Night fasting as an alternative to improve nutritional support and glycaemic control in hospitalised patients with exclusive enteral nutrition

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the grey area represents the laboratory normal reference range for men; no data are available for patients 2 and 4; †: deceased." ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Tânia Matos, Cristiana Costa, Alexandra Novais Araújo, Sónia do Vale" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Tânia" "apellidos" => "Matos" ] 1 => array:2 [ "nombre" => "Cristiana" "apellidos" => "Costa" ] 2 => array:2 [ "nombre" => "Alexandra Novais" "apellidos" => "Araújo" ] 3 => array:2 [ "nombre" => "Sónia" "apellidos" => "do Vale" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2530016422001069?idApp=UINPBA00004N" "url" => "/25300164/0000007000000006/v1_202305211954/S2530016422001069/v1_202305211954/en/main.assets" ] "en" => array:21 [ "idiomaDefecto" => true "cabecera" => "Original article" "titulo" => "Night fasting as an alternative to improve nutritional support and glycaemic control in hospitalised patients with exclusive enteral nutrition" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "429" "paginaFinal" => "437" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Anieli Golin, Sibila Reck de Jesus, Bruna Pessoa Alves, Mairin Schott, Andréa Rodrigues Marques, Leonardo Dachi dos Santos, Juliana Fleck, João Batista Teixeira da Rocha, Elisângela Colpo" "autores" => array:9 [ 0 => array:3 [ "nombre" => "Anieli" "apellidos" => "Golin" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] ] ] 1 => array:3 [ "nombre" => "Sibila Reck de" "apellidos" => "Jesus" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "Bruna Pessoa" "apellidos" => "Alves" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] ] ] 3 => array:3 [ "nombre" => "Mairin" "apellidos" => "Schott" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] ] ] 4 => array:3 [ "nombre" => "Andréa Rodrigues" "apellidos" => "Marques" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "b" "identificador" => "aff0010" ] ] ] 5 => array:3 [ "nombre" => "Leonardo Dachi dos" "apellidos" => "Santos" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "b" "identificador" => "aff0010" ] ] ] 6 => array:3 [ "nombre" => "Juliana" "apellidos" => "Fleck" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "c" "identificador" => "aff0015" ] ] ] 7 => array:3 [ "nombre" => "João Batista Teixeira da" "apellidos" => "Rocha" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "d" "identificador" => "aff0020" ] ] ] 8 => array:4 [ "nombre" => "Elisângela" "apellidos" => "Colpo" "email" => array:1 [ 0 => "elicolpo@ufn.edu.br" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] ] "afiliaciones" => array:4 [ 0 => array:3 [ "entidad" => "Master in Health Science and Life Science, and Department of Nutrition, Universidade Franciscana, Santa Maria, RS, Brazil" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Department of Nutrition, Hospital Universitário de Santa Maria, Santa Maria, RS, Brazil" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Department of Pharmacy, Universidade Franciscana, Santa Maria, RS, Brazil" "etiqueta" => "c" "identificador" => "aff0015" ] 3 => array:3 [ "entidad" => "Department of Biochemistry, Universidade Federal de Santa Maria, RS, Brazil" "etiqueta" => "d" "identificador" => "aff0020" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Ayuno nocturno como alternativa para mejorar el soporte nutricional y el control glucémico en pacientes hospitalizados con nutrición enteral exclusiva" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1615 "Ancho" => 2508 "Tamanyo" => 210325 ] ] "descripcion" => array:1 [ "en" => "Capillary blood glucose during the seven-day follow-up in the discontinuous and continuous groups. (A) Dawn, (B) Morning, (C) Afternoon, (D) Night. Two-way ANOVA indicated a significant main effect of time vs groups F (6, 557.6)=1.83; p=0.013." ] ] ] "textoCompleto" => "IntroductionThe immediate initiation of enteral nutrition therapy (ENT) is critical to recovering or improving the patient's nutritional status<a class="elsevierStyleCrossRef" href="#bib0190">1</a> and minimises the catabolic status induced by serious illness,<a class="elsevierStyleCrossRef" href="#bib0195">2</a> as long as the gastrointestinal tract of the patient is physiological and structurally functional.<a class="elsevierStyleCrossRef" href="#bib0200">3</a> The adequate nutritional supply of calories and proteins from EN, is critical for improving the nutritional status of hospitalised patients unable to feed orally,<a class="elsevierStyleCrossRef" href="#bib0205">4</a> but when the supply is diminished, malnutrition can occur, increase the morbimortality rate, and the hospitalisation time.<a class="elsevierStyleCrossRef" href="#bib0210">5</a>Commonly, EN is administered by the continuous method (slow and steady influx of nutrients over 24h) to reduce the risk of diarrhoea<a class="elsevierStyleCrossRef" href="#bib0195">2</a>; to decrease the risk of contamination by microorganisms, and to prevent variation in insulin levels under constant glycaemic stimulation.<a class="elsevierStyleCrossRefs" href="#bib0215">6,7</a> In cyclic feeding, EN is infused for less than 24h (with a stop of six to eight hours)—as occurs in normal human eating.It is performed to restore gastric acidity and bacterial colonisation of the stomach and to maintain the cortisol levels associated with circadian rhythms (light/dark).<a class="elsevierStyleCrossRef" href="#bib0225">8</a> Intermittent feeding is usually delivered over 20–60min every 4–6h by infusion pump or by the gravity drip method and may allow for more mobility of the patient.<a class="elsevierStyleCrossRef" href="#bib0230">9</a>Few studies have evaluated different ENT methods, suggesting that the continuous EN method may result in better nitrogen balance and a decrease in the excretion of C-peptide in the urine, compared to the bolus method<a class="elsevierStyleCrossRef" href="#bib0215">6</a>; that the intermittent versus the continuous method did not significantly affect glycaemic variability or insulinaemia, and that professionals should not be limited to only one feeding method<a class="elsevierStyleCrossRef" href="#bib0235">10</a>; that intermittent (bolus) feeding resembles a typical oral eating pattern by properly stimulating hepatic rhythmicity<a class="elsevierStyleCrossRef" href="#bib0240">11</a>; circadian rhythms are observed in the release of hormones and are controlled by light and feeding time, and the energetic expenditure is higher at night and may be affected by the continuous and intermittent feeding methods.<a class="elsevierStyleCrossRef" href="#bib0245">12</a> However, there is still no consensus on which method should be adopted to provide better patient outcomes, as the effects on metabolic parameters seem contradictory.<a class="elsevierStyleCrossRefs" href="#bib0230">9,13</a>Along with dietary assessment, biochemical parameters, such as the haemogram and serum albumin (Alb), are frequently used to evaluate the nutritional status of hospitalised patients.<a class="elsevierStyleCrossRef" href="#bib0255">14</a> Reck-de-Jesus et al.<a class="elsevierStyleCrossRef" href="#bib0260">15</a> pointed out that nutrient inadequacy can contribute to anaemia and hypoalbuminaemia, due to the association of haemoglobin (Hb) and Alb in patients with exclusive EN.We hypothesised that a discontinuous method, with a nightly discontinuation of EN infusion may be more effective compared to the continuous method, because it can be considered closer to the normal physiology of food ingestion by humans and could lead to benefits on nutrient intake and glycaemic control. Therefore, this study's first aim was to determine which of the methods—continuous or discontinuous EN—is more effective in meeting nutrient recommendations and blood biochemical parameters that are closer to the patient's needs. The second aim was to determine which of the methods could improve glycaemic control and biochemical parameters related to protein anabolism.Materials and methodsStudy design and ethical considerationsThis was a quasi-experimental clinical study, paired by sex and age (register number RBR-5vkzjt, <a href="http://www.ensaiosclinicos.gov.br/rg/RBR-5vkzjt/">http://www.ensaiosclinicos.gov.br/rg/RBR-5vkzjt/</a>). The study involved hospital patients admitted to the medical clinic unit (with 27 beds), in a public hospital. This study was approved by the Ethics and Research Committee (number 2.103.411). Data collection occurred after written informed consent was obtained from the patients or their guardians.Inclusion and exclusion criteriaIncluded in this study were patients expected to be hospitalised for at least seven days, with EN administered exclusively by vacuum infusion pump, in a closed system, with the patient conscious or in the company of a responsible person. Patients were excluded if they had generalised oedema, sepsis, or chronic renal failure, or if they were on mechanical ventilation, because these conditions induce metabolic stress and may interfere with anthropometrics, biochemical data, and energy expenditure; if they were receiving comfort measures only, if they were receiving parenteral or oral feeding combined with ENT, if they were discharged from the hospital, transferred to other clinics, or if they died before re-evaluation after seven days.Experimental design52 patients were followed. Data collection began within 72h of a patient's admission to infirmary of the medical clinic and followed for seven days. According to the hospital protocol, all patients with EN receive the diet over a 22-h daily period, in infusion pump, in which the diet is suspended for 2h/day (in the morning) for daily hospital routines such as bathing, physiotherapy, and speech therapy. Under these circumstances, this period is not accounted for in calculating the patients’ nutritional needs. Therefore, the study patients were divided into two groups: the discontinuous group (DG) had 23 patients, exclusive EN was administered in mL/h for a cycle of 18h/day, and the patients were submitted to four consecutive hours of night fasting (from midnight until 04:00); the continuous group (CG) had 29 patients, and EN was administered in mL/h for a cycle of 22h/day, without night fasting.Dietary assessmentThe patients’ nutritional needs were estimated and prescribed by the nutritionist according to established hospital protocols. To evaluate nutritional status, the standard formulas, according to the nutritional need of the patients and the illnesses, with caloric density between 1.0 and 2.0kcal/mL were used according to the nutritional diagnosis, from 30 to 35kcal/kg of current weight for undernourished patients; from 25 to 30kcal/kg of current weight for eutrophic patients; 25kcal/kg of current weight for overweight patients; and 20–25kcal/kg of adjusted weight for obese patients. The protein quantity offered varied from 0.8 to 2.0g/kg of current weight, according to the hospital protocol for each diagnosis. In both groups, the patients started at the goal rate within 72h.During the seven-day follow-up, medical record reviews were undertaken to collect the following data: demographic data, energy needs (kcal/kg of weight/d); protein needs (PTN/kg of weight/d); and the nutritional prescription, such as route of access, diet type, caloric density, infusion volume, total caloric content of the diet, and dietary protein (total PTN/day).The daily administered volume and the diet type were verified by the researcher through the patient electronic record, in order to verify the received energy quantity (kcal/kg of weight/day; kcal/day) and protein quantity (PTN/kg of weight/day; total PTN/day), intercurrences due to the enteral diet, such as gastrointestinal (nausea, vomiting, constipation, diarrhoea), mechanical (patient-started probe, patient-traced probe, bottle-open probe, clogged probe, infusion pump problem, gastrostomy diet leak, and other tube-related occurrences), and examinations and procedures (diet turned off for gastrostomy, diet paused to perform exams).Percentages of volume adequacy,<a class="elsevierStyleCrossRef" href="#bib0265">16</a> energy adequacy and protein adequacy<a class="elsevierStyleCrossRef" href="#bib0270">17</a> were calculated, and the values were considered satisfactory when above 80%.<a class="elsevierStyleCrossRef" href="#bib0275">18</a> The fibre contents were calculated by age and gender according to the infused diet type and compared to the dietary reference intakes, which comprise the adequate intake—AI.<a class="elsevierStyleCrossRef" href="#bib0280">19</a> None of the patients received additional sources or supplementation of calories, protein, or fibre—only those prescribed by enteral nutrition.Biochemical and anthropometric evaluationLaboratory values, including Hb, haematocrit (Ht), C-reactive protein (CRP), and Alb, were monitored by biochemical analysis according to the medical protocol. Capillary glucose was monitored according to the medical prescription, being performed every four, six or eight hours/day. The quantification of glucose was taken during the seven-day follow-up. Blood glucose levels were presented according to the following periods of the day: morning (6a.m. until 12p.m.) afternoon (12p.m. until 6p.m.), night (6p.m. until 12a.m.) and dawn (12a.m. until 6a.m.). The male and female reference values used were: >13 and >12g/dL for Hb and 40–54% and 37–47% for Ht, respectively<a class="elsevierStyleCrossRef" href="#bib0285">20</a>; <0.5mg/dL for CRP<a class="elsevierStyleCrossRef" href="#bib0290">21</a>; and >3.5g/dL for Alb.<a class="elsevierStyleCrossRef" href="#bib0295">22</a> Hyperglycaemia in hospitalised patients (adults and elderly) was defined as glucose levels >140mg/dL and hypoglycaemia as blood glucose <70mg/dL.<a class="elsevierStyleCrossRef" href="#bib0300">23</a>As the majority of patients were bedridden and unable to stand, weight (kg) and height (m) were estimated by the criteria of Chumlea et al.<a class="elsevierStyleCrossRef" href="#bib0305">24</a> Circumferences and knee height, which are found in the formulas, were tape measured, while the subscapular skinfold (SSF) was gauged with the aid of a scientific adipometer CescorfTM and performed in triplicate. Body mass index (BMI, kg/m2) was calculated, and classification was based on the WHO<a class="elsevierStyleCrossRef" href="#bib0310">25</a> criteria for adults and the Lipschitz<a class="elsevierStyleCrossRef" href="#bib0315">26</a> criteria for the elderly. These parameters were evaluated only at baseline.Statistical analysisThe sample size calculation considered the number of hospitalisations per month (average of eight patients per month and 11-month follow-up), in which a 95% confidence level and 5% margin of error were used, indicating 72 patients using ENT. Statistical analysis was performed by calculating average values daily until the seventh day of follow-up for each patient. The biochemical analyses (Hb, Ht, CRP, and Alb) were obtained on the day of admission and at the seventh day of hospitalisation. Capillary glucose was monitored daily during the different periods of the day (morning, afternoon, night and dawn).Data are expressed as mean±standard deviation and relative frequency. Statistic 10 software (Copyright © Stat Soft. Inc., Tulsa, OK, USA) was used for descriptive analysis, t-tests for each group independently, Mann–Whitney, repeat measures ANOVA, followed by post hoc Duncan's multiple range test, or Fisher Chi-square test, according to data distribution. Statistical significance was set at p<0.05.ResultsOf the 74 patients receiving exclusive EN, 22 were excluded because they progressed to an oral diet in less than seven days (n=10) or were transferred to other units (n=5), discharged from the hospital (n=5), or died (n=5). Therefore, 52 patients remained in seven-day follow up, 23 (44.2%) from the DG and 29 (55.8%) from the CG.<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> shows the demographic data and the per group admission of patients to medical clinics. In both groups most patients were male, declared white, with average patient ages of 51.6±20.2 years in the DG and 55.2±14.5 years in the CG. Most patients were admitted to the neurological clinic in the DG (70%) and the CG (41%); however, these data were not statistically significant (p=0.08). In addition, energy and protein requirements showed no statistical differences between groups (p>0.05).<elsevierMultimedia ident="tbl0005"></elsevierMultimedia>During the seven-day follow-up, it was observed that the DG received a volume closer to the prescribed volume when compared with the CG, and the difference was statistically significant at day five (p=0.02), as shown in <a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>A. The difference between the administered and prescribed calories was also significantly smaller in the DG than in the CG at day five (p=0.04), as shown in <a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>B. Thus, the CG received a lower volume and fewer calories relative to the prescription, and the DG received a volume and calories closer to the prescription, during most of the follow-up (<a class="elsevierStyleCrossRef" href="#sec0085">Table S1</a>).<elsevierMultimedia ident="fig0005"></elsevierMultimedia>The DG received slightly more protein relative to the CG, with significant differences at day five (p=0.017) after admission (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>C and <a class="elsevierStyleCrossRef" href="#sec0085">Table S1</a>). Protein administration in the CG was below that prescribed, while in the DG, the administered amount was closer to the prescribed amount. However, in both groups, the adequacies of average volume (DG=97.7%; CG=89.3%), calories (DG=97.1%; CG=90.0%), and protein (DG=98.1%; CG=90.4%) during the seven-day follow-up were satisfactory (<a class="elsevierStyleCrossRef" href="#sec0085">Table S2</a>), with adequacy values greater than 80%.