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허윤정,석민지,손영길,류승완 한국정맥경장영양학회 2016 한국정맥경장영양학회 학술대회집 Vol.2016 No.-
배경: 중환자에서 영양불량은 면역반응을 약화시키고 감염을 증가시키며 호흡부전을 악화시켜, 이로 인한 사망률과 이환율이 증가하게 된다. 따라서 중환자들에 있어서 적절한 영양지원은 필수적이라고 여겨지고 있다. 이에 중환자실에 재원중인 환자들의 영양 상태와 영양공급 현황을 파악하고자 한다. 대상 및 방법: 2016년 4월 11일부터 2016년 4월 22일까지 일개병원의 내과계 및 외과계 중환자실에 재원중인 33명의 환자들을 대상으로 하였다. 체중과 알부민 수치를 지표로 한 ICD-9-CM을 이용하여 영양 상태를 평가하였으며, 영양공급방법과 총영양요구량에 비해 실제적으로 공급된 영양공급 비율을 측정하였다. 결과: 총 환자는 33명이며, 내과계 14명(42.4%), 외과계 19명(57.6%)이고 성별분표는 남자23명(69.7%), 여자 10명(33%)이며, 평균나이는 남자 67.8세, 여자 68.5세였다. ICD-9-CM을 이용한 영양상태 판정 결과 내과계에서는 mild malnutrition 1명(7.1%), moderate malnutrition 5명(35.7%), severe malnutrition 7명(50.0%) 이었으며, 외과계에서는 mild malnutrition 6명(31.6%), moderate malnutrition 1명(5.3%), severe malnutrition 10명(52.6%)으로 조사되었다. 또한 영양공급방법에서는 내과계에서는 oral 3명(21.4%), EN 3명(21.4%), PN 8명(57.2%)이었으며, 외과계에서는 oral 1명(0.5%), EN 13명(68.4%), PN 3명(15.8%), NPO 2명(10.5%)이었다. 영양공급량은 내과계 67.7%, 외과계 84.6%로 공급되고 있었다. 결론: 중환자실에 재원중인 환자 중 영양지원이 필요한 moderate malnutrition 이상의 환자는 33명중 23명으로 69.7%로 파악되었으며, 대부분의 환자들은 kwashiorkor type의 protein malnutrition을 보였다. 영양불량 환자에게 있어 영양지원의 중요성이 대두되고 있으나, 많은 환 자에서 실제 영양공급량은 부족함을 알 수 있었다. 따라서 영양집중지원팀의 적극적인 홍보 및 활동이 필요하겠다.
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허윤정,박재현,정은영,장효정,석민지,류승완 한국정맥경장영양학회 2015 한국정맥경장영양학회 학술대회집 Vol.2015 No.-
Objective: We aimed to compare the morbidity, duration of parenteral nutrition and hospital length of stay in very low birth weight infants(VLBWIs) fed either bovine milk-based formula (BOV) or exclusively human breast milk(eBM) in neonatal intensive care unit (NICU). Methods: VLBWIs (gestation age : 25 - 30 weeks) who were born in Keimyung University Dongsan Medical Center, Daegu, South Korea and admitted to NICU, were enrolled. Neonates born from March to August 2014 (N = 28) were fed with BOV. Infants born from September to December 2014 (N = 18)were fed witheBM. If mother’s own milk was unavailable due to insufficient breast milk production, pasteurized(heating at 62.5℃ for 30 minutes) donor human milk was used. Results: Gestational age (28.0 ± 1.7 vs 27.8 ± 1.4) and birth weight (1,055.0 ± 265.9 vs 1,175.6 ± 187.5) were similar in BOV and eBM group, respectively. Other demographic variables between two groups were also similar. There was a significant difference in the duration of parenteral nutrition (36.4 vs 24.1 days, p = 0.038) and hospital length of stay (74.3 vs 61.2 days, p = 0.037) were shorter in eBM group than in BOV group. The eBM group showed lower incidence of nosocomial sepsis than BOV group (53.6% vs. 22.2%, p = 0.035).There was no perinatal cytomegalovirus infection among pasteurized donor human milk-fed infants. Conclusion: An exclusively human-milk based diet is associated with a significant improvement in the incidence of nosocomial sepsis, duration of parenteral nutrition and hospital length of stay.
