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Clinical nutrition in critical intensive care

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https://www.readbyqxmd.com/read/27925048/resting-energy-expenditure-in-critically-ill-patients-evaluation-methods-and-clinical-applications
#1
Ana Cláudia Soncini Sanches, Cassiana Regina de Góes, Marina Nogueira Berbel Bufarah, André Luiz Balbi, Daniela Ponce
Patients on intensive care present systemic, metabolic, and hormonal alterations that may adversely affect their nutritional condition and lead to fast and important depletion of lean mass and malnutrition. Several factors and medical conditions can influence the energy expenditure (EE) of critically ill patients, such as age, gender, surgery, serious infections, medications, ventilation modality, and organ dysfunction. Clinical conditions that can present with EE change include acute kidney injury, a complex disorder commonly seen in critically ill patients with manifestations that can range from minimum elevations in serum creatinine to renal failure requiring dialysis...
October 2016: Revista da Associação Médica Brasileira
https://www.readbyqxmd.com/read/27915963/kidney-transplant-recipients-requiring-critical-care-admission-within-one-year-of-transplant
#2
Okechukwu O Okidi, David Van Dellen, Cassandra Sobajo, Angela Summers, John R Greer, Titus Augustine
OBJECTIVES: Kidney transplant is the gold standard for treatment of renal failure. With the increasing age of the recipient population, which carries significant comorbidities, and the use of more marginal organs, there is potential for increased critical care admissions. In this study, we investigated the incidence, indications, and outcomes of patients admitted to critical care within 1 year of transplant. We also aimed to identify any precipitating factors or events that may trigger these admissions, as well as establish variables that could affect mortality...
December 2, 2016: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/27904620/the-relationship-between-vitamin-d-clinical-outcomes-and-mortality-rate-in-icu-patients-a-prospective-observational-study
#3
Nooshin Vosoughi, Parviz Kashefi, Behnood Abbasi, Awat Feizi, Gholamreza Askari, Leila Azadbakht
BACKGROUND: According to the high prevalence of Vitamin D deficiency, a few studies have been conducted to clarify the relationship between 25-hydroxyvitamin D (25(OH)D) and clinical outcomes in critically ill patients. The objective of this study was to determine this probable association. MATERIALS AND METHODS: Serum 25(OH)D, C-reactive protein, malnutrition measurements, and Intensive Care Unit (ICU)-acquired infection from 185 patients in ICU were assessed in the first 24 h of admission and they were followed for the other outcomes...
2016: Journal of Research in Medical Sciences: the Official Journal of Isfahan University of Medical Sciences
https://www.readbyqxmd.com/read/27903201/nutrition-in-the-intensive-care-unit-you-must-breathe-what-you-eat
#4
John F Cade, Daryl A Jones, Rinaldo Bellomo
The imprecision in prescribing of enteral nutrition in critically ill patients must result in occasions of overfeeding as well as underfeeding. Overfeeding could cause increased CO2 production and thus increased work of breathing and prolonged ventilator dependence. This possibility is supported by the limited relevant literature. We examined this possibility mathematically using the data in The Augmented versus Routine Approach to Giving Energy Trial (TARGET) feasibility study and in its main study protocol...
December 2016: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/27891355/the-effect-of-continuous-enteral-nutrition-on-nutrition-indices-compared-to-the-intermittent-and-combination-enteral-nutrition-in-traumatic-brain-injury-patients
#5
Sakine Mazaherpur, Alireza Khatony, Alireza Abdi, Yahia Pasdar, Farid Najafi
INTRODUCTION: Nutrition support is one of the most common care, which is undertaken for patients who suffered from Traumatic Brain Injury (TBI) and are admitted in intensive care units. Literature indicates some controversies regarding the appropriate method of nutrition support in these patients. AIM: This study was conducted for determining the effect of continuous enteral nutrition on nutrition indices, compared to the intermittent enteral and combination nutrition in TBI patients...
