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Nutrition in critically ill

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https://www.readbyqxmd.com/read/28537514/novel-family-centered-intervention-to-improve-nutrition-in-patients-recovering-from-critical-illness-a-feasibility-study
#1
Andrea P Marshall, Margot Lemieux, Rupinder Dhaliwal, Hilda Seyler, Kristen N MacEachern, Daren K Heyland
BACKGROUND: Critically ill patients are at increased risk of developing malnutrition-related complications because of physiological changes, suboptimal delivery, and reduced intake. Strategies to improve nutrition during critical illness recovery are required to prevent iatrogenic underfeeding and risk of malnutrition. The purpose of this study was to assess the feasibility and acceptability of a novel family-centered intervention to improve nutrition in critically ill patients. MATERIALS AND METHODS: A 3-phase, prospective cohort feasibility study was conducted in 4 intensive care units (ICUs) across 2 countries...
June 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28534027/current-concepts-and-unresolved-questions-in-dietary-protein-requirements-and-supplements-in-adults
#2
REVIEW
Stuart M Phillips
Protein needs for otherwise healthy individuals older than 19 years are defined by the recommended dietary allowance (RDA) at 0.80 g protein/kg/day. There is no recommendation in the current RDA for subpopulations of older adults or people in various pathological situations. Despite the lack of a separate recommendation, there exists a growing body of evidence that is strongly suggestive of an increased need and/or benefit for protein in older persons. That is, intakes beyond the RDA are, in older persons, associated with benefits...
2017: Frontiers in Nutrition
https://www.readbyqxmd.com/read/28531396/translation-and-adaptation-of-the-nutric-score-to-identify-critically-ill-patients-who-benefit-the-most-from-nutrition-therapy
#3
Mariane Rosa, Daren K Heyland, Daieni Fernandes, Estela I Rabito, Manoela L Oliveira, Aline Marcadenti
INTRODUCTION AND OBJECTIVES: Due to the scarcity of tools to assess the nutritional risk in critically ill patients, the NUTrition Risk in the Critically ill Score (NUTRIC Score) was developed and validated primarily in a limited population to quantify the risk of adverse events that may be modified by aggressive nutrition therapy. The objective of this study was to translate and adapt the NUTRIC Score into Portuguese language for further demonstrate its feasibility and clinical utility in Brazilian Intensive Care Units (ICUs)...
August 2016: Clinical Nutrition ESPEN
https://www.readbyqxmd.com/read/28531392/a-randomised-controlled-feasibility-and-proof-of-concept-trial-in-delayed%C3%A2-gastric-emptying-when-metoclopramide-fails-we-should-revisit%C3%A2-nasointestinal-feeding-versus-dual-prokinetic-treatment-achieving-goal-nutrition-in-critical-illness-and-delayed-gastric
#4
Stephen J Taylor, Kaylee Allan, Helen McWilliam, Alex Manara, Jules Brown, Rosemary Greenwood, Deirdre Toher
BACKGROUND & AIMS: Delayed gastric emptying (DGE) commonly limits the use of enteral nutrition (EN) and may increase ventilator-associated pneumonia. Nasointestinal feeding has not been tested against dual prokinetic treatment (Metoclopramide and Erythromycin) in DGE refractory to metoclopramide. This trial tests the feasibility of recruiting this 'treatment-failed' population and the proof of concept that nasointestinal (NI) feeding can increase the amount of feed tolerated (% goal) when compared to nasogastric (NG) feeding plus metoclopramide and erythromycin treatment...
August 2016: Clinical Nutrition ESPEN
https://www.readbyqxmd.com/read/28531142/optimal-energy-delivery-rather-than-the-implementation-of-a-feeding-protocol-may-benefit-clinical-outcomes-in-critically-ill-patients
#5
Chen-Yu Wang, Chun-Te Huang, Chao-Hsiu Chen, Mei-Fen Chen, Shiu-Lan Ching, Yi-Chia Huang
Malnutrition is common in intensive care units (ICU), and volume based feeding protocols have been proposed to increase nutrient delivery. However, the volume based approach compared to trophic feeding has not been proven entirely successful in critically ill patients. Our study aimed to compare the clinical outcomes both before and after the implementation of the feeding protocol, and to also evaluate the effects of total energy delivery on outcomes in these patients. We retrospectively collected all patient data, one year before and after the implementation of the volume-based feeding protocol, in the ICU at Taichung Veterans General Hospital...
