Displaying publications 1 - 20 of 40 in total

Abstract:
Sort:
  1. Chin L, Choo PPL, Ng DC
    BMJ Case Rep, 2021 Nov 02;14(11).
    PMID: 34728517 DOI: 10.1136/bcr-2021-246970
    Matched MeSH terms: Parenteral Nutrition/adverse effects; Parenteral Nutrition, Total/adverse effects; Parenteral Nutrition Solutions
  2. Iqbal QM
    Med J Malaysia, 1976 Mar;30(3):221-3.
    PMID: 822263
    Matched MeSH terms: Parenteral Nutrition*
  3. Notz Q, Lee ZY, Menger J, Elke G, Hill A, Kranke P, et al.
    Crit Care, 2022 01 19;26(1):23.
    PMID: 35045885 DOI: 10.1186/s13054-022-03896-3
    BACKGROUND: Parenteral lipid emulsions in critical care are traditionally based on soybean oil (SO) and rich in pro-inflammatory omega-6 fatty acids (FAs). Parenteral nutrition (PN) strategies with the aim of reducing omega-6 FAs may potentially decrease the morbidity and mortality in critically ill patients.

    METHODS: A systematic search of MEDLINE, EMBASE, CINAHL and CENTRAL was conducted to identify all randomized controlled trials in critically ill patients published from inception to June 2021, which investigated clinical omega-6 sparing effects. Two independent reviewers extracted bias risk, treatment details, patient characteristics and clinical outcomes. Random effect meta-analysis was performed.

    RESULTS: 1054 studies were identified in our electronic search, 136 trials were assessed for eligibility and 26 trials with 1733 critically ill patients were included. The median methodologic score was 9 out of 14 points (95% confidence interval [CI] 7, 10). Omega-6 FA sparing PN in comparison with traditional lipid emulsions did not decrease overall mortality (20 studies; risk ratio [RR] 0.91; 95% CI 0.76, 1.10; p = 0.34) but hospital length of stay was substantially reduced (6 studies; weighted mean difference [WMD] - 6.88; 95% CI - 11.27, - 2.49; p = 0.002). Among the different lipid emulsions, fish oil (FO) containing PN reduced the length of intensive care (8 studies; WMD - 3.53; 95% CI - 6.16, - 0.90; p = 0.009) and rate of infectious complications (4 studies; RR 0.65; 95% CI 0.44, 0.95; p = 0.03). When FO was administered as a stand-alone medication outside PN, potential mortality benefits were observed compared to standard care.

    CONCLUSION: Overall, these findings highlight distinctive omega-6 sparing effects attributed to PN. Among the different lipid emulsions, FO in combination with PN or as a stand-alone treatment may have the greatest clinical impact. Trial registration PROSPERO international prospective database of systematic reviews (CRD42021259238).

    Matched MeSH terms: Parenteral Nutrition*
  4. Abidin Z, Kuhan N
    Med J Malaysia, 1984 Sep;39(3):192-6.
    PMID: 6443580
    Seven infants with birth weights less than lS00g received total parenteral nutrition for seven to 16 days through the peripheral route, commencing within the first 24 hours of life. Excessive weight loss was prevented and the infants showed significant weight gain. The time required to regain the initial birth weight showed an improvement over that expected in conventionally managed infants. Metabolic and septic complications were minimal and easily manageable. The results demonstrate that the technique, when properly used, warrants consideration in feeding low birth weight infants incapable of tolerating enteral feeding.
    Matched MeSH terms: Parenteral Nutrition, Total*
  5. Mohd Basri bin Mat Nor
    MyJurnal
    Nutritional support is vital in improving the clinical outcomes of the critically ill patients. Almost all published guidelines regarding nutritional support in the critically ill recommend the use of enteral nutrition over parenteral nutrition. In acute pancreatitis, trial of enteral feeding should be given into the small bowel. The success rate of small bowel feeding tube is highest if inserted endoscopically. In this case report, a simple bedside procedure which did not require endoscopic feeding tube placement offered a good alternative. Self advancing small bowel feeding tube, Tiger tube was inserted successfully to provide nutritional support in moderately severe acute pancreatitis.
    Matched MeSH terms: Parenteral Nutrition; Parenteral Nutrition, Total
  6. Yaacob Y, Zakaria R, Mohammad Z, Ralib AR, Muda AS
    Malays J Med Sci, 2011 Oct;18(4):98-102.
    PMID: 22589680
    Central venous catheter placement is indicated in patients requiring long-term therapy. With repeated venous catheterisations, conventional venous access sites can be exhausted. This case illustrates the expanding role of radiology in managing difficult venous access. We present a case of translumbar, transhepatic, and transcollateral placement of central catheter in a woman with a difficult venous access problem who required lifelong parenteral nutrition secondary to short bowel syndrome. This case highlights the technical aspects of interventional radiology in vascular access management.
    Matched MeSH terms: Parenteral Nutrition; Parenteral Nutrition, Total
  7. Bolisetty S, Osborn D, Schindler T, Sinn J, Deshpande G, Wong CS, et al.
    BMC Pediatr, 2020 02 08;20(1):59.
    PMID: 32035481 DOI: 10.1186/s12887-020-1958-9
    BACKGROUND: The first consensus standardised neonatal parenteral nutrition formulations were implemented in many neonatal units in Australia in 2012. The current update involving 49 units from Australia, New Zealand, Singapore, Malaysia and India was conducted between September 2015 and December 2017 with the aim to review and update the 2012 formulations and guidelines.

