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SEVERE BRAIN INJURY: DOES NUTRITION THERAPY IMPROVE REHABILITATION OUTCOMES IN TERMS OF BEDSORES?
6
SINPE conference abstracts / Nutrition 65 (2019) 110580
From May 2017 to July 2018, n. 65 BIVA were performed in both AN or CL underweight patients. Results are presented in Table 1. Median phase angle is 6,1§1,6 (5,9§1,0 in men, 6,1§1,0 in women). Results by age group are presented in Table 2. Result by subgroup (AN or CL) are presented in Table 3. Median phase angle is 6,4§2,0 in AN, 5,7§0,9 in CL. In our sample there are no significant differences in BMI and phase angle neither between underweight men and women nor between anorectic and constitutionally lean patients. Though, phase angle could be a reliable marker of changes in body composition throughout nutritional treatment.Marra M, Caldara A, Montagnese C, De Filippo E, Pasanisi F, Contaldo F, Scalfi L. Bioelectrical impedance phase angle in constitutionally lean females, ballet dancers and patients with anorexia nervosa. Eur J Clin Nutr. 2009 Jul;63(7):905-8
NUTRITIONAL SUPPORT IN HOSPITALIZED PATIENTS UNDERGOING ALLOGENIC HEMATOPOIETIC STEM CELL TRANSPLANTATION ,1
1
2
A. De Rosa * , C. De Caprio , A.M. Risitano , S. Marotta 2, L. Marano 2, F. Pasanisi 1, F. Contaldo 1 1 Medicina Interna e Nutrizione Clinica, AOU Federico II, Napoli, Italy 2 EMATOLOGIA AOU FEDERICO II, NAPOLI, Italy Assessment of the need of parenteral nutrition (PN) for patients undergoing allogeneic Haematopoietic Stem Cell Transplantation (HSCT) and effectiveness of nutritional support. 41 consecutive patients (20 females, 21 males) undergoing allogenic HSCT at the Transplant Center of the AOU Federico II of Naples in the years 20142016. Anthropometric parameters, biochemical indices and artificial / parenteral nutrition requirements were evaluated at admission and discharge. Total or supportive PN due to several disease and therapy related complications was indicated for 68.3% of patients (89.3% galenic, 35.7% glutamine enriched, indication reported in table 1). Median duration of nutritional support was 13 days, median timing for start support was 8 days. 87.5% of patients in PN received a TBF conditioning scheme (thiotepa, busulfan, fludarabine), 57.1% immunosuppressive therapy with high-dose cyclophosphamide, 53.6% hematopoietic stem cells from a haploidentical donor (67.9% bone marrow source). Average length of hospitalization, biochemical nutritional and hematological indices and anthropometric parameters observed at discharge are shown in table 2. 42.2% of the patients had home artificial nutrition support (71.5% oral nutritional supplement, 28.5% PN). PN (personalized nutritional intervention) allows patients undergoing allogenic HSCT who have developed more severe complications to achieve a clinical-haematological recovery such as patients without or with minor complications.
SEVERE BRAIN INJURY: DOES NUTRITION THERAPY IMPROVE REHABILITATION OUTCOMES IN TERMS OF BEDSORES? S. Madiai *, A. Consales, C.F. Gheri, S. Pancani, F. Campani, B. Biffi, S. Vidali, C. Macchi, A.M. Romoli, M. Dalladonna, M.L.E. Luisi IRCCS Fondazione Don Carlo Gnocchi, Firenze, Italy We aimed to evaluate the effect an adequate nutritional intervention, carried out by an experienced Nutritional Team, has on the risk and degree of bedsores (BS) in patients with severe brain injuries (SBI). The study was conducted on 50 patients (mean age 59 years, 34% females) admitted in the SBI ward of our hospital. Patients were screened at admission and discharge for the risk of malnutrition (MUST) and of Braden Scale; number and degree of BS (EDUAP Guidelines) and biochemical markers of malnutrition were also registered. A significant decrease in patients’ artificial nutrition, MUST score and number and degree of bedsores was observed at discharge. At the same time, after hospitalization, patients showed higher levels of albumin, transferrin and lymphocytes and higher energy and proteins intake per day (Table 1).
