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https://www.readbyqxmd.com/read/28640510/paediatric-intensive-care-nurses-decision-making-around-gastric-residual-volume-measurement
#1
Lyvonne N Tume, Lynne Latten, Lindsay Kenworthy
BACKGROUND: Measuring gastric residual volume (GRV) to guide enteral feeding is a common nursing practice in intensive care units, yet little evidence supports this practice. In addition, this practice has been shown to potentially contribute to inadequate energy delivery in intensive care, which remains a problem in critically ill children. AIMS: We aimed to explore paediatric intensive care nurses' decision-making surrounding this practice. METHODS: This is a cross-sectional electronic survey in a single mixed general and cardiac surgical PICU in the UK...
June 22, 2017: Nursing in Critical Care
https://www.readbyqxmd.com/read/28633000/nutrition-support-for-critically-ill-patients-with-cancer
#2
Kristen Lach, Sarah J Peterson
Oncology patients often experience the classic signs of malnutrition-weight loss as well as fat and muscle wasting, which have been associated with poor tolerance to treatment and increased morbidity and mortality. Nutrition status may be an important factor in determining tolerance to treatment and outcomes associated with it. Thus, identification of those with preexisting malnutrition or who are at risk for developing malnutrition is crucial not only at time of cancer diagnosis but also throughout the treatment course so that nutrition interventions may be implemented to prevent development or worsening of malnutrition in this high-risk population...
June 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28625248/-core-knowledge-and-skill-based-approach-to-subspecialty-construction-in-critical-intensive-care-medicine-with-distinct-chinese-peculiarity
#3
Lijun Wang, Fang Tian
With the rapid development of critical care medicine (CCM) in China, there are increases in the number of intensive care units (ICUs), the scale of one center ICU and the team. Subspecialty construction of CCM is of great concerns for personnel training as well as discipline development, and is currently one of the urgent problems that need to be resolved. Experience of CCM subspecialty construction from Europe and the United States is lacking and it is necessary to propose some opinions on innovation to construct CCM subspecialties with Chinese characteristics...
June 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28608513/out-of-office-hours-elective-surgical-intensive-care-admissions-and-their-associated-complications
#4
David J R Morgan, Kwok Ming Ho, Yang Jian Ong, Marlene L Kolybaba
BACKGROUND: The 'weekend' effect is a controversial theory that links reduced staffing levels, staffing seniority and supportive services at hospitals during 'out-of-office hours' time periods with worsening patient outcomes. It is uncertain whether admitting elective surgery patients to intensive care units (ICU) during 'out-of-office hours' time periods mitigates this affect through higher staffing ratios and seniority. METHODS: Over a 3-year period in Western Australia's largest private hospital, this retrospective nested-cohort study compared all elective surgical patients admitted to the ICU based on whether their admission occurred 'in-office hours' (Monday-Friday 08...
June 12, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28601441/evaluation-and-handling-of-constipation-in-critical-patients
#5
J Pérez-Sánchez, J Fernández-Boronat, E Martínez-Méndez, M L Marín-Cagigas, D Mota-Puerto, M C Pérez-Román, G Martínez-Estalella
OBJECTIVE: To evaluate the effectiveness of nursing care against constipation and to identify, analyze and evaluate causes and consequences. METHODOLOGY: Observational, descriptive and prospective study in polyvalent ICU tertiary hospital (2013-2015). INCLUSION CRITERIA: >18 years, stay >7 days, connected to respiratory support, with nasogastric tube and enteral or mixed nutrition. Patients with gastrointestinal pathology, encephalopathic and jejunostomy/ileostomy were excluded...
June 7, 2017: Enfermería Intensiva
https://www.readbyqxmd.com/read/28582805/enteral-nutritional-support-in-non-icu-hospitalized-patients-current-practice-in-mexico
#6
Arianne I Lupián-Angulo, Luis A Ortíz-Reyes, Lilia Castillo-Martínez, Aurora E Serralde-Zúñiga
BACKGROUND AND OBJECTIVES: Patients receiving >=80% of their energy requirements by enteral nutrition (EN) have better clinical outcomes; unfortunately, there are discrepancies between the amount prescribed and amount received. The aim of this study was to explore the nutritional clinical practice, determine the adequacy and identify reasons for underfeeding. METHODS AND STUDY DESIGN: A retrospective study was conducted in hospitalized, non-intensive care unit, adult patients receiving EN for >=72 h...
2017: Asia Pacific Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/28561252/general-care-of-the-pregnant-patient-in-the-intensive-care-unit
#7
Timothy M E Crozier
Pregnant women represent a small subset of all intensive care unit (ICU) admissions and may require intensive care for "obstetric" or "nonobstetric" reasons. Women may be admitted to the ICU at any stage of pregnancy or in the postpartum period. Pregnancy may be discovered at the time of admission to the ICU. Pregnancy impacts on ICU care in a variety of ways and requires a multidisciplinary approach to management. Pregnancy is associated with considerable physiological changes that affect most organ systems, including an expansion in blood volume, an increase in minute ventilation, and an increased risk of thrombosis...
