1.
Optimizing early enteral nutrition in severe stroke (OPENS): protocol for a multicentre randomized controlled trial.
Yuan, F, Yang, F, Zhang, W, Jia, Y, Ma, Y, Qu, Y, Wang, X, Huo, K, Wang, C, Yuan, X, et al
BMC neurology. 2019;(1):24
Abstract
BACKGROUND Malnutrition is one of the crucial factors associated with poor prognosis in critical ill patients, yet a significant evidence gap surrounds the management of initial enteral feeding in severe stroke. The Optimizing Early Enteral Nutrition in Severe Stroke (OPENS) trial will compare a strategy of modified full enteral nutrition (EN) (standard full EN in conjunction with prokinetic drug) and a strategy of permissive underfeeding (40 to 60% of estimated caloric requirements) with standard full EN (advancement to target nutrition goals) in patients with severe stroke. METHODS The OPENS trial is a multicenter randomized controlled study. A total of 600 adult patients with severe stroke will be enrolled in 12 study sites in China, and randomized to standard full EN, modified full EN, or permissive underfeeding. The primary outcome measurement is the proportion of participants with a poor outcome (modified Rankin Scale ≥3) at day 90 of enrollment. Secondary outcomes include incidence rates of complications during hospitalization, disability at hospital discharge, and the ability of activities of daily living at day 90 of enrollment. The relationship between intervention and the primary outcome will be analyzed using multivariate logistic regression adjusted for study site, demographics, and baseline characteristics. DISCUSSION The OPENS trial will explore the optimum initial feeding strategy for acute severe stroke. This trial is, therefore, an important step in bridging the evidence gap surrounding the enteral feeding for patients with severe stroke during the first week of hospitalization. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT02982668 ; First Posted: December 5, 2016.
2.
Benefit of oral nutritional supplements for children with acute lymphoblastic leukaemia during remission-induction chemotherapy: a quasi-experimental study.
Liang, R, Chen, GY, Fu, SX, Zhong, J, Ma, Y
Asia Pacific journal of clinical nutrition. 2018;(1):144-147
Abstract
BACKGROUND AND OBJECTIVES To determine the effect of oral nutritional supplements (ONS) on children with acute lymphoblastic leukaemia undergoing remission-induction chemotherapy. METHODS AND STUDY DESIGN We included 127 paediatric patients who were diagnosed with acute lymphoblastic leukaemia and undergoing remission- induction chemotherapy in the First Affiliated Hospital of Zhengzhou University. Children from two paediatric wards who met the inclusion criteria were enrolled. One ward was randomly chosen as the intervention group and the other ward as the control group. Children in the two groups were matched for age and sex. The ONS group was administered Peptamen® (n=60) and the control group was administered a low-fat diet (n=67). RESULTS The baseline information before treatment was not significantly different between groups (p>0.05). In the control group, weight loss at the end of chemotherapy was significantly higher than that of ONS group (p<0.05). The hemoglobin level and the concentrations of total protein, albumin, and pre-albumin were significantly higher in the ONS group than in the control group (p<0.05 and p<0.01, respectively). The incidences of hypoalbuminaemia, gastrointestinal complications, and infection were lower in the ONS group than in the control group (p<0.05). The ONS group also used lower amount of albumin infusion, fewer blood-product infusion, and had lower hospital costs than the control group. CONCLUSIONS During remission-induction chemotherapy, oral nutritional supplements can improve the nutritional status of children, reduce the incidence of complications, and decrease the costs of hospitalization.