Annals of Clinical Nutrition and Metabolism

Review

Bedside support for neurologically impaired patients via nutritional evaluations, swallowing function assessments, and gastrointestinal function tests: a narrative review: Daisuke Masui, Naoki Hashizume, Yoshinori Koga, Hiroto Eto, Hiroki Yoshida, Shotaro Taki, Takato Aikoh, Shiori Tsuruhisa, Tomohiro Kurahachi, Naruki Higashidate, Tatsuru Kaji; Ann Clin Nutr Metab 2026;18(1):10-17. Published online March 30, 2026; DOI: https://doi.org/10.15747/ACNM.25.0018

Abstract PDF: Purpose
Neurologically impaired patients often experience complex challenges in respiratory and nutritional management that may necessitate surgical intervention. Furthermore, some patients admitted to specialized facilities for neurologically impaired individuals do not receive adequate postoperative follow-up after being transferred. Kurume University Hospital has established a system of continuous routine rounds at such facilities. This review aims to describe the rationale, methods, and outcomes of multidisciplinary bedside support, with particular emphasis on nutritional evaluation, swallowing function assessment, and gastrointestinal function testing.
Current concept
Routine collaboration between pediatric surgeons and facility-based pediatricians enables continuous perioperative management. Preoperatively, patient background, nutritional status, and family preferences are recorded through structured communication and shared decision-making tools, such as the Ottawa Personal Decision Guide. During hospitalization, multidisciplinary evaluations include bioelectrical impedance analysis for nutritional assessment, endoscopic and pH impedance testing for swallowing function, and multichannel intraluminal impedance monitoring for gastroesophageal reflux. Postoperatively, periodic facility rounds ensure ongoing evaluation, with repeated assessments guiding nutritional optimization, early complication detection, and timely surgical consultation. This approach provides families and healthcare teams with detailed information on functional outcomes, strengthens trust, and enhances continuity of care. Sustained bedside engagement at facilities for neurologically impaired patients improves pre- and postoperative monitoring, promotes seamless collaboration between institutions, and ensures individualized evaluation of nutrition, swallowing, and gastrointestinal function.
Conclusion
By providing actionable data to families and multidisciplinary teams, this model strengthens shared decision-making and supports long-term outcomes. The system may serve as a framework for integrated perioperative care in similar high-risk patient populations.

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Original Article

The Influence of Pediatric Nutrition Support Team on Hospitalized Pediatric Patients Receiving Parenteral Nutrition: Sijin Baek, Juhyun Rho, Hyung Wook Namgung, Eunsook Lee, Euni Lee, Hye Ran Yang; J Clin Nutr 2020;12(1):7-13. Published online June 30, 2020; DOI: https://doi.org/10.15747/jcn.2020.12.1.7

Purpose: Malnutrition is a common problem in hospitalized patients that can increase the risk of complications, including infections and length of hospitalization. Appropriate nutritional support is important, particularly in pediatric patients, because growth and development are closely related to the nutritional supply. This study examined the status of nutritional support for pediatric patients in general wards to determine if interventions of the pediatric nutrition support team (pNST) contribute to appropriate nutritional support and help improve their nutritional status.
Methods: Between July 2016 and June 2017, all pediatric inpatients who received parenteral nutrition support at the Seoul National University Bundang Hospital were recruited and divided into the NST group and non-NST group according to the activities of pNST. The nutritional status was assessed in all subjects, and the calories and proteins delivered through nutritional support in each group were calculated and then compared with the recommended requirements in pediatric patients.
Results: The number of patients recruited was 174: 100 (57.5%) in the NST group and 74 (42.5%) in the non-NST group. Significantly more calories and protein were supplied in the NST group than the non-NST group in hospitalized children aged between four and 17 years (P<0.05). In the non-NST group, the amounts of calories supplied were insufficient compared to the recommended requirements. The proportion of patients supplied with the appropriate number of calories was 60.0% in the NST group and 20.0% in the non-NST group (P<0.001), and the proportion of cases supplied with the appropriate amount of protein was 87.0% in the NST group and 62.2% in the non-NST group (P<0.001).
Conclusion: Interventions of the pediatric nutrition support team contributed to the sufficient supply of calories and protein and the improvement of clinical outcomes in hospitalized children on parenteral nutrition therapy.

Citations

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Perioperative nutritional practices and pediatric nutrition support team implementation in Korea: a cross-sectional study
Dayoung Ko, Honam Hwang, Hee-Beom Yang, Joong Kee Youn, Hyun-Young Kim
Ann Clin Nutr Metab.2025; 17(3): 181. CrossRef

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Review Article

Nutrition Support for Pediatric Surgical Patients: Jun Beom Park; Surg Metab Nutr 2019;10(1):9-14. Published online June 30, 2019; DOI: https://doi.org/10.18858/smn.2019.10.1.9

Abstract PDF: Pediatric patients have characteristics such as a low capacity for storing energy/nutrients and high energy metabolism as compared those of adults. Because of the inherent characteristics that they are continually growing, supplying both rapid and adequate nutrition is of the utmost importance. In the case of children undergoing surgery (and particularly gastrointestinal surgery), there is a high possibility of a restricted supply of nutrition, and so active intervention to supply sufficient nutrition must be carried out. Of course, enteral nutrition is preferred, but continuous monitoring of nutrition is of paramount importance; thus, parenteral nutrition should be provided when necessary. Nutritional support requires continuous monitoring when and if complications arise. The complications of parenteral nutrition have yet to be overcome, so further research on this topic is certainly warranted.

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