Annals of Clinical Nutrition and Metabolism

Original Articles

Physiological Change of Serum Bilirubin Level by ω-3 Enriched Parenteral Nutrition Versus ω-3 Free Parenteral Nutrition in Healthy Male Subjects: Mi Rin Lee, Min-Gul Kim, Jae Do Yang, Hong Pil Hwang, Yunjeong Kim, Ji-Young Jeon, Sungwoo Ahn, Hee Chul Yu; Surg Metab Nutr 2019;10(1):20-26. Published online June 30, 2019; DOI: https://doi.org/10.18858/smn.2019.10.1.20

Abstract PDF ePub: Purpose:

Bilirubin is a biomarker for the diagnosis of liver diseases or bile duct dysfunction. This study assessed the physiological changes in the blood bilirubin level infusing ω-3 enriched parenteral nutrition (PN) and ω-3 free PN in healthy male subjects.

Materials and Methods:

This study was a randomized, open-label, two-treatment, two-way crossover trial. Sixteen subjects were assigned randomly to one of two sequences of the two treatments: ω-3 enriched PN or ω-3 free PN was infused via aperipheral venous catheter for six hours at 3 mL/kg/h. Blood samples were collected every one hour from 0 to 12 hours after starting an intravenous infusion for bilirubin concentrations. The total bilirubin and direct bilirubin concentrations in the blood were analyzed using an enzymatic method.

Results:

The bilirubin concentration in the blood was reduced while infusing the ω-3 enriched PN and ω-3 free PN. When it stopped infusing, the bilirubin concentration was recovered. A similar pattern was observed, but there was a further decline and recovery in ω-3 free PN.

Conclusion:

When ω-3 enriched PN and ω-3 free PN are infused in healthy male subjects, the blood bilirubin level decreasedand there is no difference between the two groups.

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Nutritional Therapy Related Complications in Hospitalized Adult Patients: A Korean Multicenter Trial: Eun-Mi Seol, Kye Sook Kwon, Jeong Goo Kim, Jung-Tae Kim, Jihoon Kim, Sun-Mi Moon, Do Joong Park, Jung Hyun Park, Je Hoon Park, Ji Young Park, Jung-Min Bae, Seung Wan Ryu, Ji-Young Sul, Dong Woo Shin, Cheung Soo Shin, Byung Kyu Ahn, Soo Min Ahn, Hee Chul Yu, Gil Jae Lee, Sanghoon Lee, A Ran Lee, Jae Young Jang, Hyun Jeong Jeon, Sung Min Jung, Sung-Sik Han, Suk-Kyung Hong, Sun-Hwi Hwang, Yunhee Choi, Hyuk-Joon Lee; J Clin Nutr 2019;11(1):12-22. Published online June 30, 2019; DOI: https://doi.org/10.15747/jcn.2019.11.1.12

Purpose:

Nutritional therapy (NT), such as enteral nutrition (EN) or parenteral nutrition (PN), is essential for the malnourished patients. Although the complications related to NT has been well described, multicenter data on symptoms in the patients with receiving NT during hospitalization are still lacking.

Methods:

Nutrition support team (NST) consultations, on which NT-related complications were described, were collected retrospectively for one year. The inclusion criteria were patients who were (1) older than 18 years, (2) hospitalized, and (3) receiving EN or PN at the time of NST consultation. The patients’ demographics (age, sex, body mass index [BMI]), type of NT and type of complication were collected. To compare the severity of each complication, the intensive care unit (ICU) admission, hospital stay, and type of discharge were also collected.

Results:

A total of 14,600 NT-related complications were collected from 13,418 cases from 27 hospitals in Korea. The mean age and BMI were 65.4 years and 21.8 kg/m². The complications according to the type of NT, calorie deficiency (32.4%, n=1,229) and diarrhea (21.6%, n=820) were most common in EN. Similarly, calorie deficiency (56.8%, n=4,030) and GI problem except for diarrhea (8.6%, n=611) were most common in PN. Regarding the clinical outcomes, 18.7% (n=2,158) finally expired, 58.1% (n=7,027) were admitted to ICU, and the mean hospital days after NT-related complication were 31.3 days. Volume overload (odds ratio [OR]=3.48) and renal abnormality (OR=2.50) were closely associated with hospital death; hyperammonemia (OR=3.09) and renal abnormality (OR=2.77) were associated with ICU admission; “micronutrient and vitamin deficiency” (geometric mean [GM]=2.23) and volume overload (GM=1.61) were associated with a longer hospital stay.

Conclusion:

NT may induce or be associated with several complications, and some of them may seriously affect the patient’s outcome. NST personnel in each hospital should be aware of each problem during nutritional support.