April 2017: Seminars in Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28550982/early-provision-of-oropharyngeal-colostrum-leads-to-sustained-breast-milk-feedings-in-preterm-infants
#8
Ruth Snyder, Aimee Herdt, Nancy Mejias-Cepeda, John Ladino, Kathryn Crowley, Philip Levy
BACKGROUND: Oropharyngeal colostrum (OC) application strategies have been shown to be feasible and safe for very low birth weight (VLBW) infants. Evidence to support the nutritional and clinical advantages of OC care remains somewhat theoretical. The objectives of this study were to a) confirm the feasibility and safety of OC application in preterm infants and b) determine if OC application is associated with improved nutritional and clinical outcomes from birth to discharge. We hypothesized that OC application in the first few days would promote sustained breast milk feedings through discharge...
May 10, 2017: Pediatrics and Neonatology
https://www.readbyqxmd.com/read/28549221/preventing-underfeeding-and-overfeeding-a-clinician-s-guide-to-the-acquisition-and-implementation-of-indirect-calorimetry
#9
Amy K Ladd, Heather E Skillman, Matthew A Haemer, Peter M Mourani
BACKGROUND: In critically ill patients, indirect calorimetry (IC) is the gold standard to determine energy needs, as the use of predictive equations can result in underfeeding or overfeeding. The aim of this quality improvement (QI) initiative was to describe the rationale for and implementation of a process to target energy provision according to IC measurements in a tertiary academic medical center pediatric intensive care unit (PICU). MATERIALS AND METHODS: To justify the purchase of an indirect calorimeter for clinical use, a needs assessment was conducted, followed by a training and implementation period...
May 1, 2017: Nutrition in Clinical Practice
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
#10
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/28526141/total-parenteral-and-enteral-nutrition-in-the-icu-evolving-concepts
#11
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/28524040/-a-case-of-the-severe-human-infection-by-avian-influenza-h7n9-was-rescued-successfully-by-the-sepsis-bundle
#12
Shaohong Wang, Jintao Liu, Haili Luo, Xianguo Pan, Tongmei Yuan, Xuemei Long
One confirmed diagnosis case of severe human infection by avian influenza H7N9 admitted to intensive care unit (ICU) of the Second Affiliated Hospital of Guizhou Medical University on January 12th, 2017 was reported. The patient was treated with the sepsis bundle, and recovered finally, including a series of comprehensive treatments, such as respiratory support, circulation support, antiviral, anti-inflammation, immunization enhancement, critical nursing, fluid management, nutritional support and treatment of complications...
May 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28503510/a-case-report-of-the-nutrition-support-for-a-patient-with-hellp-syndrome
#13
Seo Eun Yeon, Sun Jung Kim, Ju Hee Kim, Hae-Yun Chung, Se Hee Na, Song Mi Lee
A 30-year-old female patient, 18 weeks gestational age, with no prior medical history was admitted to hospital complaining severe right upper quadrant pain. The patient was admitted to intensive care unit (ICU) after emergency surgery to treat intraperitoneal hemorrhage caused by rupture of liver hematoma. Despite the absence of high blood pressure, the patient was diagnosed with hemolysis, elevated liver enzymes, and low platelet count (HELLP) syndrome on the basis of abnormal levels of blood aspartate aminotransferase/alanine aminotransferase, lactate dehydrogenase, total bilirubin, direct bilirubin, C-reactive protein (CRP) and platelet along with liver damage and proteinuria...
April 2017: Clinical Nutrition Research
https://www.readbyqxmd.com/read/28459409/-correlation-factor-analysis-on-constipation-in-long-term-ventilated-patients-in-intensive-care-unit-a-prospective-observational-cohort-study
#14
Mingying Dai, Huimin Wang, Kun Li, Bangxu Yu, Xinting Pan
OBJECTIVE: To explore the factors associated with delayed defecation in long-term ventilated patients in intensive care unit (ICU) and their potential effect on prognosis. METHODS: A prospective observational cohort study was conducted. The patients admitted to general ICU of the Affiliated Hospital of Qingdao University from October 1st in 2013 to September 30th in 2015 who underwent mechanical ventilation (MV) for ≥6 days were enrolled, and they were divided into early defecation group (< 6 days) and late defecation group (≥6 days)...
January 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28450219/terminally-ill-taiwanese-cancer-patients-and-family-caregivers-agreement-on-patterns-of-life-sustaining-treatment-preferences-is-poor-to-fair-and-declines-over-a-decade-results-from-two-independent-cross-sectional-studies
#15
Tsang-Wu Liu, Fur-Hsing Wen, Cheng-Hsu Wang, Ruey-Long Hong, Jyh-Ming Chow, Jen-Shi Chen, Chang-Fang Chiu, Siew Tzuh Tang
CONTEXT/OBJECTIVE: Temporal changes have not been examined in patient-caregiver agreement on life-sustaining treatment (LST) preferences at end of life (EOL). We explored the extent of and changes in patient-caregiver agreement on LST-preference patterns for two independent cohorts of Taiwanese cancer patient-family caregiver dyads recruited a decade apart. METHODS: We surveyed preferences for cardiopulmonary resuscitation, intensive care unit care, cardiac massage, intubation with mechanical ventilation, intravenous nutritional support, tube feeding, and dialysis among 1049 and 1901 dyads in 2003-2004 and 2011-2012, respectively...
