1
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Nelson AD, Elkins JR, Stocchi L, Farraye FA, Hashash JG. Use and Misuse of Parenteral Nutrition in Patients with Inflammatory Bowel Disease. Inflamm Bowel Dis 2022; 28:1592-1602. [PMID: 35472221 DOI: 10.1093/ibd/izac085] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Indexed: 12/09/2022]
Abstract
Malnutrition is a very common and often underrecognized condition among patients with inflammatory bowel diseases (IBD). This is most commonly due to increased nutritional requirements and gastrointestinal losses, along with reduced oral intake. Screening for malnutrition is an essential component of managing both inpatients and outpatients with IBD. Although enteral nutrition is the preferred route of supplementation, parenteral nutrition (PN) remains an important strategy and should be considered in certain situations, such as cases with short-bowel syndrome, high-output intestinal fistula, prolonged ileus, or small-bowel obstruction. Appropriate use of PN is critical in order to prevent associated complications. This review addresses the common indications for use of PN, the composition of PN, and the possible complications encountered with PN use, as well as scenarios of inappropriate PN use among patients with IBD. A clinical management algorithm for utilizing PN among patients with IBD is proposed in this review.
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Affiliation(s)
- Alfred D Nelson
- Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, FL, USA
| | | | - Luca Stocchi
- Division of Colorectal Surgery, Mayo Clinic, Jacksonville, FL, USA
| | - Francis A Farraye
- Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, FL, USA
| | - Jana G Hashash
- Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, FL, USA
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2
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Burdge GC. α-linolenic acid interconversion is sufficient as a source of longer chain ω-3 polyunsaturated fatty acids in humans: An opinion. Lipids 2022; 57:267-287. [PMID: 35908848 DOI: 10.1002/lipd.12355] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 07/11/2022] [Accepted: 07/13/2022] [Indexed: 01/20/2023]
Abstract
α-linolenic acid (αLNA) conversion into the functionally important ω-3 polyunsaturated fatty acids (PUFA), eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA), has been regarded as inadequate for meeting nutritional requirements for these PUFA. This view is based on findings of small αLNA supplementation trials and stable isotope tracer studies that have been interpreted as indicating human capacity for EPA and, in particular, DHA synthesis is limited. The purpose of this review is to re-evaluate this interpretation. Markedly differing study designs, inconsistent findings and lack of trial replication preclude robust consensus regarding the nutritional adequacy of αLNA as a source of EPC and DHA. The conclusion that αLNA conversion in humans is constrained is inaccurate because it presupposes the existence of an unspecified, higher level of metabolic activity. Since capacity for EPA and DHA synthesis is the product of evolution it may be argued that the levels of EPA and DHA it maintains are nutritionally appropriate. Dietary and supra-dietary EPA plus DHA intakes confer health benefits. Paradoxically, such health benefits are also found amongst vegetarians who do not consume EPA and DHA, and for whom αLNA conversion is the primary source of ω-3 PUFA. Since there are no reported adverse effects on health or cognitive development of diets that exclude EPA and DHA, their synthesis from αLNA appears to be nutritionally adequate. This is consistent with the dietary essentiality of αLNA and has implications for developing sustainable nutritional recommendations for ω-3 PUFA.
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Affiliation(s)
- Graham C Burdge
- School of Human Development and Health, Faculty of Medicine, University of Southampton, Southampton General Hospital, Southampton, UK
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3
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Nosewicz J, Sparks A, Hart PA, Roberts KM, Kaffenberger JA, Korman A, Trinidad JC, Spaccarelli N, Kaffenberger BH. The Evaluation and Management of Macronutrient Deficiency Dermatoses. J Am Acad Dermatol 2022; 87:640-647. [PMID: 35427683 DOI: 10.1016/j.jaad.2022.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 03/31/2022] [Accepted: 04/03/2022] [Indexed: 10/18/2022]
Abstract
In industrialized countries, nutritional dermatoses are likely underdiagnosed and result in increased disease morbidity and utilization of hospital resources. These findings underscore the need for physicians to be able to correctly identify these deficiencies. Nutritional dermatoses may be split into micronutrient deficiencies and macronutrient deficiencies. This article is intended to serve as a supplement to a two-part review of micronutrient deficiency dermatoses and highlights cutaneous findings in patients with protein-energy malnutrition and essential fatty acid deficiency. This article reviews the evaluation, cutaneous manifestations, and management of macronutrient deficiencies.
