Annals of Clinical Nutrition and Metabolism

Nutritional Support and Wound Healing: Chi-Min Park; J Clin Nutr 2020;12(2):21-25. Published online December 31, 2020; DOI: https://doi.org/10.15747/jcn.2020.12.2.21

Abstract PDF: Wound healing is a coordinated process of sequential events consisting of four phases: hemostasis, inflammation, proliferation, and remodeling. Many factors can affect each phase of this process and have a harmful or beneficial effect on wound healing. Nutrition is closely associated with the wound healing process and is one of the major influencing factors on the outcomes of wound healing. Malnutrition and nutrient deficiencies could adversely affect wound healing and delay it. Many kinds of nutrients can enhance the healing process. Physicians should always assess every patient’s nutritional status to determine nutritional deficiencies. This will enable supplementation, thereby enhancing wound healing. Herein, we review the relationship between nutrition and wound healing, and the effects and mechanisms of each nutrient that is closely related to the wound healing process.

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Effect of Nutritional Intervention by the Nutrition Support Team on Postnatal Growth in Preterm Infants: So Jin Yoon, Joo Hee Lim, Soon Min Lee, Sun Jung Kim, Sun Kyung Lee, Soo Min Lee; J Clin Nutr 2020;12(2):26-33. Published online December 31, 2020; DOI: https://doi.org/10.15747/jcn.2020.12.2.26

Purpose: Nutritional intervention by an interdisciplinary nutrition support team (NST) can potentially improve postnatal growth outcomes in preterm infants. This study aimed to measure the growth impact of a nutritional intervention package performed by an NST in a quality improvement effort in a neonatal intensive care unit (NICU).
Methods: Fifty-two infants born below 2,000 g and admitted to NICU participated in the Quality Improvement (QI) program between March 2016 and February 2017. The nutritional intervention was applied according to newly established nutritional guidelines on parenteral and enteral nutrition, and an NST performed a weekly nutritional assessment. The Z-scores of weight, height, and head circumference were calculated according to the gestational age and sex. The clinical impact on postnatal growth was compared between the QI and pre-QI groups. The pre-QI group included 69 infants admitted in the same NICU between 2014 and 2015.
Results: The time to the initiation of enteral nutrition decreased significantly (P<0.001). Changes in weight (P=0.027), head circumference (P=0.003), Z-scores between birth, and 40 weeks postconceptional age (PCA) were significantly larger in the QI than the pre-QI group. The percentage of infants weighing below the 10th percentile at one month after birth and at 40 weeks PCA was higher in the pre-QI than the QI group.
Conclusion: The implementation of evidence-based best practices for preterm nutrition resulted in significant improvements in the growth outcomes in preterm infants.

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Nutrition Supply and Growth Post Nutrition Support Team Activity in Neonatal Intensive Care Unit
Hye Min Ha, Yu Jin Jung, Yoo Rha Hong, So Yoon Choi
Pediatric Gastroenterology, Hepatology & Nutrition.2024; 27(5): 313. CrossRef

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Characteristics and Practice of Parenteral Nutrition in Hospitalized Adult Cancer Patients in Korea: Hyo Jung Park, You Min Sohn, Jee Eun Chung, Jung Tae Kim, Jin A Yang, Hye Jung Bae, Ye Won Sung, Sun Hwa Kim,Ji Yoon Cho, Kyung Mi Jung, Hee Kyung Bae; J Clin Nutr 2020;12(2):34-40. Published online December 31, 2020; DOI: https://doi.org/10.15747/jcn.2020.12.2.34

Abstract PDF: Purpose: There have been no clinical studies on the characteristics of parenteral nutrition (PN) for adult cancer inpatients in South Korea. The published evidence describing modern PN practices in these patients is also extremely limited. Therefore in this retrospective multicenter cross-sectional study, we aimed to investigate the PN support practice in hospitalized adult cancer patients.
Methods: The study included adult cancer patients hospitalized in nine hospitals in South Korea and received PN, during the period from August 1st, 2017 to October 30th, 2017. We evaluated the relevant hospital-based PN practices in this group.
Results: Among the 11,580 inpatient admissions during this period, 759 cancer patients received PN (6.6%). The majority of enrolled patients (97.2%) used commercially available PN and 71.2% of these used peripheral PN formulations. The average in-hospital PN duration was 16.1±19.9 days. Patients received only 65.4±25.4% calories of the recommended target calories. The in-hospital mortality of enrolled patients was 26.1%.
Conclusion: We conclude that commercial PN is the most common form of PN administered to hospitalized adult cancer patients and the overall in-hospital mortality in the patients using PN is higher in South Korea compared to other countries.

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Comparison of Energy Requirements of Patients with Brain Injury of the Intensive Care Unit: Indirect Calorimetry vs. Predictive Equations: EunJoo Bae, SeongSuk Kang, MiYeon Kim, JinYoung Jang, HyunJung Lim, TaeGon Kim; J Clin Nutr 2020;12(2):41-47. Published online December 31, 2020; DOI: https://doi.org/10.15747/jcn.2020.12.2.41

Abstract PDF: Purpose: The metabolic activity and demand usually increase in seriously ill patients, especially in patients with a brain injury (BI). These nutritional demands have been traditionally satisfied using predictive equations (PEs). Recently, indirect calorimetry (IC) has been used widely because it is more accurate than other methods. This study measured the energy expenditures (EE) using IC (GE, CARESCAPE B650, Helsinki, Finland) and calculated the PEs simultaneously in patients with BI.
Methods: This study was conducted on 55 patients with a BI for three years (2017.7∼2020.8), who were mechanically ventilated within a hospital for ≤seven days. The EE values using IC were measured once in each patient, and the EE values using PE were calculated using 5 PEs (ESPEN, Harris-Benedict, HB; Frankenfield, FK; Penn state, PS; and Faisy) at the same time. The 55 patients were divided into two groups, acute group (39 patients; ≤3 hospital days group, AG) and subacute group (16 patients; >3 hospital days group, SG) according to the time, and the values were obtained.
Results: There were no differences in the patient’s characteristics between the two groups, including age, gender, severity of the condition (Simplified Acute Physiology Score II), and anthropometric parameters. In AG, the energy expenditure values using PEs were significantly lower than those using IC in the three PEs (IC 1,712.0±476 kcal, ESPEN 1,558.6±324 kcal, P=0.038, HB 1,582.4±273 kcal, P=0.037, PS 1,530.8±340 kcal, P=0.005). In SG, the EE value using PEs did not differ significantly from that using IC.
Conclusion: An accurate assessment of EE is critical for seriously ill patients. These results showed that the previously well-known PEs might not be correct, particularly in acute patients with BI. Therefore, it is recommended that the EE values be obtained using IC, at least in acute patients with BI.

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