October 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/27878815/interventions-to-reduce-cognitive-impairments-following-critical-illness-a-topical-systematic-review
#6
REVIEW
H K Nedergaard, H I Jensen, P Toft
BACKGROUND: Critical illness is associated with cognitive impairments. Effective treatment or prevention has not been established. The aim of this review was to create a systematic summary of the current evidence concerning clinical interventions during intensive care admission to reduce cognitive impairments after discharge. METHODS: Medline, Embase, Cochrane Central, PsycInfo and Cinahl were searched. Inclusion criteria were studies assessing the effect of interventions during intensive care admission on cognitive function in adult patients...
November 22, 2016: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/27875283/does-persistent-inflammatory-catabolic-syndrome-exist-in-critically-ill-neonates
#7
Nicole Ellis, Caitlin Hughes, Vera Mazurak, Chloe Joynt, Bodil Larsen
BACKGROUND: Persistent inflammatory catabolic syndrome (PICS) has not been described in the infant population. This study proposes a definition of PICS in critically ill infants. METHODS: A published adult criterion of PICS was modified using anthropometric and biochemical reference ranges for infants. A prospective chart review of admissions to a tertiary surgical neonatal intensive care unit (NICU) was performed over 65 days. Demographic, anthropometric, biochemical, and other clinical variables such as length of stay and medication use were collected daily throughout admission...
October 10, 2016: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/27803805/nutrition-in-critical-illness-a-current-conundrum
#8
REVIEW
L John Hoffer, Bruce R Bistrian
Critically ill people are unable to eat. What's the best way to feed them? Nutrition authorities have long recommended providing generous amounts of protein and calories to critically ill patients, either intravenously or through feeding tubes, in order to counteract the catabolic state associated with this condition. In practice, however, patients in modern intensive care units are substantially underfed. Several large randomized clinical trials were recently carried out to determine the clinical implications of this situation...
2016: F1000Research
https://www.readbyqxmd.com/read/27765525/the-clinical-and-economic-impact-of-the-use-of-diabetes-specific-enteral-formula-on-icu-patients-with-type-2-diabetes
#9
Yin-Yi Han, Sheng-Ru Lai, Jamie S Partridge, Michael Y Wang, Suela Sulo, Fang-Wei Tsao, Refaat A Hegazi
BACKGROUND & AIMS: Patients admitted to intensive care units (ICUs) often need enteral nutrition (EN) support. For patients with type 2 diabetes (T2D), standard EN formulas may not provide ideal nutrients. The purpose was to investigate whether use of a diabetes-specific formula (DSF) could provide clinical and health economic benefits (compared to standard formulas) in critically ill patients with T2D. METHODS: This study was a retrospective analysis of medical records and expenditure data covering a 5-year period (2009-2013) from the hospitalization database of the National Taiwan University Hospital...
October 6, 2016: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/27720664/pharmacological-management-of-acute-kidney-injury-and-chronic-kidney-disease-in-neonates
#10
Jennifer G Jetton, Mark Sorenson
Both acute kidney injury (AKI) and chronic kidney disease (CKD) are seen more frequently in the neonatal intensive care unit (NICU) as advances in supportive care improve the survival of critically ill infants as well as those with severe, congenital kidney and urinary tract anomalies. Many aspects of the infant's care, including fluid balance, electrolyte and mineral homeostasis, acid-base balance, and growth and nutrition require close monitoring by and collaboration among neonatologists, nephrologists, dieticians, and pharmacologists...
October 6, 2016: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27712030/effectiveness-of-pressure-ulcer-prevention-strategies-for-adult-patients-in-intensive-care-units-a-systematic-review
#11
Nahla Tayyib, Fiona Coyer
BACKGROUND: Pressure ulcers are associated with substantial health burden, but could be preventable. Hospital-acquired pressure ulcers (HAPUs) prevention has become a priority for all healthcare settings, as it is considered a sign of quality of care providing. Intensive care unit (ICU) patients are at higher risk for HAPUs development. Despite the availability of published prevention strategies, there is a little evidence about which strategies can be safely integrated into routine standard care and have an impact on HAPUs prevention...
