Effectiveness of central parenteral nutrition versus peripheral parenteral nutrition plus enteral nutrition in reversing protein-energy malnutrition in children with advanced neuroblastoma and Wilms' tumor: a prospective randomized study

Rickard, Karyl A.; Foland, Beth Bartlett; Detamore, Catherine M.; Coates, Thomas D.; Grosfeld, Jay L.; White, Nancy M.; Weetman, Robert M.; Provisor, Arthur J.; Loghmani, Emily; Oei, T O; Yu, Pao‐Lo; Baehner, Robert L.

doi:10.1093/ajcn/38.3.445

Cited by 31 publications

(8 citation statements)

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“…It may also improve survival, decrease treatment-related toxicity, and improve quality of life. 5,6 Malnutrition represents a treatable co-morbidity in children with cancer, including those with nephroblastoma, 7,8 and assessment of nutritional status at presentation allows appropriate management strategies to be implemented. 9 Malnutrition is associated with impaired immunocompetence, including depressed cell-mediated immunity, reduced mucosal secretory antibody response and lower antibody affinity, 10 suggesting a synergistic relationship with infections, which impacts on child mortality.…”

Section: Introductionmentioning

confidence: 99%

Relationship between nutritional status and treatment-related neutropenia in children with nephroblastoma

Hadley

Pillay

Wiles

2017

South African Journal of Clinical Nutrition

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Background: Assessment of nutritional status of paediatric oncology patients is crucial, as it may influence treatment and clinical outcomes. Concurrent malnutrition and cancer in children may lead to reduced chemotherapy delivery due to impaired tolerance and increased toxicity. Aim: This study aimed to determine the relationship between nutritional status and the prevalence, frequency and duration of treatment-related neutropenia in a cohort of South African children with nephroblastoma. Methods: Seventy-seven children between the ages of 1 and 12 years diagnosed with nephroblastoma at Inkosi Albert Luthuli Central Hospital (IALCH), Durban, between 2004 and 2012, were studied prospectively. Nutritional status was assessed using weight, height, mid-upper arm circumference (MUAC), triceps skinfold thickness (TSFT) and serum albumin. The administration of filgastrim (Neupogen®) was used as a surrogate for neutropenia and the frequency and duration of its use was recorded. Results: There was a significant relationship between the prevalence of treatment-induced neutropenia and malnutrition defined by MUAC. The mean frequency and duration of neutropenia was significantly higher in those classified as malnourished using MUAC. There was a positive correlation between frequency and duration of neutropenia. Conclusions: Malnutrition was prevalent among children with nephroblastoma. The prevalence of treatment-induced neutropenia was higher in those with poor nutritional status, identified by MUAC. Poor nutritional status according to MUAC was also linked to an increased frequency and duration of neutropenia. It is important to include MUAC in the nutritional assessment of children with nephroblastoma.

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Section: Introductionmentioning

confidence: 99%

Relationship between nutritional status and treatment-related neutropenia in children with nephroblastoma

Hadley

Pillay

Wiles

2017

South African Journal of Clinical Nutrition

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“…Contributing factors include reduced dietary intake as a result of reduced appetite, malabsorption and increased nutritional requirements associated with some diseases. Poor nutritional status and sub-optimal growth can have a detrimental effect on both short- and long-term disease outcomes (Corey 1988; CPS 1994; Koscik 2004). …”

Section: Introductionmentioning

confidence: 99%

Oral protein calorie supplementation for children with chronic disease

Smith

Saljuqi²,

Watling

2015

Cochrane Database of Systematic Reviews

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Background Poor growth and nutritional status are common in children with chronic diseases. Oral protein calorie supplements are used to improve nutritional status in these children. These expensive products may be associated with some adverse effects, e.g. the development of inappropriate eating behaviour patterns. This is a new update of a Cochrane review last updated in 2009. Objectives To examine evidence that in children with chronic disease, oral protein calorie supplements alter daily nutrient intake, nutritional indices, survival and quality of life and are associated with adverse effects, e.g. diarrhoea, vomiting, reduced appetite, glucose intolerance, bloating and eating behaviour problems. Search methods Trials of oral protein calorie supplements in children with chronic diseases were identified through comprehensive electronic database searches, handsearching relevant journals and abstract books of conference proceedings. Companies marketing these products were also contacted. Most recent search of the Group's Trials Register: 24 February 2015. Selection criteria Randomised or quasi‐randomised controlled trials comparing oral protein calorie supplements for at least one month to increase calorie intake with existing conventional therapy (including advice on improving nutritional intake from food or no specific intervention) in children with chronic disease. Data collection and analysis We independently assessed the outcomes: indices of nutrition and growth; anthropometric measures of body composition; calorie and nutrient intake (total from oral protein calorie supplements and food); eating behaviour; compliance; quality of life; specific adverse effects; disease severity scores; and mortality; we also assessed the risk of bias in the included trials. Main results Four studies (187 children) met the inclusion criteria. Three studies were carried out in children with cystic fibrosis and one study included children with paediatric malignant disease. Overall there was a low risk of bias for blinding and incomplete outcome data.Two studies had a high risk of bias for allocation concealment. Few statistical differences were found in the outcomes we assessed between treatment and control groups, except change in total energy intake at six and 12 months, mean difference 304.86 kcal per day (95% confidence interval 5.62 to 604.10) and mean difference 265.70 kcal per day (95% confidence interval 42.94 to 485.46), respectively. However, these were based on the analysis of just 58 children in only one study. Only two chronic diseases were included in these analyses, cystic fibrosis and paediatric malignant disease. No other studies were identified which assessed the effectiveness of oral protein calorie supplements in children with other chronic diseases. Authors' conclusions Oral protein calor...