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Comparison of Fecal Calprotectin Levels According to Feeding Kinds in Very Preterm Infants
박재현,장효정,류승완,석민지 한국정맥경장영양학회 2017 한국정맥경장영양학회 학술대회집 Vol.2017 No.-
Introduction: Functional and biochemical maturation of the gastrointestinal tract are established over the last trimester of gestation, which affects the digestive, absorptive function of very preterm infants. Fecal calprotectin (FCP) indicates neutrophil migration to the gastrointestinal mucosa and can suggest the severity of mucosal inflammation. We investigated the fecal calprotectin level according to feeding kinds in very preterm infants with or without feeding intolerance (FI). Patients & Methods: We prospectively investigated 68 very preterm infants born at 28-31 weeks` gestation in Keimyung Universitiy Dongsan Medical Center between July 2016 and April 2017. All enrolled infants was fed within 3 hours of life using preterm formula, who achieved full enteral feeding (>100cc/kg/day) within 7days of life. Fecal calprotectin levels were routinely investigated at 7days and 28days of life in fully enteral-fed very preterm infants without parenteral nutrition. FI was defined as gastric residual volume ≥ 50% of previous feeding volume, abdominal distention or emesis, and the disruption of the patient`s feeding plan. The infants with FI were temporarily fed with amino-acid based formula (AAF, Neocate®) after investigation with FCP. Infants with necrotizing enterocolitis, bacterial sepsis, and perinatal asphyxia during hospitalization were not included. FCP were measured by using a commercial quantitative enzyme-linked immunosorbent assay on the Alegria system (ORGENTEC Diagnostika, Mainz, Germany). Results: Median gestational age was 30.1 weeks, and median birth weight was 1488g. The median age to achieve full enteral feeding was 3.8days. In sixteen infants with FI, which was developed at median 3.3 days of life (range: 2-6 days of life), FCP levels in formula-fed or breast-fed infants (905±133 μg/g) was significantly higher than that in infants fed amino acid based-formula (217±232 μg/g) (p<0.01). FCP level in formula-fed or breast-fed infants with FI (905±133 μ g/g) was significantly higher than that without FI (405±267 μg/g) (p< 0.01). In infants without FI, FCP level in formula-fed infants (360±283 μg/g) was not significantly different with that in breast-fed infants (477±234 μg/g) (p >0.05). Conclusions: FCP might be sensitive according to feeding kinds in very preterm infants with feeding intolerance.
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생체 전기 임피던스 분석으로 측정한 내장 지방 단면적이 대장 수술의 임상병리학적 결과에 미치는 영향
김경의 ( Kyeong Eui Kim ),송우진 ( Woo Jin Song ),석민지 ( Minji Seok ),배성욱 ( Sung Uk Bae ),정운경 ( Woon Kyung Jeong ),백성규 ( Seong Kyu Baek ) 한국정맥경장영양학회 2021 한국정맥경장영양학회지 Vol.13 No.1
Purpose: This study investigated the relationship between the visceral fat area (VFA) and clinico-pathological outcomes in patients with colorectal cancer (CRC). Methods: This retrospective study included 204 patients who underwent anthropometric measurement by bioelectrical impedance analysis (BIA) before surgical treatment for CRC between January 2016 and June 2020. Results: According to the average value of the visceral fat area, 119 (58.3%) patients had a low visceral fat area, and 85 (59.1%) patients had a high visceral fat area. Patients with visceral obesity showed a higher BMI compared to patients without visceral obesity, (21.8±1.9 vs. 25.7±2.5, P<0.001). There was no significant difference in the overall perioperative outcomes including total operation time, time to gas out, sips of water, soft diet, hospital stay, and morbidity between patients in the low and high VFA groups. We divided patients into two subgroups according to the degree of cancer progression and more advanced cases with low VFA showed significantly more total and positive retrieved lymph nodes (LNs) (20.9±10.3 vs. 16.1±7.1, P=0.021 and 3.3±2.9 vs. 2.2±2.3, P=0.019, respectively) and a higher proportion of more than 12 retrieved LNs compared to patients with a high VFA (95.1% vs. 90.0%, P=0.047). Body composition analysis showed that phase angle, muscle composition, and body fluid composition were not statistically different between the two groups. However, body fat mass was statistically higher in the high VFA group (22.0±4.6 vs. 12.8±3.1, P<0.001). Conclusion: Visceral obesity measured by BIA showed lower total and positive retrieved LNs and was not associated with adverse peri-operative outcomes, inflammatory and nutritional, and pathologic outcomes for CRC.
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