    METHODS: A systematic review of available evidence for each parenteral nutrient was undertaken and new standardised formulations and guidelines were developed.

    RESULTS: Five existing preterm Amino acid-Dextrose formulations have been modified and two new concentrated Amino acid-Dextrose formulations added to optimise amino acid and nutrient intake according to gestation. Organic phosphate has replaced inorganic phosphate allowing for an increase in calcium and phosphate content, and acetate reduced. Lipid emulsions are unchanged, with both SMOFlipid (Fresenius Kabi, Australia) and ClinOleic (Baxter Healthcare, Australia) preparations included. The physicochemical compatibility and stability of all formulations have been tested and confirmed. Guidelines to standardise the parenteral nutrition clinical practice across facilities have also been developed.

    CONCLUSIONS: The 2017 PN formulations and guidelines developed by the 2017 Neonatal Parenteral Nutrition Consensus Group offer concise and practical instructions to clinicians on how to implement current and up-to-date evidence based PN to the NICU population.

    Matched MeSH terms: Parenteral Nutrition*; Parenteral Nutrition Solutions*
  8. Rizka H, Diyah EA
    Med J Malaysia, 2023 Jul;78(4):541-546.
    PMID: 37518930
    Malnutrition is one of the most frequent effects of an enterocutaneous fistula (ECF). There are some factors that contribute to it including inadequate intake, fluid loss via fistula and underlying disease. The role of nutrition is very important as a part of ECF therapy to give adequate nutrition, maintain fluid and electrolyte state and increase the likelihood of fistula closure spontaneously. Therefore, it is anticipated that adequate nutrition management will lower morbidity and mortality while enhancing clinical results. Nutritional requirements and nutritional route, whether oral, enteral and parenteral nutrition in ECF management, are influenced by the anatomical, physiological and aetiology of the fistula. The purpose of this review was to highlight the evidence based on nutritional therapy in ECF patients by calling attention to nutritional route selection based on the anatomy and physiology fistula to prevent malnutrition.
    Matched MeSH terms: Parenteral Nutrition
  9. Gee T, Lim SY, Sudhakaran N, Hassan MF
    J Surg Case Rep, 2019 Apr;2019(4):rjz095.
    PMID: 30997009 DOI: 10.1093/jscr/rjz095
    Short bowel syndrome in adults occurs as a result of massive small intestinal resection commonly due to severe Crohn's disease, volvulus or tumors. Diarrhea and weight loss are hallmarks of malabsorption which are aggravated if the colon is removed along with the small intestinal resection. Enteral nutrition autonomy is difficult to achieve in such cases of malabsorption where parenteral nutrition are required more often than not. We report a case of short bowel syndrome with severe malabsorption following extensive small bowel removal. The patient eventually underwent intestinal rehabilitation surgery and achieved independence from parenteral nutrition.
    Matched MeSH terms: Parenteral Nutrition; Parenteral Nutrition, Total
  10. Premakumar CM, Turner MA, Morgan C
    Nutr Rev, 2019 12 01;77(12):878-889.
    PMID: 31504841 DOI: 10.1093/nutrit/nuz049
    CONTEXT: Very preterm neonates (VPNs) are unable to digest breast milk and therefore rely on parenteral nutrition (PN) formulations. This systematic review was prepared following PRISMA-P 2015 guidelines. For the purpose of this review, desirable mean plasma arginine concentration is defined as ≥80 micromoles/L.