December 2016: Worldviews on Evidence-based Nursing
https://www.readbyqxmd.com/read/27694354/the-abcds-of-managing-morbidly-obese-patients-in-intensive-care-units
#12
Luis A Berrios
More than one-third of the US adult population and 17% of the youth are now obese, and obesity is associated with more than $147 billion a year in health care costs. Critical care nurses should understand the physiological differences and practice guidelines for patients with a body mass index greater than 30. The ABCD approach encompasses key clinical concepts in the management of critically ill obese and morbidly obese patients, including management of airways and breathing, minimizing nurses' back and other injuries, increasing awareness of bias, circulation problems, risks of decubitus ulcers and other skin breakdown, differences in drug calculations and metabolism, limitations in diagnostic equipment and imaging, diet and nutritional recommendations, and concerns with durable medical equipment...
October 2016: Critical Care Nurse
https://www.readbyqxmd.com/read/27672280/clinical-management-of-acute-liver-failure-results-of-an-international-multi-center-survey
#13
Liane Rabinowich, Julia Wendon, William Bernal, Oren Shibolet
AIM: To assess the practice of caring for acute liver failure (ALF) patients in varying geographic locations and medical centers. METHODS: Members of the European Acute Liver Failure Consortium completed an 88-item questionnaire detailing management of ALF. Responses from 22 transplantation centers in 11 countries were analyzed, treating between 300 and 500 ALF cases and performing over 100 liver transplants (LT) for ALF annually. The questions pertained to details of the institution and their clinical activity, standards of care, referral and admission, ward- based care versus intensive care unit (ICU) as well as questions regarding liver transplantation - including criteria, limitations, and perceived performance...
September 7, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/27668228/effectiveness-of-enteral-feeding-protocol-on-clinical-outcomes-in-critically-ill-patients-a-study-protocol-for-before-and-after-design
#14
Zhongheng Zhang, Qian Li, Lingzhi Jiang, Bo Xie, Xiaowei Ji, Jiahong Lu, Ronglin Jiang, Shu Lei, Shihao Mao, Lijun Ying, Di Lu, Xiaoshui Si, Jianxin He, Mingxia Ji, Jianhua Zhu, Guodong Chen, Yadi Shao, Yinghe Xu, Ronghai Lin, Chao Zhang, Weiwen Zhang, Jian Luo, Tianzheng Lou, Xuwei He, Kun Chen, Renhua Sun
INTRODUCTION: Enteral feed is an important component of nutritional therapy in critically ill patients and underfeeding has been associated with adverse outcomes. The article developed an enteral feeding protocol and planed a before-and-after comparative trial to explore whether implementation of enteral feeding protocol was able to improve clinical outcomes. METHODS AND ANALYSIS: The study will be conducted in intensive care units (ICUs) of ten tertiary care academic centers...
August 2016: Annals of Translational Medicine
https://www.readbyqxmd.com/read/27637335/the-impact-of-an-omega-3-fatty-acid-rich-lipid-emulsion-on-fatty-acid-profiles-in-critically-ill-septic-patients
#15
Thomas C Hall, Dilraj K Bilku, Christopher P Neal, Jill Cooke, Helena L Fisk, Philip C Calder, Ashley R Dennison
BACKGROUND: Death from sepsis in the intensive therapy unit (ITU) is frequently preceded by the development of multiple organ failure as a result of uncontrolled inflammation. Treatment with omega-3 (n-3) fatty acids (FAs), principally eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), has been demonstrated to attenuate the effects of uncontrolled inflammation and may be clinically beneficial in reducing mortality from organ dysfunction. Fish oil (FO) is a source of EPA and DHA...
