BACKGROUND Malnutrition is common in critically ill patients,and it is associated with an increased risk of complications.Early enteral nutrition with adequate caloric and protein intake is critical nevertheless it is...BACKGROUND Malnutrition is common in critically ill patients,and it is associated with an increased risk of complications.Early enteral nutrition with adequate caloric and protein intake is critical nevertheless it is difficult to achieve.Peptide-based formulas have been shown to be beneficial in patients with feeding intolerance.However,there are limited studies showing the efficacy and safety of high-protein peptide-based formula in critically ill surgical patients.AIM To determine the effects of a high-protein peptide formulation on gastrointestinal tolerance,nutritional status,biochemical changes,and adverse events in patients in the surgery intensive care unit(SICU)compared to an isocaloric isonitrogenous standard polymeric formulation.METHODS This study was a multi-center double-blind,randomized controlled trial.We enrolled adult patients in the surgical intensive care unit,age≥15 years and expected to receive enteral feeding for at least 5-14 d post-operation.They were randomly assigned to receive either the high-protein peptide-based formula or the isocaloric isonitrogenous standard formula for 14 d.Gastric residual volume(GRV),nutritional status,body composition and biochemical parameters were assessed at baseline and on days 3,5,7,9,11,and 14.RESULTS A total of 19 patients were enrolled,9 patients in the peptide-based formula group and 10 patients in the standard formula group.During the study period,there were no differences of the average GRV,body weight,body composition,nutritional status and biochemical parameters in the patients receiving peptide-based formula,compared to the standard regimen.However,participants in the standard formula lost their body weight,body mass index(BMI)and skeletal muscle mass significantly.While body weight,BMI and muscle mass were maintained in the peptide-based formula,from baseline to day 14.Moreover,the participants in the peptide-based formula tended to reach their caloric target faster than the standard formula.CONCLUSION The study emphasizes the importance of early nutritional support in the SICU and showed the efficacy and safety of a high-protein,peptide-based formula in meeting caloric and protein intake targets while maintaining body weight and muscle mass.展开更多
Background:Malnutrition is a leading global health challenge,worsened by dietary shifts toward the con-sumption of ultra-processed food.In Brazil,food and nutrition surveillance is integrated into the Primary Health C...Background:Malnutrition is a leading global health challenge,worsened by dietary shifts toward the con-sumption of ultra-processed food.In Brazil,food and nutrition surveillance is integrated into the Primary Health Care(PHC)services of the Unified Health System(SUS)via the Food and Nutrition Surveillance System(Sisvan).Despite its potential for assessing population dietary trends and supporting public health policies,population coverage and use by health professionals and managers remain limited.This study aimed to identify facilitators and barriers to the use of Sisvan food intake markers in PHC,especially regarding data handling in collection,registration and analysis.Methods:A cross-sectional study was conducted in 2021,involving PHC managers and health professionals from all five Brazilian macro-regions.A questionnaire with closed-and open-ended questions was distributed elec-tronically to assess the use of food intake markers,data entry routines,and practices for data analysis.Socio-demographic characteristics of participants were described.Thematic analysis was used to open-ended responses to identify barriers and facilitators.Findings:Among 301 participants,78.1%worked in municipalities that collected food intake markers,primarily using Sisvan forms(88.9%).However,only 42.1%reported routine data analysis at both individual and col-lective levels.The brevity and simplicity of the Sisvan forms and their integration with electronic systems were among the facilitators.Barriers were related to work overload,insufficient infrastructure,system slowness,and lack of professional training.Recommendations included enhancing system usability,expanding professional qualification programs,and fostering interprofessional collaboration.Interpretation:The findings highlight the underutilization of data on food intake markers for planning and de-cision making in PHC in Brazil,despite a significant proportion of participants acknowledging data collection.Addressing identified barriers could enhance Sisvan’s potential to monitor dietary trends and guide public health interventions.This study underscores the need for targeted strategies,such as continuing education,better integration with electronic health records,and infrastructure improvements,to strengthen food and nutrition surveillance in Brazil.展开更多
