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Nutrition in critically ill

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https://www.readbyqxmd.com/read/28107096/implementation-of-an-aggressive-enteral-nutrition-protocol-and-the-effect-on-clinical-outcomes
#1
Daniel Dante Yeh, Catrina Cropano, Sadeq A Quraishi, Eva Fuentes, Haytham M A Kaafarani, Jarone Lee, Yuchiao Chang, George Velmahos
BACKGROUND: Macronutrient deficiency in critical illness is associated with worse outcomes. We hypothesized that an aggressive enteral nutrition (EN) protocol would result in higher macronutrient delivery and fewer late infections. METHODS: We enrolled adult surgical intensive care unit (ICU) patients receiving >72 hours of EN from July 2012 to June 2014. Our intervention consisted of increasing protein prescription (2.0-2.5 vs 1.5-2.0 g/kg/d) and compensatory feeds for EN interruption...
January 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28102514/carbapenemase-producing-klebsiella-pneumoniae-bloodstream-infection-in-critically-ill-patients-risk-factors-and-predictors-of-mortality
#2
M Papadimitriou-Olivgeris, F Fligou, C Bartzavali, A Zotou, A Spyropoulou, K Koutsileou, S Vamvakopoulou, N Sioulas, V Karamouzos, E D Anastassiou, I Spiliopoulou, M Christofidou, M Marangos
A significant increase in carbapenemase-producing Klebsiella pneumoniae (CP-Kp) bacteraemias has been observed worldwide. The objective of the present work was to study the risk factors and predictors of mortality of CP-Kp bacteraemias among critically ill patients. During a 4-year period (2012-3015), a matched 1:2 case-control study was conducted. Klebsiella pneumoniae was identified by Vitek 2 technology. Antibiotic susceptibility was performed by the agar disc diffusion method and Etest. The presence of the bla KPC, bla VIM and bla NDM genes was confirmed by polymerase chain reaction (PCR)...
January 19, 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/28098633/more-food-for-thought-nutrition-the-nutrition-risk-in-the-critically-ill-score-and-the-dilemma-of-goal-feeding
#3
Matthew J Martin
No abstract text is available yet for this article.
February 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28098623/greater-protein-and-energy-intake-may-be-associated-with-improved-mortality-in-higher-risk-critically-ill-patients-a-multicenter-multinational-observational-study
#4
Charlene Compher, Jesse Chittams, Therese Sammarco, Michele Nicolo, Daren K Heyland
OBJECTIVES: Controversy exists about the value of greater nutritional intake in critically ill patients, possibly due to varied patient nutritional risk. The objective of this study was to investigate whether clinical outcomes vary by protein or energy intake in patients with risk evaluated by the NUTrition Risk in the Critically Ill score. DESIGN: Prospective observational cohort. SETTING: A total of 202 ICUs. PATIENTS: A total of 2,853 mechanically ventilated patients in ICU greater than or equal to 4 days and a subset of 1,605 patients in ICU greater than or equal to 12 days...
February 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28089618/24-hour-protein-arginine-and-citrulline-metabolism-in-fed-critically-ill-children-a-stable-isotope-tracer-study
#5
Carlijn T I de Betue, Xiomara C Garcia Casal, Dick A van Waardenburg, Stephen M Schexnayder, Koen F M Joosten, Nicolaas E P Deutz, Marielle P K J Engelen
BACKGROUND & AIMS: The reference method to study protein and arginine metabolism in critically ill children is measuring plasma amino acid appearances with stable isotopes during a short (4-8 h) time period and extrapolate results to 24-h. However, 24-h measurements may be variable due to critical illness related factors and a circadian rhythm could be present. Since only short duration stable isotope studies in critically ill children have been conducted before, the aim of this study was to investigate 24-h appearance of specific amino acids representing protein and arginine metabolism, with stable isotope techniques in continuously fed critically ill children...