    OBJECTIVE: The review was performed to answer the following research question: "In VPNs, are high amounts of arginine in PN, compared with low amounts of arginine, associated with appropriate circulating concentrations of arginine?" Therefore, the aims were to 1) quantify the relationship between parenteral arginine intakes and plasma arginine concentrations in PN-dependent VPNs; 2) identify any features of study design that affect this relationship; and 3) estimate the target parenteral arginine dose to achieve desirable preterm plasma arginine concentrations.

    DATA SOURCES: The PubMed, Scopus, Web of Science, and Cochrane databases were searched regardless of study design; review articles were not included.

    DATA EXTRACTION: Only articles that discussed amino acid (AA) intake and measured plasma AA profile post PN in VPNs were included. Data were obtained using a data extraction checklist that was devised for the purpose of this review.

    DATA ANALYSIS: Twelve articles met the inclusion criteria. The dose-concentration relationship of arginine content (%) and absolute arginine intake (mg/(kg × d)) with plasma arginine concentrations showed a significant positive correlation (P < 0.001).

    CONCLUSION: Future studies using AA solutions with arginine content of 17%-20% and protein intakes of 3.5-4.0 g/kg per day may be needed to achieve higher plasma arginine concentrations.

    Matched MeSH terms: Parenteral Nutrition*
  11. Roszali MA, Zakaria AN, Mohd Tahir NA
    Clin Nutr ESPEN, 2021 02;41:275-280.
    PMID: 33487276 DOI: 10.1016/j.clnesp.2020.11.023
    BACKGROUND & AIMS: Hyperglycemia is among the common complications of parenteral nutrition (PN) and is often associated with increased mortality despite being treatable. Studies of parenteral nutrition causing hyperglycemia are limited and even available studies lack methodological conduct. This study aimed to evaluate the prevalence, predictors and management of PN-associated hyperglycemia (PN-AH).

    METHODS: A retrospective study was conducted at a tertiary hospital. Patients ≥ 18 years old who received parenteral nutrition from 2015 to 2018 were conveniently selected. The demographic data, diagnosis, clinically relevant data, blood glucose readings and management of hyperglycemia were gathered from electronic medical records.

    RESULTS: Among 300 patients included in the study, 140 (46.7%) reported the PN-AH events. Multivariate logistic regression analysis showed female sex, Malay ethnicity, underlying type 2 diabetes mellitus, liver impairment, elevated pre-PN glucose level > 180 mg/dL and ICU admission were independently associated with hyperglycemia (p 

    Matched MeSH terms: Parenteral Nutrition/adverse effects
  12. Chen Y, Liu Z, Wang Q, Gao F, Xu H, Ke L, et al.
    Crit Care, 2024 Jan 20;28(1):26.
    PMID: 38245768 DOI: 10.1186/s13054-024-04813-6
    BACKGROUND AND AIMS: Exclusive enteral nutrition (EN) is often observed during the first week of ICU admission because of the extra costs and safety considerations for early parenteral nutrition. This study aimed to assess the association between nutrition intake and 28-day mortality in critically ill patients receiving exclusive EN.

    METHODS: This is a post hoc analysis of a cluster-randomized clinical trial that assesses the effect of implementing a feeding protocol on mortality in critically ill patients. Patients who stayed in the ICUs for at least 7 days and received exclusive EN were included in this analysis. Multivariable Cox hazard regression models and restricted cubic spline models were used to assess the relationship between the different doses of EN delivery and 28-day mortality. Subgroups with varying lactate levels at enrollment were additionally analyzed to address the potential confounding effect brought in by the presence of shock-related hypoperfusion.

