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Gastrointestinal graft versus host disease is one of the most severe complications after hematopoietic stem cell transplantation, which can occur in patients of any age groups. Its clinical manifestations include nausea, vomit, abdominal pain, diarrhea and the like. Severe gastrointestinal graft versus host disease could directly influence the patients' clinical prognosis and therapeutic efficacy of transplantation. Here we had a review of the research progress on nutritional support and diet management strategies for gastrointestinal graft versus host disease. It is of great clinical significance to form a step-wise nutritional support model to reduce the risk of malnutrition in patients with gastrointestinal graft versus host disease, which would contribute to improving patients' general condition, relieving digestive tract symptoms, and reducing the risk of complications.
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Over the past 60 years, clinical nutrition has evolved into a key technology for saving the lives of patients with intestinal failure or complex diseases. However, the 21st century has seen issues with adverse outcomes due to a lack of timely and effective nutritional screening and intervention. Despite the benefits of minimally invasive surgery, nutritional risks or adverse outcomes still exceed 50% in gastrointestinal surgery. The study explores the importance of comprehensive nutritional management for surgical patients, beginning with a reevaluation of their nutritional risks and malnutrition, especially in the context of increasing chronic diseases like cancer, elderly comorbidities, and inflammatory bowel disease. It emphasizes the importance of clinical nutrition guidelines and consensus in surgical practice validated by various studies. The article then details the comprehensive nutritional management of surgical patients, including the importance of nutritional risk screening, assessment, diagnosis, and nutritional support treatment, especially during the early and recovery phases of major gastrointestinal surgery. The aim is to enhance the awareness of surgeons and healthcare workers about nutritional management to improve patients' clinical outcomes and quality of life.
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Objective:To summarize the clinical features and prognosis of congenital chylothorax and provide a basis for rational diagnosis and treatment.Methods:Clinical data of 11 cases of congenital chylothorax treated in the Department of Neonatology of Women's Hospital, School of Medicine, Zhejiang University from January 2020 to December 2022 were retrospectively collected and analyzed. Intrauterine intervention, clinical manifestations, auxiliary examinations, management strategies, outcomes, and postnatal follow-up were summarized using descriptive statistical analysis.Results:All the patients were born by cesarean section at the gestational age of (35.7±2.2) weeks (32 +1-39 +0 weeks). The male-to-female ratio was 4∶7. Four cases were complicated by fetal edema. Nine cases received intrauterine treatment, including thoracentesis in six cases, thoraco-amniotic shunting in one case, and thoracentesis combined with thoraco-amniotic shunting in two cases. Six patients had mild asphyxia. All 11 patients developed respiratory distress within 24 h after birth and were found with pleural effusion by chest X-ray and ultrasound. After a series of treatments, including chest drainage, respiratory support, sequential nutritional therapy, and octreotide, nine cases were cured and discharged from the hospital, while two cases died of pulmonary collapse after withdrawing treatment (both complicated by fetal edema). No recurrence of chylothorax was reported in the nine patients and their growth and development were normal during a follow-up to 3-22 months after birth. Conclusions:Patients with congenital chylothorax are prone to intrapartum asphyxia and respiratory distress after birth. Most patients can survive and have good outcomes after intrauterine intervention and postnatal comprehensive treatment.
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Abstract Managing anemia before surgery is extremely important as it is a clinical condition that can significantly increase surgical risk and affect patient outcomes. Anemia is characterized by a reduction in the number of red blood cells or hemoglobin levels leading to a lower oxygen-carrying capacity of the blood. Proper treatment requires a multifaceted approach to ensure patients are in the best possible condition for surgery and to minimize potential complications. The challenge is recognizing anemia early and implementing a timely intervention to correct it. Anemic patients are more susceptible to surgical complications such as increased infection rates, slower wound healing and increased risk of cardiovascular events during and after surgery. Additionally, anemia can exacerbate existing medical conditions, causing greater strain on organs and organ systems. To correct anemia and optimize patient outcomes, several essential measures must be taken with the most common being identifying and correcting iron deficiency.