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Affiliation(s)
- Jacob Nosewicz
- Division of Dermatology, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Alexander Sparks
- Division of Dermatology, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Phil A Hart
- Division of Gastroenterology, Hepatology, and Nutrition, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Kristen M Roberts
- Division of Gastroenterology, Hepatology, and Nutrition, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Jessica A Kaffenberger
- Division of Dermatology, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Abraham Korman
- Division of Dermatology, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - John C Trinidad
- Division of Dermatology, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Natalie Spaccarelli
- Division of Dermatology, The Ohio State University Wexner Medical Center, Columbus, Ohio
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4
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Torres C, Badalyan V, Mohan P. Twelve-year outcomes of intestinal failure-associated liver disease in children with short-bowel syndrome: 97% transplant-free survival and 81% enteral autonomy. JPEN J Parenter Enteral Nutr 2021; 46:197-206. [PMID: 33794031 DOI: 10.1002/jpen.2112] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 03/19/2021] [Accepted: 03/25/2021] [Indexed: 01/28/2023]
Abstract
Our aim was to analyze the outcomes in children with short-bowel syndrome (SBS), parenteral nutrition dependence (PND), and intestinal failure-associated liver disease (IFALD) treated in our Intestinal Rehabilitation Program (IRP) during 2007-2018. We retrospectively reviewed charts of 135 patients with SBS-PND at the time of enrollment in IRP; of these, 89 (66%) had IFALD, defined as conjugated bilirubin (CB) of ≥2 mg/dl at enrollment and/or abnormal liver biopsy showing stage 2-4 fibrosis. Outcomes included resolution of CB, enteral autonomy, laboratory parameters (platelets, aspartate aminotransferase to platelet ratio index), growth trends, transplant rates, and mortality. Of the 89 patients, 74 had elevated CB at enrollment; the other 15 had normalized CB but had fibrosis on liver biopsy. Thirty-eight patients had liver biopsies: 36 (95%) had fibrosis, including 21/36 with bridging fibrosis/cirrhosis. The median proportion of residual small bowel was 23% (interquartile range, 13%-38%) of the expected length for age and median, daily energy requirement by PN was 100%. Two received a transplant, three died (one posttransplant), and the remaining 85 survived; 69 (81%) achieved enteral autonomy. Seventy-three (99%) of the 74 patients with hyperbilirubinemia normalized their CB with medical treatment. In a subset of eight of 89 patients with initial platelet count of <100,000/μl(median 50,500/μl) and median CB of 21 mg/dl, seven achieved CB normalization and had improved platelet count. Overall survival was 97% (censored 96.3%). We demonstrate high transplant-free survival and enteral autonomy rates among children with SBS-IFALD relying on low-dose soybean lipid emulsion.
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Affiliation(s)
- Clarivet Torres
- Intestinal Rehabilitation Program, Division of Gastroenterology, Hepatology, and Nutrition, Children's National Hospital, Washington, DC, USA.,George Washington University School of Medicine, Washington, DC, USA
| | - Vahe Badalyan
- Intestinal Rehabilitation Program, Division of Gastroenterology, Hepatology, and Nutrition, Children's National Hospital, Washington, DC, USA.,George Washington University School of Medicine, Washington, DC, USA
| | - Parvathi Mohan
- Intestinal Rehabilitation Program, Division of Gastroenterology, Hepatology, and Nutrition, Children's National Hospital, Washington, DC, USA.,George Washington University School of Medicine, Washington, DC, USA
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5
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Zhang T, Han X, Zhang X, Chen Z, Mi Y, Gou X. Dietary Fatty Acid Factors in Alzheimer's Disease: A Review. J Alzheimers Dis 2020; 78:887-904. [PMID: 33074226 DOI: 10.3233/jad-200558] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Alzheimer's disease (AD) is an irreversible neurodegenerative disease characterized by brain function disorder and chronic cognitive function impairment. The onset of AD is complex and is mostly attributed to interactions between genetic factors and environmental factors. Lifestyle, dietary habits, and food consumption are likely to play indispensable functions in aged-related neurodegenerative diseases in elderly people. An increasing number of epidemiological studies have linked dietary fatty acid factors to AD, raising the point of view that fatty acid metabolism plays an important role in AD initiation and progression as well as in other central nervous system disorders. In this paper, we review the effects of the consumption of various dietary fatty acids on AD onset and progression and discuss the detrimental and beneficial effects of some typical fatty acids derived from dietary patterns on the pathology of AD. We outline these recent advances, and we recommend that healthy dietary lifestyles may contribute to preventing the occurrence and decreasing the pathology of AD.