<a class="elsevierStyleCrossRef" href="#bib0275">18</a> A comparison of the fibre amount administered to the DG and CG (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>D) showed that both groups received quantities below the recommended AI, with no statistically significant difference between the groups.Capillary glucose (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>) in the DG was in the normal range for hospitalised patients (<140mg/dL), according SBD<a class="elsevierStyleCrossRef" href="#bib0300">23</a> and ADA,<a class="elsevierStyleCrossRef" href="#bib0320">27</a> during the evaluation period, whereas the CG had an average glucose level above the reference range, indicating interaction between time and DG and CG groups (F=1.83; p=0.013). During the dawn period (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>A), when the patients in the DG were not receiving any nutrition, they had lower capillary glucose than those in the CG, with a significant difference on day two (p=0.032), day four (p=0.002), and day six (p<0.001). During the morning period (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>B), a significant difference in the glucose levels between the CG and DG groups was observed on day four (p=0.017). During the afternoon (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>C) on day two (p=0.03), and day four (p=0.003). At night (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>D), no significant differences were observed.<elsevierMultimedia ident="fig0010"></elsevierMultimedia>No hypoglycaemia was observed in patients in either group during the study period. However, hyperglycaemic events were more frequently observed in the CG, when compared to DG group (statistically higher values were observed in the CG in the morning: day one (p=0.01), day two (p=0.03) and days three, four and seven (p<0.001); afternoon day two (p<0.001) and days four and seven (p=0.002); night: day three (p=0.003) and day seven (p<0.001); and dawn only day one showed no statistical differences between groups (p>0.05), according to Fisher's exact test (<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>).<elsevierMultimedia ident="tbl0010"></elsevierMultimedia>When the Alb levels were compared with the reference level of >3.5g/dL,<a class="elsevierStyleCrossRef" href="#bib0295">22</a> both groups presented hypoalbuminaemia. Interaction between time and DG and CG groups was observed (F=6.17; p=0.016), as shown in <a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>. Both groups had average Hb and Ht values below the reference values on admission [DG (Hb=10.2±1.9g/dL; Ht=31.6±5.3%) and CG (Hb=9.7g/dL±1.6; Ht=30.5±4.9%)], and they remained low during the hospitalisation. When the patients’ haemograms were examined, the difference between Hb values indicated the main effect of time, independently of the groups (F=4.16; p=0.047), there was a tendency of values to increase after seven days of hospitalisation in comparison with the day of admission. Analysis of Ht revealed a similar tendency, but the main effect of time was not significant (F=3.18; p=0.08), as indicated in <a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>. The CRP decreased in both groups (CG; CRP2−CRP1=−3.7±3.5mg/dL) and in DG (CRP2−CRP1=−2.1±4.1mg/dL); however, the main effect of time was not significant (F=1.41; p=0.24) (data not shown).<elsevierMultimedia ident="tbl0015"></elsevierMultimedia>In the DG group, 17 patients received EN by nasoenteric tube and six by gastrostomy; in the CG group, 23 patients received EN by nasoenteric tube and six by gastrostomy. The number of patients with intercurrences is also indicated during the seven-day follow-up in the continuous and discontinuous groups (<a class="elsevierStyleCrossRef" href="#sec0085">Table S3</a>). The comparison by Mann–Whitney Test revealed no significant differences between the groups (U values varied from 289 to 326 and p values from 0.41 to 0.89).Open-tube probe, tube replacement, and tube control X-ray were the most common procedures during the follow-up in both groups (<a class="elsevierStyleCrossRef" href="#sec0085">Table S4</a>). The high occurrence of tube replacement and tube control X-ray was due to tube removal by the patient.Besides the most common complications observed in both groups, the DG had four episodes of gastrostomy diet leak. In the CG, the most observed intercurrence was the pause of the diet for the performance of exams; this was higher than in the DG. Regarding medications, antibiotics were used in six and 10 DG and CG patients, respectively, and antibacterial agents in five patients of the CG. This might have been associated with the number of gastrointestinal complications observed in the CG, and their absence in the DG.DiscussionIn the present investigation we observed that the discontinuous EN was more effective in meeting nutrient recommendations and closer to the patient's needs. This factor may have been attributed to the higher intake volume in the discontinuous EN group and fewer intercurrences in this group compared to the continuous EN group. In addition, the overall data about glucose levels indicated a beneficial effect of 4h of EN discontinuation in relation to the continuous infusion group. The results suggested that even a small period of EN discontinuation can have some positive metabolic effects in patients receiving EN. The data also indicate that additional studies are needed to clarify if longer periods of EN discontinuation (for instance, eight or 12h) can produce better results.The beneficial effects of discontinuation in EN may be related to the circadian rhythmicity in the general metabolism, which is dictated by the 24-h light–dark clock cycles and have an impact on metabolism.<a class="elsevierStyleCrossRefs" href="#bib0325">28,29</a> In humans, the highest glucose tolerance occurs in the morning, whereas in the evening the opposite is observed.<a class="elsevierStyleCrossRef" href="#bib0335">30</a> Insulin secretion is critical in the control of the daily rate of glucose tolerance in mammals. Of importance for circadian regulation of carbohydrate metabolism, insulin secretion exhibits regular oscillations during the day, and together with other hormones secreted rhythmically, regulates the body metabolism.<a class="elsevierStyleCrossRef" href="#bib0340">31</a> In the present study, lower glucose levels during the night were observed in the group with EN discontinuation for a period of 4h. These results may have been influenced by the circadian metabolic responses. Fonken et al.<a class="elsevierStyleCrossRef" href="#bib0345">32</a> indicated that exposure to light at night can influence the circadian system and metabolism in mice. Thus, continuous enteral nutrition, indicated by the CG, may be associated with higher blood glucose levels during the night, associated with circadian disruption.Generally, the average capillary glucose in the DG was lower and had fewer oscillations and hyperglycaemic events in comparison with the CG. Many studies have shown benefits of nightly fasting on patients’ glycaemic indexes. Saito, Nishimura, and Kato<a class="elsevierStyleCrossRefs" href="#bib0350">33,34</a> concluded in their studies that circadian rhythms can only be kept normal when the enteral diet infusion is diurnal by the cyclic method, and the continuous or nocturnal feeding method is associated with increased glucose intolerance. Also, Simon, Brandenberg, and Follenius<a class="elsevierStyleCrossRef" href="#bib0360">35</a> observed that subjects who received continuous EN had an increase in plasma glucose levels during time sleeping. Better adaptation of glycaemia with night fasting compared to the continuous method may result in values closer to normal. These results may help in reducing inflammatory processes and improving the prognosis of hospitalised patients.<a class="elsevierStyleCrossRef" href="#bib0365">36</a> In both groups, patients received much lower amounts of fibre than required, mainly because the enteral diets administered were fibre-free.Although most patients were admitted with anaemia and hypoalbuminaemia, the haemogram improved in both groups during the hospitalisation, and serum albumin especially in the DG patients. Studies report that continuous feeding decreases skeletal muscle synthesis, and intermittent (bolus) feeding could provide synthesis because of greater hormonal oscillations, mainly insulin.<a class="elsevierStyleCrossRef" href="#bib0225">8</a> A limiting factor of our study was that plasma insulin levels were not analysed—data that could clarify these findings.The longer time of dietary pause for examination and the gastrointestinal complications seen in the CG versus the DG may be linked to the severity of cases. Additionally, the dietary gastrostomy leakage noticed in four patients of the DG might have occurred due to a greater volume infused in the DG than in the CG. However, no significant differences were observed between groups during the seven-day follow-up. Some studies report that the continuous nutrient method may alter normal intestinal physiology and is associated with side effects and increased tube obstruction.<a class="elsevierStyleCrossRef" href="#bib0235">10</a> Nasiri et al.<a class="elsevierStyleCrossRef" href="#bib0370">37</a> in a randomised controlled triple-blind study in ICU patients, concluded that the bolus method can still be used as a standard method to decrease the risk of EN intolerance if used properly. This disruption frequently occurs in hospital practice, resulting in an enteral diet that falls short of the patient's needs, thereby compromising the nutritional state of these patients.In our study, there were some limitations. The first was the small number of patients included. The second limitation was the lack of monitoring of serum insulin levels and units of insulin needed to maintain glycaemic control. This would help to analyse whether the lower glucoses in the DG compared with the CG could have been influenced by the insulin oscillations caused by feeding interruptions. Also, the short evaluation time (seven days) may have been insufficient to demonstrate more significant differences in some biochemical parameters, such as albumin levels. To better evaluate the effect of discontinuation of the ENT infusion, a significantly longer monitoring time is needed.ConclusionThe results presented here support the beneficial effects of 4h of EN discontinuation in relation to the group receiving EN continuously, providing greater nutrient administration, and when the biochemical endpoint considered was glycaemia. We also observed a very modest effect of EN discontinuation in plasma albumin levels, which can be related to the changes observed in glycaemia. However, additional studies with longer than 4h of EN discontinuation will be needed to validate our findings.Authors’ contributionsAG, EC, ARM and LDS contributed equally to the conception of the research; AG and EC contributed equally to the design of the research; AG, SRJ, BA, and JF contributed to the acquisition of the data; AG, JBTR, and EC contributed to the interpretation and analysis of the data; and AG and EC drafted the manuscript. All authors critically revised the manuscript, agree to be fully accountable for ensuring the integrity and accuracy of the work, and read and approved the final manuscript.FundingThis research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.Conflict of interestThe authors declare that there is no conflict of interest." "textoCompletoSecciones" => array:1 [ "secciones" => array:14 [ 0 => array:3 [ "identificador" => "xres1901290" "titulo" => "Abstract" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Background" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusions" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec1644347" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres1901289" "titulo" => "Resumen" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Introducción" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusiones" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec1644348" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:3 [ "identificador" => "sec0010" "titulo" => "Materials and methods" "secciones" => array:6 [ 0 => array:2 [ "identificador" => "sec0015" "titulo" => "Study design and ethical considerations" ] 1 => array:2 [ "identificador" => "sec0020" "titulo" => "Inclusion and exclusion criteria" ] 2 => array:2 [ "identificador" => "sec0025" "titulo" => "Experimental design" ] 3 => array:2 [ "identificador" => "sec0030" "titulo" => "Dietary assessment" ] 4 => array:2 [ "identificador" => "sec0035" "titulo" => "Biochemical and anthropometric evaluation" ] 5 => array:2 [ "identificador" => "sec0040" "titulo" => "Statistical analysis" ] ] ] 6 => array:2 [ "identificador" => "sec0045" "titulo" => "Results" ] 7 => array:2 [ "identificador" => "sec0050" "titulo" => "Discussion" ] 8 => array:2 [ "identificador" => "sec0055" "titulo" => "Conclusion" ] 9 => array:2 [ "identificador" => "sec0060" "titulo" => "Authors’ contributions" ] 10 => array:2 [ "identificador" => "sec0070" "titulo" => "Funding" ] 11 => array:2 [ "identificador" => "sec0075" "titulo" => "Conflict of interest" ] 12 => array:2 [ "identificador" => "xack667841" "titulo" => "Acknowledgements" ] 13 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2021-11-12" "fechaAceptado" => "2022-03-11" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec1644347" "palabras" => array:5 [ 0 => "Blood glucose" 1 => "Hormones" 2 => "Nutrition therapy" 3 => "Serum albumin" 4 => "Nutritional status" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec1644348" "palabras" => array:5 [ 0 => "Glucemia" 1 => "Hormonas" 2 => "Terapia nutricional" 3 => "Albúmina sérica" 4 => "Estado nutricional" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "BackgroundEnteral nutrition (EN) assists in the nutritional status of hospitalised patients unable to feed orally. The aim of this study was to determine which method—continuous EN or discontinuous EN, a diet in which the infusion is discontinued for 4h during the night,—is more effective in meeting nutrient recommendations and improving glycaemic control and biochemical parameters related to protein anabolism. MethodsPatients were divided into two groups: discontinuous (EN administered in mL/h, 18h/day, 4-h night fasting) and continuous (EN administered in mL/h, 22h/day). All patients with EN receive the diet over a 22-h daily period, in which the diet is suspended for two hours/day for daily hospital routines such as bathing, and physiotherapy, and followed for seven days. Evaluated data: prescribed and administered volume, calories, protein, and fibre; capillary blood glucose; erythrogram; serum albumin. Results52 patients were followed-up, with 23 (44.2%) in the discontinuous group and 29 (55.8%) in the continuous group. Compared with the continuous group, the discontinuous group received volumes closer to those prescribed, equal or higher calories, and more protein. The capillary glucose values were within the reference range in the discontinuous group, while the continuous group presented elevated values. Both groups presented hypoalbuminaemia, haemoglobin, and haematocrit below the reference values; however, in the discontinuous group, the serum albumin values improved during hospitalisation relative to the continuous. ConclusionsThe method involving discontinuation of EN for 4h was more effective in meeting nutrient recommendations compared with the continuous method. Additionally, in the discontinuous group, we observed a better control of glycaemia when compared to that of the continuous group." "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Background" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusions" ] ] ] "es" => array:3 [ "titulo" => "Resumen" "resumen" => "IntroducciónLa nutrición enteral (NE) ayuda en la nutrición de pacientes imposibilitados de alimentarse por vía oral. El objetivo fue determinar si el método discontinuo, en el que suspende la infusión de la nutrición durante 4 h en la noche, es más eficaz que el continuo para atender las recomendaciones de nutrientes, mejora del control glucémico y los parámetros bioquímicos relacionados con el anabolismo proteico. MétodosLos pacientes fueron divididos en 2 grupos: discontinuo (NE administrada en ml/h, 18h/día, 4 h en ayuno nocturno) y continuo (NE administrada en ml/h, 22h/día). La colecta de datos se inició 72h después de la admisión y continuó durante 7 días. Datos evaluados: volumen prescrito y administrado, calorías, proteínas y fibra; glucemia capilar, eritrograma y albúmina sérica. ResultadosCincuenta y dos pacientes fueron valorados durante 7 días, 23 (44,2%) en el grupo discontinuo y 29 (55,8%) en el continuo. Comparado con el grupo continuo, el discontinuo recibió volúmenes próximos a los prescritos, calorías iguales o mayores y más proteína. Los valores de la glucemia capilar estuvieron dentro de la referencia en el grupo discontinuo, mientras que en el continuo los valores fueron mayores. Tanto el grupo continuo como el discontinuo presentaron hipoalbuminemia, hemoglobina y hematocrito por debajo de los valores de referencia; entretanto, en el grupo discontinuo, los valores de albúmina sérica mejoraron durante la hospitalización respecto a los del continuo. ConclusionesEl método discontinuo de NE por 4 h fue más eficaz en el cumplimiento de las recomendaciones de los nutrientes comparado al continuo. Además, se observó un mejor control de la glucemia comparado con la del método continuo." "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Introducción" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusiones" ] ] ] ] "apendice" => array:1 [ 0 => array:1 [ "seccion" => array:1 [ 0 => array:4 [ "apendice" => "The following are the supplementary data to this article:<elsevierMultimedia ident="upi0005"></elsevierMultimedia>" "etiqueta" => "Appendix A" "titulo" => "Supplementary data" "identificador" => "sec0085" ] ] ] ] "multimedia" => array:6 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1645 "Ancho" => 2508 "Tamanyo" => 207012 ] ] "descripcion" => array:1 [ "en" => "Difference between administered and prescribed (A) volume (mL/d), (B) energy (kcal/d), (C) protein (g/d), and (D) fibre (g/d) between the discontinuous and continuous groups during the seven-day follow-up. Repeated Measures ANOVA. *p<0.05." ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1615 "Ancho" => 2508 "Tamanyo" => 210325 ] ] "descripcion" => array:1 [ "en" => "Capillary blood glucose during the seven-day follow-up in the discontinuous and continuous groups. (A) Dawn, (B) Morning, (C) Afternoon, (D) Night. Two-way ANOVA indicated a significant main effect of time vs groups F (6, 557.6)=1.83; p=0.013." ] ] 2 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:3 [ "leyenda" => "Alb=albumin; BMI=body mass index; CRP=C-reactive protein; Hb=haemoglobin; Ht=haematocrit.Values are presented as No. (%) or mean±SD." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Patient characteristics \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Discontinuous group (n=23) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Continuous group (n=29) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">p-Value \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="4" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Gender (n, %)</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Female \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">07 (30) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">08 (28) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.82<a class="elsevierStyleCrossRef" href="#tblfn0010">b</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Male \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">16 (70) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">21 (72) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="4" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"></td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Age, y (mean, SD) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">51.6±20.2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">55.2±14.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.44<a class="elsevierStyleCrossRef" href="#tblfn0005">a</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="4" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="4" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Ethnicity (n, %)</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">White \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">20 (87) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">26 (90) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.76<a class="elsevierStyleCrossRef" href="#tblfn0010">b</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Non-white \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">03 (13) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">03 (10) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="4" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="4" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">BMI, kg/m2(mean, SD)</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Adults \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">20.7±3.5 (n=13) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">21.2±6.9 (n=17) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.82<a class="elsevierStyleCrossRef" href="#tblfn0005">a</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Elderly \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">21.2±4.0 (n=10) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">23.9±5.4 (n=12) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.21<a class="elsevierStyleCrossRef" href="#tblfn0005">a</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="4" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="4" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Requirements</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Calories/day \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">28.5±5.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">29.1±3.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.59<a class="elsevierStyleCrossRef" href="#tblfn0005">a</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Protein/day \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.5±0.20 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.4±0.12 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.54<a class="elsevierStyleCrossRef" href="#tblfn0005">a</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="4" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="4" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Medical clinic (n, %)</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Neurology \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">16 (70) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12 (41) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.08<a class="elsevierStyleCrossRef" href="#tblfn0010">b</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Internal medicine \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">02 (9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">09 (31) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Other clinics \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">05 (21) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">08 (28) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="4" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="4" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Biochemical values base lines (mean, SD)</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Hb, g/dL \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10.2±1.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9.7±1.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.41<a class="elsevierStyleCrossRef" href="#tblfn0005">a</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Ht, % \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">31.6±5.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">30.5±4.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.56<a class="elsevierStyleCrossRef" href="#tblfn0005">a</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">CRP, mg/dL \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5.9±4.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9.7±6.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.12<a class="elsevierStyleCrossRef" href="#tblfn0005">a</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Alb, g/dL \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2.2±0.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2.1±0.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.16<a class="elsevierStyleCrossRef" href="#tblfn0005">a</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Capillary glucose, mg/dL \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">126.3±53.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">140.7±56.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.20<a class="elsevierStyleCrossRef" href="#tblfn0005">a</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab3176597.png" ] ] ] "notaPie" => array:2 [ 0 => array:3 [ "identificador" => "tblfn0005" "etiqueta" => "a" "nota" => "T-test independent by groups." ] 1 => array:3 [ "identificador" => "tblfn0010" "etiqueta" => "b" "nota" => "Chi-square test." ] ] ] "descripcion" => array:1 [ "en" => "Clinical characteristics and hospitalisation of patients with exclusive enteral nutrition in the discontinuous and continuous groups." ] ] 3 => array:8 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at2" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "CG=continuous group; DG=discontinuous group. Number of hyperglycaemic events (>140mg/dL, according to SBD – 2019 and ADA – 2020). Fisher's exact test." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">d 1 \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">d 2 \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">d 3 \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">d 4 \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">d 5 \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">d 6 \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">d 7 \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " rowspan="3" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Morning</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">CG (n=29) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">14 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">13 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">18 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">13 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">18 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">DG (n=23) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">13 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">p-Value \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.01 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.03 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.51 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.57 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="9" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " rowspan="3" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Afternoon</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">CG (n=29) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">18 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">19 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">14 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">19 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">DG (n=23) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">p-Value \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.74 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.10 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.002 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.08 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.15 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.002 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="9" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " rowspan="3" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Night</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">CG (n=29) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">13 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">11 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">21 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">DG (n=23) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">p-Value \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.57 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.37 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.003 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.51 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.37 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.06 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="9" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " rowspan="3" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Dawn</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">CG (n=29) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">18 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">19 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">23 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">17 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">23 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">16 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">DG (n=23) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">p-Value \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.00 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.002 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.002 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.004 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.02 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab3176601.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Number of hyperglycaemic events in the discontinuous and continuous groups during the 7-d follow-up." ] ] 4 => array:8 [ "identificador" => "tbl0015" "etiqueta" => "Table 3" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at3" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "Data are expressed as means±SD. (Repeated measures-ANOVA)." "tablatextoimagen" => array:3 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " colspan="3" align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Albumin (g/dL)</th></tr><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">d 1 \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">d 7 \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">F; P \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Continuous group (n=29) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2.1±0.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2.1±0.4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " rowspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">InteractionF=6.17;p=0.016</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Discontinuous group (n=23) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2.2±0.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2.4±0.4 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab3176600.png" ] ] 1 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " colspan="3" align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Haemoglobin (g/dL)</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Continuous group (n=29) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9.7±1.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9.8±1.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " rowspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Time effectF=4.16;p=0.047</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Discontinuous group (n=23) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10.2±1.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10.6±1.5 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab3176598.png" ] ] 2 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " colspan="3" align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Haematocrit (%)</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Continuous group (n=29) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">30.5±4.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">31.1±5.2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " rowspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Time effectF=3.18;p=0.08</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Discontinuous group (n=23) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">31.6±5.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">32.7±4.5 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab3176599.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Albumin, haemoglobin and haematocrit distribution in the discontinuous and continuous groups during the seven-day follow-up." ] ] 5 => array:5 [ "identificador" => "upi0005" "tipo" => "MULTIMEDIAECOMPONENTE" "mostrarFloat" => false "mostrarDisplay" => true "Ecomponente" => array:2 [ "fichero" => "mmc1.doc" "ficheroTamanyo" => 29306 ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:37 [ 0 => array:3 [ "identificador" => "bib0190" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Nutrition support in hospitalized adults at nutritional risk" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J. Feinberg" 1 => "E.E. Nielsen" 2 => "S.K. Korang" 3 => "E.K. Halberg" 4 => "M.S. Nielsen" 5 => "K. Zhang" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/14651858.CD011598.pub2" "Revista" => array:4 [ "tituloSerie" => "Cochrane Database Syst Rev" "fecha" => "2017" "volumen" => "19" "paginaInicial" => "CD011598" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0195" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "ESPEN guideline on clinical nutrition in the intensive care unit" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "P. Singer" 1 => "A.R. Blaser" 2 => "M.M. Berger" 3 => "W. Alhazzani" 4 => "P.C. Calder" 5 => "M.P. Casaer" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.clnu.2018.08.037" "Revista" => array:6 [ "tituloSerie" => "Clin Nutr" "fecha" => "2019" "volumen" => "38" "paginaInicial" => "48" "paginaFinal" => "79" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30348463" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0200" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Guidelines for the provision assessment of nutrition support therapy in the adult critically ill patient: Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.)" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "S.A. Mcclave" 1 => "B.E. Taylor" 2 => "R.G. Martindale" 3 => "M.M. Warren" 4 => "D.R. Johnson" 5 => "C. Braunschweig" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1177/0148607115621863" "Revista" => array:5 [ "tituloSerie" => "J Parenter Enteral Nutr" "fecha" => "2016" "volumen" => "40" "paginaInicial" => "159" "paginaFinal" => "211" ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0205" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Importance of target calorie intake in hospitalized patients" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "H. Akbay" 1 => "I.M. Gömceli" 2 => "B.O. Yolcular" 3 => "A.H. Cekin" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.5152/tjg.2017.16718" "Revista" => array:6 [ "tituloSerie" => "Turk J Gastroenterol" "fecha" => "2017" "volumen" => "28" "paginaInicial" => "289" "paginaFinal" => "297" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28699602" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0210" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Nutritional risk and nutritional status at admission and discharge among Chinese hospitalized patients: a prospective, nationwide, multicenter study" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M. Zhu" 1 => "J. Wei" 2 => "W. Chen" 3 => "X. Yang" 4 => "H. Cui" 5 => "S. Zhu" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1080/07315724.2017.1304293" "Revista" => array:5 [ "tituloSerie" => "J Am Coll Nutr" "fecha" => "2017" "volumen" => "36" "paginaInicial" => "357" "paginaFinal" => "363" ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0215" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Continuous enteral nutrition versus single bolus: effects on urine C peptide and nitrogen balance" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "A. Sanz-París" 1 => "J. Lázaro" 2 => "A. Guallar" 3 => "P. Gracia" 4 => "A. Caverni" 5 => "R. Albero" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1157/13074390" "Revista" => array:5 [ "tituloSerie" => "Med Clin (Barc)" "fecha" => "2005" "volumen" => "124" "paginaInicial" => "613" "paginaFinal" => "615" ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0220" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Causes and consequences of interrupted enteral nutrition: a prospective observational study in critically ill surgical patients" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M.P. Peev" 1 => "D.D. Yeh" 2 => "S.A. Quraishi" 3 => "P. Osler" 4 => "Y. Chang" 5 => "E. Gillis" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1177/0148607114526887" "Revista" => array:5 [ "tituloSerie" => "J Parenter Enteral Nutr" "fecha" => "2015" "volumen" => "20" "paginaInicial" => "1" "paginaFinal" => "7" ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0225" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Intermittent versus continuous feeding in critically ill adults" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "J.J. Patel" 1 => "M.D. Rosenthal" 2 => "D.K. Heyland" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/MCO.0000000000000447" "Revista" => array:6 [ "tituloSerie" => "Curr Opin Clin Nutr Metab Care" "fecha" => "2017" "volumen" => "21" "paginaInicial" => "116" "paginaFinal" => "120" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29232262" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0230" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Methods of enteral nutrition administration in critically ill patients: continuous, intermittent, cyclic, and bolus feeding" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "S. Ichimaru" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/ncp.10105" "Revista" => array:6 [ "tituloSerie" => "Nutr Clin Pract" "fecha" => "2018" "volumen" => "33" "paginaInicial" => "790" "paginaFinal" => "795" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29924423" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0235" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Continuous versus bolus tube feeds: does the mortality affect glycemic variability, tube feeding volume, calorie intake, or insulin utilization?" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "D.C. Evans" 1 => "R. Forbes" 2 => "C. Jones" 3 => "R. Cotterman" 4 => "C. Njoku" 5 => "C. Thongrong" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.4103/2229-5151.177357" "Revista" => array:6 [ "tituloSerie" => "Int J Crit Illn Inj Sci" "fecha" => "2016" "volumen" => "6" "paginaInicial" => "9" "paginaFinal" => "15" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27051616" "web" => "Medline" ] ] ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0240" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Implications of enteral and parenteral feeding times: considering a circadian picture" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "J. Rothschild" 1 => "W. Lagakos" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1177/0148607114551026" "Revista" => array:5 [ "tituloSerie" => "J Parenter Enteral Nutr" "fecha" => "2014" "volumen" => "39" "paginaInicial" => "266" "paginaFinal" => "270" ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib0245" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Circadian rhythm of energy expenditure and oxygen consumption" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "M. Leuck" 1 => "R. Levandovski" 2 => "A. Harb" 3 => "C. Quiles" 4 => "M.P. Hidalgo" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1177/0148607113482331" "Revista" => array:5 [ "tituloSerie" => "J Parenter Enteral Nutr" "fecha" => "2014" "volumen" => "38" "paginaInicial" => "263" "paginaFinal" => "268" ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib0250" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A more physiological feeding process in ICU: intermittent infusion with semi-solid nutrients" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "K. Lu" 1 => "F. Zeng" 2 => "Y. Li" 3 => "C. Chen" 4 => "M. Huang" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/MD.0000000000012173" "Revista" => array:5 [ "tituloSerie" => "Medicine" "fecha" => "2018" "volumen" => "97" "paginaInicial" => "e12173" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30200118" "web" => "Medline" ] ] ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib0255" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Malnutrition in very old hospitalized patients: a new etiologic factor of anemia?" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "E. Frangos" 1 => "A. Trombetti" 2 => "C.E. Graf" 3 => "V. Lachat" 4 => "N. Samaras" 5 => "U.M. Vischer" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s12603-015-0641-6" "Revista" => array:6 [ "tituloSerie" => "J Nutr Health Aging" "fecha" => "2016" "volumen" => "20" "paginaInicial" => "705" "paginaFinal" => "713" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27499303" "web" => "Medline" ] ] ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib0260" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Association of anemia and malnutrition in hospitalized patients with exclusive enteral nutrition" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "S. Reck-de-Jesus" 1 => "B. Pessoa-Alves" 2 => "A. Golin" 3 => "M. Schott" 4 => "L. Dachi" 5 => "A. Marques" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.20960/nh.1628" "Revista" => array:6 [ "tituloSerie" => "Nutr Hosp" "fecha" => "2018" "volumen" => "35" "paginaInicial" => "753" "paginaFinal" => "760" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30070860" "web" => "Medline" ] ] ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib0265" "etiqueta" => "16" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Terapia Nutricional Enteral em Unidade de Terapia Intensiva: infusão versus necessidades" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "A.C.C. Teixeira" 1 => "L. Caruso" 2 => "F.G. Soriano" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1590/S0103-507X2006000400003" "Revista" => array:6 [ "tituloSerie" => "Rev Bras Ter Intensiva" "fecha" => "2006" "volumen" => "18" "paginaInicial" => "331" "paginaFinal" => "337" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25310545" "web" => "Medline" ] ] ] ] ] ] ] ] 16 => array:3 [ "identificador" => "bib0270" "etiqueta" => "17" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Estado nutricional e dieta enteral prescrita e recebida por pacientes de uma Unidade de Terapia Intensiva" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "M.D. Stefanello" 1 => "F.A. Poll" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.7322/abcshs.v39i2.625" "Revista" => array:5 [ "tituloSerie" => "ABCS Health Sci" "fecha" => "2014" "volumen" => "39" "paginaInicial" => "71" "paginaFinal" => "76" ] ] ] ] ] ] 17 => array:3 [ "identificador" => "bib0275" "etiqueta" => "18" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Enteral nutrition: differences between volume, energy and protein prescribed and administered in adults" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M.C.S. Assis" 1 => "S.M.R. Silva" 2 => "D.M. Leães" 3 => "C.L. Novekki" 4 => "C.R.M. Silveira" 5 => "E.D. Mello" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1590/S0103-507X2010000400006" "Revista" => array:6 [ "tituloSerie" => "Rev Bras Ter Intensiva" "fecha" => "2010" "volumen" => "22" "paginaInicial" => "346" "paginaFinal" => "350" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25302510" "web" => "Medline" ] ] ] ] ] ] ] ] 18 => array:3 [ "identificador" => "bib0280" "etiqueta" => "19" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "IOM Food and Nutrition Board. Dietary reference intakes for energy, carbohydrate, fiber, fat, fatty acids, cholesterol, protein and amino acids" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "Institute of Medicine" 1 => "I.O.M. Medicine" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:3 [ "fecha" => "2001" "editorial" => "National Academies Press" "editorialLocalizacion" => "Washington, DC" ] ] ] ] ] ] 19 => array:3 [ "identificador" => "bib0285" "etiqueta" => "20" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "WHO Hemoglobin concentrations for the diagnosis of anemia and assessment of severity. Vitamin and Mineral Nutrition Information System" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "World Health Organization" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:3 [ "fecha" => "2011" "editorial" => "World Health Organization" "editorialLocalizacion" => "Geneva" ] ] ] ] ] ] 20 => array:3 [ "identificador" => "bib0290" "etiqueta" => "21" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A test in context: high-sensitivity C-reactive protein" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "M.P. Ridker" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jacc.2015.11. 037" "Revista" => array:5 [ "tituloSerie" => "J Am Col Cardiol" "fecha" => "2016" "volumen" => "67" "paginaInicial" => "712" "paginaFinal" => "723" ] ] ] ] ] ] 21 => array:3 [ "identificador" => "bib0295" "etiqueta" => "22" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Hypoalbuminemia in acute illness: is there a rationale for intervention? A meta-analysis of cohort studies and controlled trials" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "J.L. Vincent" 1 => "M.J. Dubois" 2 => "R.J. Navickis" 3 => "M.M. Wilkes" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/01.SLA.0000055547.93484.87" "Revista" => array:5 [ "tituloSerie" => "Ann Surg" "fecha" => "2003" "volumen" => "237" "paginaInicial" => "319" "paginaFinal" => "334" ] ] ] ] ] ] 22 => array:3 [ "identificador" => "bib0300" "etiqueta" => "23" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Sociedade Brasileira de Diabetes. SBD Diretrizes da Sociedade Brasileira de Diabetes: 2019–2020. São Paulo: Editora Clannad, 2019, 491 p. Available at: <a target="_blank" href="http://www.diabetes.org.br/profissionais/images/DIRETRIZES-COMPLETA-2019-2020.pdf">www.diabetes.org.br/profissionais/images/DIRETRIZES-COMPLETA-2019-2020.pdf</a> [accessed June 2020]." ] ] ] 23 => array:3 [ "identificador" => "bib0305" "etiqueta" => "24" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Prediction of body weight for non-ambulatory elderly from anthropometry" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "W.C. Chumlea" 1 => "S. Guo" 2 => "A.F. Roche" 3 => "M.L. Steinbaugh" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/S0002-8223(21)02009-5" "Revista" => array:6 [ "tituloSerie" => "J Am Diet Assoc" "fecha" => "1988" "volumen" => "88" "paginaInicial" => "564" "paginaFinal" => "568" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3367012" "web" => "Medline" ] ] ] ] ] ] ] ] 24 => array:3 [ "identificador" => "bib0310" "etiqueta" => "25" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "World Health Organization. WHO. Obesity: Preventing and managing the global epidemic of obesity. Report of the WHO Consultation of Obesity. Geneva 3–5. 1997." ] ] ] 25 => array:3 [ "identificador" => "bib0315" "etiqueta" => "26" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Screening for nutritional status in the elderly" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "D.A. Lipschitz" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Prim Care" "fecha" => "1994" "volumen" => "1" "paginaInicial" => "55" "paginaFinal" => "67" ] ] ] ] ] ] 26 => array:3 [ "identificador" => "bib0320" "etiqueta" => "27" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "American Diabetes Association. ADA. Diabetes care in the hospital: standards of medical care in diabetes 2020. Diabetes Care. 2020;43(Suppl. 1):S193–202. <a target="_blank" href="doi:10.2337/dc20-S015">doi:10.2337/dc20-S015</a>." ] ] ] 27 => array:3 [ "identificador" => "bib0325" "etiqueta" => "28" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Metabolic effects of intermittent fasting" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "R.E. Patterson" 1 => "D.D. Sears" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1146/annurev-nutr-071816-064634" "Revista" => array:6 [ "tituloSerie" => "Annu Rev Nutr" "fecha" => "2017" "volumen" => "37" "paginaInicial" => "371" "paginaFinal" => "393" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28715993" "web" => "Medline" ] ] ] ] ] ] ] ] 28 => array:3 [ "identificador" => "bib0330" "etiqueta" => "29" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The influence of meal frequency and timing on health in humans: the role of fasting" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "A. Paoli" 1 => "G. Tinsley" 2 => "A. Bianco" 3 => "T. Moro" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3390/nu11040719" "Revista" => array:6 [ "tituloSerie" => "Nutrients" "fecha" => "2019" "volumen" => "11" "paginaInicial" => "719" "paginaFinal" => "738" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30925707" "web" => "Medline" ] ] ] ] ] ] ] ] 29 => array:3 [ "identificador" => "bib0335" "etiqueta" => "30" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Roles of circadian rhythmicity and sleep in human glucose regulation" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "E. Van Cauter" 1 => "K.S. Polonsky" 2 => "A.J. Scheen" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1210/edrv.18.5.0317" "Revista" => array:6 [ "tituloSerie" => "Endocr Rev" "fecha" => "1997" "volumen" => "18" "paginaInicial" => "716" "paginaFinal" => "738" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9331550" "web" => "Medline" ] ] ] ] ] ] ] ] 30 => array:3 [ "identificador" => "bib0340" "etiqueta" => "31" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Modulation of glucose regulation and insulin secretion by circadian rhythmicity and sleep" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "E. Van Cauter" 1 => "J.D. Blackman" 2 => "D. Roland" 3 => "J.P. Spire" 4 => "S. Refetoff" 5 => "K.S. Polonsky" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1172/JCI115396" "Revista" => array:6 [ "tituloSerie" => "J Clin Invest" "fecha" => "1991" "volumen" => "88" "paginaInicial" => "934" "paginaFinal" => "942" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1885778" "web" => "Medline" ] ] ] ] ] ] ] ] 31 => array:3 [ "identificador" => "bib0345" "etiqueta" => "32" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Dim light at night disrupts molecular circadian rhythms and affects metabolism" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "L.K. Fonken" 1 => "T.G. Aubrecht" 2 => "O.H. Meléndez-Fernández" 3 => "Z.M. Weil" 4 => "R.J. Nelson" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1177/0748730413493862" "Revista" => array:6 [ "tituloSerie" => "J Biol Rhythms" "fecha" => "2013" "volumen" => "28" "paginaInicial" => "262" "paginaFinal" => "271" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23929553" "web" => "Medline" ] ] ] ] ] ] ] ] 32 => array:3 [ "identificador" => "bib0350" "etiqueta" => "33" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Modifications of circadian cortisol rhythm by cyclic and continuous total enteral nutrition" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "M. Saito" 1 => "K. Nishimura" 2 => "H. Kato" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3177/jnsv.35.639" "Revista" => array:6 [ "tituloSerie" => "J Nutr Sci Vitaminol" "fecha" => "1989" "volumen" => "35" "paginaInicial" => "639" "paginaFinal" => "647" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2517510" "web" => "Medline" ] ] ] ] ] ] ] ] 33 => array:3 [ "identificador" => "bib0355" "etiqueta" => "34" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Effects of cyclic and continuous total enteral nutrition on 24-h rhythms of body temperature and urinary excretions" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "K. Nishimura" 1 => "H. Kato" 2 => "M. Saito" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3177/jnsv.38.117" "Revista" => array:6 [ "tituloSerie" => "J Nutr Sci Vitaminol" "fecha" => "1992" "volumen" => "38" "paginaInicial" => "117" "paginaFinal" => "125" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1506918" "web" => "Medline" ] ] ] ] ] ] ] ] 34 => array:3 [ "identificador" => "bib0360" "etiqueta" => "35" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Ultradian oscillations of plasma glucose, insulin, and C-peptide in man during continuous enteral nutrition" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "C. Simon" 1 => "G. Brandenberger" 2 => "M. Follenius" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1210/jcem-64-4-669" "Revista" => array:5 [ "tituloSerie" => "J Clin Endocrinol Metab" "fecha" => "1987" "volumen" => "64" "paginaInicial" => "669" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3102544" "web" => "Medline" ] ] ] ] ] ] ] ] 35 => array:3 [ "identificador" => "bib0365" "etiqueta" => "36" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Diabetic-specific enteral nutrition formula in hyperglycemic, mechanically ventilated, critically ill patients: a prospective, open-label, blind-randomized, multicenter study" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "A. Mesejo" 1 => "J.C. Montejo-González" 2 => "C. Vaquerizo-Alonso" 3 => "G. Lobo-Tamer" 4 => "M. Zabarte-Martinez" 5 => "J.I. Herrero-Meseguer" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1186/s13054-015-1108-1" "Revista" => array:4 [ "tituloSerie" => "Crit Care" "fecha" => "2015" "volumen" => "19" "paginaInicial" => "390" ] ] ] ] ] ] 36 => array:3 [ "identificador" => "bib0370" "etiqueta" => "37" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Comparison of intermittent and bolus enteral feeding methods on enteral feeding intolerance of patients with sepsis: a triple-blind controlled trial in intensive care units" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "M. Nasiri" 1 => "Z. Farsi" 2 => "M. Ahangari" 3 => "D. Fahimeh" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.15171/mejdd.2017.77" "Revista" => array:5 [ "tituloSerie" => "Middle East J Digest Dis" "fecha" => "2017" "volumen" => "9" "paginaInicial" => "218" "paginaFinal" => "227" ] ] ] ] ] ] ] ] ] ] "agradecimientos" => array:1 [ 0 => array:4 [ "identificador" => "xack667841" "titulo" => "Acknowledgements" "texto" => "We are thankful for the opportunity and support given to us by the multidisciplinary team at Hospital Universitário de Santa Maria." 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Night fasting as an alternative to improve nutritional support and glycaemic control in hospitalised patients with exclusive enteral nutrition

