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critical care paed nutrition

Alethea Tan, Sarah Smailes, Thessa Friebel, Ashish Magdum, Quentin Frew, Naguib El-Muttardi, Peter Dziewulski
Burn survival has improved with advancements in fluid resuscitation, surgical wound management, wound dressings, access to antibiotics and nutritional support for burn patients. Despite these advancements, the presence of smoke inhalation injury in addition to a cutaneous burn still significantly increases morbidity and mortality. The pathophysiology of smoke inhalation has been well studied in animal models. Translation of this knowledge into effectiveness of clinical management and correlation with patient outcomes including the paediatric population, is still limited...
August 2016: Burns: Journal of the International Society for Burn Injuries
Adam Kuchnia, Carrie Earthman, Levi Teigen, Abigail Cole, Marina Mourtzakis, Michael Paris, Willem Looijaard, Peter Weijs, Heleen Oudemans-van Straaten, Gregory Beilman, Andrew Day, Roger Leung, Charlene Compher, Rupinder Dhaliwal, Sarah Peterson, Hannah Roosevelt, Daren K Heyland
BACKGROUND: In critically ill patients, muscle loss is associated with adverse outcomes. Raw bioelectrical impedance analysis (BIA) parameters (eg, phase angle [PA] and impedance ratio [IR]) have received attention as potential markers of muscularity, nutrition status, and clinical outcomes. Our objective was to test whether PA and IR could be used to assess low muscularity and predict clinical outcomes. METHODS: Patients (≥18 years) having an abdominal computed tomography (CT) scan and admitted to intensive care underwent multifrequency BIA within 72 hours of scan...
May 24, 2016: JPEN. Journal of Parenteral and Enteral Nutrition
Renata Reis de Lima e Silva, Cláudia Porto Sabino Pinho, Isa Galvão Rodrigues, José Gildo de Moura Monteiro Júnior
INTRODUCTION: The phase angle (PA) has been considered a sensitive tool to assess nutritional status and effectiveness of interventions dietetics. OBJECTIVE: To evaluate the PA as an indicator of nutritional status and prognosis in critically ill patients. METHODS: Prospective observational study of patients admitted to the Coronary Intensive Care Unit between May and October 2013. The PA was determined by bioelectrical impedance analysis, PA was considered low below 5º values for men and 4...
2015: Nutrición Hospitalaria: Organo Oficial de la Sociedad Española de Nutrición Parenteral y Enteral
Hongmei Gao, Junli Yao, Ling Lu, Lin Dou, Wenxiu Chang
OBJECTIVE: To study the feasibility of the acute gastrointestinal injury (AGI) classification standard for evaluation of gastrointestinal function in intensive care unit (ICU) patients, and to discuss its value in administration of early enteral nutrition (EN). METHODS: A perspective study was conducted. 85 patients with AGI admitted to ICU of Tianjin First Center Hospital from January 2013 to June 2013 were enrolled. EN was conducted after ICU admission or within 12-24 hours after high catabolic state...
April 2014: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
Chen-Tai Hou, Ying-Hsun Wu, Pei-Ning Huang, Chien-Hsiang Cheng, Yi-Chia Huang
BACKGROUND & AIMS: Stress, inflammation, and clinical conditions may increase the utilization and metabolic turnover of vitamin B-6 and lower the body pool of vitamin B-6. There is the possibility that hyperglycemia in critically ill patients might be at least partially due to compromised vitamin B-6 status. The purpose of this study was to compare blood glucose responses between critically ill surgical patients with adequate and deficient vitamin B-6 status. METHODS: The study was designed as a cross-sectional observational study...
August 2011: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
Marcia G Ory, B Mitchell Peck, Colette Browning, Samuel N Forjuoh
CONTEXT: Although physician influence can be especially powerful with older adults, relatively little is known about how primary care physicians (PCPs) interact with their patients regarding lifestyle issues. OBJECTIVE: To document the length of time that PCPs discuss lifestyle issues with their older patients and to examine patient, physician, and contextual correlates. DESIGN: Descriptive and multivariate analysis of videotapes of physician-patient encounters...