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Affiliation(s)
- Tianying Zhang
- Shaanxi Key Laboratory of Brain Disorders & Institute of Basic and Translational Medicine, Xi'an Medical University, Xi'an, PR China
| | - Xiaojuan Han
- Shaanxi Key Laboratory of Brain Disorders & Institute of Basic and Translational Medicine, Xi'an Medical University, Xi'an, PR China
| | - Xiaohua Zhang
- Shaanxi Key Laboratory of Brain Disorders & Institute of Basic and Translational Medicine, Xi'an Medical University, Xi'an, PR China
| | - Zhi Chen
- College of Animal Science and Technology, Yangzhou University, Yangzhou, PR China
| | - Yajing Mi
- Shaanxi Key Laboratory of Brain Disorders & Institute of Basic and Translational Medicine, Xi'an Medical University, Xi'an, PR China
| | - Xingchun Gou
- Shaanxi Key Laboratory of Brain Disorders & Institute of Basic and Translational Medicine, Xi'an Medical University, Xi'an, PR China
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6
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Ho BE, Chan SC, Faino AV, Mortensen M, Williamson N, Javid PJ, Horslen SP, Wendel D. Evaluation of SMOFlipid in Pediatric Intestinal-Failure Patients and Its Effects on Essential Fatty Acid Levels. JPEN J Parenter Enteral Nutr 2020; 45:546-552. [PMID: 32415692 DOI: 10.1002/jpen.1850] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Accepted: 04/14/2020] [Indexed: 11/06/2022]
Abstract
BACKGROUND SMOFlipid is a mixed-lipid emulsion approved for adults in the United States as an alternative to soybean oil-based lipid (SO). There are limited data on the use of SMOFlipid in pediatrics and its effect on the fatty acid (FA) profile. Our objective was to characterize changes in FA profile, liver function, and growth in pediatric patients with intestinal failure (IF), following transition from SO or a fish-oil (FO) and SO combination to SMOFlipid. METHODS A retrospective case series was conducted on pediatric parenteral nutrition-dependent IF patients transitioned to SMOFlipid. Demographics, anthropometrics, labs, and achievement of nutrition goals were assessed. Linear mixed-effect models assessed effects on FA levels and clinical outcomes. RESULTS One hundred thirty-nine FA panels were collected from 20 patients. Median SMOFlipid dose at study completion was 2 g/kg/d (interquartile range, 1.6-2). During the 1.5 years after SMOFlipid initiation, ω-6 FA increased to physiologic levels, arachidonic acid increased from 298 to 461 nmol/mL (P < .001), and linoleic acid increased from 1172 to 1922 nmol/mL (P < .001). ω-3 FA remained within normal limits. Body mass index z-score and length z-score increased, though no significant changes were found. In addition, no significant changes were found in mead acid, hepatic function, triene-to-tetraene ratio, or triglycerides. CONCLUSION In 20 pediatric IF patients, SMOFlipid allowed greater ω-6 FA provision while maintaining ω-3 FA, hepatic function, and patient growth. This longitudinal study identified improved FA profile associated with SMOFlipid use in comparison with SO with or without FO.