Ayuno nocturno como alternativa para mejorar el soporte nutricional y el control glucémico en pacientes hospitalizados con nutrición enteral exclusiva

Anieli Golina, Sibila Reck de Jesusa, Bruna Pessoa Alvesa, Mairin Schotta, Andréa Rodrigues Marquesb, Leonardo Dachi dos Santosb, Juliana Fleckc, João Batista Teixeira da Rochad, Elisângela Colpoa,

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elicolpo@ufn.edu.br

Corresponding author.

a Master in Health Science and Life Science, and Department of Nutrition, Universidade Franciscana, Santa Maria, RS, Brazil

b Department of Nutrition, Hospital Universitário de Santa Maria, Santa Maria, RS, Brazil

c Department of Pharmacy, Universidade Franciscana, Santa Maria, RS, Brazil

d Department of Biochemistry, Universidade Federal de Santa Maria, RS, Brazil

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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">The immediate initiation of enteral nutrition therapy &#40;ENT&#41; is critical to recovering or improving the patient&#39;s nutritional status<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">1</span></a> and minimises the catabolic status induced by serious illness&#44;<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">2</span></a> as long as the gastrointestinal tract of the patient is physiological and structurally functional&#46;<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">3</span></a> The adequate nutritional supply of calories and proteins from EN&#44; is critical for improving the nutritional status of hospitalised patients unable to feed orally&#44;<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">4</span></a> but when the supply is diminished&#44; malnutrition can occur&#44; increase the morbimortality rate&#44; and the hospitalisation time&#46;<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">5</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Commonly&#44; EN is administered by the continuous method &#40;slow and steady influx of nutrients over 24<span class="elsevierStyleHsp" style=""></span>h&#41; to reduce the risk of diarrhoea<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">2</span></a>&#59; to decrease the risk of contamination by microorganisms&#44; and to prevent variation in insulin levels under constant glycaemic stimulation&#46;<a class="elsevierStyleCrossRefs" href="#bib0215"><span class="elsevierStyleSup">6&#44;7</span></a> In cyclic feeding&#44; EN is infused for less than 24<span class="elsevierStyleHsp" style=""></span>h &#40;with a stop of six to eight hours&#41;&#8212;as occurs in normal human eating&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">It is performed to restore gastric acidity and bacterial colonisation of the stomach and to maintain the cortisol levels associated with circadian rhythms &#40;light&#47;dark&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">8</span></a> Intermittent feeding is usually delivered over 20&#8211;60<span class="elsevierStyleHsp" style=""></span>min every 4&#8211;6<span class="elsevierStyleHsp" style=""></span>h by infusion pump or by the gravity drip method and may allow for more mobility of the patient&#46;<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">9</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">Few studies have evaluated different ENT methods&#44; suggesting that the continuous EN method may result in better nitrogen balance and a decrease in the excretion of C-peptide in the urine&#44; compared to the bolus method<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">6</span></a>&#59; that the intermittent versus the continuous method did not significantly affect glycaemic variability or insulinaemia&#44; and that professionals should not be limited to only one feeding method<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">10</span></a>&#59; that intermittent &#40;bolus&#41; feeding resembles a typical oral eating pattern by properly stimulating hepatic rhythmicity<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">11</span></a>&#59; circadian rhythms are observed in the release of hormones and are controlled by light and feeding time&#44; and the energetic expenditure is higher at night and may be affected by the continuous and intermittent feeding methods&#46;<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">12</span></a> However&#44; there is still no consensus on which method should be adopted to provide better patient outcomes&#44; as the effects on metabolic parameters seem contradictory&#46;<a class="elsevierStyleCrossRefs" href="#bib0230"><span class="elsevierStyleSup">9&#44;13</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">Along with dietary assessment&#44; biochemical parameters&#44; such as the haemogram and serum albumin &#40;Alb&#41;&#44; are frequently used to evaluate the nutritional status of hospitalised patients&#46;<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">14</span></a> Reck-de-Jesus et al&#46;<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">15</span></a> pointed out that nutrient inadequacy can contribute to anaemia and hypoalbuminaemia&#44; due to the association of haemoglobin &#40;Hb&#41; and Alb in patients with exclusive EN&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">We hypothesised that a discontinuous method&#44; with a nightly discontinuation of EN infusion may be more effective compared to the continuous method&#44; because it can be considered closer to the normal physiology of food ingestion by humans and could lead to benefits on nutrient intake and glycaemic control&#46; Therefore&#44; this study&#39;s first aim was to determine which of the methods&#8212;continuous or discontinuous EN&#8212;is more effective in meeting nutrient recommendations and blood biochemical parameters that are closer to the patient&#39;s needs&#46; The second aim was to determine which of the methods could improve glycaemic control and biochemical parameters related to protein anabolism&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Materials and methods</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Study design and ethical considerations</span><p id="par0035" class="elsevierStylePara elsevierViewall">This was a quasi-experimental clinical study&#44; paired by sex and age &#40;register number RBR-5vkzjt&#44; <a href="http://www.ensaiosclinicos.gov.br/rg/RBR-5vkzjt/">http&#58;&#47;&#47;www&#46;ensaiosclinicos&#46;gov&#46;br&#47;rg&#47;RBR-5vkzjt&#47;</a>&#41;&#46; The study involved hospital patients admitted to the medical clinic unit &#40;with 27 beds&#41;&#44; in a public hospital&#46; This study was approved by the Ethics and Research Committee &#40;number 2&#46;103&#46;411&#41;&#46; Data collection occurred after written informed consent was obtained from the patients or their guardians&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Inclusion and exclusion criteria</span><p id="par0040" class="elsevierStylePara elsevierViewall">Included in this study were patients expected to be hospitalised for at least seven days&#44; with EN administered exclusively by vacuum infusion pump&#44; in a closed system&#44; with the patient conscious or in the company of a responsible person&#46; Patients were excluded if they had generalised oedema&#44; sepsis&#44; or chronic renal failure&#44; or if they were on mechanical ventilation&#44; because these conditions induce metabolic stress and may interfere with anthropometrics&#44; biochemical data&#44; and energy expenditure&#59; if they were receiving comfort measures only&#44; if they were receiving parenteral or oral feeding combined with ENT&#44; if they were discharged from the hospital&#44; transferred to other clinics&#44; or if they died before re-evaluation after seven days&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Experimental design</span><p id="par0045" class="elsevierStylePara elsevierViewall">52 patients were followed&#46; Data collection began within 72<span class="elsevierStyleHsp" style=""></span>h of a patient&#39;s admission to infirmary of the medical clinic and followed for seven days&#46; According to the hospital protocol&#44; all patients with EN receive the diet over a 22-h daily period&#44; in infusion pump&#44; in which the diet is suspended for 2<span class="elsevierStyleHsp" style=""></span>h&#47;day &#40;in the morning&#41; for daily hospital routines such as bathing&#44; physiotherapy&#44; and speech therapy&#46; Under these circumstances&#44; this period is not accounted for in calculating the patients&#8217; nutritional needs&#46; Therefore&#44; the study patients were divided into two groups&#58; the discontinuous group &#40;DG&#41; had 23 patients&#44; exclusive EN was administered in mL&#47;h for a cycle of 18<span class="elsevierStyleHsp" style=""></span>h&#47;day&#44; and the patients were submitted to four consecutive hours of night fasting &#40;from midnight until 04&#58;00&#41;&#59; the continuous group &#40;CG&#41; had 29 patients&#44; and EN was administered in mL&#47;h for a cycle of 22<span class="elsevierStyleHsp" style=""></span>h&#47;day&#44; without night fasting&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Dietary assessment</span><p id="par0050" class="elsevierStylePara elsevierViewall">The patients&#8217; nutritional needs were estimated and prescribed by the nutritionist according to established hospital protocols&#46; To evaluate nutritional status&#44; the standard formulas&#44; according to the nutritional need of the patients and the illnesses&#44; with caloric density between 1&#46;0 and 2&#46;0<span class="elsevierStyleHsp" style=""></span>kcal&#47;mL were used according to the nutritional diagnosis&#44; from 30 to 35<span class="elsevierStyleHsp" style=""></span>kcal&#47;kg of current weight for undernourished patients&#59; from 25 to 30<span class="elsevierStyleHsp" style=""></span>kcal&#47;kg of current weight for eutrophic patients&#59; 25<span class="elsevierStyleHsp" style=""></span>kcal&#47;kg of current weight for overweight patients&#59; and 20&#8211;25<span class="elsevierStyleHsp" style=""></span>kcal&#47;kg of adjusted weight for obese patients&#46; The protein quantity offered varied from 0&#46;8 to 2&#46;0<span class="elsevierStyleHsp" style=""></span>g&#47;kg of current weight&#44; according to the hospital protocol for each diagnosis&#46; In both groups&#44; the patients started at the goal rate within 72<span class="elsevierStyleHsp" style=""></span>h&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">During the seven-day follow-up&#44; medical record reviews were undertaken to collect the following data&#58; demographic data&#44; energy needs &#40;kcal&#47;kg of weight&#47;d&#41;&#59; protein needs &#40;PTN&#47;kg of weight&#47;d&#41;&#59; and the nutritional prescription&#44; such as route of access&#44; diet type&#44; caloric density&#44; infusion volume&#44; total caloric content of the diet&#44; and dietary protein &#40;total PTN&#47;day&#41;&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">The daily administered volume and the diet type were verified by the researcher through the patient electronic record&#44; in order to verify the received energy quantity &#40;kcal&#47;kg of weight&#47;day&#59; kcal&#47;day&#41; and protein quantity &#40;PTN&#47;kg of weight&#47;day&#59; total PTN&#47;day&#41;&#44; intercurrences due to the enteral diet&#44; such as gastrointestinal &#40;nausea&#44; vomiting&#44; constipation&#44; diarrhoea&#41;&#44; mechanical &#40;patient-started probe&#44; patient-traced probe&#44; bottle-open probe&#44; clogged probe&#44; infusion pump problem&#44; gastrostomy diet leak&#44; and other tube-related occurrences&#41;&#44; and examinations and procedures &#40;diet turned off for gastrostomy&#44; diet paused to perform exams&#41;&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">Percentages of volume adequacy&#44;<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">16</span></a> energy adequacy and protein adequacy<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">17</span></a> were calculated&#44; and the values were considered satisfactory when above 80&#37;&#46;<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">18</span></a> The fibre contents were calculated by age and gender according to the infused diet type and compared to the dietary reference intakes&#44; which comprise the adequate intake&#8212;AI&#46;<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">19</span></a> None of the patients received additional sources or supplementation of calories&#44; protein&#44; or fibre&#8212;only those prescribed by enteral nutrition&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Biochemical and anthropometric evaluation</span><p id="par0070" class="elsevierStylePara elsevierViewall">Laboratory values&#44; including Hb&#44; haematocrit &#40;Ht&#41;&#44; C-reactive protein &#40;CRP&#41;&#44; and Alb&#44; were monitored by biochemical analysis according to the medical protocol&#46; Capillary glucose was monitored according to the medical prescription&#44; being performed every four&#44; six or eight hours&#47;day&#46; The quantification of glucose was taken during the seven-day follow-up&#46; Blood glucose levels were presented according to the following periods of the day&#58; morning &#40;6<span class="elsevierStyleHsp" style=""></span>a&#46;m&#46; until 12<span class="elsevierStyleHsp" style=""></span>p&#46;m&#46;&#41; afternoon &#40;12<span class="elsevierStyleHsp" style=""></span>p&#46;m&#46; until 6<span class="elsevierStyleHsp" style=""></span>p&#46;m&#46;&#41;&#44; night &#40;6<span class="elsevierStyleHsp" style=""></span>p&#46;m&#46; until 12<span class="elsevierStyleHsp" style=""></span>a&#46;m&#46;&#41; and dawn &#40;12<span class="elsevierStyleHsp" style=""></span>a&#46;m&#46; until 6<span class="elsevierStyleHsp" style=""></span>a&#46;m&#46;&#41;&#46; The male and female reference values used were&#58; &#62;13 and &#62;12<span class="elsevierStyleHsp" style=""></span>g&#47;dL for Hb and 40&#8211;54&#37; and 37&#8211;47&#37; for Ht&#44; respectively<a class="elsevierStyleCrossRef" href="#bib0285"><span class="elsevierStyleSup">20</span></a>&#59; &#60;0&#46;5<span class="elsevierStyleHsp" style=""></span>mg&#47;dL for CRP<a class="elsevierStyleCrossRef" href="#bib0290"><span class="elsevierStyleSup">21</span></a>&#59; and &#62;3&#46;5<span class="elsevierStyleHsp" style=""></span>g&#47;dL for Alb&#46;<a class="elsevierStyleCrossRef" href="#bib0295"><span class="elsevierStyleSup">22</span></a> Hyperglycaemia in hospitalised patients &#40;adults and elderly&#41; was defined as glucose levels &#62;140<span class="elsevierStyleHsp" style=""></span>mg&#47;dL and hypoglycaemia as blood glucose &#60;70<span class="elsevierStyleHsp" style=""></span>mg&#47;dL&#46;<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">23</span></a></p><p id="par0075" class="elsevierStylePara elsevierViewall">As the majority of patients were bedridden and unable to stand&#44; weight &#40;kg&#41; and height &#40;m&#41; were estimated by the criteria of Chumlea et al&#46;<a class="elsevierStyleCrossRef" href="#bib0305"><span class="elsevierStyleSup">24</span></a> Circumferences and knee height&#44; which are found in the formulas&#44; were tape measured&#44; while the subscapular skinfold &#40;SSF&#41; was gauged with the aid of a scientific adipometer CescorfTM and performed in triplicate&#46; Body mass index &#40;BMI&#44; kg&#47;m<span class="elsevierStyleSup">2</span>&#41; was calculated&#44; and classification was based on the WHO<a class="elsevierStyleCrossRef" href="#bib0310"><span class="elsevierStyleSup">25</span></a> criteria for adults and the Lipschitz<a class="elsevierStyleCrossRef" href="#bib0315"><span class="elsevierStyleSup">26</span></a> criteria for the elderly&#46; These parameters were evaluated only at baseline&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Statistical analysis</span><p id="par0080" class="elsevierStylePara elsevierViewall">The sample size calculation considered the number of hospitalisations per month &#40;average of eight patients per month and 11-month follow-up&#41;&#44; in which a 95&#37; confidence level and 5&#37; margin of error were used&#44; indicating 72 patients using ENT&#46; Statistical analysis was performed by calculating average values daily until the seventh day of follow-up for each patient&#46; The biochemical analyses &#40;Hb&#44; Ht&#44; CRP&#44; and Alb&#41; were obtained on the day of admission and at the seventh day of hospitalisation&#46; Capillary glucose was monitored daily during the different periods of the day &#40;morning&#44; afternoon&#44; night and dawn&#41;&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">Data are expressed as mean<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>standard deviation and relative frequency&#46; Statistic 10 software &#40;Copyright &#169; Stat Soft&#46; Inc&#46;&#44; Tulsa&#44; OK&#44; USA&#41; was used