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ABSTRACT Objective: To evaluate the combined impact of videofluoroscopic swallow study (VFSS) and therapeutic feeding and swallowing interventions on clinical outcomes in children with oropharyngeal dysphagia (OPD). Methods: This was an uncontrolled longitudinal analytical study in which OPD patients were evaluated before and after VFSS. Children ≤ 24 months of age diagnosed with OPD in a clinical setting and undergoing VFSS for investigation and management of OPD were included in the study. The study participants received therapeutic feeding and swallowing interventions after having undergone VFSS, being followed at an outpatient clinic for pediatric dysphagia in order to monitor feeding and swallowing difficulties. Respiratory and feeding outcomes were compared before and after VFSS. Results: Penetration/aspiration events were observed in 61% of the VFSSs (n = 72), and therapeutic feeding and swallowing interventions were recommended for 97% of the study participants. After the VFSS, there was a reduction in the odds of receiving antibiotic therapy (OR = 0.007) and in the duration of antibiotic therapy (p = 0.014), as well as in the odds of being admitted to hospital (p = 0.024) and in the length of hospital stay (p = 0.025). A combination of oral and enteral feeding became more common than oral or enteral feeding alone (p = 0.002). Conclusions: A high proportion of participants exhibited penetration/aspiration on VFSS. Therapeutic feeding and swallowing interventions following a VFSS appear to be associated with reduced respiratory morbidity in this population.
RESUMO Objetivo: Avaliar o impacto conjunto da videofluoroscopia da deglutição (VFD) e intervenções terapêuticas de alimentação e deglutição nos desfechos clínicos em crianças com disfagia orofaríngea (DOF). Métodos: Trata-se de um estudo analítico longitudinal não controlado em que pacientes com DOF foram avaliados antes e depois da VFD. Foram incluídas no estudo crianças com idade ≤ 24 meses e diagnóstico clínico de DOF, submetidas à VFD para a investigação e manejo da DOF. Os participantes do estudo receberam intervenções terapêuticas de alimentação e deglutição após terem sido submetidos à VFD, sendo então acompanhados em um ambulatório de disfagia pediátrica para o monitoramento das dificuldades de alimentação e deglutição. Os desfechos respiratórios e alimentares foram comparados antes e depois da VFD. Resultados: Eventos de penetração/aspiração foram observados em 61% das VFD (n = 72), e intervenções terapêuticas de alimentação e deglutição foram recomendadas a 97% dos participantes do estudo. Após a VFD, houve uma redução das chances de receber antibioticoterapia (OR = 0,007) e da duração da antibioticoterapia (p = 0,014), bem como das chances de internação hospitalar (p = 0,024) e do tempo de internação (p = 0,025). A alimentação por via oral e enteral em conjunto tornou-se mais comum do que a alimentação exclusivamente por via oral ou enteral (p = 0,002). Conclusões: Houve alta proporção de crianças que apresentaram penetração/aspiração na VFD. As intervenções terapêuticas de alimentação e deglutição após a VFD parecem estar associadas à redução da morbidade respiratória nessa população.