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Affiliation(s)
- Beatrice E Ho
- Department of Pharmacy, Seattle Children's Hospital, Seattle, Washington, USA.,School of Pharmacy, University of Washington, Seattle, Washington, USA
| | - Stacie C Chan
- Department of Pharmacy, Seattle Children's Hospital, Seattle, Washington, USA.,School of Pharmacy, University of Washington, Seattle, Washington, USA
| | - Anna V Faino
- Children's Core for Biomedical Statistics, Seattle Children's Research Institute, Seattle, Washington, USA
| | - Melissa Mortensen
- Department of Gastroenterology, Hepatology and Nutrition, Seattle Children's Hospital, Seattle, Washington, USA
| | - Nila Williamson
- Department of Gastroenterology, Hepatology and Nutrition, Seattle Children's Hospital, Seattle, Washington, USA.,Washington State Department of Health, Tumwater, Washington, USA
| | - Patrick J Javid
- Division of Pediatric General and Thoracic Surgery, Seattle Children's Hospital, Seattle, Washington, USA
| | - Simon P Horslen
- Department of Gastroenterology, Hepatology and Nutrition, Seattle Children's Hospital, Seattle, Washington, USA.,Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington, USA
| | - Danielle Wendel
- Department of Gastroenterology, Hepatology and Nutrition, Seattle Children's Hospital, Seattle, Washington, USA.,Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington, USA
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7
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Carta G, Murru E, Vargiu R, Collu M, Carta M, Banni S, Stancampiano R. Essential fatty acids deficient diet modulates N-Acylethanolamide profile in rat's tissues. Prostaglandins Leukot Essent Fatty Acids 2020; 153:102053. [PMID: 31978675 DOI: 10.1016/j.plefa.2020.102053] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 12/17/2019] [Accepted: 01/13/2020] [Indexed: 10/25/2022]
Abstract
No data are available on whether a diet deficient of the essential fatty acids is able to modulate tissue levels of endocannabinoids and congeners. Male rats fed for 12 weeks a diet deficient of essential fatty acids, palmitic and oleic acids (EFAD), replaced with saturated fatty acids (SAFA), showed lowered n-3 and n-6 PUFAs levels in plasma, liver and adipose tissue, with concomitant steep increase of oleic and mead acids, while in hypothalamus no changes in PUFA concentration were detected and only palmitoleic acid was found increased. We found a reduction of anandamide and palmitoylethanolamide in liver and brain, while oleoylethanolamide increased significantly in liver and adipose tissue, associated to a 50 % body weight decrease. Changes in N-acylethanolamide profile may contribute to body weight reduction distinctive of EFA deficiency.
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Affiliation(s)
- Gianfranca Carta
- Dipartimento Scienze Biomediche, Università di Cagliari, Cittadella Universitaria, S.S. 554, km. 4,500, Monserrato, Cagliari 09042, Italy
| | - Elisabetta Murru
- Dipartimento Scienze Biomediche, Università di Cagliari, Cittadella Universitaria, S.S. 554, km. 4,500, Monserrato, Cagliari 09042, Italy
| | - Romina Vargiu
- Dipartimento Scienze Biomediche, Università di Cagliari, Cittadella Universitaria, S.S. 554, km. 4,500, Monserrato, Cagliari 09042, Italy
| | - Maria Collu
- Dipartimento Scienze Biomediche, Università di Cagliari, Cittadella Universitaria, S.S. 554, km. 4,500, Monserrato, Cagliari 09042, Italy
| | - Manolo Carta
- Dipartimento Scienze Biomediche, Università di Cagliari, Cittadella Universitaria, S.S. 554, km. 4,500, Monserrato, Cagliari 09042, Italy
| | - Sebastiano Banni
- Dipartimento Scienze Biomediche, Università di Cagliari, Cittadella Universitaria, S.S. 554, km. 4,500, Monserrato, Cagliari 09042, Italy.