for descriptive analysis&#44; <span class="elsevierStyleItalic">t</span>-tests for each group independently&#44; Mann&#8211;Whitney&#44; repeat measures ANOVA&#44; followed by post hoc Duncan&#39;s multiple range test&#44; or Fisher Chi-square test&#44; according to data distribution&#46; Statistical significance was set at <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#46;</p></span></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Results</span><p id="par0090" class="elsevierStylePara elsevierViewall">Of the 74 patients receiving exclusive EN&#44; 22 were excluded because they progressed to an oral diet in less than seven days &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>10&#41; or were transferred to other units &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>5&#41;&#44; discharged from the hospital &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>5&#41;&#44; or died &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>5&#41;&#46; Therefore&#44; 52 patients remained in seven-day follow up&#44; 23 &#40;44&#46;2&#37;&#41; from the DG and 29 &#40;55&#46;8&#37;&#41; from the CG&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> shows the demographic data and the per group admission of patients to medical clinics&#46; In both groups most patients were male&#44; declared white&#44; with average patient ages of 51&#46;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>20&#46;2 years in the DG and 55&#46;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>14&#46;5 years in the CG&#46; Most patients were admitted to the neurological clinic in the DG &#40;70&#37;&#41; and the CG &#40;41&#37;&#41;&#59; however&#44; these data were not statistically significant &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;08&#41;&#46; In addition&#44; energy and protein requirements showed no statistical differences between groups &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0100" class="elsevierStylePara elsevierViewall">During the seven-day follow-up&#44; it was observed that the DG received a volume closer to the prescribed volume when compared with the CG&#44; and the difference was statistically significant at day five &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;02&#41;&#44; as shown in <a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>A&#46; The difference between the administered and prescribed calories was also significantly smaller in the DG than in the CG at day five &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;04&#41;&#44; as shown in <a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>B&#46; Thus&#44; the CG received a lower volume and fewer calories relative to the prescription&#44; and the DG received a volume and calories closer to the prescription&#44; during most of the follow-up &#40;<a class="elsevierStyleCrossRef" href="#sec0085">Table S1</a>&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0105" class="elsevierStylePara elsevierViewall">The DG received slightly more protein relative to the CG&#44; with significant differences at day five &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;017&#41; after admission &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>C and <a class="elsevierStyleCrossRef" href="#sec0085">Table S1</a>&#41;&#46; Protein administration in the CG was below that prescribed&#44; while in the DG&#44; the administered amount was closer to the prescribed amount&#46; However&#44; in both groups&#44; the adequacies of average volume &#40;DG<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>97&#46;7&#37;&#59; CG<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>89&#46;3&#37;&#41;&#44; calories &#40;DG<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>97&#46;1&#37;&#59; CG<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>90&#46;0&#37;&#41;&#44; and protein &#40;DG<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>98&#46;1&#37;&#59; CG<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>90&#46;4&#37;&#41; during the seven-day follow-up were satisfactory &#40;<a class="elsevierStyleCrossRef" href="#sec0085">Table S2</a>&#41;&#44; with adequacy values greater than 80&#37;&#46;<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">18</span></a> A comparison of the fibre amount administered to the DG and CG &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>D&#41; showed that both groups received quantities below the recommended AI&#44; with no statistically significant difference between the groups&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">Capillary glucose &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41; in the DG was in the normal range for hospitalised patients &#40;&#60;140<span class="elsevierStyleHsp" style=""></span>mg&#47;dL&#41;&#44; according SBD<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">23</span></a> and ADA&#44;<a class="elsevierStyleCrossRef" href="#bib0320"><span class="elsevierStyleSup">27</span></a> during the evaluation period&#44; whereas the CG had an average glucose level above the reference range&#44; indicating interaction between time and DG and CG groups &#40;<span class="elsevierStyleItalic">F</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#46;83&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;013&#41;&#46; During the dawn period &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>A&#41;&#44; when the patients in the DG were not receiving any nutrition&#44; they had lower capillary glucose than those in the CG&#44; with a significant difference on day two &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;032&#41;&#44; day four &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;002&#41;&#44; and day six &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#46; During the morning period &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>B&#41;&#44; a significant difference in the glucose levels between the CG and DG groups was observed on day four &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;017&#41;&#46; During the afternoon &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>C&#41; on day two &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;03&#41;&#44; and day four &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;003&#41;&#46; At night &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>D&#41;&#44; no significant differences were observed&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0115" class="elsevierStylePara elsevierViewall">No hypoglycaemia was observed in patients in either group during the study period&#46; However&#44; hyperglycaemic events were more frequently observed in the CG&#44; when compared to DG group &#40;statistically higher values were observed in the CG in the morning&#58; day one &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;01&#41;&#44; day two &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;03&#41; and days three&#44; four and seven &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#59; afternoon day two &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41; and days four and seven &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;002&#41;&#59; night&#58; day three &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;003&#41; and day seven &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#59; and dawn only day one showed no statistical differences between groups &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#41;&#44; according to Fisher&#39;s exact test &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0120" class="elsevierStylePara elsevierViewall">When the Alb levels were compared with the reference level of &#62;3&#46;5<span class="elsevierStyleHsp" style=""></span>g&#47;dL&#44;<a class="elsevierStyleCrossRef" href="#bib0295"><span class="elsevierStyleSup">22</span></a> both groups presented hypoalbuminaemia&#46; Interaction between time and DG and CG groups was observed &#40;<span class="elsevierStyleItalic">F</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>6&#46;17&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;016&#41;&#44; as shown in <a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#46; Both groups had average Hb and Ht values below the reference values on admission &#91;DG &#40;Hb<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>10&#46;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;9<span class="elsevierStyleHsp" style=""></span>g&#47;dL&#59; Ht<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>31&#46;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>5&#46;3&#37;&#41; and CG &#40;Hb<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>9&#46;7<span class="elsevierStyleHsp" style=""></span>g&#47;dL<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;6&#59; Ht<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>30&#46;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&#46;9&#37;&#41;&#93;&#44; and they remained low during the hospitalisation&#46; When the patients&#8217; haemograms were examined&#44; the difference between Hb values indicated the main effect of time&#44; independently of the groups &#40;<span class="elsevierStyleItalic">F</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>4&#46;16&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;047&#41;&#44; there was a tendency of values to increase after seven days of hospitalisation in comparison with the day of admission&#46; Analysis of Ht revealed a similar tendency&#44; but the main effect of time was not significant &#40;<span class="elsevierStyleItalic">F</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>3&#46;18&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;08&#41;&#44; as indicated in <a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#46; The CRP decreased in both groups &#40;CG&#59; CRP2<span class="elsevierStyleHsp" style=""></span>&#8722;<span class="elsevierStyleHsp" style=""></span>CRP1<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#8722;3&#46;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#46;5<span class="elsevierStyleHsp" style=""></span>mg&#47;dL&#41; and in DG &#40;CRP2<span class="elsevierStyleHsp" style=""></span>&#8722;<span class="elsevierStyleHsp" style=""></span>CRP1<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#8722;2&#46;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&#46;1<span class="elsevierStyleHsp" style=""></span>mg&#47;dL&#41;&#59; however&#44; the main effect of time was not significant &#40;<span class="elsevierStyleItalic">F</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#46;41&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;24&#41; &#40;data not shown&#41;&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0125" class="elsevierStylePara elsevierViewall">In the DG group&#44; 17 patients received EN by nasoenteric tube and six by gastrostomy&#59; in the CG group&#44; 23 patients received EN by nasoenteric tube and six by gastrostomy&#46; The number of patients with intercurrences is also indicated during the seven-day follow-up in the continuous and discontinuous groups &#40;<a class="elsevierStyleCrossRef" href="#sec0085">Table S3</a>&#41;&#46; The comparison by Mann&#8211;Whitney Test revealed no significant differences between the groups &#40;<span class="elsevierStyleItalic">U</span> values varied from 289 to 326 and <span class="elsevierStyleItalic">p</span> values from 0&#46;41 to 0&#46;89&#41;&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">Open-tube probe&#44; tube replacement&#44; and tube control X-ray were the most common procedures during the follow-up in both groups &#40;<a class="elsevierStyleCrossRef" href="#sec0085">Table S4</a>&#41;&#46; The high occurrence of tube replacement and tube control X-ray was due to tube removal by the patient&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">Besides the most common complications observed in both groups&#44; the DG had four episodes of gastrostomy diet leak&#46; In the CG&#44; the most observed intercurrence was the pause of the diet for the performance of exams&#59; this was higher than in the DG&#46; Regarding medications&#44; antibiotics were used in six and 10 DG and CG patients&#44; respectively&#44; and antibacterial agents in five patients of the CG&#46; This might have been associated with the number of gastrointestinal complications observed in the CG&#44; and their absence in the DG&#46;</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Discussion</span><p id="par0140" class="elsevierStylePara elsevierViewall">In the present investigation we observed that the discontinuous EN was more effective in meeting nutrient recommendations and closer to the patient&#39;s needs&#46; This factor may have been attributed to the higher intake volume in the discontinuous EN group and fewer intercurrences in this group compared to the continuous EN group&#46; In addition&#44; the overall data about glucose levels indicated a beneficial effect of 4<span class="elsevierStyleHsp" style=""></span>h of EN discontinuation in relation to the continuous infusion group&#46; The results suggested that even a small period of EN discontinuation can have some positive metabolic effects in patients receiving EN&#46; The data also indicate that additional studies are needed to clarify if longer periods of EN discontinuation &#40;for instance&#44; eight or 12<span class="elsevierStyleHsp" style=""></span>h&#41; can produce better results&#46;</p><p id="par0145" class="elsevierStylePara elsevierViewall">The beneficial effects of discontinuation in EN may be related to the circadian rhythmicity in the general metabolism&#44; which is dictated by the 24-h light&#8211;dark clock cycles and have an impact on metabolism&#46;<a class="elsevierStyleCrossRefs" href="#bib0325"><span class="elsevierStyleSup">28&#44;29</span></a> In humans&#44; the highest glucose tolerance occurs in the morning&#44; whereas in the evening the opposite is observed&#46;<a class="elsevierStyleCrossRef" href="#bib0335"><span class="elsevierStyleSup">30</span></a> Insulin secretion is critical in the control of the daily rate of glucose tolerance in mammals&#46; Of importance for circadian regulation of carbohydrate metabolism&#44; insulin secretion exhibits regular oscillations during the day&#44; and together with other hormones secreted rhythmically&#44; regulates the body metabolism&#46;<a class="elsevierStyleCrossRef" href="#bib0340"><span class="elsevierStyleSup">31</span></a> In the present study&#44; lower glucose levels during the night were observed in the group with EN discontinuation for a period of 4<span class="elsevierStyleHsp" style=""></span>h&#46; These results may have been influenced by the circadian metabolic responses&#46; Fonken et al&#46;<a class="elsevierStyleCrossRef" href="#bib0345"><span class="elsevierStyleSup">32</span></a> indicated that exposure to light at night can influence the circadian system and metabolism in mice&#46; Thus&#44; continuous enteral nutrition&#44; indicated by the CG&#44; may be associated with higher blood glucose levels during the night&#44; associated with circadian disruption&#46;</p><p id="par0150" class="elsevierStylePara elsevierViewall">Generally&#44; the average capillary glucose in the DG was lower and had fewer oscillations and hyperglycaemic events in comparison with the CG&#46; Many studies have shown benefits of nightly fasting on patients&#8217; glycaemic indexes&#46; Saito&#44; Nishimura&#44; and Kato<a class="elsevierStyleCrossRefs" href="#bib0350"><span class="elsevierStyleSup">33&#44;34</span></a> concluded in their studies that circadian rhythms can only be kept normal when the enteral diet infusion is diurnal by the cyclic method&#44; and the continuous or nocturnal feeding method is associated with increased glucose intolerance&#46; Also&#44; Simon&#44; Brandenberg&#44; and Follenius<a class="elsevierStyleCrossRef" href="#bib0360"><span class="elsevierStyleSup">35</span></a> observed that subjects who received continuous EN had an increase in plasma glucose levels during time sleeping&#46; Better adaptation of glycaemia with night fasting compared to the continuous method may result in values closer to normal&#46; These results may help in reducing inflammatory processes and improving the prognosis of hospitalised patients&#46;<a class="elsevierStyleCrossRef" href="#bib0365"><span class="elsevierStyleSup">36</span></a> In both groups&#44; patients received much lower amounts of fibre than required&#44; mainly because the enteral diets administered were fibre-free&#46;</p><p id="par0155" class="elsevierStylePara elsevierViewall">Although most patients were admitted with anaemia and hypoalbuminaemia&#44; the haemogram improved in both groups during the hospitalisation&#44; and serum albumin especially in the DG patients&#46; Studies report that continuous feeding decreases skeletal muscle synthesis&#44; and intermittent &#40;bolus&#41; feeding could provide synthesis because of greater hormonal