January 4, 2017: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28088628/methods-needed-to-measure-predictive-accuracy-a-study-of-diabetic-patients
#6
Hafiz M R Khan, Sarah Mende, Aamrin Rafiq, Kemesha Gabbidon, P Hemachandra Reddy
Diabetes is one of the leading causes of morbidity and mortality and it can result in several complications such as kidney failure, heart failure, stroke, and blindness making it a major medical and public health concern in the United States. Statistical methods are important to detect risk factors and identify the best sampling plan to determine predictive bounds for diabetic patients' data. The main objective of this paper is to identify the best fit bootstrapping sampling method and to draw the predictive bound considering diabetes patient data...
January 11, 2017: Biochimica et Biophysica Acta
https://www.readbyqxmd.com/read/28079708/parenteral-nutrition-in-the-critically-ill
#7
Jan Gunst, Greet Van den Berghe
PURPOSE OF REVIEW: Feeding guidelines have recommended early, full nutritional support in critically ill patients to prevent hypercatabolism and muscle weakness. Early enteral nutrition was suggested to be superior to early parenteral nutrition. When enteral nutrition fails to meet nutritional target, it was recommended to administer supplemental parenteral nutrition, albeit with a varying starting point. Sufficient amounts of amino acids were recommended, with addition of glutamine in subgroups...
January 11, 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28077899/a-double-blind-randomized-clinical-trial-comparing-the-effect-of-neostigmine-and-metoclopramide-on-gastric-residual-volume-of-mechanically-ventilated-icu-patients
#8
Afshin Gholipour Baradari, Abbas Alipour, Abolfazl Firouzian, Laleh Moarab, Amir Emami Zeydi
BACKGROUND: In critically ill patients, enteral feeding through the nasogastric tube is the method of choice for nutritional support. Gastrointestinal feeding intolerance and disturbed gastric emptying are common challenges in these patients. The aim of this study was to compare the effect of Neostigmine and Metoclopramide on gastric residual volume (GRV) in mechanically ventilated ICU patients. METHODS: In a double blind, randomized clinical trial, a total of 60 mechanically ventilated ICU patients with GRV >120 mL (3 hours after the last gavage), were randomly assigned into two groups A and B...
December 2016: Acta Informatica Medica: AIM
https://www.readbyqxmd.com/read/28049258/the-impact-of-implementation-of-an-enteral-feeding-protocol-on-the-improvement-of-enteral-nutrition-in-critically-ill-adults
#9
Seoung-Hyun Kim, Chi-Min Park, Jeong-Meen Seo, Mingew Choi, Dae-Sang Lee, Dong Kyung Chang, Miyong Rha, Soyoung Yu, Seonhye Lee, Eunmee Kim, Young Yun Cho
BACKGROUND AND OBJECTIVES: The optimal delivery of enteral nutrition (EN) may improve clinical outcomes in critically ill patients; thus, optimal EN protocols should be developed. The purpose of this study was to evaluate the impact of implementing an EN protocol on the improvement of EN practices and on the clinical outcomes of critically ill patients. METHODS AND STUDY DESIGN: This was a retrospective study with prospectively collected data. Multidisciplinary working group developed an evidence-based EN protocol based on an extensive review of literature and existing guidelines...
January 2017: Asia Pacific Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/28049256/initial-energy-supplementation-in-critically-ill-patients-receiving-enteral-nutrition-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#10
Feng Tian, Xuejin Gao, Chao Wu, Li Zhang, Xianfeng Xia, Xinying Wang
BACKGROUND AND OBJECTIVES: Here we systematically reviewed and quantitatively analyzed randomized controlled trials (RCTs) to compare the important initial outcomes of critically ill adults receiving low- and highenergy enteral nutrition. METHODS AND STUDY DESIGN: RCTs comparing low- and high-energy supplementation in critically ill adults receiving enteral nutrition admitted to the intensive care unit for an expected stay of >48 h were included. Abstracts submitted to major scientific meetings were included and the primary endpoint was mortality...