Although the development of BS is a multifactorial process, influenced by many more factors other than nutrition, we suggest that a correct nutritional intervention could improve the healing process, hence the outcome, in patients with SBI. These preliminary results are consistent with the most recent ESPEN Neurological Guidelines, which recommend the presence in the neurological rehabilitation team of a dietitian or nutritionist with experience in SBI, who can provide a personalized nutritional plan and monitor it over time in order to maximize the rehabilitation potential of the patient.
Table 1 Comparison between patients’ characteristics at admission and discharge. Variables are represented through their mean § standard deviation.
Age (years) Sex (% females) MUST (score) Total proteins level (mg/dL) Albumin level (g/dL) Transferrin level (mg/dL) Lymphocytes (x10^3/mL) Enteral nutrition (yes%) Oral nutrition (yes%) Total intake die (kcal) Total intake die/weight (kcal/kg/die) Proteins intake die (g) Proteins/weight (g/kg/die) Bedsores (nr) Bedsore stage
Nr
Admission
Discharge
p value
50 50 50 50 49 47 50 41 43 43 21
59.1§16.7 34% 2.1§1.0 6,1§0.7 3.0§0.6 176.6§44.0 1.8§0.8 83% 14% 1704.7§332.3 25.2§6.3
1.3§1.2 6.0§0.5 3.2§0.5 202.7§53.4 2.1§1.0 51% 53% 2073.5§287.4 32.3§8.9
<0.001 0.427 <0.001 <0.001 0.008 0.045 0.023 <0.001 <0.001
40 19 50 50
71.9§18.2 1.1§0.3 2.4§1.4 2.2§0.5
85.6§18.0 1.3§0.3 0.5§1.0 0.5§1.0
0.001 0.036 <0.001 <0.001
BIOIMPEDANCE VECTOR ANOREXIA NERVOSA
ANALYSIS
IN
PATIENTS
WITH
A. Mascheroni *, B. Tamburelli, M.E. Tirelli, A. Asta, C. Chiariello, A.M. Misotti ASST Melegnano e Martesana / UOSD Dietologia e Nutrizione Clinica, Melegnano (MI), Italy The aim of this analysis is to evaluate the results of Bioimpedance Vector Analysis (BIVA) performed in patients with Anorexia Nervosa (AN). Anthropometric values, as body height and weight, were measured in patients with AN that accessed our service from May 2017 to July 2018. BIVA was performed with a single-frequency bioimpedance analyzer (BIA 101 RJL, Akern Bioresearch, Firenze, Italy) and resting energy expenditure (REE) measured with and indirect calorimetry. Median resistance, reactance and phase angle and standard deviations were calculated. From May 2017 to July 2018, n. 53 BIVA were performed in patients with AN. Results are presented in Table 1. Females are 94% of our sample; median age is 23,5 §9,4 (16,7§1,5 in males, 24,0§9,5 in females); median BMI is 17,7§2,7 (15,6§3,0 in males, 17,8§2,7 in females); median resistance is 660§103 (694§197 in males; 658§98 in females); median reactance is 72§16 (76§ in males; 72§16 in females); median phase angle is 6,4§1,8 (6,3§1,1 in males; 6,4§1,9 in females). Median REE is 1194§224 kcal (1316§107 in men; 1187§228 in women). The distribution of phase angles of our sample is shown in Figure 1, with the median phase angle indicated with the arrow. BIVA could be helpful and may distinguish between fluid or tissue-related increases in body weight over treatment period in patients with AN.Haas V, Riedl A, Hofmann T, Nischan A, Burghardt R, Boschmann M, Klapp B. Bioimpedance and bioimpedance vector analysis in patients with anorexia nervosa. Eur Eat Disord Rev. 2012 Sep;20(5):400-5.