oscillations&#44; mainly insulin&#46;<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">8</span></a> A limiting factor of our study was that plasma insulin levels were not analysed&#8212;data that could clarify these findings&#46;</p><p id="par0160" class="elsevierStylePara elsevierViewall">The longer time of dietary pause for examination and the gastrointestinal complications seen in the CG versus the DG may be linked to the severity of cases&#46; Additionally&#44; the dietary gastrostomy leakage noticed in four patients of the DG might have occurred due to a greater volume infused in the DG than in the CG&#46; However&#44; no significant differences were observed between groups during the seven-day follow-up&#46; Some studies report that the continuous nutrient method may alter normal intestinal physiology and is associated with side effects and increased tube obstruction&#46;<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">10</span></a> Nasiri et al&#46;<a class="elsevierStyleCrossRef" href="#bib0370"><span class="elsevierStyleSup">37</span></a> in a randomised controlled triple-blind study in ICU patients&#44; concluded that the bolus method can still be used as a standard method to decrease the risk of EN intolerance if used properly&#46; This disruption frequently occurs in hospital practice&#44; resulting in an enteral diet that falls short of the patient&#39;s needs&#44; thereby compromising the nutritional state of these patients&#46;</p><p id="par0165" class="elsevierStylePara elsevierViewall">In our study&#44; there were some limitations&#46; The first was the small number of patients included&#46; The second limitation was the lack of monitoring of serum insulin levels and units of insulin needed to maintain glycaemic control&#46; This would help to analyse whether the lower glucoses in the DG compared with the CG could have been influenced by the insulin oscillations caused by feeding interruptions&#46; Also&#44; the short evaluation time &#40;seven days&#41; may have been insufficient to demonstrate more significant differences in some biochemical parameters&#44; such as albumin levels&#46; To better evaluate the effect of discontinuation of the ENT infusion&#44; a significantly longer monitoring time is needed&#46;</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Conclusion</span><p id="par0170" class="elsevierStylePara elsevierViewall">The results presented here support the beneficial effects of 4<span class="elsevierStyleHsp" style=""></span>h of EN discontinuation in relation to the group receiving EN continuously&#44; providing greater nutrient administration&#44; and when the biochemical endpoint considered was glycaemia&#46; We also observed a very modest effect of EN discontinuation in plasma albumin levels&#44; which can be related to the changes observed in glycaemia&#46; However&#44; additional studies with longer than 4<span class="elsevierStyleHsp" style=""></span>h of EN discontinuation will be needed to validate our findings&#46;</p></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Authors&#8217; contributions</span><p id="par0175" class="elsevierStylePara elsevierViewall">AG&#44; EC&#44; ARM and LDS contributed equally to the conception of the research&#59; AG and EC contributed equally to the design of the research&#59; AG&#44; SRJ&#44; BA&#44; and JF contributed to the acquisition of the data&#59; AG&#44; JBTR&#44; and EC contributed to the interpretation and analysis of the data&#59; and AG and EC drafted the manuscript&#46; All authors critically revised the manuscript&#44; agree to be fully accountable for ensuring the integrity and accuracy of the work&#44; and read and approved the final manuscript&#46;</p></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Funding</span><p id="par0185" class="elsevierStylePara elsevierViewall">This research received no specific grant from any funding agency in the public&#44; commercial&#44; or not-for-profit sectors&#46;</p></span><span id="sec0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130">Conflict of interest</span><p id="par0190" class="elsevierStylePara elsevierViewall">The authors declare that there is no conflict of interest&#46;</p></span></span>"
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        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Background</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Enteral nutrition &#40;EN&#41; assists in the nutritional status of hospitalised patients unable to feed orally&#46; The aim of this study was to determine which method&#8212;continuous EN or discontinuous EN&#44; a diet in which the infusion is discontinued for 4<span class="elsevierStyleHsp" style=""></span>h during the night&#44;&#8212;is more effective in meeting nutrient recommendations and improving glycaemic control and biochemical parameters related to protein anabolism&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Patients were divided into two groups&#58; discontinuous &#40;EN administered in mL&#47;h&#44; 18<span class="elsevierStyleHsp" style=""></span>h&#47;day&#44; 4-h night fasting&#41; and continuous &#40;EN administered in mL&#47;h&#44; 22<span class="elsevierStyleHsp" style=""></span>h&#47;day&#41;&#46; All patients with EN receive the diet over a 22-h daily period&#44; in which the diet is suspended for two hours&#47;day for daily hospital routines such as bathing&#44; and physiotherapy&#44; and followed for seven days&#46; Evaluated data&#58; prescribed and administered volume&#44; calories&#44; protein&#44; and fibre&#59; capillary blood glucose&#59; erythrogram&#59; serum albumin&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">52 patients were followed-up&#44; with 23 &#40;44&#46;2&#37;&#41; in the discontinuous group and 29 &#40;55&#46;8&#37;&#41; in the continuous group&#46; Compared with the continuous group&#44; the discontinuous group received volumes closer to those prescribed&#44; equal or higher calories&#44; and more protein&#46; The capillary glucose values were within the reference range in the discontinuous group&#44; while the continuous group presented elevated values&#46; Both groups presented hypoalbuminaemia&#44; haemoglobin&#44; and haematocrit below the reference values&#59; however&#44; in the discontinuous group&#44; the serum albumin values improved during hospitalisation relative to the continuous&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">The method involving discontinuation of EN for 4<span class="elsevierStyleHsp" style=""></span>h was more effective in meeting nutrient recommendations compared with the continuous method&#46; Additionally&#44; in the discontinuous group&#44; we observed a better control of glycaemia when compared to that of the continuous group&#46;</p></span>"
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        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Introducci&#243;n</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">La nutrici&#243;n enteral &#40;NE&#41; ayuda en la nutrici&#243;n de pacientes imposibilitados de alimentarse por v&#237;a oral&#46; El objetivo fue determinar si el m&#233;todo discontinuo&#44; en el que suspende la infusi&#243;n de la nutrici&#243;n durante 4 h en la noche&#44; es m&#225;s eficaz que el continuo para atender las recomendaciones de nutrientes&#44; mejora del control gluc&#233;mico y los par&#225;metros bioqu&#237;micos relacionados con el anabolismo proteico&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">M&#233;todos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Los pacientes fueron divididos en 2 grupos&#58; discontinuo &#40;NE administrada en ml&#47;h&#44; 18<span class="elsevierStyleHsp" style=""></span>h&#47;d&#237;a&#44; 4 h en ayuno nocturno&#41; y continuo &#40;NE administrada en ml&#47;h&#44; 22<span class="elsevierStyleHsp" style=""></span>h&#47;d&#237;a&#41;&#46; La colecta de datos se inici&#243; 72<span class="elsevierStyleHsp" style=""></span>h despu&#233;s de la admisi&#243;n y continu&#243; durante 7 d&#237;as&#46; Datos evaluados&#58; volumen prescrito y administrado&#44; calor&#237;as&#44; prote&#237;nas y fibra&#59; glucemia capilar&#44; eritrograma y alb&#250;mina s&#233;rica&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Cincuenta y dos pacientes fueron valorados durante 7 d&#237;as&#44; 23 &#40;44&#44;2&#37;&#41; en el grupo discontinuo y 29 &#40;55&#44;8&#37;&#41; en el continuo&#46; Comparado con el grupo continuo&#44; el discontinuo recibi&#243; vol&#250;menes pr&#243;ximos a los prescritos&#44; calor&#237;as iguales o mayores y m&#225;s prote&#237;na&#46; Los valores de la glucemia capilar estuvieron dentro de la referencia en el grupo discontinuo&#44; mientras que en el continuo los valores fueron mayores&#46; Tanto el grupo continuo como el discontinuo presentaron hipoalbuminemia&#44; hemoglobina y hematocrito por debajo de los valores de referencia&#59; entretanto&#44; en el grupo discontinuo&#44; los valores de alb&#250;mina s&#233;rica mejoraron durante la hospitalizaci&#243;n respecto a los del continuo&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusiones</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">El m&#233;todo discontinuo de NE por 4 h fue m&#225;s eficaz en el cumplimiento de las recomendaciones de los nutrientes comparado al continuo&#46; Adem&#225;s&#44; se observ&#243; un mejor control de la glucemia comparado con la del m&#233;todo continuo&#46;</p></span>"
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          "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Capillary blood glucose during the seven-day follow-up in the discontinuous and continuous groups&#46; &#40;A&#41; Dawn&#44; &#40;B&#41; Morning&#44; &#40;C&#41; Afternoon&#44; &#40;D&#41; Night&#46; Two-way ANOVA indicated a significant main effect of time vs groups <span class="elsevierStyleItalic">F</span> &#40;6&#44; 557&#46;6&#41;<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#46;83&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;013&#46;</p>"
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>White&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">20 &#40;87&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">26 &#40;90&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;76<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Non-white&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">03 &#40;13&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">03 &#40;10&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">BMI&#44; kg&#47;m</span><span class="elsevierStyleSup"><span class="elsevierStyleItalic">2</span></span><span class="elsevierStyleItalic">&#40;mean&#44; SD&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Adults&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">20&#46;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#46;5 &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>13&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">21&#46;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>6&#46;9 &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>17&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;82<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Elderly&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">21&#46;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&#46;0 &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>10&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">23&#46;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>5&#46;4 &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>12&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;21<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Requirements</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Calories&#47;day&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">28&#46;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>5&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">29&#46;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;59<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Protein&#47;day&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;20&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;54<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Medical clinic &#40;n&#44; &#37;&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Neurology&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">16 &#40;70&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12 &#40;41&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;08<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Internal medicine&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">02 &#40;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">09 &#40;31&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Other clinics&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">05 &#40;21&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">08 &#40;28&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Biochemical values base lines &#40;mean&#44; SD&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Hb&#44; g&#47;dL&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&#46;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&#46;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;41<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Ht&#44; &#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">31&#46;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>5&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">30&#46;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;56<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>CRP&#44; mg&#47;dL&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#46;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&#46;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>6&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;12<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Alb&#44; g&#47;dL&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;16<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                            2 => "A&#46; Harb"
                            3 => "C&#46; Quiles"
                            4 => "M&#46;P&#46; Hidalgo"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1177/0148607113482331"
                      "Revista" => array:5 [
                        "tituloSerie" => "J Parenter Enteral Nutr"
                        "fecha" => "2014"
                        "volumen" => "38"
                        "paginaInicial" => "263"
                        "paginaFinal" => "268"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib0250"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A more physiological feeding process in ICU&#58; intermittent infusion with semi-solid nutrients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "K&#46; Lu"
                            1 => "F&#46; Zeng"
                            2 => "Y&#46; Li"
                            3 => "C&#46; Chen"
                            4 => "M&#46; Huang"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/MD.0000000000012173"
                      "Revista" => array:5 [
                        "tituloSerie" => "Medicine"
                        "fecha" => "2018"
                        "volumen" => "97"
                        "paginaInicial" => "e12173"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30200118"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib0255"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Malnutrition in very old hospitalized patients&#58; a new etiologic factor of anemia&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "E&#46; Frangos"
                            1 => "A&#46; Trombetti"
                            2 => "C&#46;E&#46; Graf"
                            3 => "V&#46; Lachat"
                            4 => "N&#46; Samaras"
                            5 => "U&#46;M&#46; Vischer"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s12603-015-0641-6"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Nutr Health Aging"
                        "fecha" => "2016"
                        "volumen" => "20"
                        "paginaInicial" => "705"
                        "paginaFinal" => "713"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27499303"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib0260"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Association of anemia and malnutrition in hospitalized patients with exclusive enteral nutrition"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "S&#46; Reck-de-Jesus"
                            1 => "B&#46; Pessoa-Alves"
                            2 => "A&#46; Golin"
                            3 => "M&#46; Schott"
                            4 => "L&#46; Dachi"
                            5 => "A&#46; Marques"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.20960/nh.1628"
                      "Revista" => array:6 [
                        "tituloSerie" => "Nutr Hosp"