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Antecedentes: Los dispositivos de asistencia ventricular (VAD, sigla en inglés) se utilizan cada vez más para el manejo de la insuficiencia cardíaca descompensada en unidades de cuidados intensivos. El manejo nutricional es fundamental para la evolución clínica de estos pacientes. Objetivos: El objetivo fue evaluar en cuánto tiempo se puede alcanzar las necesidades nutricionales, utilizando distintas modalidades de apoyo nutricional, en pacientes que requirieron asistencia con VAD por insuficiencia cardíaca aguda en una clínica privada del país. Métodos: En una clínica privada se efectuó un estudio observacional retrospectivo analizando los datos clínicos relacionados al aporte nutricional de 12 pacientes que requirieron asistencia con VAD. Las vías de aporte nutricional evaluadas fueron la nutrición enteral (NE) y/o nutrición parenteral (NP). Se midió el tiempo de implementación del apoyo nutricional y su efecto se estimó por una valoración nutricional subjetiva y por la medición de indicadores de laboratorio. Además, se vigilaron las complicaciones asociadas al aporte nutricional. Resultados: El estudio incluyó a 12 pacientes. Los objetivos nutricionales se alcanzaron por completo en el 91% de los pacientes (n=11) en 3,7 ± 1 días después de iniciado el apoyo nutricional. En ese momento, 5 pacientes recibían NE exclusiva, 4 pacientes NP complementaria a la NE, 1 paciente NE complementaria a la alimentación oral y 1 paciente con vía oral. Al momento de alcanzar los requerimientos nutricionales ningún paciente tenía NP exclusiva. Conclusión: Concluimos que el apoyo nutricional precoz es factible y seguro en pacientes con VAD. Alcanzar los objetivos nutricionales es posible sin efectos adversos graves. Se necesitan estudios futuros para determinar el beneficio a largo plazo del apoyo nutricional agresivo para pacientes en estado crítico que requieren apoyo hemodinámico.
Background: Ventricular assist devices (VAD) are being used more frequently in patients with severe heart failure. Nutritional support is a critical factor for the outcome in these patients. Aim: to evaluate the time required and mode of nutritional support in patients with severe cardiac dysfunction being treated with VAD. Methods: 12 patients with VAD being treated in an intensive care unit were evaluated to determine the time and mode of support required to achieve adequate nutrition. Enteral and / or parenteral modes of nutritional support were used. The outcomes were evaluated by subjective appreciation, weight measurement and serum levels of albumin, pre-albumin and vitamin D. Results: Adequate nutritional support was achieved in 91% of patients a mean of 3 days after beginning of treatment (SD 1 day). At that time 5 patients were receiving only enteral nutrition, 4 patients enteral and parenteral nutrition, 1 patient enteral nutrition in addition to oral nutrition and 1 patients was receiving only oral nutrition. No patient was receiving only parenteral nutrition. Conclusion: early nutritional support is posible and safe in patients with an VAD. Further studies are needed to evaluate long term benefits of this strategy of nutritional support.
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Humans , Male , Female , Child , Adolescent , Adult , Middle Aged , Young Adult , Heart-Assist Devices , Nutritional Support/methods , Heart Failure/therapy , Time Factors , Nutritional Status , Acute Disease , Retrospective Studies , Enteral Nutrition , Parenteral Nutrition , Nutritional Support/adverse effectsABSTRACT
Objective: To compare the differences to determine resting energy expenditure (REE) measured with indirect calorimetry and REE predicted by formula method and body composition analyzer in patients with decompensated hepatitis B cirrhosis, so as to provide theoretical guidance for the implementation of precision nutrition intervention. Methods: Patients with decompensated hepatitis B cirrhosis who were admitted to Henan Provincial People's Hospital from April 2020 to December 2020 were collected. REE was determined by the body composition analyzer and the H-B formula method. Results: were analyzed and compared to REE measured by the metabolic cart. Results A total of 57 cases with liver cirrhosis were included in this study. Among them, 42 were male, aged (47.93 ± 8.62) years, and 15 were female aged (57.20 ± 11.34) years. REE measured value in males was (1 808.14 ± 201.47) kcal/d, compared with the results calculated by the H-B formula method and the measured result of body composition, and the difference was statistically significant (P = 0.002 and 0.003, respectively). REE measured value in females was (1 496.60 ± 131.28) kcal/d, compared with the results calculated by the H-B formula method and the measured result of body composition, and the difference was statistically significant (P = 0.016 and 0.004, respectively). REE measured with the metabolic cart had correlation with age and area of visceral fat in men (P = 0.021) and women (P = 0.037). Conclusion: Metabolic cart use will be more accurate to obtain resting energy expenditure in patients with decompensated hepatitis B cirrhosis. Body composition analyzer and formula method may underestimate REE predictions. Simultaneously, it is suggested that the effect of age on REE in H-B formula should be fully considered for male patients, while the area of visceral fat may have a certain impact on the interpretation of REE in female patients.