| | - Roberto Stancampiano
- Dipartimento Scienze Biomediche, Università di Cagliari, Cittadella Universitaria, S.S. 554, km. 4,500, Monserrato, Cagliari 09042, Italy
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8
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Santos IC, Smuts J, Crawford ML, Grant RP, Schug KA. Large-volume injection gas chromatography-vacuum ultraviolet spectroscopy for the qualitative and quantitative analysis of fatty acids in blood plasma. Anal Chim Acta 2019; 1053:169-177. [DOI: 10.1016/j.aca.2018.12.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2018] [Revised: 11/29/2018] [Accepted: 12/01/2018] [Indexed: 10/27/2022]
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9
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Gramlich L, Ireton-Jones C, Miles JM, Morrison M, Pontes-Arruda A. Essential Fatty Acid Requirements and Intravenous Lipid Emulsions. JPEN J Parenter Enteral Nutr 2019; 43:697-707. [PMID: 30908685 DOI: 10.1002/jpen.1537] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Accepted: 02/28/2019] [Indexed: 01/08/2023]
Abstract
Linoleic acid (LA) and α-linolenic acid (ALA) must be supplied to the human body and are therefore considered essential fatty acids. This narrative review discusses the signs, symptoms, diagnosis, prevention, and treatment of essential fatty acid deficiency (EFAD). EFAD may occur in patients with conditions that severely limit the intake, digestion, absorption, and/or metabolism of fat. EFAD may be prevented in patients requiring parenteral nutrition by inclusion of an intravenous lipid emulsion (ILE) as a source of LA and ALA. Early ILEs consisted solely of soybean oil (SO), a good source of LA and ALA, but being rich in LA may promote the production of proinflammatory fatty acids. Subsequent ILE formulations replaced part of the SO with other fat sources to decrease the amount of proinflammatory fatty acids. Although rare, EFAD is diagnosed by an elevated triene:tetraene (T:T) ratio, which reflects increased metabolism of oleic acid to Mead acid in the absence of adequate LA and ALA. Assays for measuring fatty acids have improved over the years, and therefore it is necessary to take into account the particular assay used and its reference range when determining if the T:T ratio indicates EFAD. In patients with a high degree of suspicion for EFAD, obtaining a fatty acid profile may provide additional useful information for making a diagnosis of EFAD. In patients receiving an ILE, the T:T ratio and fatty acid profile should be interpreted in light of the fatty acid composition of the ILE to ensure accurate diagnosis of EFAD.
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Affiliation(s)
- Leah Gramlich
- Division of Gastroenterology, University of Alberta, Edmonton, Alberta, Canada
| | | | - John M Miles
- Department of Dietetics and Nutrition, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Maya Morrison
- Baxter Healthcare Corporation, Deerfield, Illinois, USA
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10
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Plogsted S, Adams SC, Allen K, Cober MP, Greaves J, Ralph A, Robinson DT, Sabino K, Walker R, Ward CT, Ybarra J, Holcombe B. Parenteral Nutrition Lipid Injectable Emulsion Products Shortage Considerations. Nutr Clin Pract 2017; 32:427-429. [DOI: 10.1177/0884533617695244] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
| | - Stephen C. Adams
- VITALine Infusion Pharmacy Services, Geisinger Medical Center, Danville, Pennsylvania, USA
| | - Karen Allen
- University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | | | - June Greaves
- Coram/CVS Specialty Infusion Services, Denver, Colorado, USA
| | - Amy Ralph
- Yale–New Haven Hospital, New Haven, Connecticut, USA
| | - Daniel T. Robinson
- Division of Neonatology, Ann & Robert H. Lurie Children’s Hospital, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Kim Sabino
- Saint Francis Hospital and Medical Center, Hartford, Connecticut, USA
| | - Renee Walker
- Michael E. DeBakey Veteran Affairs Medical Center, Houston, Texas, USA
| | | | - Joe Ybarra
- Medical City McKinney, McKinney, Texas, USA
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11
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Derenski K, Catlin J, Allen L. Parenteral Nutrition Basics for the Clinician Caring for the Adult Patient. Nutr Clin Pract 2016; 31:578-95. [PMID: 27440772 DOI: 10.1177/0884533616657650] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Parenteral nutrition (PN) is a life-sustaining therapy providing nutrients to individuals with impaired intestinal tract function and enteral access challenges. It is one of the most complex prescriptions written routinely in the hospital and home care settings. This article is to aid the nutrition support clinician in the safe provision of PN, including selecting appropriate patients for PN, vascular access, development of a PN admixture, appropriate therapy monitoring, recognition of preparation options, and awareness of preparation and stability concerns.
