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- Hasil, Leslee, et al.
(författare)
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From clinical guidelines to practice : The nutrition elements for enhancing recovery after colorectal surgery
- 2022
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Ingår i: Nutrition in clinical practice. - : John Wiley & Sons. - 0884-5336 .- 1941-2452. ; 37:2, s. 300-315
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Forskningsöversikt (refereegranskat)abstract
- The Enhanced Recovery After Surgery (ERAS) Care System improves patient outcomes. The ERAS Protocol describes multimodal, evidence-based processes that are bundled into >20 care elements, and the ERAS Implementation Program provides strategies to guide the successful adoption of the care elements. Although formal training is essential to implement ERAS correctly, with this article we aim to bridge the gap between the nutritionally relevant care elements of the protocol and their implementation for colorectal surgery. This article also describes how dietitians can support optimal patient outcomes by playing an active role in implementing, monitoring, and evaluating ERAS practices.
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- Milton, Debra L., 1956-, et al.
(författare)
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Low risk for microbial contamination of syringe and tube feeding bag surfaces after multiple reuses with home blenderized tube feeding
- 2022
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Ingår i: Nutrition in clinical practice. - : John Wiley & Sons. - 0884-5336 .- 1941-2452. ; 37:4, s. 907-912
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Tidskriftsartikel (refereegranskat)abstract
- Background: Guidelines for the reuse of enteral tube feeding (ETF) equipment guidelines are limited to manufacturer recommendations. ETF equipment reuse studies are needed as the enteral population has increased, along with blenderized tube feeding (BTF).Methods: This experiment tested microbial contamination of a reusable gravity feeding bag and syringe after 15 BTF reuses and cleanings. Eight bags and syringes were filled with the BTF, held at room temperature for 20 min, and then emptied, washed, and air dried. After the last air drying, the inner surfaces of the bag and syringe were swabbed, and aerobic microbial counts were performed using serial dilutions and plate counts.Results: The microbial counts for all syringes and six bags were <1 colony-forming unit (CFU)/cm2; one bag was <5 CFU/cm2 and one bag was 12.5 CFU/cm2. No legal guidelines for surface cleanliness exist for the food sector. Several studies propose a safe microbial level to be <2.5 CFU/cm2, and the European Commission recommended <10 CFU/cm2. Based on these proposed guidelines, microbial counts of all syringes and seven bags were within the proposed guidelines, except for one bag just above 10 CFU/cm2.Conclusion: The feeding bag used in this study may be used multiple times for BTF with a reduced risk of microbial contamination when manufacturer's cleaning guidelines are followed. Although bolus tube feeding is an off-label use for syringes, they are frequently used for BTF, and in this study the cleaning after 15 uses over 5 days was effective to reduce microbial counts.
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- Torsy, Tim, et al.
(författare)
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Comparison of Two Methods for Estimating the Tip Position of a Nasogastric Feeding Tube : A Randomized Controlled Trial
- 2018
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Ingår i: Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition. - : John Wiley & Sons. - 1941-2452. ; 33:6, s. 843-850
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Several studies have shown that the nose-earlobe-xiphoid distance (NEX) is inadequate to estimate the insertion length of nasogastric tubes. An alternative approach tested in these studies, which leads to > 90% well-placed nasogastric tubes, used a corrected calculation of the NEX: (NEX × 0.38696) + 30.37. The primary aim of this study was to determine whether using the corrected NEX was more successful than the NEX in determining the insertion length. The secondary aim was to investigate the likelihood to successfully obtain gastric aspirate.METHODS: Adult patients in a general hospital (N = 215) needing a nasogastric tube were randomized to the control (NEX) or intervention group (corrected NEX). Tip positioning was verified using X-ray. Correct tip positioning was defined as between 3 and 10 cm under the lower esophageal sphincter (LES).RESULTS: In >20% of all patients, both methods underestimated the required tube length for correct positioning. The NEX showed an overestimation (17.2%) of the insertion length (>10 cm under the LES) compared with the corrected NEX (4.8%). There was no difference (P = 0.938) between the 2 groups in obtaining gastric aspirate (55.6% vs 56%). However, correct tip positioning resulted in a fourfold increase of obtaining gastric aspirate.CONCLUSIONS: Both methods resulted in a high risk of incorrectly placed tubes due to malposition of the tip near the LES or distal esophagus. This may increase the risk of reflux and pulmonary aspiration. Based on these results, the development of more reliable methods requires consideration.
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- Wernerman, J, et al.
(författare)
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Assessment of Protein Turnover in Health and Disease
- 2017
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Ingår i: Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition. - : Wiley. - 1941-2452. ; 32:1_suppl, s. 15S-20S
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Tidskriftsartikel (refereegranskat)
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