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Humans , Male , Female , Energy Metabolism , Liver Cirrhosis/metabolism , Calorimetry, Indirect/methods , HospitalizationABSTRACT
Paroxysmal sympathetic hyperactivity (PSH) is mainly secondary to a variety of acquired brain injuries, with the highest incidence of traumatic brain injury. Multiple symptoms such as paroxysmal tachycardia, shortness of breath, hypertension, hyperthermia and dystonia can occur simultaneously and repeatedly. The pathophysiological mechanism of PSH is complex. At present, drug treatment is mainly used to control symptoms; however, the combined use of multiple drugs will bring different degrees of toxic and side effects to multiple organs such as liver, kidney and lung while inhibiting sympathetic excitement. This paper mainly reviews the recent advance in non-drug treatment of PSH after craniocerebral injury from 4 aspects: nutritional support, hyperbaric oxygen therapy, avoidance of adverse stimulation and family support to standardize the PSH comprehensive management, and reduce episodes in order to improve prognosis and provide reference for clinical treatment.
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Objective:To investigate the incidence and related risk factors of refeeding syndrome (RFS) in patients with severe stroke.Methods:Patients with severe stroke admitted to the Department of Neurology, the First Affiliated Hospital of Soochow University underwent nutritional treatment again after fasting between December 2017 and October 2022 were included retrospectively. The incidence of RFS in patients with severe stroke was summarized. Multivariate logistic regression models were used to analyze the independent risk factors for RFS. A restricted cubic spline model was used to explore the dose-response relationship between relevant indicators and RFS. Results:A total of 188 patients were included, including 108 males and 80 females, with a median age of 72 years (interquartile range, 63-77 years); 185 patients (98.4%) had ischemic stroke and 3 (1.6%) had cerebral hemorrhage; 59 (31.4%) received enteral nutrition, 36 (19.1%) received gastrointestinal decompression, 30 (16.0%) received mechanical ventilation; and 60 patients (31.9%) developed RFS. Multivariate logistic regression analysis showed that serum creatinine (odds ratio [ OR] 1.011, 95% confidence interval [ CI] 1.001-1.020; P=0.025), serum potassium ( OR 8.349, 95% CI 3.025-23.039; P<0.001), serum phosphorus ( OR 46.578, 95% CI 6.444-336.661; P<0.001) and diabetes ( OR 2.173, 95% CI 1.087-4.345; P=0.028) were the independent risk factors for the occurrence of RFS. The restricted cubic spline model analysis showed that there was a non-linear relationship between serum creatinine and RFS, and the increased risk of RFS showed an "S" shape with the increase of serum creatinine. When serum creatinine exceeded 70.68 μmoI/L, the risk of RFS continued to increase. There was no non-linear relationship between serum phosphorus and serum potassium and RFS. Conclusions:Serum creatinine, serum phosphorus, serum potassium and diabetes are the independent risk factors for RFS in patients with severe stroke. These risk factors should be utilized to identify the high-risk patients with RFS early and the targeted measures should be taken as soon as possible.
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Objective:To carry out evidence-based nursing practice of nutritional management of patients in the perioperative period of hepatobiliary surgery, formulate review indicators based on the best evidence, analyze obstacles, and provide reference for the application of evidence in clinical practice.Methods:According to the "6S" evidence model, the search was conducted on Cochrane Library, Joanna Briggs Institute evidence-based Health Care Center Database, National Guideline Clearinghouse, National Institute for Health and Clinical Excellence, the British Journal of Medicine, PubMed, SinoMed, CNKI and Wanfang Database from the date of database construction to September 30, 2021. Through systematic search, evaluation and summary of evidence, the evidence-based nursing review plan for perioperative patients in hepatobiliary surgery was determined and the status review was conducted. Influencing factors were analyzed, and action strategies were formulated.Results:A total of 14 pieces of best evidence were included in this study, and 16 review indicators were formulated, of which the implementation rate of one indicator was 85%, and the implementation rate of the other indicators was 0-55%. The main obstacles include the following: the lack of relevant knowledge at the medical and nursing level; the resistance of medical staff caused by the increasing clinical work, the lack of systems, procedures, quantitative tools, and instruments and equipment; insufficient leadership, etc.Conclusions:There is a big gap between evidence-based nursing evidence and clinical practice. It should be combined with the judgment of clinical professionals and the results of the baseline review to analyze the obstacles and formulate action strategies to promote the effective transformation of evidence.