September 2016: Prostaglandins, Leukotrienes, and Essential Fatty Acids
https://www.readbyqxmd.com/read/27623980/relevance-of-non-nutritional-calories-in-mechanically-ventilated-critically-ill-patients
#16
E Bousie, D van Blokland, H J W Lammers, A R H van Zanten
BACKGROUND/OBJECTIVES: Overfeeding in critically ill patients is associated with many complications. Propofol, dextrose infusion and citrate dialysis provide non-nutritional calories (NNCs), potentially causing overfeeding. The relevance of NNCs for total caloric intake has not been systematically studied. SUBJECTS/METHODS: We retrospectively studied adult mechanically ventilated intensive care unit (ICU) patients receiving enteral nutrition with or without supplemental parenteral nutrition...
September 14, 2016: European Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/27621112/nutritional-risk-assessment-and-cultural-validation-of-the-modified-nutric-score-in-critically-ill-patients-a-multicenter-prospective-cohort-study
#17
Rosa Mendes, Sara Policarpo, Philip Fortuna, Marta Alves, Daniel Virella, Daren K Heyland
PURPOSE: Characterize the nutritional risk of critically ill patients with the modified NUTrition Risk in the Critically ill (NUTRIC) score. MATERIALS: National, multicenter, prospective, observational study conducted in 15 polyvalent Portuguese intensive care unit (ICU), during 6 months. Adult patients were eligible. Those transferred from another ICU or readmitted, brain dead at admission, and with length of ICU stay (LOS) of 72 hours or less were excluded. NUTRIC score was calculated at admission; scores ≥5 represent a high nutritional risk...
August 10, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/27596080/-current-situation-of-enteral-nutrition-interruptions-in-sepsis-children-in-pediatric-intensive-care-unit
#18
B L Fang, S Y Qian, X L Jia, Z Li, J Liu
OBJECTIVE: To analyze the interruptions of enteral nutrition (EN) and it's relationship to prognosis in children with sepsis in pediatric intensive care unit (PICU). METHOD: Daily EN intake and reasons for EN interruptions were prospectively observed and recorded in children with sepsis who were admitted to our PICU from November 2012 to April 2013. Clinical prognosis was compared between children with and without EN interruptions by t, rank-sum and χ(2) tests...
September 2016: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
https://www.readbyqxmd.com/read/27562444/hypophosphatemia-in-enterally-fed-patients-in-the-surgical-intensive-care-unit-common-but-unrelated-to-timing-of-initiation-or-aggressiveness-of-nutrition-delivery
#19
Eva Fuentes, Daniel Dante Yeh, Sadeq A Quraishi, Emily A Johnson, Haytham Kaafarani, Jarone Lee, David R King, Marc DeMoya, Peter Fagenholz, Kathryn Butler, Yuchiao Chang, George Velmahos
INTRODUCTION: Hypophosphatemia has been associated with refeeding malnourished patients, but its clinical significance is unclear. We investigated the incidence of refeeding hypophosphatemia (RH) in the surgical intensive care unit (SICU) and its association with early enteral nutrition (EN) administration and clinical outcomes. METHODS: We performed a retrospective review of a 2-year database of patients receiving EN in the SICU. RH was defined as a post-EN phosphorus (PHOS) level decrement of >0...
August 25, 2016: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/27527069/the-efficacy-and-safety-of-prokinetic-agents-in-critically-ill-patients-receiving-enteral-nutrition-a-systematic-review-and-meta-analysis-of-randomized-trials
#20
Kim Lewis, Zuhoor Alqahtani, Lauralyn Mcintyre, Saleh Almenawer, Fayez Alshamsi, Andrew Rhodes, Laura Evans, Derek C Angus, Waleed Alhazzani
BACKGROUND: Intolerance to enteral nutrition is common in critically ill adults, and may result in significant morbidity including ileus, abdominal distension, vomiting and potential aspiration events. Prokinetic agents are prescribed to improve gastric emptying. However, the efficacy and safety of these agents in critically ill patients is not well-defined. Therefore, we conducted a systematic review and meta-analysis to determine the efficacy and safety of prokinetic agents in critically ill patients...
August 15, 2016: Critical Care: the Official Journal of the Critical Care Forum
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