutrition care and monitoring. However, during this study period, no specific nutrition intervention was carried out targeting HIV-positive children attending these CTCs. Health workers attending these children also were not equipped with any inservice nutrition training to improve their management skills, and the new WHO Guidelines for an integrated approach to the nutritional care of HIV-infected children (6 months – 14 years)[22] had not yet been locally adapted.
Sunguya B.F., Poudel K.C., Mlunde L.B., Urassa D.P., Yasuoka J, & Jimba M. (2014). Poor Nutrition Status and Associated Feeding Practices among HIV-Positive Children in a Food Secure Region in Tanzania: A Call for Tailored Nutrition Training. PLoS ONE, 9(5), e98308.
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Publication 2014
Acquired Immunodeficiency Syndrome Antiretroviral Therapy, Highly Active Cereals Child Child Malnutrition Child Nutritional Physiological Phenomena Deficiency, Iron Dietary Modification Food Fruit Health Personnel Iron Deficiency Anemia Malnutrition Marines Micronutrients Nutritional Support Opportunistic Infections Vegetables Vitamin A Vitamin A Deficiency

Most recents protocols related to «Nutritional Support»

1
RCT on Optimized Nutrition in Allo-HSCT
One hundred and seventeen patients (intervention n=57, control n=60) were included in this RCT conducted at the Department of Haematology, Oslo University Hospital from August 2010 to February 2017. The aims of the RCT were to assess the impact of optimized energy and protein intake compared to routine hospital nutrition support on global QoL and clinical outcomes three months after allo-HSCT. A detailed description of the RCT and main clinical outcomes have been reported previously and showed no significant differences among the two study groups on any of the QoL-C30 scales or items [17 (link)].
Gudmundstuen A.M., Efficace F., Tjønnfjord G.E., Skaarud K.J., Cottone F., Hjermstad M.J, & Iversen P.O. (2023). The prognostic value of patient-reported outcomes in allogeneic hematopoietic stem cell transplantation: exploratory analysis of a randomized nutrition intervention trial. Annals of Hematology, 102(4), 927-935.
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Publication 2023
Nutritional Support Patients Proteins
2
Carbapenem-Resistant E. coli Infections
Three carbapenem-resistant E. coli strains (blaNDM positive) were isolated from the urine samples of a 62-year-old female patient with unilateral indwelling ureteral stents. The patient underwent cystectomy and chemotherapy for recurrence of ovarian and fallopian cancer three months ago. The first E. coli strain (JNQH497-NDM-37) was recovered in an outpatient clinic. Based on the antibiotic susceptibility testing results, empirical levofloxacin treatment (500 mg qd) was then started for urinary tract infection. After 3 weeks, the second strain (JNQH498-NDM-36) was isolated from the urine during hospital admission. The patient was then given meropenem (1000 mg intravenously [i.v.] q8h). The third E. coli strain (JNQH462-NDM-36) was identified from the urine 5 weeks after admission. Her conditions were improved after the removal of ureteral stents via cystoscopy, continuous meropenem treatment as well as implementation of nutritional support. The patient was discharged home on hospital day 16. Ethics committee approval of this study was obtained from the institutional review board of the First Affiliated Hospital of Xiamen University, and informed consent from the patient was also obtained.
Ma W., Zhu B., Wang W., Wang Q., Cui X., Wang Y., Dong X., Li X., Ma J., Cheng F., Shi X., Chen L., Niu S, & Hao M. (2023). Genetic and enzymatic characterization of two novel blaNDM-36, -37 variants in Escherichia coli strains. European Journal of Clinical Microbiology & Infectious Diseases, 42(4), 471-480.
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Publication 2023
Antibiotics Carbapenems Cystectomy Cystoscopy Escherichia coli Ethics Committees Ethics Committees, Research Levofloxacin Malignant Neoplasms Meropenem Nutritional Support Ovary Patients Pharmacotherapy Recurrence Stents Strains Susceptibility, Disease Ureter Urinary Tract Infection Urine Woman
3
Depression Treatment Preferences Among Pregnant Adolescents
Eight attributes that consisted of treatment benefits were selected. The first one was on Information delivery (two levels- Health facility, individualized) where we asked participants if they would like information on how to use services in the facility around SRHR and MCH that could assist with depression management and the second level focused on provision of individualized information sheets on general care including nutritional care for mother and baby. The second option focused on Additional Participants (Co-participate with Caregivers, provide information sheets for care-givers) included asking if adolescents would like group sessions with their caregivers including partners vs information sheet on depression care for their partners. The third choice was around Treatment duration option (4 sessions for 1.5 hours, 8 sessions for 1.5 hours) for the entire depression treatment. The fifth choice was around Intervention delivery agents (whether CHV, or Facility nurses) probing if the therapy for depression should be delivered by lay workers or facility -based nurses. We also included an attribute around additional training support (exploring links to vocational training vs more formalized learning needs (i.e. back to school) were tested. We also had a choice task around further support needs so we asked whether greater peer support or parenting skills support were preferred). The seventh choice in terms of rethinking the health services (Adolescent friendly services, combined with older mothers) the choice given was between using and strengthening adolescent friendly services or using the routine MCH services and be serviced along with older adult mothers and finally in order to address the challenges that Incentives for improving health care uptake choices were offered between (transport allowance, refreshment provision, or a choice for provision of both).