May 21, 2017: Nutrients
https://www.readbyqxmd.com/read/28530846/monitoring-nutrition-in-critical-illness-what-can-we-use
#6
Suzie Ferrie, Erica Tsang
BACKGROUND: Nutrition monitoring in the context of critical care presents unique challenges. Traditionally used anthropometric and biochemical markers may be difficult to obtain or confounded by factors such as fluid status and the inflammatory response. A previous survey identified 15 parameters in common use, all of which have confounding influences during critical illness. MATERIALS AND METHODS: A literature search was conducted to assess current use of commonly used nutrition-monitoring parameters and to explore other possible methods that might be more useful...
May 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28526589/a-rapid-salmonella-detection-method-involving-thermophilic-helicase-dependent-amplification-and-a-lateral-flow-assay
#7
Xin-Jun Du, Tian-Jiao Zhou, Ping Li, Shuo Wang
Salmonella is a major foodborne pathogen that is widespread in the environment and can cause serious human and animal disease. Since conventional culture methods to detect Salmonella are time-consuming and laborious, rapid and accurate techniques to detect this pathogen are critically important for food safety and diagnosing foodborne illness. In this study, we developed a rapid, simple and portable Salmonella detection strategy that combines thermophilic helicase-dependent amplification (tHDA) with a lateral flow assay to provide a detection result based on visual signals within 90 min...
May 16, 2017: Molecular and Cellular Probes
https://www.readbyqxmd.com/read/28526141/total-parenteral-and-enteral-nutrition-in-the-icu-evolving-concepts
#8
REVIEW
Amir O Elhassan, Lien B Tran, Richard C Clarke, Sumit Singh, Alan D Kaye
Appropriate nutrition in the hospital setting, particularly in critically ill patients, has long been tied to improving clinical outcomes. During critical illness, inflammatory mediators and cytokines lead to the creation of a catabolic state to facilitate the use of endogenous energy sources to meet increased energy demands. This process results in increasing the likelihood of overfeeding. The literature has revealed exponential advances in understanding the molecular basis of nutritional support and evolution of clinical protocols aimed at treating artificial nutritional support as a therapeutic intervention, preventing loss of lean body mass and metabolic deterioration to improve clinical outcomes in the critically ill...
June 2017: Anesthesiology Clinics
https://www.readbyqxmd.com/read/28522351/effect-of-early-supplemental-parenteral-nutrition-in-the-paediatric-icu-a-preplanned-observational-study-of-post-randomisation-treatments-in-the-pepanic-trial
#9
Ilse Vanhorebeek, Sascha Verbruggen, Michaël P Casaer, Jan Gunst, Pieter J Wouters, Jan Hanot, Gonzalo Garcia Guerra, Dirk Vlasselaers, Koen Joosten, Greet Van den Berghe
BACKGROUND: Large randomised controlled trials have shown that early supplemental parenteral nutrition in patients admitted to adult and paediatric intensive care units (PICUs) is harmful. Overdosing of energy with too little protein was suggested as a potential reason for this. This study analysed which macronutrient was associated with harm caused by early supplemental parenteral nutrition in the Paediatric Early versus Late Parenteral Nutrition In Critical Illness (PEPaNIC) randomised trial...
May 15, 2017: Lancet Respiratory Medicine
https://www.readbyqxmd.com/read/28506286/high-protein-intake-without-concerns
#10
Olav Rooyackers, Martin Sundström Rehal, Felix Liebau, Åke Norberg, Jan Wernerman
The high fashion in nutrition for the critically ill is to recommend a high protein intake. Several opinion leaders are surfing on this wave, expanding the suggested protein allowance upwards. At the same time, there is no new evidence supporting this change in recommendations. Observational data show that in clinical practice protein intake is most often far below current ESPEN recommendations of 1.2-1.5 g/kg/day. Therefore, it may be in the best interests of our patients just to adhere to that guideline, and not to stretch them upwards for protein intake? Here we give arguments to stay conservative...