January 2017: Asia Pacific Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/28042237/gut-microbiome-surgical-complications-and-probiotics
#11
REVIEW
George Stavrou, Katerina Kotzampassi
The trigger for infectious complications in patients following major abdominal operations is classically attributed to endogenous enteral bacterial translocation, due to the critical condition of the gut. Today, extensive gut microbiome analysis has enabled us to understand that almost all "evidence-based" surgical or medical intervention (antibiotics, bowel preparation, opioids, deprivation of nutrition), in addition to stress-released hormones, could affect the relative abundance and diversity of the enteral microbiome, allowing harmful bacteria to proliferate in the place of depressed beneficial species...
2017: Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology
https://www.readbyqxmd.com/read/28033171/the-importance-of-nutrition-in-critically-ill-patients
#12
Kristopher R Maday
Metabolic and physiologic changes during critical illness can be protective mechanisms for hospitalized patients but increases their risk for malnutrition. Clinicians must assess patients' nutritional status during acute illness and determine their need for nutritional support. By understanding the physiologic changes and patients' metabolic adaptations to stress, clinicians can choose the appropriate assessment tool and type of nutritional support needed to improve outcomes in critically ill patients.
January 2017: JAAPA: Official Journal of the American Academy of Physician Assistants
https://www.readbyqxmd.com/read/28025639/evaluation-of-bone-metabolism-in-critically-ill-patients-using-ctx-and-pinp
#13
Alexandra Gavala, Konstantinos Makris, Anna Korompeli, Pavlos Myrianthefs
Background. Prolonged immobilization, nutritional and vitamin D deficiency, and specific drug administration may lead to significant bone resorption. Methods and Patients. We prospectively evaluated critically ill patients admitted to the ICU for at least 10 days. Demographics, APACHE II, SOFA scores, length of stay (LOS), and drug administration were recorded. Blood collections were performed at baseline and on a weekly basis for five consecutive weeks. Serum levels of PINP, β-CTx, iPTH, and 25(OH)vitamin D were measured at each time-point...
2016: BioMed Research International
https://www.readbyqxmd.com/read/28025528/elevated-plasma-vitamin-b12-concentrations-are-independent-predictors-of-in-hospital-mortality-in-adult-patients-at-nutritional-risk
#14
Silvia Cappello, Emanuele Cereda, Mariangela Rondanelli, Catherine Klersy, Barbara Cameletti, Riccardo Albertini, Daniela Magno, Marilisa Caraccia, Annalisa Turri, Riccardo Caccialanza
Background: Elevated plasma vitamin B12 concentrations were identified as predictors of mortality in patients with oncologic, hepatic and renal diseases, and in elderly and critically ill medical patients. The association between vitamin B12 concentrations and in-hospital mortality in adult patients at nutritional risk has not been assessed. Methods: In this five-year prospective study, we investigated whether high vitamin B12 concentrations (>1000 pg/mL) are associated with in-hospital mortality in 1373 not-bed-ridden adult patients at nutritional risk (Nutrition Risk Index <97...
December 23, 2016: Nutrients
https://www.readbyqxmd.com/read/28005459/proceedings-of-the-2016-clinical-nutrition-week-research-workshop-the-optimal-dose-of-protein-provided-to-critically-ill-patients
#15
Daren K Heyland, Olav Rooyakers, Marina Mourtzakis, Renee D Stapleton
Recent literature has created considerable confusion about the optimal amount of protein/amino acids that should be provided to the critically ill patient. In fact, the evidentiary basis that directly tries to answer this question is relatively small. As a clinical nutrition research community, there is an urgent need to develop the optimal methods to assess the impact of exogenous protein/amino acid administration in the intensive care unit setting. That assessment can be conducted at various levels: (1) impact on stress response pathways, (2) impact on muscle synthesis and protein balance, (3) impact on muscle mass and function, and (4) impact on the patient's recovery...