    RESULTS: Overall, 1322 patients were included in the analysis. The median (interquartile range) daily energy and protein delivery during the first week of enrollment were 14.6 (10.3-19.6) kcal/kg and 0.6 (0.4-0.8) g/kg, respectively. An increase of 5 kcal/kg energy delivery was associated with a significant reduction (approximately 14%) in 28-day mortality (adjusted hazard ratio [HR] = 0.865, 95% confidence interval [CI]: 0.768-0.974, P = 0.016). For protein intake, a 0.2 g/kg increase was associated with a similar mortality reduction with an adjusted HR of 0.868 (95% CI 0.770-0.979). However, the benefits associated with enhanced nutrition delivery could be observed in patients with lactate concentration ≤ 2 mmol/L (adjusted HR = 0.804 (95% CI 0.674-0.960) for energy delivery and adjusted HR = 0.804 (95% CI 0.672-0.962) for protein delivery, respectively), but not in those > 2 mmol/L.

    CONCLUSIONS: During the first week of critical illness, enhanced nutrition delivery is associated with reduced mortality in critically ill patients receiving exclusive EN, only for those with lactate concentration ≤ 2 mmol/L.

    TRIAL REGISTRATION: ISRCTN12233792, registered on November 24, 2017.

    Matched MeSH terms: Parenteral Nutrition/methods
  13. Klek S, Del Rio Requejo IM, Hardy G, Francisco LMP, Abbasoglu O, Acosta JCA, et al.
    Nutrition, 2024 Jul;123:112396.
    PMID: 38554461 DOI: 10.1016/j.nut.2024.112396
    OBJECTIVE: Parenteral nutrition represents a therapeutic option for patients with type 3 intestinal failure. If used exclusively, parenteral nutrition has to be complete to provide all essential nutrients. The aim was to assess the availability of parenteral nutrition in all parts of the world, to better comprehend the global situation, and to prepare an action plan to increase access to parenteral nutrition.

    METHODS: An international survey using an electronic questionnaire was conducted in August 2019 and repeated in May 2022. An electronic questionnaire was sent to 52 members or affiliates of the International Clinical Nutrition Section of the American Society for Parenteral and Enteral Nutrition. Questions addressed the availability of parenteral nutrition admixtures and their components, reimbursement, and prescribing pre- and post-COVID-19 pandemic. All participating countries were categorized by their economic status.

    RESULTS: Thirty-six country representatives responded, answering all questions. Parenteral nutrition was available in all countries (100%), but in four countries (11.1%) three-chamber bags were the only option, and in six countries a multibottle system was still used. Liver-sparing amino acids were available in 18 (50%), kidney-sparing in eight (22.2%), and electrolyte-free in 11 (30.5%) countries (30.5%). In most countries (n = 28; 79.4%), fat-soluble and water-soluble vitamins were available. Trace elements solutions were unavailable in four (11.1%) countries. Parenteral nutrition was reimbursed in most countries (n = 33; 91.6%). No significant problems due to the coronavirus pandemic were reported.

    CONCLUSIONS: Despite the apparent high availability of parenteral nutrition worldwide, there are some factors that may have a substantial effect on the quality of parenteral nutrition admixtures. These shortages create an environment of inequality.

    Matched MeSH terms: Parenteral Nutrition Solutions/supply & distribution
  14. Shasha Khairullah, Rokiah Che Ismail
    JUMMEC, 2010;13(1):50-58.
    MyJurnal
    Prescribing medication is not without its adverse effects. Complications due to drug therapy are on the rise in Malaysia, especially when antibiotics are used indiscriminately. We reviewed cases admitted to the Acute Medical Ward of University of Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia, over a two-month period from March to April 2009. The authors found that Stevens-Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) were the most common severe adverse cutaneous reactions due to ingestion or parenteral use of drugs. In this report, is a brief description of the two conditions and ways to manage them. The authors have come to a conclusion that judicious use of medications with adequate patient education is important in order to avoid these adverse effects.
    Matched MeSH terms: Parenteral Nutrition
  15. Ibrahim NR, Kheng TH, Nasir A, Ramli N, Foo JLK, Syed Alwi SH, et al.
    Arch. Dis. Child. Fetal Neonatal Ed., 2017 May;102(3):F225-F229.
    PMID: 27671836 DOI: 10.1136/archdischild-2015-310246
    OBJECTIVE: To determine whether feeding with 2-hourly or 3-hourly feeding interval reduces the time to achieve full enteral feeding and to compare their outcome in very low birthweight preterm infants.