For this analysis we applied dummy coding where the baseline attribute category for each attribute is omitted from estimations, and used as a reference category. The reference categories applied in this study are indicated in Table 1 as reference.
The design was pilot-tested with a selection of the pregnant adolescents who had been participated in the qualitative interviews to refine the survey and to assess the salience of the attributes to the treatment decision. Participants completed DCE questionnaires and participated in a personal cognitive interview as part of the pilot testing. To determine the burden on participants, the number of completed items and the time it took to complete them were recorded. Personal cognitive interviews were utilized to assess participants’ knowledge of the questionnaire’s levels and face validity. The final set of attributes and levels are presented in Table 1.
We tested multiple-choice elicitation formats and chose to use full-profile tasks between two treatment profiles in which participants indicated which treatment they would prefer to take. This setup allowed for the elicitation of acceptable tradeoffs people were willing to make between different treatment attributes. If the number of attributes is low enough that participants can reasonably complete a full-profile task, this maximizes information about trade-offs [38 (link)]. We allowed the participants to select an opt-out option. An example choice task with decision scenario is shown in Fig 2.
Kumar M., Tele A., Kathono J., Nyongesa V., Yator O., Mwaniga S., Huang K.Y., McKay M., Lai J., Levy M., Cuijpers P., Quaife M, & Unutzer J. (2023). Understanding depression treatment and perinatal service preferences of Kenyan pregnant adolescents: A discrete choice experiment. PLOS ONE, 18(3), e0273274.
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Publication 2023
Adolescent Aged Cognition Infant Mothers Nurses Nutritional Support Obstetric Delivery Training Support Workers
4
iPSC Differentiation into Dopaminergic Neurons
Seven different iPSCs, two different clones of two healthy controls (CONTROL 1 and CONTROL 2), two clones of THDA (THDA1#5 and THDA1#17), two clones of THDB (THDB1#1 and THDB1#15), and one isogenic (isoTHDA1#17), were differentiated into dopaminergic neurons using a 30‐day protocol based on DAn patterning factors and co‐culture with mouse PA6 feeding cells to provide trophic factor support, with minor modifications (Sánchez‐Danés et al, 2012 (link)). Specifically, iPSCs were cultured in mTeSR commercial medium until they reached 80% confluence and then mechanically aggregated to form embryoid bodies (EBs), without using lentiviral vectors to express LMX1A transcriptional factor. EBs were cultured for 10 days in suspension in N2B27 medium, consisting of DMEM/F12 medium (GIBCO), neurobasal medium (GIBCO), 0.5× B27 supplement (GIBCO), 0.5× N2 supplement (GIBCO), 2 mM ultraglutamine (Lonza) and penicillin–streptomycin (Lonza). In this step, N2B27 was supplemented with SHH (100 ng/ml, Peprotech), FGF‐8 (100 ng/ml, Peprotech), and bFGF (10 ng/ml; Peprotech). Neural progenitor cells (NPCs) were then seeded on top of PA6 for 21 days in N2B27 medium, as described (Sánchez‐Danés et al, 2012 (link)). Studied cultures were fixed with PFA 4% and characterized for dopaminergic specificity and for cell morphology.
Tristán‐Noguero A., Fernández‐Carasa I., Calatayud C., Bermejo‐Casadesús C., Pons‐Espinal M., Colini Baldeschi A., Campa L., Artigas F., Bortolozzi A., Domingo‐Jiménez R., Ibáñez S., Pineda M., Artuch R., Raya Á., García‐Cazorla À, & Consiglio A. (2023). iPSC‐based modeling of THD recapitulates disease phenotypes and reveals neuronal malformation. EMBO Molecular Medicine, 15(3), e15847.
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Publication 2023
Cell Culture Techniques Clone Cells Cloning Vectors Dopaminergic Neurons Embryoid Bodies FGF8 protein, human Hydrochloride, Dopamine Induced Pluripotent Stem Cells Mus Neural Stem Cells Nutritional Support Penicillins Streptomycin Transcription Factor
5
Nutritional Impacts on Geriatric Patients
The target hospital was a small-scale (48-bed) hospital providing care-mix medical care in Nada Ward, Kobe, Hyogo.
The subjects were 36 geriatric patients (81.7 ± 7.7 years; 20 males and 16 females) admitted to the target hospital between January 1, 2017 and December 31, 2020, suffering from chronic diseases, receiving only oral nutritional support, and whose meal intake information 1 month after hospitalization as well as blood test findings at admission and discharge were available. All of the subjects had chronic diseases such as diabetes and hypertension, but they were treated in an acute hospital and their medical conditions were stable at the time of this study.
No double-counting transpired. However, we excluded those who had severe restrictions on protein intake (≤ 45 g/ day).
Fukuda Y., Ochi M., Kanazawa R., Nakajima H., Fukuo K, & Nakai M. (2023). Positive Correlation Between Changes in Serum Albumin Levels and Breakfast Non-Protein Calorie/Nitrogen Ratio in Geriatric Patients. Journal of Clinical Medicine Research, 15(2), 109-115.
Publication 2023
Diabetes Mellitus Disease, Chronic Females Hematologic Tests High Blood Pressures Hospitalization Males Nutritional Support Patient Discharge Patients Proteins

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