December 1, 2016: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28004327/nutritional-and-bioenergetic-considerations-in-critically-ill-patients-with-acute-neurological-injury
#16
Peter A Abdelmalik, Susan Dempsey, Wendy Ziai
The brain, due to intensive cellular processes and maintenance of electrochemical gradients, is heavily dependent on a constant supply of energy. Brain injury, and critical illness in general, induces a state of increased metabolism and catabolism, which has been proven to lead to poor outcomes. Of all the biochemical interventions undertaken in the ICU, providing nutritional support is perhaps one of the most undervalued, but potentially among the safest, and most effective interventions. Adequate provisions of calories and protein have been shown to improve patient outcomes, and guidelines for the nutritional support of the critically ill patient are reviewed...
December 21, 2016: Neurocritical Care
https://www.readbyqxmd.com/read/28002075/what-factors-influence-protein-synthesis-and-degradation-in-critical-illness
#17
Filippo G Di Girolamo, Roberta Situlin, Gianni Biolo
PURPOSE OF REVIEW: The optimal approach to improve protein metabolism in critical illness is not yet fully defined. Here, we have summarized recent literature dealing with the main catabolic and anabolic factors influencing protein kinetics in acute hypercatabolic patients. RECENT FINDINGS: Protein/amino acid intake levels should be adapted to type and severity of illness, keeping in mind that energy overfeeding is associated with poor outcome. A number of anticatabolic nutraceuticals and drugs have been tested in acute patients...
December 20, 2016: Current Opinion in Clinical Nutrition and Metabolic Care
https://www.readbyqxmd.com/read/28000453/prognostic-value-of-severity-by-various-visceral-proteins-in-critically-ill-patients-with-sirs-during-7-days-of-stay
#18
Hicham Bouharras-El Idrissi, Jorge Molina-López, Lourdes Herrera-Quintana, Álvaro Domínguez-García, Gabriela Lobo-Támer, Irene Pérez-Moreno, Antonio Pérez-de la Cruz, Elena Planells-Del Pozo
INTRODUCTION: Critically ill patients typically develop a catabolic stress state as a result of a systemic inflammatory response (SIRS) that alters clinical-nutritional biomarkers, increasing energy demands and nutritional requirements. OBJECTIVE: To evaluate the status of albumin, prealbumin and transferrin in critically ill patients and the association between these clinical-nutritional parameters with the severity during a seven day stay in intensive care unit (ICU)...
November 29, 2016: Nutrición Hospitalaria: Organo Oficial de la Sociedad Española de Nutrición Parenteral y Enteral
https://www.readbyqxmd.com/read/28000452/phase-angle-and-onodera-s-prognostic-nutritional-index-in-critically-ill-patients
#19
Karina Marques Vermeulen, Leilane Lilian Araújo Leal, Mariana Câmara Martins Bezerra Furtado, Sancha Helena de Lima Vale, Lúcia Leite Lais
INTRODUCTION: Assessing severity and nutritional prognosis in critical patients has become increasingly important in recent years, since these parameters are related to morbidity/mortality and used to guide therapeutic options. OBJECTIVE: Determine nutritional prognosis through the Phase Angle (PA) and Onodera's Prognostic Nutritional Index (OPNI) and its relationship with severity, hospitalization time and mortality of critically ill patients. METHODS: Descriptive cross-sectional study, involving adult patients hospitalized in an Intensive Care Unit (ICU)...
November 29, 2016: Nutrición Hospitalaria: Organo Oficial de la Sociedad Española de Nutrición Parenteral y Enteral
https://www.readbyqxmd.com/read/27997410/influence-of-nutrition-therapy-on-the-intestinal-microbiome
#20
Monika A Krezalek, Andrew Yeh, John C Alverdy, Michael Morowitz
PURPOSE OF REVIEW: This review describes the relationship between nutritional therapies and the intestinal microbiome of critically ill patients. RECENT FINDINGS: The intestinal microbiome of the critically ill displays a near complete loss of health-promoting microbiota with overgrowth of virulent healthcare-associated pathogens. Early enteral nutrition within 24 h of admission to the ICU has been advocated in medical and surgical patients to avoid derangements of the intestinal epithelium and the microbiome associated with starvation...
December 16, 2016: Current Opinion in Clinical Nutrition and Metabolic Care
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