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Objective:To investigate the effects of nutritional support on chemotherapeutic efficacy and safety in patients with acute myeloid leukemia.Methods:A total of 130 patients with acute myeloid leukemia who received treatment in Lishui Municipal Central Hospital from January 2021 to December 2021 were included in this study. They were divided into a control group and an observation group ( n = 65/group) according to different nutritional support methods. Patients in the control group were given routine intervention, while patients in the observation group were given nutritional support based on routine intervention. These two interventions were administered till 1 month after chemotherapy. Chemotherapeutic efficacy and safety were compared between the two groups. Results:Total response rate in the observation group was significantly higher than that in the control group [92.3% (60/65) vs. 78.5% (51/65), Z = 4.91, P < 0.05]. After chemotherapy, waist-to-hip ratio, arm girth, and body mass index in the observation group were (0.9 ± 0.1), (25.7 ± 1.2) cm, (21.9 ± 2.1) kg/m 2, respectively, which were significantly greater than (0.8 ± 0.1), (24.4 ± 1.1) cm, (20.6 ± 2.1) kg/m 2 in the control group, respectively ( t = 4.13, 6.63, 3.64, all P < 0.05). Transferrin, albumin, prealbumin, and total serum protein in the observation group were (1.4 ± 0.3) g/L, (27.5 ± 3.1) g/L, (171.3 ± 11.3) mg/L, and (61.2 ± 4.3) g/L, respectively, which were significantly higher than (1.3 ± 0.3) g/L, (25.2 ± 2.9) g/L, (154.3 ± 10.3) mg/L, (56.6 ± 4.0) g/L respectively in the control group ( t = 2.24, 4.48, 8.93, 6.31, all P < 0.05). The scores of emotional state, social status, role cognition, and somatic perception in the observation group were (57.5 ± 4.6) points, (64.5 ± 3.8) points, (56.5 ± 4.1) points, (62.0 ± 4.2) points, which were significantly higher than (47.9 ± 4.2) points, (56.4 ± 3.2) points, (47.7 ± 4.5) points, (55.5 ± 5.4) points in the control group ( t = 12.34, 13.04, 11.55, 7.65, all P < 0.05). The total incidence of adverse reactions in the observation group was 9.2% (6/65), which was significantly lower than 24.6% (16/65) in the control group ( χ2 = 4.43, P < 0.05). Conclusion:Nutritional support can substantially improve chemotherapeutic efficacy in the treatment of acute myeloid leukemia, decrease the incidence of adverse reactions, and is safe. Therefore, nutritional support for patients with acute myeloid leukemia deserves clinical promotion.
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Objective:To analyze the worldwide development status and frontier hotspots in the field of critical care nutrition in recent 10 years, and to inform domestic future research direction.Methods:Publications on critical care nutrition researches between January 1, 2012 and December 31, 2021 were retrieved from Web of Science core database. CiteSpace and VOSviewer were used for visual analysis.Results:After screening, a total of 2,467 articles were included, with an overall increasing trend in the number of publications. A total of 11,301 authors devoted to critical care nutrition researches, among whom Daren K. Heyland (81) published the most globally and Academician Jieshou Li (9) published the most in China. The United States (812), China (221) and Canada (206) were the top 3 countries concerning numbers of publications in this field. The main research institutions were Harvard University, Queen's University and University of Leuven while Nanjing University ranked the highest domestically. Journal of Parenteral and Enteral Nutrition, Nutrition in Clinical Practice and Clinical Nutrition were the three most active journals in this field. Cluster analysis of keywords identified 11 representative cluster labels. Global focuses in critical care nutrition were influence of malnutrition, nutritional treatment pattern and energy and protein supplementation. Special interests were in the nutrition therapy in newborns, obese population and sepsis patients as well as intestinal microbial flora and coronavirus disease 2019.Conclusions:Critical care nutrition research is still under rapid development. Close collaboration between domestic core research circles and institutions should be emphasized while promoting international interactions. Researches on key issues such as energy and protein supplementation should be encouraged, so as to provide stronger evidence for better diagnosis and treatment standards in critical care nutrition.