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“…14 Perhaps his greatest contribution was his persistence and dedication to the goal of IV nutrition despite the many technical and 376 SPENCER AND COMPHER Vol. 27,No. 5 scientific roadblocks and the considerable obstacle presented by the general belief of the medical community that this was a futile and perhaps foolish quest.…”

Section: Rhoads' Key Contributions To Tpnmentioning

confidence: 99%

“…62 The AGA 378 SPENCER AND COMPHER Vol. 27,No. 5 position paper questions the use of home TPN when the projected life expectancy, usually because of active cancer, is Ͻ3 months' duration.…”

Section: Tpn Use Meets Modern Demands For Evidence Basismentioning

confidence: 99%

Total parenteral nutrition, an ally in the management of patients with intestinal failure and malnutrition: a long‐term view

Spencer¹,

Compher²

2003

J Parenter Enteral Nutr

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Jonathan Rhoads, MD, devoted his career to efforts designed to improve supportive patient care. He was a pioneer in the development of parenteral nutrition, continuing with determination despite daunting clinical challenges. The research efforts of Dr. Rhoads and his colleagues in addressing and remedying nutritional obstacles in surgical patients, including hypoproteinemia and infused-volume constraints, helped pave the way toward the collaborative development of total parenteral nutrition and elevated surgical practice of modern-day medicine.The following abstracted articles are 2 representative examples of Rhoads' body of research and demonstrate how much of his early work dealt with the substantial challenges he faced in the development of a viable parenteral nutrition formula. These research efforts were instrumental in pushing the development of parenteral nutrition forward.The full text of this article is available on the A.S.P.E.N. website at www.nutritioncare.org/ publications/journals/jpenabs.html.ABSTRACT. The Influence of Hypoproteinemia on the Formation of Callus in Experimental Fracture. Jonathan E. Rhoads, William Kasinskas. Surgery 11:38 -44, 1942 Background: This abstract relates the importance of adequate serum protein levels for proper bone healing. The process in which the dog's ulna was sawed, whereby the radius acted as a natural splint, was clever and compassionate. This study and its findings help support the idea that adequate serum protein levels and nutritional status impact sound surgical practices and outcomes. Hypoproteinemia has been shown to delay healing in soft tissue wounds in dogs and is frequently present in patients with wound disruption. These observations suggest that hypoproteinemia may also play a role in the delay of fracture healing, and their purpose was to determine the effect of hypoproteinemia on the formation of bony callus after fractures in dogs. Methods: Normal appearing, medium-sized mongrel dogs were used. Hypoproteinemia was induced by a low-protein diet and repeated plasmapheresis. The diet was adequate for all of the dog's requirements except protein, which was approximately 1%. Plasmapheresis consisted of aspirating blood from the femoral artery, whereby the plasma was removed and the remaining diluted cells were returned to the animal from which they were taken. This procedure was completed about 3 times per week until the serum protein level declined to below 4 g/dL and then as needed to maintain that level for a period of 6 weeks after fracture. During the control periods, the diet consisted of table scraps. The 3 stock dogs subsisting on this diet maintained plasma protein levels of 6 to 7 g/dL. The type of fracture induced for the study was Gigli saw section of the ulna, which permits self-splinting by the radius and allows readily accessible x-ray examination. In the spring of 1938, 3 dogs were rendered hypoproteinemic, with plasma protein levels near 4 g/dL, and the left ulna of each animal was sectioned about 5 cm above the distal end. The hypopr...

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Effectiveness of central parenteral nutrition versus peripheral parenteral nutrition plus enteral nutrition in reversing protein-energy malnutrition in children with advanced neuroblastoma and Wilms' tumor: a prospective randomized study

Cited by 31 publications

References 10 publications

Relationship between nutritional status and treatment-related neutropenia in children with nephroblastoma

Relationship between nutritional status and treatment-related neutropenia in children with nephroblastoma

Oral protein calorie supplementation for children with chronic disease

Total parenteral nutrition, an ally in the management of patients with intestinal failure and malnutrition: a long‐term view

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