                        "fecha" => "2018"
                        "volumen" => "35"
                        "paginaInicial" => "753"
                        "paginaFinal" => "760"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30070860"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib0265"
              "etiqueta" => "16"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Terapia Nutricional Enteral em Unidade de Terapia Intensiva&#58; infus&#227;o versus necessidades"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "A&#46;C&#46;C&#46; Teixeira"
                            1 => "L&#46; Caruso"
                            2 => "F&#46;G&#46; Soriano"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1590/S0103-507X2006000400003"
                      "Revista" => array:6 [
                        "tituloSerie" => "Rev Bras Ter Intensiva"
                        "fecha" => "2006"
                        "volumen" => "18"
                        "paginaInicial" => "331"
                        "paginaFinal" => "337"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25310545"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib0270"
              "etiqueta" => "17"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Estado nutricional e dieta enteral prescrita e recebida por pacientes de uma Unidade de Terapia Intensiva"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "M&#46;D&#46; Stefanello"
                            1 => "F&#46;A&#46; Poll"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.7322/abcshs.v39i2.625"
                      "Revista" => array:5 [
                        "tituloSerie" => "ABCS Health Sci"
                        "fecha" => "2014"
                        "volumen" => "39"
                        "paginaInicial" => "71"
                        "paginaFinal" => "76"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib0275"
              "etiqueta" => "18"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Enteral nutrition&#58; differences between volume&#44; energy and protein prescribed and administered in adults"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46;C&#46;S&#46; Assis"
                            1 => "S&#46;M&#46;R&#46; Silva"
                            2 => "D&#46;M&#46; Le&#227;es"
                            3 => "C&#46;L&#46; Novekki"
                            4 => "C&#46;R&#46;M&#46; Silveira"
                            5 => "E&#46;D&#46; Mello"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1590/S0103-507X2010000400006"
                      "Revista" => array:6 [
                        "tituloSerie" => "Rev Bras Ter Intensiva"
                        "fecha" => "2010"
                        "volumen" => "22"
                        "paginaInicial" => "346"
                        "paginaFinal" => "350"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25302510"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib0280"
              "etiqueta" => "19"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "IOM Food and Nutrition Board&#46; Dietary reference intakes for energy&#44; carbohydrate&#44; fiber&#44; fat&#44; fatty acids&#44; cholesterol&#44; protein and amino acids"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "Institute of Medicine"
                            1 => "I&#46;O&#46;M&#46; Medicine"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Libro" => array:3 [
                        "fecha" => "2001"
                        "editorial" => "National Academies Press"
                        "editorialLocalizacion" => "Washington&#44; DC"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib0285"
              "etiqueta" => "20"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "WHO Hemoglobin concentrations for the diagnosis of anemia and assessment of severity&#46; Vitamin and Mineral Nutrition Information System"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "World Health Organization"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Libro" => array:3 [
                        "fecha" => "2011"
                        "editorial" => "World Health Organization"
                        "editorialLocalizacion" => "Geneva"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib0290"
              "etiqueta" => "21"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A test in context&#58; high-sensitivity C-reactive protein"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "M&#46;P&#46; Ridker"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jacc.2015.11. 037"
                      "Revista" => array:5 [
                        "tituloSerie" => "J Am Col Cardiol"
                        "fecha" => "2016"
                        "volumen" => "67"
                        "paginaInicial" => "712"
                        "paginaFinal" => "723"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib0295"
              "etiqueta" => "22"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Hypoalbuminemia in acute illness&#58; is there a rationale for intervention&#63; A meta-analysis of cohort studies and controlled trials"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "J&#46;L&#46; Vincent"
                            1 => "M&#46;J&#46; Dubois"
                            2 => "R&#46;J&#46; Navickis"
                            3 => "M&#46;M&#46; Wilkes"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/01.SLA.0000055547.93484.87"
                      "Revista" => array:5 [
                        "tituloSerie" => "Ann Surg"
                        "fecha" => "2003"
                        "volumen" => "237"
                        "paginaInicial" => "319"
                        "paginaFinal" => "334"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib0300"
              "etiqueta" => "23"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "Sociedade Brasileira de Diabetes&#46; SBD Diretrizes da Sociedade Brasileira de Diabetes&#58; 2019&#8211;2020&#46; S&#227;o Paulo&#58; Editora Clannad&#44; 2019&#44; 491 p&#46; Available at&#58; <a target="_blank" href="http://www.diabetes.org.br/profissionais/images/DIRETRIZES-COMPLETA-2019-2020.pdf">www&#46;diabetes&#46;org&#46;br&#47;profissionais&#47;images&#47;DIRETRIZES-COMPLETA-2019-2020&#46;pdf</a> &#91;accessed June 2020&#93;&#46;"
                ]
              ]
            ]
            23 => array:3 [
              "identificador" => "bib0305"
              "etiqueta" => "24"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prediction of body weight for non-ambulatory elderly from anthropometry"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "W&#46;C&#46; Chumlea"
                            1 => "S&#46; Guo"
                            2 => "A&#46;F&#46; Roche"
                            3 => "M&#46;L&#46; Steinbaugh"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/S0002-8223(21)02009-5"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Am Diet Assoc"
                        "fecha" => "1988"
                        "volumen" => "88"
                        "paginaInicial" => "564"
                        "paginaFinal" => "568"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3367012"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            24 => array:3 [
              "identificador" => "bib0310"
              "etiqueta" => "25"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "World Health Organization&#46; WHO&#46; Obesity&#58; Preventing and managing the global epidemic of obesity&#46; Report of the WHO Consultation of Obesity&#46; Geneva 3&#8211;5&#46; 1997&#46;"
                ]
              ]
            ]
            25 => array:3 [
              "identificador" => "bib0315"
              "etiqueta" => "26"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Screening for nutritional status in the elderly"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "D&#46;A&#46; Lipschitz"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Prim Care"
                        "fecha" => "1994"
                        "volumen" => "1"
                        "paginaInicial" => "55"
                        "paginaFinal" => "67"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            26 => array:3 [
              "identificador" => "bib0320"
              "etiqueta" => "27"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "American Diabetes Association&#46; ADA&#46; Diabetes care in the hospital&#58; standards of medical care in diabetes 2020&#46; Diabetes Care&#46; 2020&#59;43&#40;Suppl&#46; 1&#41;&#58;S193&#8211;202&#46; <a target="_blank" href="doi:10.2337/dc20-S015">doi&#58;10&#46;2337&#47;dc20-S015</a>&#46;"
                ]
              ]
            ]
            27 => array:3 [
              "identificador" => "bib0325"
              "etiqueta" => "28"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Metabolic effects of intermittent fasting"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "R&#46;E&#46; Patterson"
                            1 => "D&#46;D&#46; Sears"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1146/annurev-nutr-071816-064634"
                      "Revista" => array:6 [
                        "tituloSerie" => "Annu Rev Nutr"
                        "fecha" => "2017"
                        "volumen" => "37"
                        "paginaInicial" => "371"
                        "paginaFinal" => "393"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28715993"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            28 => array:3 [
              "identificador" => "bib0330"
              "etiqueta" => "29"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The influence of meal frequency and timing on health in humans&#58; the role of fasting"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "A&#46; Paoli"
                            1 => "G&#46; Tinsley"
                            2 => "A&#46; Bianco"
                            3 => "T&#46; Moro"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3390/nu11040719"
                      "Revista" => array:6 [
                        "tituloSerie" => "Nutrients"
                        "fecha" => "2019"
                        "volumen" => "11"
                        "paginaInicial" => "719"
                        "paginaFinal" => "738"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30925707"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            29 => array:3 [
              "identificador" => "bib0335"
              "etiqueta" => "30"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Roles of circadian rhythmicity and sleep in human glucose regulation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "E&#46; Van Cauter"
                            1 => "K&#46;S&#46; Polonsky"
                            2 => "A&#46;J&#46; Scheen"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1210/edrv.18.5.0317"
                      "Revista" => array:6 [
                        "tituloSerie" => "Endocr Rev"
                        "fecha" => "1997"
                        "volumen" => "18"
                        "paginaInicial" => "716"
                        "paginaFinal" => "738"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9331550"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            30 => array:3 [
              "identificador" => "bib0340"
              "etiqueta" => "31"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Modulation of glucose regulation and insulin secretion by circadian rhythmicity and sleep"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "E&#46; Van Cauter"
                            1 => "J&#46;D&#46; Blackman"
                            2 => "D&#46; Roland"
                            3 => "J&#46;P&#46; Spire"
                            4 => "S&#46; Refetoff"
                            5 => "K&#46;S&#46; Polonsky"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1172/JCI115396"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Invest"
                        "fecha" => "1991"
                        "volumen" => "88"
                        "paginaInicial" => "934"
                        "paginaFinal" => "942"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1885778"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            31 => array:3 [
              "identificador" => "bib0345"
              "etiqueta" => "32"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Dim light at night disrupts molecular circadian rhythms and affects metabolism"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "L&#46;K&#46; Fonken"
                            1 => "T&#46;G&#46; Aubrecht"
                            2 => "O&#46;H&#46; Mel&#233;ndez-Fern&#225;ndez"
                            3 => "Z&#46;M&#46; Weil"
                            4 => "R&#46;J&#46; Nelson"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1177/0748730413493862"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Biol Rhythms"
                        "fecha" => "2013"
                        "volumen" => "28"
                        "paginaInicial" => "262"
                        "paginaFinal" => "271"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23929553"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            32 => array:3 [
              "identificador" => "bib0350"
              "etiqueta" => "33"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Modifications of circadian cortisol rhythm by cyclic and continuous total enteral nutrition"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "M&#46; Saito"
                            1 => "K&#46; Nishimura"
                            2 => "H&#46; Kato"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3177/jnsv.35.639"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Nutr Sci Vitaminol"
                        "fecha" => "1989"
                        "volumen" => "35"
                        "paginaInicial" => "639"
                        "paginaFinal" => "647"
                        "link" => array:1 [
                          0 => array:2 [
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                      "titulo" => "Effects of cyclic and continuous total enteral nutrition on 24-h rhythms of body temperature and urinary excretions"
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                          "etal" => false
                          "autores" => array:3 [
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                        "tituloSerie" => "J Nutr Sci Vitaminol"
                        "fecha" => "1992"
                        "volumen" => "38"
                        "paginaInicial" => "117"
                        "paginaFinal" => "125"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1506918"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
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                      "doi" => "10.1210/jcem-64-4-669"
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                        "tituloSerie" => "J Clin Endocrinol Metab"
                        "fecha" => "1987"
                        "volumen" => "64"
                        "paginaInicial" => "669"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3102544"
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                      "titulo" => "Diabetic-specific enteral nutrition formula in hyperglycemic&#44; mechanically ventilated&#44; critically ill patients&#58; a prospective&#44; open-label&#44; blind-randomized&#44; multicenter study"
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                      "titulo" => "Comparison of intermittent and bolus enteral feeding methods on enteral feeding intolerance of patients with sepsis&#58; a triple-blind controlled trial in intensive care units"
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                        0 => array:2 [
                          "etal" => false
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                        "tituloSerie" => "Middle East J Digest Dis"
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Article information

ISSN: 25300164
Original language: English

DOI:10.1016/j.endinu.2022.03.007

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Year/Month	Html	Pdf	Total

2024 October	13	6	19
2024 September	20	23	43
2024 August	35	28	63
2024 July	30	12	42
2024 June	29	14	43
2024 May	28	10	38
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2024 February	16	5	21
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2023 December	37	1	38
2023 November	9	0	9
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2023 September	10	2	12
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2023 July	14	2	16
2023 June	12	0	12
2023 May	9	4	13
2023 April	4	3	7
2023 March	0	7	7
2023 February	0	6	6
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2022 September	0	5	5

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