May 15, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28487264/optimizing-protein-intake-and-nitrogen-balance-opinib-in-adult-critically-ill-patients-a-study-protocol-for-a-randomized-controlled-trial
#11
Matteo Danielis, Giulia Lorenzoni, Laura Cavaliere, Mariangela Ruffolo, Luca Peressoni, Amato De Monte, Rodolfo Muzzi, Fabio Beltrame, Dario Gregori
BACKGROUND: Adequate nutrition of critically ill patients plays a key role in the modulation of metabolic response to stress. OBJECTIVE: This paper presents the development of a protocol for a randomized controlled trial (RCT) aimed at comparing clinical outcomes of patients in the intensive care unit (ICU) administered with standard and protein-fortified diet. Together with the RCT study protocol, the results of the observational analysis conducted to assess the feasibility of the RCT are presented...
May 9, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/28481068/-early-parenteral-nutrition-in-complex-post-operative-periods
#12
A I Molina Caballero, A Pérez Martínez, S Hernández Martín, N González Temprano, L Ayuso González, J Pisón Chacón
OBJECTIVE: The protein hypercatabolic state in critically ill pediatric patients can be minimized by an effective nutrition therapy. We conducted a study to evaluate the benefits of early parenteral nutrition (EPN) assessing its effect on nutritional parameters and clinical relevance after complex surgical procedures. METHODS: Prospective randomized study in patients undergoing abdominal surgery in which nothing by mouth is anticipated for a period ≥ 3 days, between 2012 and 2014...
October 10, 2016: Cirugía Pediátrica: Organo Oficial de la Sociedad Española de Cirugía Pediátrica
https://www.readbyqxmd.com/read/28475354/role-of-glucagon-in-catabolism-and-muscle-wasting-of-critical-illness-and-modulation-by-nutrition
#13
Steven E Thiessen, Sarah Derde, Inge Derese, Thomas Dufour, Chloé Albert Vega, Lies Langouche, Chloë Goossens, Nele Peersman, Pieter Vermeersch, Sarah Vander Perre, Jens J Holst, Pieter J Wouters, Ilse Vanhorebeek, Greet Van den Berghe
RATIONALE: Critical illness is hallmarked by muscle wasting and disturbances in glucose, lipid and amino acid homeostasis. Circulating concentrations of glucagon, a catabolic hormone that affects these metabolic pathways, are elevated during critical illness. Insight in the nutritional regulation of glucagon and its metabolic role during critical illness is lacking. OBJECTIVES: We evaluated whether macronutrient infusion can suppress plasma glucagon during critical illness and studied the role of illness-induced glucagon abundance in the disturbed glucose, lipid and amino acid homeostasis and in muscle wasting during critical illness...
May 5, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28468893/continuous-renal-replacement-therapy-a-potential-source-of-calories-in-the-critically-ill
#14
Andrea M New, Erin M Nystrom, Erin Frazee, John J Dillon, Kianoush B Kashani, John M Miles
Background: Overfeeding can lead to multiple metabolic and clinical complications and has been associated with increased mortality in the critically ill. Continuous venovenous hemofiltration (CVVH) represents a potential source of calories that is poorly recognized and may contribute to overfeeding complications.Objective: We aimed to quantify the systemic caloric contribution of acid-citrate-dextrose regional anticoagulation and dextrose-containing replacement fluids in the CVVH circuit.Design: This was a prospective study in 10 critically ill adult patients who received CVVH from April 2014 to June 2014...
May 3, 2017: American Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/28468010/nutrition-and-liver-health
#15
Alan A Jackson
Good clinical practice is based on a secure and accurate diagnosis. Poor nutrition is frequently associated with disorders of the liver, and a specific nutrition diagnosis is needed for providing best care and experiencing successful outcome. There is opportunity for better-structured approaches to making secure and consistent nutritional diagnoses in patients with liver disease. Nutrition is the set of integrated processes by which cells, tissues, organs and the whole body acquire the energy and nutrients to retain normal structure and perform the required functions...