April 24, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28427779/fish-oil-lc-pufas-do-not-affect-blood-coagulation-parameters-and-bleeding-manifestations-analysis-of-8-clinical-studies-with-selected-patient-groups-on-omega-3-enriched-medical-nutrition
#16
Stephanie Jeansen, Renger F Witkamp, Jossie A Garthoff, Ardy van Helvoort, Philip C Calder
BACKGROUND & AIMS: The increased consumption of fish oil enriched-products exposes a wide diversity of people, including elderly and those with impaired health to relatively high amounts of n-3 long-chain polyunsaturated fatty acids (n-3 LC-PUFAs). There is an ongoing debate around the possible adverse effects of n-3 LC-PUFAs on bleeding risk, particularly relevant in people with a medical history of cardiovascular events or using antithrombotic drugs. METHODS: This analysis of 8 clinical intervention studies conducted with enteral medical nutrition products containing fish oil as a source of n-3 LC-PUFAs addresses the occurrence of bleeding-related adverse events and effects on key coagulation parameters (Prothrombin Time [PT], (activated) and Partial Thromboplastin Time [(a)PTT])...
March 29, 2017: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28418793/wide-variability-in-caloric-density-of-expressed-human-milk-can-lead-to-major-underestimation-or-overestimation-of-nutrient-content
#17
Charles W Sauer, Mallory A Boutin, Jae H Kim
BACKGROUND: Very-low-birth-weight infants continue to face significant difficulties with postnatal growth. Human milk is the optimal form of nutrition for infants but may exhibit variation in nutrient content. OBJECTIVE: This study aimed to perform macronutrient analysis on expressed human milk from mothers whose babies are hospitalized in the neonatal intensive care unit. METHODS: Up to five human milk samples per participant were analyzed for protein, carbohydrate, and fat content using reference chemical analyses (Kjeldahl for protein, high pressure liquid chromatography for carbohydrates, and Mojonnier for fat)...
May 2017: Journal of Human Lactation: Official Journal of International Lactation Consultant Association
https://www.readbyqxmd.com/read/28388373/protein-kinetics-and-metabolic-effects-related-to-disease-states-in-the-intensive-care-unit
#18
Robert G Martindale, Daren K Heyland, Saúl J Rugeles, Jan Wernerman, Peter J M Weijs, Jayshil J Patel, Stephen A McClave
Evaluating protein kinetics in the critically ill population remains a very difficult task. Heterogeneity in the intensive care unit (ICU) population and wide spectrum of disease processes creates complexity in assessing protein kinetics. Traditionally, protein has been delivered in the context of total energy. Focus on energy delivery has recently come into question, as the importance of supplemental protein in patient outcomes has been shown in several recent trials. The ICU patient is prone to catabolism, immobilization, and impaired immunity, which is a perfect storm for massive loss of lean body tissue with a unidirectional flow of amino acids from muscle to immune tissue for immunoglobulin production, as well as liver for gluconeogenesis and acute phase protein synthesis...
April 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28388371/experimental-and-outcome-based-approaches-to-protein-requirements-in-the-intensive-care-unit
#19
Peter J M Weijs, Roland N Dickerson, Daren K Heyland, Frederick A Moore, Saúl J Rugeles, Stephen A McClave
Insight into protein requirements of intensive care unit (ICU) patients is urgently needed, but at present, it is unrealistic to define protein requirements for different diagnostic groups of critical illness or at different stages of illness. No large randomized controlled trials have randomized protein delivery, adequately addressed energy intake, and evaluated relevant clinical outcomes. As a pragmatic approach, experimental studies have focused on protein requirements of heterogeneous ICU patients. Data are scarce and the absolute value of protein requirements therefore is an approximation...
April 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28386479/bedside-ultrasound-measurement-of-rectus-femoris-a-tutorial-for-the-nutrition-support-clinician
#20
Carlos Alfredo Galindo Martín, Enrique Monares Zepeda, Octavio Augusto Lescas Méndez
Intensive care unit acquired weakness is a long-term consequence after critical illness; it has been related to muscle atrophy and can be considered as one of the main nutritional support challenges at the intensive care unit. Measuring muscle mass by image techniques has become a new area of research for the nutritional support field, extending our knowledge about muscle wasting and the impact of nutritional approaches in the critical care setting, although currently there is no universally accepted technique to perform muscle measurements by ultrasound...
2017: Journal of Nutrition and Metabolism
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