SINPE conference abstracts / Nutrition 65 (2019) 110580
From May 2017 to July 2018, n. 65 BIVA were performed in both AN or CL underweight patients. Results are presented in Table 1. Median phase angle is 6,1§1,6 (5,9§1,0 in men, 6,1§1,0 in women). Results by age group are presented in Table 2. Result by subgroup (AN or CL) are presented in Table 3. Median phase angle is 6,4§2,0 in AN, 5,7§0,9 in CL. In our sample there are no significant differences in BMI and phase angle neither between underweight men and women nor between anorectic and constitutionally lean patients. Though, phase angle could be a reliable marker of changes in body composition throughout nutritional treatment.Marra M, Caldara A, Montagnese C, De Filippo E, Pasanisi F, Contaldo F, Scalfi L. Bioelectrical impedance phase angle in constitutionally lean females, ballet dancers and patients with anorexia nervosa. Eur J Clin Nutr. 2009 Jul;63(7):905-8
NUTRITIONAL SUPPORT IN HOSPITALIZED PATIENTS UNDERGOING ALLOGENIC HEMATOPOIETIC STEM CELL TRANSPLANTATION ,1
1
2
A. De Rosa * , C. De Caprio , A.M. Risitano , S. Marotta 2, L. Marano 2, F. Pasanisi 1, F. Contaldo 1 1 Medicina Interna e Nutrizione Clinica, AOU Federico II, Napoli, Italy 2 EMATOLOGIA AOU FEDERICO II, NAPOLI, Italy Assessment of the need of parenteral nutrition (PN) for patients undergoing allogeneic Haematopoietic Stem Cell Transplantation (HSCT) and effectiveness of nutritional support. 41 consecutive patients (20 females, 21 males) undergoing allogenic HSCT at the Transplant Center of the AOU Federico II of Naples in the years 20142016. Anthropometric parameters, biochemical indices and artificial / parenteral nutrition requirements were evaluated at admission and discharge. Total or supportive PN due to several disease and therapy related complications was indicated for 68.3% of patients (89.3% galenic, 35.7% glutamine enriched, indication reported in table 1). Median duration of nutritional support was 13 days, median timing for start support was 8 days. 87.5% of patients in PN received a TBF conditioning scheme (thiotepa, busulfan, fludarabine), 57.1% immunosuppressive therapy with high-dose cyclophosphamide, 53.6% hematopoietic stem cells from a haploidentical donor (67.9% bone marrow source). Average length of hospitalization, biochemical nutritional and hematological indices and anthropometric parameters observed at discharge are shown in table 2. 42.2% of the patients had home artificial nutrition support (71.5% oral nutritional supplement, 28.5% PN). PN (personalized nutritional intervention) allows patients undergoing allogenic HSCT who have developed more severe complications to achieve a clinical-haematological recovery such as patients without or with minor complications.
SEVERE BRAIN INJURY: DOES NUTRITION THERAPY IMPROVE REHABILITATION OUTCOMES IN TERMS OF BEDSORES? S. Madiai *, A. Consales, C.F. Gheri, S. Pancani, F. Campani, B. Biffi, S. Vidali, C. Macchi, A.M. Romoli, M. Dalladonna, M.L.E. Luisi IRCCS Fondazione Don Carlo Gnocchi, Firenze, Italy We aimed to evaluate the effect an adequate nutritional intervention, carried out by an experienced Nutritional Team, has on the risk and degree of bedsores (BS) in patients with severe brain injuries (SBI). The study was conducted on 50 patients (mean age 59 years, 34% females) admitted in the SBI ward of our hospital. Patients were screened at admission and discharge for the risk of malnutrition (MUST) and of Braden Scale; number and degree of BS (EDUAP Guidelines) and biochemical markers of malnutrition were also registered. A significant decrease in patients’ artificial nutrition, MUST score and number and degree of bedsores was observed at discharge. At the same time, after hospitalization, patients showed higher levels of albumin, transferrin and lymphocytes and higher energy and proteins intake per day (Table 1).