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Reasonable nutrition management is important in the long-term care of cancer survivors. It can contribute to reducing the risk of metabolic complications, improving patients' understanding, beliefs, and behavior as regards healthy lifestyles, promoting lifestyle and dietary changes, and positively impacting disease treatment and long-term prognosis. To improve the long-term management of Chinese cancer survivors, reduce medical costs, and maximize clinical benefits and patient outcomes, the Cancer Nutrition Branch of the Chinese Nutrition Society has developed this consensus based on the current cancer patient management and nutritional therapy in China, evidence-based medicine from domestic and foreign publications, as well as expert opinions and experiences in clinical and nutritional fields. Following the Oxford Centre for Evidence-based Medicine (OCEBM) grading system, this consensus provides recommendations for nutritional risk screening, assessment (diagnosis), enteral and parenteral nutrition support, and medical nutrition therapy for cancer survivors, aiming to inform and support the standardized nutritional management of cancer survivors.
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Nutrition support nurse specialists play an important role in clinical management of patients with malnutrition and swallowing disorders. Here is the case report where nutrition support nurses were engaged in the whole course management of an elderly patient with severe malnutrition and swallowing disorder, including the early assessment, the multidisciplinary team intervention, and rehabilitation. With this case as well as related literature, the practice of the early intervention, dynamic whole course management, and the role of nutrition support nurses were discussed.
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Objective:To evaluate and summarize the best evidence of energy and protein intake targets and calculation in adult critically ill patients, and to provide evidence-based basis for critical nutrition management.Methods:Evidence related to energy and protein intake targets and calculation of adult critically ill patients, including guideline, expert consensus, systematic review and evidence summary, were systematically searched in PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Embase, Cochrane Library, UpToDate, BMJ Best Practice, Joanna Briggs Institute (JBI), Web of Science, SinoMed, Medive, China National Knowledge Infrastructure, Wanfang database, VIP database, Guidelines International Network (GIN), National Institute for Health and Care Excellence (NICE), National Guideline Clearinghouse (NGC), Registered Nurses Association of Ontario (RNAO), and Society of Critical Care Medicine (SCCM) from January 2012 to June 2022. Two researchers independently evaluated the quality of the included literatures using the JBI Evidence-based Health Care Center evaluation tool and the Appraisal of Clinical Practice Guidelines for Research and Evaluation Ⅱ (AGREE Ⅱ), extracted and summarized the best evidence for the nutritional intake goal and calculation of adult critically ill patients, and described the evidence.Results:A total of 18 literatures were included, including 5 clinical guidelines, 8 expert consensus, 3 systematic reviews and 2 evidence summaries. After literature quality evaluation, 18 articles were all enrolled. The evidence was summarized from the four aspects, including energy target calculation method, dose body weight, energy and protein intake target, and calculation method, 24 pieces of the best evidence were finally formed.Conclusions:The best evidence of energy and protein intake targets and calculation for critically ill patients was summarized based on evidence-based. Clinical medical staff can choose indirect calorimetry to calculate energy goals when equipment is available. Patient's height, body weight should be recorded accurately, dose body weight can be determined by body mass index (BMI). Meanwhile, blood urea nitrogen (BUN) loss, fat-free body weight, simple formulas and other methods should be used to continuously evaluate and adjust protein intake targets, to achieve the purpose of optimizing intensive nutrition support.
