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Pharmaceutical Aspects of Artificial Nutrition.

ABSTRACT: Artificial nutrition, including enteral (EN) and parenteral (PN) nutrition, is indicated whenever adequate oral nutrition fails to sufficiently supply the necessary nutrients to the body. It is a convenient, efficacious, safe, and well-tolerated form of clinical nutrition in the hospital and home setting. EN is administered via nasogastric tube or ostomies while PN usually requires a central venous access for administration, straight into the blood stream. The infused nutrients can then be taken up directly by the different organs. PN is targeted as a single daily portion formulated as an oil-in-water emulsion providing the necessary substrates for the catabolic and anabolic metabolism including macro- and micronutrients and fluids. PN has a complex pharmaceutical composition-all-in-one admixture-and its compounding or ready-to-use preparation. The use of PN is more challenging and more expensive compare to the use of EN, commercially available as ready-to-use formulations. EN and concomitant medication is highly challenging. Upon incorrect handling and administration, PN is associated with potentially severe or even fatal complications, mostly relating to the central venous access (e.g., catheter-related sepsis) or to a metabolic intolerance (e.g., hyperglycemia, refeeding syndrome) because of inappropriate administration. A correct order of admixing, correct dosing, and administration of the artificial is crucial for safety and efficacy; clinical and biochemical monitoring of the patient and treatment regimen adaption are necessary. The high number of reactive solutes allow only limited stability of a ready-to-use PN admixture. The potential for numerous incompatibilities and interactions renders PN admixtures generally unsuitable as drug vehicle. Laboratory compatibility and stability testing and pharmaceutical expertise are a prerequisite to define the PN composition including nutrients or even drugs admixed to define the appropriate and individualized nutrition and medication regimen. The aim of this narrative review is to present the actual state-of-the-art to deliver best quality artificial nutrition with special regard on pharmaceutical aspects such as instabilities, incompatibilities, and concomitant co-medication.

SUBMITTER: Reber E

PROVIDER: S-EPMC6912726 | biostudies-literature | 2019 Nov

REPOSITORIES: biostudies-literature

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Pharmaceutical Aspects of Artificial Nutrition.

Reber Emilie E Messerli Markus M Stanga Zeno Z Mühlebach Stefan S

Journal of clinical medicine 20191119 11

Artificial nutrition, including enteral (EN) and parenteral (PN) nutrition, is indicated whenever adequate oral nutrition fails to sufficiently supply the necessary nutrients to the body. It is a convenient, efficacious, safe, and well-tolerated form of clinical nutrition in the hospital and home setting. EN is administered via nasogastric tube or ostomies while PN usually requires a central venous access for administration, straight into the blood stream. The infused nutrients can then be taken ...[more]

PMID: 31752291

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Project description:Childhood diet has a significant influence on diet-related diseases in adulthood, so an understanding of environmental influences on nutrition, is important. The aim of this cross-sectional study was to indicate family factors associated with some aspects of children's nutrition in Central Poland. A questionnaire was used to investigate 892 mothers' approach to breastfeeding, frequency of eating with children at fast food restaurants, and serving them snacks, sugary drinks, and fried food. Prevalence of dental caries among children, based on the mothers' self-assessment, was also assessed. Majority of the mothers breastfed for a period not longer than six months. There was a positive association between breastfeeding duration and mothers' education level and the number of children in a family. Sweets were used as a reward, more often among younger children and in families with higher number of children. The frequency of consumption of sweet beverages rose with the child's age and decreased with mother's education level and family income. It was also more frequent in rural areas. Most children received snacks and fried food at least once a week. There was a negative association between eating with parents at fast food restaurants and, both, the number of children in the family and living in a village. Fast food consumption rose with the mother's education level and family income. Prevalence of dental caries according to mothers' declarations was much lower than in national studies but was associated with frequent consumption of snacks and sweet beverages in the examined population. Extensive activities to reduce the occurrence of dental caries at the national level and education concerning the role of a family environment in providing a proper childhood nutrition, with a special emphasis on breastfeeding benefits, seems necessary for Polish parents. Designing community-wide education campaigns referencing population-based programs and other health and disease prevention activities, need to be promoted.

Project description:Background and objectiveThe impact of diet on COVID-19 patients has been a global concern since the pandemic began. Choosing different types of food affects peoples' mental and physical health and, with persistent consumption of certain types of food and frequent eating, there may be an increased likelihood of death. In this paper, a regression system is employed to evaluate the prediction of death status based on food categories.MethodsA Healthy Artificial Nutrition Analysis (HANA) model is proposed. The proposed model is used to generate a food recommendation system and track individual habits during the COVID-19 pandemic to ensure healthy foods are recommended. To collect information about the different types of foods that most of the world's population eat, the COVID-19 Healthy Diet Dataset was used. This dataset includes different types of foods from 170 countries around the world as well as obesity, undernutrition, death, and COVID-19 data as percentages of the total population. The dataset was used to predict the status of death using different machine learning regression models, i.e., linear regression (ridge regression, simple linear regularization, and elastic net regression), and AdaBoost models.ResultsThe death status was predicted with high accuracy, and the food categories related to death were identified with promising accuracy. The Mean Square Error (MSE), Root Mean Square Error (RMSE), Mean Absolute Error (MAE), and R2 metrics and 20-fold cross-validation were used to evaluate the accuracy of the prediction models for the COVID-19 Healthy Diet Dataset. The evaluations demonstrated that elastic net regression was the most efficient prediction model. Based on an in-depth analysis of recent nutrition recommendations by WHO, we confirm the same advice already introduced in the WHO report1. Overall, the outcomes also indicate that the remedying effects of COVID-19 patients are most important to people which eat more vegetal products, oilcrops grains, beverages, and cereals - excluding beer. Moreover, people consuming more animal products, animal fats, meat, milk, sugar and sweetened foods, sugar crops, were associated with a higher number of deaths and fewer patient recoveries. The outcome of sugar consumption was important and the rates of death and recovery were influenced by obesity.ConclusionsBased on evaluation metrics, the proposed HANA model may outperform other algorithms used to predict death status. The results of this study may direct patients to eat particular types of food to reduce the possibility of becoming infected with the COVID-19 virus.

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Pharmaceutical Aspects of Artificial Nutrition.

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Pharmaceutical Aspects of Artificial Nutrition.

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