文摘BACKGROUND Malnutrition is common in critically ill patients,and it is associated with an increased risk of complications.Early enteral nutrition with adequate caloric and protein intake is critical nevertheless it is difficult to achieve.Peptide-based formulas have been shown to be beneficial in patients with feeding intolerance.However,there are limited studies showing the efficacy and safety of high-protein peptide-based formula in critically ill surgical patients.AIM To determine the effects of a high-protein peptide formulation on gastrointestinal tolerance,nutritional status,biochemical changes,and adverse events in patients in the surgery intensive care unit(SICU)compared to an isocaloric isonitrogenous standard polymeric formulation.METHODS This study was a multi-center double-blind,randomized controlled trial.We enrolled adult patients in the surgical intensive care unit,age≥15 years and expected to receive enteral feeding for at least 5-14 d post-operation.They were randomly assigned to receive either the high-protein peptide-based formula or the isocaloric isonitrogenous standard formula for 14 d.Gastric residual volume(GRV),nutritional status,body composition and biochemical parameters were assessed at baseline and on days 3,5,7,9,11,and 14.RESULTS A total of 19 patients were enrolled,9 patients in the peptide-based formula group and 10 patients in the standard formula group.During the study period,there were no differences of the average GRV,body weight,body composition,nutritional status and biochemical parameters in the patients receiving peptide-based formula,compared to the standard regimen.However,participants in the standard formula lost their body weight,body mass index(BMI)and skeletal muscle mass significantly.While body weight,BMI and muscle mass were maintained in the peptide-based formula,from baseline to day 14.Moreover,the participants in the peptide-based formula tended to reach their caloric target faster than the standard formula.CONCLUSION The study emphasizes the importance of early nutritional support in the SICU and showed the efficacy and safety of a high-protein,peptide-based formula in meeting caloric and protein intake targets while maintaining body weight and muscle mass.
基金funded by the Brazilian National Council for Scientific and Technological Development(process no.442963/2019-0)under the Call MS/CNPq No.26/2019,in partnership with the Ministry of Health and the General Coordination of Food and Nutrition.
文摘Background:Malnutrition is a leading global health challenge,worsened by dietary shifts toward the con-sumption of ultra-processed food.In Brazil,food and nutrition surveillance is integrated into the Primary Health Care(PHC)services of the Unified Health System(SUS)via the Food and Nutrition Surveillance System(Sisvan).Despite its potential for assessing population dietary trends and supporting public health policies,population coverage and use by health professionals and managers remain limited.This study aimed to identify facilitators and barriers to the use of Sisvan food intake markers in PHC,especially regarding data handling in collection,registration and analysis.Methods:A cross-sectional study was conducted in 2021,involving PHC managers and health professionals from all five Brazilian macro-regions.A questionnaire with closed-and open-ended questions was distributed elec-tronically to assess the use of food intake markers,data entry routines,and practices for data analysis.Socio-demographic characteristics of participants were described.Thematic analysis was used to open-ended responses to identify barriers and facilitators.Findings:Among 301 participants,78.1%worked in municipalities that collected food intake markers,primarily using Sisvan forms(88.9%).However,only 42.1%reported routine data analysis at both individual and col-lective levels.The brevity and simplicity of the Sisvan forms and their integration with electronic systems were among the facilitators.Barriers were related to work overload,insufficient infrastructure,system slowness,and lack of professional training.Recommendations included enhancing system usability,expanding professional qualification programs,and fostering interprofessional collaboration.Interpretation:The findings highlight the underutilization of data on food intake markers for planning and de-cision making in PHC in Brazil,despite a significant proportion of participants acknowledging data collection.Addressing identified barriers could enhance Sisvan’s potential to monitor dietary trends and guide public health interventions.This study underscores the need for targeted strategies,such as continuing education,better integration with electronic health records,and infrastructure improvements,to strengthen food and nutrition surveillance in Brazil.