    DESIGN: Parallel-group randomised controlled trial with a 1:1 allocation ratio.

    SETTING: Two regional tertiary neonatal intensive care units.

    PATIENTS: 150 preterm infants less than 35 weeks gestation with birth weight between 1.0 and 1.5 kg were recruited.

    INTERVENTIONS: Infants were enrolled to either 2-hourly or 3-hourly interval feeding after randomisation. Blinding was not possible due to the nature of the intervention.

    MAIN OUTCOME MEASURES: The primary outcome was time to achieve full enteral feeding (≥100 mL/kg/day). Secondary outcomes include time to regain birth weight, episode of feeding intolerance, peak serum bilirubin levels, duration of phototherapy, episode of necrotising enterocolitis, nosocomial sepsis and gastro-oesophageal reflux.

    RESULTS: 72 infants were available for primary outcome analysis in each group as three were excluded due to death-three deaths in each group. The mean time to full enteral feeding was 11.3 days in the 3-hourly group and 10.2 days in the 2-hourly group (mean difference 1.1 days; 95% CI -0.4 to 2.5; p=0.14). The mean time to regain birth weight was shorter in 3-hourly group (12.9 vs 14.8 days, p=0.04). Other subgroup analyses did not reveal additional significant results. No difference in adverse events was found between the groups.

    CONCLUSION: 3-hourly feeding was comparable with 2-hourly feeding to achieve full enteral feeding without any evidence of increased adverse events.

    TRIAL REGISTRATION NUMBER: ACTRN12611000676910, pre-result.