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Gastric cancer is one of the common tumors in the world and a major cause of cancer death.Although the 5-year survival rate of gastric cancer patients has increased greatly with the improvement levels of diagnosis and treatment,the high malnutri-tion rate of gastric cancer patients still has a significant impact on their overall survival and quality of life.Malnutrition is considered an independent prognostic factor for cancer patients,early detection of malnutrition in gastric cancer patients and more reasonable peri-operative nutritional support play an important role in the survival and prognosis of gastric cancer patients.This article combines exist-ing research at domestic and abroad to review the nutritional risk screening and assessment of gastric cancer patients during periopera-tive period,as well as the research progress of perioperative nutritional support and immunonutrition,in order to provide more compre-hensive nutritional management strategies for patients with gastric cancer during the perioperative period.
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The most common complication in patients with end-stage liver disease is mal-nutrition, which is caused by the metabolic disorders of sugar, protein and fat for the metabolic dys-function of liver during the perioperative period of liver transplantation. Nutritional support is very important during the liver transplantation.Perioperative nutritional support can improve the nutri-tional status of patients, increase the chance of liver transplantation, reduce postoperative mortality and improve outcome. By reviewing the recent interventions of perioperative nutrition support for liver transplantation, and analyzing nutritional screening and nutritional assessment tools and their advantages and disadvantages, the authors emphasize the rational assessment of early nutrition, provide reasonable and personalized parenteral and enteral nutrition support, especially for energy, protein and other nutrients. We also emphasize the importance of long-term reasonable nutrition support, monitoring and diet nutrition education in order to provide reference and suggestion for improving the nutritional status of liver transplantation patients and to provide evidence-based basis for constructing standardized perioperative nutrition support program of liver transplantation.
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Micronutrients (MNs), including vitamins and trace elements, play an indispensable role in human metabolism, immune function and other aspects. Due to the chronic microinflammation and long-term chemoradiotherapy, patients with malignant tumors often suffer from malnutrition, resulting in different degrees of MNs deficiency. In severe cases, MNs deficiency is closely related to the adverse clinical outcomes. Therefore, reasonable MNs supplementation is of great significance in improving the prognosis and quality of life of patients with tumors. Recently, multiple guidelines have made recommendations on the application of MN supplementation in various clinical settings, providing evidence for the standardized MN supplementation in patients with malignant tumors.
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Hip fractures are among the most common fractures in the elderly, presenting to be a leading cause of disability and mortality. Surgical treatment is currently the main treatment method for hip fractures. The incidence of perioperative malnutrition is increased after hip fractures in the elderly due to the comorbidities, decreased basal metabolic rate, accelerated protein breakdown, weakened anabolism and surgical stress. However, malnutrition not only increases the incidence of postoperative complications, but also leads to increased mortality, indicating an important role of perioperative nursing management of nutrition for the elderly patients with hip fractures. At present, there still lacks scientific guidance and application standards on perioperative nursing management of nutrition for the elderly patients with hip fractures. Therefore, the Orthopedic Nursing Committee of Chinese Nursing Association and the Editorial Board of Chinese Journal of Trauma organized relevant experts to formulate the Expert consensus on perioperative nursing management of nutrition for elderly patients with hip fractures ( version 2023) according to evidence-based medical evidences and their clinical experiences. Fourteen recommendations were made from aspects of nutrition screening, nutrition assessment, nutrition diagnosis, nutrition intervention and nutrition monitoring to provide guidance for perioperative nursing management of nutrition in elderly patients with hip fractures.
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Patients with end-stage liver disease after liver transplantation constantly suffer from malnutrition due to primary diseases and transplantation-related factors. Malnutrition will worsen clinical condition of the patients, increase the incidence of complication, length of hospital stay and medical expense after transplantation, and lower the survival rate. Sufficient nutritional support at all stages of liver transplantation is of significance. Accurate assessment of nutritional status and timely intervention are prerequisites for perioperative nutritional treatment in liver transplantation. In this article, the latest nutritional risk screening indexes and evaluation tools, nutritional support methods and other perioperative nutritional intervention measures for liver transplantation were reviewed, aiming to deepen the understanding and cognition of perioperative nutritional therapy for liver transplantation and provide reference for improving nutritional status and clinical prognosis of liver transplant recipients.