Citations

Citations to this article as recorded by

Provision of Enteral Nutrition in the Surgical Intensive Care Unit: A Multicenter Prospective Observational Study
Chan-Hee Park, Hak-Jae Lee, Suk-Kyung Hong, Yang-Hee Jun, Jeong-Woo Lee, Nak-Jun Choi, Kyu-Hyouck Kyoung
Annals of Clinical Nutrition and Metabolism.2022; 14(2): 66. CrossRef
Pathophysiology and protective approaches of gut injury in critical illness
Chang Yeon Jung, Jung Min Bae
Yeungnam University Journal of Medicine.2021; 38(1): 27. CrossRef
Nutrition Support Team Reconsultation During Nutrition Therapy in Korea
Eun‐Mi Seol, Yun‐Suhk Suh, Dal Lae Ju, Hye Jung Bae, Eunjung Kim, Hyuk‐Joon Lee
Journal of Parenteral and Enteral Nutrition.2021; 45(2): 357. CrossRef

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Determination of the Stress Factor Calculated from the Changes in the Measured Resting Energy Expenditure with Indirect Calorimetry in Patients Undergoing Pancreaticoduodenectomy: Seon Hyeong Kim, Baik Hwan Cho, Sook Bae Kim, Mi Jin Jeong, Hee Chul Yu; J Clin Nutr 2017;9(2):62-67. Published online December 31, 2017; DOI: https://doi.org/10.15747/jcn.2017.9.2.62

Abstract PDF ePub: Purpose
To predict the energy expenditure using the stress factor representing the ratio of the metabolic variation between pre-operation and post-operation in a pancreaticoduodenectomy (PD).
Methods
This was a prospective study conducted on 17 patients (11 males and 6 females) who underwent PD at Chonbuk National University Hospital between March 2010 and October 2011. The rest energy expenditure was measured by indirect calorimetry 1 day before and 3 days after surgery. The height, weight, and fat free mass were also measured 1 day before surgery.
Results
The mean measured rest energy expenditure 1 day before PD (mREE^pre) and 3 days after PD (mREE^post) were significantly different (16.8±2.6 vs. 18.8±3.5 kcal/kg/d, P=0.0076). The stress factor, representing the ratio of the metabolic changes between pre- and post-PD, was 1.12±0.17. The recommended energy requirement for PD patients is estimated to be 23∼24 kcal/ideal body weight/d [determined from the measured preoperative rest energy expenditure (16.8±2.6 kcal/kg/d)×activity factor (1.2∼1.3)×stress factor (1.12)].
Conclusion
PD patients maintained a hypermetabolic status and the applicable stress factor was 1.12.

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Review Article

Role of Retinol Binding Protein as a Biochemical Markers for Nutritional Status Assessment: Se Youl Lee, Sang In Bae, Hee Chul Yu; Surg Metab Nutr 2015;6(1):7-10. Published online June 30, 2015; DOI: https://doi.org/10.18858/smn.2015.6.1.7

Abstract PDF ePub

Malnutrition has a significant impact on the recovery of patients. Assessment of nutritional status and appropriateness of nutritional support is of clinical importance. In the various nutritional assessment methods, biochemical markers (albumin, pre-albumin, retinol binding protein, and transferrin) are widely used for high sensitivity and objectivity. For application of the biochemical markers, it should be understood that the markers have merits and de-merits. Author investigates the retinol binding protein, one of the most sensitive biochemical markers, in more detail. Retinol binding protein (RBP) is synthesized in liver (mainly, parenchymal cells) and catalyzed in kidney. RBP transports retinol, alcohol form of vitamin A, from liver to tissue. Also, RBP and transthyretin (TTR, formerly called pre-albumin) form a macromolecular complex to prevent glomerular filtration of the low molecular weight RBP in the kidney. RBP is a very useful biochemical marker because it has short half-life and immediate response to deficiency or in support of calorie and protein. However, because serum RBP level is greatly affected by the liver and kidney function, understanding of the underlying disease of patients is necessary. Moreover, it is not widely used due to very short half-life and non-generalized measurement methods. Consequently, understanding the characteristics of RBP is necessary and effort should be made to properly utilize the RBP in nutrition support and assessment.

Citations

Citations to this article as recorded by

Serum biomarkers for nutritional status as predictors in COVID-19 patients before and after vaccination
Rita Vaz-Rodrigues, Lorena Mazuecos, Margarita Villar, José Miguel Urra, Christian Gortázar, José de la Fuente
Journal of Functional Foods.2023; 101: 105412. CrossRef
Nutritional status evaluation in critical care: A study of clinical practices
Achwak Mehrez, Om Kalthoum Sallem, Hela Attia, Karim Masmoudi, Kais Gardabou, Ali Majdoub
Nutrition Clinique et Métabolisme.2023; 37(1): 51. CrossRef
Application of an early oral feeding protocol after pylorus-preserving pancreaticoduodenectomy
Jungmin Cho, Hyung Mi Kim, Mina Song, Joon Seong Park, Seung-Min Lee
Supportive Care in Cancer.2019; 27(3): 981. CrossRef

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