    Matched MeSH terms: Parenteral Nutrition/adverse effects; Parenteral Nutrition/methods
  16. Ramanujam TM
    JUMMEC, 1999;4:81-87.
    The aim of this review is to critically analyse the available literature and to propose a rational, safe and cost-effective clinical pathway to provide nutritional support in acute pancreatitis. This pathway is proposed based on assessment of peer reviewed literature and existing generally accepted knowledge. Acute pancreatitis is a heterogeneous disease and the outcome is variable. The role of nutritional support is controversial. Acute mild pancreatitis (80%) usually does not require nutritional support unless the pre-existing nutritional is poor or complications occur. Contrary to this acute severe pancreatitis is associated with severe catabolism and a high complication rate. Nutritional depletion rapidly occurs. It is logical to support the nutrition once the patient is haemodynamically stable. Although enteral nutrition should be administered whenever feasible, it is not always possible or advisable. Aggressive, hypercaloric parenteral nutrition administered via central venous line is not recommended. A combination of initial peripheral parenteral nutrition with fat in appropriate amount, and gradually switching over to enteral feedings is safer and cost-effective. It also avoids central line associated sepsis. The roles of newer specific therapeutic diets to enhance the immune status in patients with acute pancreatitis are not well established. KEYWORDS: Acute pancreatitis, Enteral nutrition, Parenteral nutrition, Immunonutrition.
    Matched MeSH terms: Parenteral Nutrition
  17. Badrasawi M, Shahar S, Sagap I
    Malays J Med Sci, 2015 12 31;22(4):6-16.
    PMID: 26715903 MyJurnal
    The management of Enterocutaneous fistula (ECF) is challenging. It remains associated with morbidity and mortality, despite advancements in medical and surgical therapies. Early nutritional support using parenteral, enteral or fystuloclysis routs is essential to reverse catabolism and replace nutrients, fluid and electrolyte losses. This study aims to review the current literature on the management of ECF. Fistulae classifications have an impact on the calories and protein requirements. Early nutritional support with parenteral, enteral nutrition or fistuloclysis played a significant role in the management outcome. Published literature on the nutritional management of ECF is mostly retrospective and lacks experimental design. Prospective studies do not investigate nutritional assessment or management experimentally. Individualising the nutritional management protocol was recommended due to the absence of management guidelines for ECF patients.
    Matched MeSH terms: Parenteral Nutrition
  18. Iqbal MS, Bahari MB, Darwis Y, Iqbal MZ, Hayat A, Venkatesh G
    J AOAC Int, 2013 6 19;96(2):290-4.
    PMID: 23767352
    A simple and selective RP-HPLC-UV method with SPE was developed and validated for the quantification of cefotaxime in all-in-one total parenteral nutrition (AIO-TPN) admixtures. Chromatographic separation was achieved on a 5 pm particle size C18 DB column (250 x 4.6 mm id) using the mobile phase ammonium acetate (25 mM, pH 4.0)-50% acetonitrile in methanol (80 + 20, v/v). The flow rate was 0.9 mL/min and the detection wavelength was 254 nm. The analyte was extracted from AIO-TPN admixtures by means of an SPE method. The cefotaxime calibration curve was linear over a concentration range of 100-1400 microg/mL with a correlation coefficient of > or = 0.9994. The intraday accuracy and precision for cefotaxime were < or = -3.15 and < or = 3.08%, respectively, whereas the interday accuracy and precision were < or = -2.48 and < or = 2.25%, respectively. The method was successfully applied to stability studies of cefotaxime in the presence of micronutrients together with low and high concentrations of macronutrients in AIO-TPN admixtures. Cefotaxime was degraded by 13.00 and 26.05% at room temperature (25 +/- 2 degrees C) after 72 h in low and high macronutrient concentration formulations of AIO-TPN admixtures, respectively. The values of cefotaxime degradation rates for low and high macronutrient concentration formulations of AIO-TPN admixtures were -0.164 and -0.353, respectively. These results indicated that there was a higher rate of degradation in the AIO-TPN admixture formulations containing high concentrations of macronutrients.
    Matched MeSH terms: Parenteral Nutrition, Total*
  19. Chan L, Ngeow YF, Parasakthi N
    Med J Malaysia, 1998 Mar;53(1):10-5.
    PMID: 10968131
    Fourteen severely ill ventilated patients in an intensive care unit, requiring short-term total parenteral nutrition, were examined for catheter-related infection. Microbiological analysis using Maki's SQ technique was carried out on catheter exit site, catheter hub, proximal subcutaneous segment of catheter and catheter up. Qualitative cultures were carried out on total parenteral nutrition and peripheral blood samples. Twenty six of 29 catheters removed (90%) were culture positive but only 7 catheters were related to positive blood cultures, giving a catheter-related bacteremia (CRB) rate of 24%. Haematogenous seeding was strongly implicated in 7/29 (24%) of catheters. Patients' skin flora appeared to be the main source of catheter-related infection. The organisms isolated for patients with CRB included coagulase-negative staphylococci, Acinetobacter and Klebsiella. It is suggested that to control infective complications of central venous catheters, emphasis should be focused on specialised intravenous therapy teams and the use of strict protocols for insertion and care of central lines.
    Matched MeSH terms: Parenteral Nutrition, Total/adverse effects*
  20. Hassan Y
    Ann Pharmacother, 1993 Sep;27(9):1134-8.
    PMID: 8219450 DOI: 10.1177/106002809302700920
    OBJECTIVE: To report on the current status and future trends of clinical pharmacy practice in Malaysia.
    DATA SOURCES: Published conference reports and journal articles.
    DATA EXTRACTION: Data on areas related to clinical pharmacy practice in Malaysian hospitals were gleaned from various publications.
    DATA SYNTHESIS: Malaysia is capable of implementing clinical pharmacy services in hospitals and perhaps also in the community setting. The important factors in clinically oriented pharmacy practice include improvement of the drug-control process, development of physical and human resources, clinical pharmacy skills, and the training of practicing pharmacists. A number of Malaysian pharmacists have already developed a unit-dose drug distribution system, patient counseling, therapeutic drug monitoring, drug information, and total parenteral nutrition services.
    CONCLUSIONS: The pharmacy profession in Malaysia has many challenges ahead and it is hoped that every practicing pharmacist will be highly committed to future professional needs so that clinical pharmacy practice in Malaysia becomes a reality.
    Matched MeSH terms: Parenteral Nutrition, Total/trends
Filters
Contact Us

Please provide feedback to Administrator (afdal@afpm.org.my)

External Links