2007: MedGenMed: Medscape General Medicine
Y-C Huang, P-H Lan, C-H Cheng, B-J Lee, M-N Kan
OBJECTIVE: To assess vitamin B6 intake and status of critically ill patients. The relationship between vitamin B6 status indicators and the severity of illness and outcome in these patients was also examined. DESIGN: Prospective clinical study. SETTING: The study was performed at the Taichung Veteran General Hospital, in the central part of Taiwan. SUBJECTS: Ninety-four patients in the intensive care unit (ICU) entered the study and 46 patients successfully completed this study...
May 2002: European Journal of Clinical Nutrition
J Varon, G L Walsh, R E Fromm
PURPOSE: Patients with cancer who require mechanical ventilation have high mortality rates. Although oncological patients have multiple clinical problems, including nutritional and immunological deficiencies, added complications from mechanical ventilation by themselves may be life-threatening and may further compromise the ability of these patients to recover from an episode of acute respiratory failure (ARF). Noninvasive mechanical ventilatory support (NIMV) using positive-pressure-ventilation delivered through a mask has gained popularity for the treatment of ARF and may limit some mechanical ventilation complications...
June 1998: Journal of Critical Care
J Hudson-Civetta, T E Banner
Many considerations resulting in the formulations of guidelines for the use of intravascular catheters in the care of critically ill patients are well explored and documented; other areas are highly conjectural, are virtually unchartered, or have not even been explored. The sterility of transducer and flush assembly over time, the use of a five-lumen PA catheter as an avenue for both hemodynamic measurement and nutritional support, and the meaningful interpretation of cultures obtained from all of the catheters are necessary areas of present research to replace theoretical concepts with data...
September 1983: Heart & Lung: the Journal of Critical Care
M W Davenport, R D Zipser
Paradoxical suppression of plasma aldosterone (PA) despite increased plasma renin activity (PRA) has recently been noted in some critically ill patients. To determine the prevalence of this entity and to identify possible etiologic factors, we studied 100 consecutive patients admitted to a medical intensive care unit (ICU). Twenty-two of 100 ICU patients had hyperreninemia and inappropriately reduced PA concentrations, with a PA to PRA ratio less than the 98th percentile of the control population. Comparison of clinical data of these 22 patients with the other hyperreninemic ICU patients revealed no differences in electrolyte concentrations, nutrition, medications, or survival...
April 1983: Archives of Internal Medicine
R A Helms, R N Dickerson, M L Ebbert, M L Christensen, H G Herrod
Plasma prealbumin (PA) and retinol-binding protein (RBP) concentrations were serially measured in 25 critically ill, malnourished infants requiring parenteral nutrition to determine if these visceral protein markers are useful in assessing acute protein repletion. Significant increases in both proteins (p less than 0.05) were noted as early as 5 to 7 days after institution of parenteral nutrition and continued significantly above baseline values through 2 weeks of observation. Gestational development (in infants less than 4 weeks old) and mean protein intake influenced visceral protein responses...
July 1986: Journal of Pediatric Gastroenterology and Nutrition
D B Chalfin, G C Carlon
Older patients, patients with malignancies, and those admitted to ICUs utilize a disproportionate amount of hospital resources. To evaluate the combined impact of age and a diagnosis of malignancy on ICU utilization and outcome, we reviewed the care provided to all 1,212 patients admitted to a medical/surgical ICU in a hospital specializing in the treatment of cancer between January 1, 1986 and December 31, 1987. Patients between 19 and 64 yr (young) were compared with those between 65 and 74 yr (young-old) and with those greater than or equal to 75 yr (old-old) with respect to utilization of nutritional support (total parenteral nutrition [TPN]), mechanical ventilation (MV), pulmonary artery (PA) catheterization, dialysis (D), and blood products (B)...
July 1990: Critical Care Medicine
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