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Affiliation(s)
| | | | - Livia Allen
- CoxHealth Medical Centers, Springfield, Missouri, USA
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12
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Klek S. Omega-3 Fatty Acids in Modern Parenteral Nutrition: A Review of the Current Evidence. J Clin Med 2016; 5:E34. [PMID: 26959070 PMCID: PMC4810105 DOI: 10.3390/jcm5030034] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2015] [Revised: 02/10/2016] [Accepted: 03/01/2016] [Indexed: 12/21/2022] Open
Abstract
Intravenous lipid emulsions are an essential component of parenteral nutrition regimens. Originally employed as an efficient non-glucose energy source to reduce the adverse effects of high glucose intake and provide essential fatty acids, lipid emulsions have assumed a larger therapeutic role due to research demonstrating the effects of omega-3 and omega-6 polyunsaturated fatty acids (PUFA) on key metabolic functions, including inflammatory and immune response, coagulation, and cell signaling. Indeed, emerging evidence suggests that the effects of omega-3 PUFA on inflammation and immune response result in meaningful therapeutic benefits in surgical, cancer, and critically ill patients as well as patients requiring long-term parenteral nutrition. The present review provides an overview of the mechanisms of action through which omega-3 and omega-6 PUFA modulate the immune-inflammatory response and summarizes the current body of evidence regarding the clinical and pharmacoeconomic benefits of intravenous n-3 fatty acid-containing lipid emulsions in patients requiring parenteral nutrition.
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Affiliation(s)
- Stanislaw Klek
- Stanley Dudrick's Memorial Hospital, General Surgery Unit, Skawina 32-050, Poland.
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13
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Slattery E, Rumore MM, Douglas JS, Seres DS. 3-in-1 vs 2-in-1 Parenteral Nutrition in Adults. Nutr Clin Pract 2014; 29:631-5. [DOI: 10.1177/0884533614533611] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Affiliation(s)
- Eoin Slattery
- Department of Medicine, Division of Preventive Medicine and Nutrition, Columbia University Medical Center–New York Presbyterian Hospital, New York, New York
| | - Martha M. Rumore
- Department of Pharmacy, Cohen Children’s Medical Center, New Hyde Park, New York
| | - Janine S. Douglas
- Department of Pharmacy, Practice and Administration, University of St. Joseph, Hartford, Connecticut
| | - David S. Seres
- Department of Medicine, Division of Preventive Medicine and Nutrition, Columbia University Medical Center–New York Presbyterian Hospital, New York, New York
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14
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Hassig TB, McKinzie BP, Fortier CR, Taber D. Clinical Management Strategies and Implications for Parenteral Nutrition Drug Shortages in Adult Patients. Pharmacotherapy 2013; 34:72-84. [DOI: 10.1002/phar.1350] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Tanna B. Hassig
- Medical/Surgical Intensive Care Unit; Medical University of South Carolina; Charleston South Carolina
| | - Brian P. McKinzie
- Surgical Trauma Intensive Care Unit; Medical University of South Carolina; Charleston South Carolina
| | - Christopher R. Fortier
- Department of Pharmacy Services; Medical University of South Carolina; Charleston South Carolina
| | - David Taber
- Division of Transplant; Medical University of South Carolina; Charleston South Carolina
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15
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Parenteral Nutrition Intravenous Fat Emulsions Product Shortage Considerations. Nutr Clin Pract 2013; 28:528-9. [DOI: 10.1177/0884533613498214] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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16
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Abstract
Parenteral nutrition plays a vital role for patients with intestinal failure and those who are unable to maintain oral or enteral nutrition alone. Parenteral nutrition has been shown to improve clinical outcome in patients with malnutrition and intestinal tract dysfunction. The use of parenteral nutrition is not without risk of serious complications. Parenteral nutrition complications can be divided into mechanical related to vascular access, septic, and metabolic. This article provides a review on the short- and long-term complications of parenteral nutrition and their management.
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Affiliation(s)
- Andrew Ukleja
- Department of Gastroenterology, Cleveland Clinic Florida, 2950 Cleveland Clinic Boulevard, Weston, FL 33331, USA.
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