Although the development of BS is a multifactorial process, influenced by many more factors other than nutrition, we suggest that a correct nutritional intervention could improve the healing process, hence the outcome, in patients with SBI. These preliminary results are consistent with the most recent ESPEN Neurological Guidelines, which recommend the presence in the neurological rehabilitation team of a dietitian or nutritionist with experience in SBI, who can provide a personalized nutritional plan and monitor it over time in order to maximize the rehabilitation potential of the patient.
Table 1 Comparison between patients’ characteristics at admission and discharge. Variables are represented through their mean § standard deviation.
Age (years) Sex (% females) MUST (score) Total proteins level (mg/dL) Albumin level (g/dL) Transferrin level (mg/dL) Lymphocytes (x10^3/mL) Enteral nutrition (yes%) Oral nutrition (yes%) Total intake die (kcal) Total intake die/weight (kcal/kg/die) Proteins intake die (g) Proteins/weight (g/kg/die) Bedsores (nr) Bedsore stage
Nr
Admission
Discharge
p value
50 50 50 50 49 47 50 41 43 43 21
59.1§16.7 34% 2.1§1.0 6,1§0.7 3.0§0.6 176.6§44.0 1.8§0.8 83% 14% 1704.7§332.3 25.2§6.3
1.3§1.2 6.0§0.5 3.2§0.5 202.7§53.4 2.1§1.0 51% 53% 2073.5§287.4 32.3§8.9
<0.001 0.427 <0.001 <0.001 0.008 0.045 0.023 <0.001 <0.001
40 19 50 50
71.9§18.2 1.1§0.3 2.4§1.4 2.2§0.5
85.6§18.0 1.3§0.3 0.5§1.0 0.5§1.0
0.001 0.036 <0.001 <0.001
BIOIMPEDANCE VECTOR ANOREXIA NERVOSA
ANALYSIS
IN
PATIENTS
WITH
A. Mascheroni *, B. Tamburelli, M.E. Tirelli, A. Asta, C. Chiariello, A.M. Misotti ASST Melegnano e Martesana / UOSD Dietologia e Nutrizione Clinica, Melegnano (MI), Italy The aim of this analysis is to evaluate the results of Bioimpedance Vector Analysis (BIVA) performed in patients with Anorexia Nervosa (AN). Anthropometric values, as body height and weight, were measured in patients with AN that accessed our service from May 2017 to July 2018. BIVA was performed with a single-frequency bioimpedance analyzer (BIA 101 RJL, Akern Bioresearch, Firenze, Italy) and resting energy expenditure (REE) measured with and indirect calorimetry. Median resistance, reactance and phase angle and standard deviations were calculated. From May 2017 to July 2018, n. 53 BIVA were performed in patients with AN. Results are presented in Table 1. Females are 94% of our sample; median age is 23,5 §9,4 (16,7§1,5 in males, 24,0§9,5 in females); median BMI is 17,7§2,7 (15,6§3,0 in males, 17,8§2,7 in females); median resistance is 660§103 (694§197 in males; 658§98 in females); median reactance is 72§16 (76§ in males; 72§16 in females); median phase angle is 6,4§1,8 (6,3§1,1 in males; 6,4§1,9 in females). Median REE is 1194§224 kcal (1316§107 in men; 1187§228 in women). The distribution of phase angles of our sample is shown in Figure 1, with the median phase angle indicated with the arrow. BIVA could be helpful and may distinguish between fluid or tissue-related increases in body weight over treatment period in patients with AN.Haas V, Riedl A, Hofmann T, Nischan A, Burghardt R, Boschmann M, Klapp B. Bioimpedance and bioimpedance vector analysis in patients with anorexia nervosa. Eur Eat Disord Rev. 2012 Sep;20(5):400-5.