Summary:Patients undergoing allogeneic bone marrow transplants (BMT) are often malnourished prior to commencing the procedure. They face intensive treatment with often marked nutritional consequences. There is no consensus on the optimal nutritional management of these patients. Elective parenteral nutrition (PN), beginning pre-transplant irrespective of the patients nutritional status, or the use of 'salvage' PN, beginning during the post-transplant period if the patient fails to maintain nutritional status with oral diet, have been used. Enteral nutrition may benefit the patient by maintaining nutritional support throughout the transplant period, avoiding the complications and expense of PN and possibly, by using specific diets, protecting the gastrointestinal tract from the effects of chemoradiation. However, naso-gastric feeding during a transplant is not without risks, including the safe insertion of a tube in patients with mucositis and pan-cytopenias, tube displacement by vomiting and aspiration from gastro-oesophageal reflux. An alternative approach is to use nasojejunal (NJ) feeding tubes which are associated with less risk of loss due to vomiting and less risk of aspiration. We report a pilot study of 15 allogeneic BMT patients who had elective NJ feeding initiated before conditioning therapy irrespective of perceived nutritional compromise. This was well tolerated and feasible with a motivated nutritional team. Bone Marrow Transplantation (2001) 28, 1135-1139. Keywords: allogeneic bone marrow transplant; enteral feeding; naso-jejunal feeding tubes; pilot study Patients undergoing BMT are often under-nourished due to previous chemotherapy and the underlying disease process. They face a long hospital stay and intensive conditioning therapy, which can have marked nutritional consequences. Subsequent complications such as infections, veno-occlus-
Neonatal mortality represents a major loss of production efficiency for herds throughout the world and despite research and development work spanning many years the losses are still not tolerable either in economic terms or in terms of animal welfare. In the United Kingdom where producers are amongst the very best, the Meat and Livestock Commission estimate that pre-weaning mortality nationally is of the order of 12.8% of all piglets born alive (MLC, 1984).The causes of death are well documented (Spicer et al 1986) but overlying, starvation, chilling and pathological problems are principal components. Central to all of these factors may be the events occurring within the first hours of a piglets life and those animals which are first born which suckle quickly and effectively have a high probability of survival.Conversely, those piglets which are later born and which are also smaller than the average for the litter may be at a severe disadvantage because of the competitive environment around the udder of the sow after parturition. Modern hybrid sows also vary widely in their ability to produce colostrum (Varley,1984)
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.