2017: Digestive Diseases
https://www.readbyqxmd.com/read/28449646/when-is-the-use-of-pacifiers-justifiable-in-the-baby-friendly-hospital-initiative-context-a-clinician-s-guide
#16
Welma Lubbe, Wilma Ten Ham-Baloyi
BACKGROUND: The use of pacifiers is an ancient practice, but often becomes a point of debate when parents and professionals aim to protect and promote breastfeeding as most appropriately for nurturing infants. We discuss the current literature available on pacifier use to enable critical decision-making regarding justifiable use of pacifiers, especially in the Baby-Friendly Hospital Initiative context, and we provide practical guidelines for clinicians. DISCUSSION: Suck-swallow-breathe coordination is an important skill that every newborn must acquire for feeding success...
April 27, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28428012/-retrospective-study-of-children-referred-from-paediatric-intensive-care-to-palliative-care-why-and-for-what
#17
Alberto García-Salido, Paula Santos-Herranz, Verónica Puertas-Martín, María Ángeles García-Teresa, Ricardo Martino-Alba, Ana Serrano-González
INTRODUCTION: The creation of paediatric palliative care units (PPCU) could optimise the management of children with palliative focus after admission to a paediatric intensive care unit (PICU). This study describes the clinical and epidemiological characteristics of children referred from PICU to the UCPP of the Autonomous Community of Madrid (CAM). The overall treatment, relapses, re-admissions, and deaths, if occurred, are described. PATIENTS AND METHOD: A retrospective review was performed using the medical records from children transferred from the CAM paediatric intensive care units to the paediatric palliative care unit (1 March 2008-31 January 2015)...
April 17, 2017: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
https://www.readbyqxmd.com/read/28401123/setting-an-implementation-research-agenda-for-canadian-investments-in-global-maternal-newborn-child-and-adolescent-health-a-research-prioritization-exercise
#18
Renee Sharma, Matthew Buccioni, Michelle F Gaffey, Omair Mansoor, Helen Scott, Zulfiqar A Bhutta
BACKGROUND: Improving global maternal, newborn, child and adolescent health (MNCAH) is a top development priority in Canada, as shown by the $6.35 billion in pledges toward the Muskoka Initiative since 2010. To guide Canadian research investments, we aimed to systematically identify a set of implementation research priorities for MNCAH in low- and middle-income countries. METHODS: We adapted the Child Health and Nutrition Research Initiative method. We scanned the Child Health and Nutrition Research Initiative literature and extracted research questions pertaining to delivery of interventions, inviting Canadian experts on MNCAH to generate additional questions...
January 2017: CMAJ Open
https://www.readbyqxmd.com/read/28388380/acquired-amino-acid-deficiencies-a-focus-on-arginine-and-glutamine
#19
Claudia R Morris, Jill Hamilton-Reeves, Robert G Martindale, Menaka Sarav, Juan B Ochoa Gautier
Nonessential amino acids are synthesized de novo and therefore not diet dependent. In contrast, essential amino acids must be obtained through nutrition since they cannot be synthesized internally. Several nonessential amino acids may become essential under conditions of stress and catabolic states when the capacity of endogenous amino acid synthesis is exceeded. Arginine and glutamine are 2 such conditionally essential amino acids and are the focus of this review. Low arginine bioavailability plays a pivotal role in the pathogenesis of a growing number of varied diseases, including sickle cell disease, thalassemia, malaria, acute asthma, cystic fibrosis, pulmonary hypertension, cardiovascular disease, certain cancers, and trauma, among others...
April 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28388377/how-many-nonprotein-calories-does-a-critically-ill-patient-require-a-case-for-hypocaloric-nutrition-in-the-critically-ill-patient
#20
Saúl J Rugeles, Juan B Ochoa Gautier, Roland N Dickerson, Jorge A Coss-Bu, Jan Wernerman, Douglas Paddon-Jones
Calculation of energy and protein doses for critically ill patients is still a matter of controversy. For more than 40 years of nutrition support, the total amount of nutrients to be delivered to these patients has been calculated based on expert recommendations, and this calculation is based on the administration of nonprotein calories in one attempt to ameliorate catabolic response and avoid the weight loss. New evidence suggests protein delivery is the most important intervention to improve clinical and metabolic outcomes...
April 2017: Nutrition in Clinical Practice
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