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icu nutrition support

Christina Rollins, Emily Bailey, Jacqueline Gregoire, Tim Milner
Clinical simulation training provides a realistic environment for students and healthcare professionals to strengthen and broaden skills and abilities. This type of learning experience creates a controlled environment in which learners may attain new skills or further develop skills that positively impact patient outcomes. Although few studies exist regarding the use of clinical simulation training and nutrition support practitioners, preliminary data following a small-bowel feeding tube (SBFT) insertion workshop for intensive care unit registered nurses and registered dietitian nutritionists showed potential use in this realm...
March 12, 2018: Nutrition in Clinical Practice
Xiujuan Xu, Geng Zhang, Mahong Hu, Chunlian Ji, Jianbiao Meng, Zhizhen Lai, Muhua Dai, Lisha Pang, Wei Zhang
OBJECTIVE: To study the influence of clinical nutritional support on the effects of mechanical ventilation (MV), and to find the factors affecting the outcome of patients undergoing MV. METHODS: A case-control study was conducted. The clinical data of 235 patients undergoing MV admitted to intensive care unit (ICU) of Tongde Hospital of Zhejiang Province from January 2015 to June 2017 were retrospectively analyzed. The patients were divided into two groups according to whether weaning successfully within 7 days...
March 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
Nicolino Ambrosino, Michele Vitacca
Background: Progress in management has improved hospital mortality of patients admitted to the intensive care units, but also the prevalence of those patients needing weaning from prolonged mechanical ventilation, and of ventilator assisted individuals. The result is a number of difficult clinical and organizational problems for patients, caregivers and health services, as well as high human and financial resources consumption, despite poor long-term outcomes. An effort should be made to improve the management of these patients...
2018: Multidisciplinary Respiratory Medicine
Pilar Anton-Martin, Michael Papacostas, Elisabeth Lee, Paul A Nakonezny, Michael L Green
BACKGROUND: Malnutrition is associated with an increased risk of mortality in patients admitted to the intensive care unit. Children requiring extracorporeal membrane oxygenation (ECMO) support represent an extremely ill subset of this population. There is a lack of data on the impact of nutrition state on survival in this cohort. We examined the association between being underweight and in-hospital mortality among children supported with ECMO. MATERIALS AND METHODS: This article reports on an observational retrospective cohort study performed among neonatal and pediatric patients supported with ECMO in a tertiary children's hospital from May 1996 through June 2013...
January 2018: JPEN. Journal of Parenteral and Enteral Nutrition
Anna Patkova, Vera Joskova, Eduard Havel, Simona Najpaverova, Daniela Uramova, Miroslav Kovarik, Zdenek Zadak, Miloslav Hronek
OBJECTIVE: The association between energy metabolism and prognosis in polytrauma patients has not yet been defined. The aim of this study was to describe energy metabolism and analyze the prognostic value of respiratory quotient (RQ) and nonprotein respiratory quotient (npRQ) in fasting polytrauma patients (fPP) and polytrauma patients with nutritional support (nsPP). METHODS: Twenty-two polytrauma patients (before and after parenteral nutrition administration) and 22 healthy controls (after overnight fasting) were examined on day 4 (median) after admission to the intensive care unit...
November 7, 2017: Nutrition
Bethan Jenkins, Philip C Calder, Luise V Marino
BACKGROUND & AIMS: Critically ill adults have increased nutrition risk. Prior to procedures patients are often fasted, leading to nutritional deficits. The use of fasting guidelines may therefore help reduce deficits from accumulating. The aim of this work was to determine the impact on nutrition support delivery following the implementation of fasting guidelines in addition to characterizing staff knowledge of the guidelines. DESIGN: Retrospective data were collected on n = 74 patients at two different time points; prior to launch of fasting guidelines and post launch, with regards to estimated nutritional requirements, nutritional targets, volume of enteral nutrition (EN) delivered and periods of fasting...
February 15, 2018: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
Michael T Vest, Paul Kolm, James Bowen, Jillian Trabulsi, Shannon L Lennon, Mary Shapero, Patty McGraw, James Halbert, Claudine Jurkovitz
BACKGROUND: Clinical practice guidelines recommend enteral nutrition for most patients receiving mechanical ventilation. However, recently published evidence on the effect of enteral nutrition on mortality, particularly for patients who are well nourished, is conflicting. OBJECTIVES: To examine the association between enteral feeding and hospital mortality in critically ill patients receiving mechanical ventilation and to determine if body mass index mediates this relationship...
March 2018: American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses
W A C Kristine Koekkoek, C H Coralien van Setten, Laura E Olthof, J C N Hans Kars, Arthur R H van Zanten
BACKGROUND & AIMS: Optimal protein intake during critical illness is unknown. Conflicting results on nutritional support during the first week of ICU stay have been published. We addressed timing of protein intake and outcomes in ICU patients requiring prolonged mechanical ventilation. METHODS: We retrospectively collected nutritional and clinical data on the first 7 days of ICU admission of adult critically ill patients, who were mechanically ventilated in our ICU for at least 7 days and admitted between January 1st 2011 and December 31st 2015...
February 17, 2018: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
Astrid Ruiz-Margáin, Alessandra Pohlmann, Patrick Ryan, Robert Schierwagen, Luis A Chi-Cervera, Christian Jansen, Osvely Mendez-Guerrero, Nayelli C Flores-García, Jennifer Lehmann, Aldo Torre, Ricardo Ulises Macías-Rodríguez, Jonel Trebicka
OBJECTIVE: Acute-on-chronic liver failure (ACLF) develops in acute decompensation of cirrhosis and shows high mortality. In critically ill patients, early diagnosis of ACLF could be important for therapeutic decisions (e.g. renal replacement, artificial liver support, liver transplantation). This study evaluated fibroblast growth factor 21 (FGF21), as a marker of mitochondrial dysfunction in the context of ACLF. DESIGN: The study included 154 individuals (112 critically patients and 42 healthy controls) divided into a training and a validation cohort...
February 24, 2018: Liver Transplantation
Nakul Katyal, Amanda Korzep, Christopher Newey
Central venous catheter (CVC) insertion is extensively utilized in Intensive Care Units for evaluation of hemodynamic status, administration of intravenous drugs, and for providing nutritional support in critically ill patients. Unfortunately, CVC use is associated with complications including lung injury, bleeding, infection, and thrombosis. We present a patient with an acute ischemic stroke from an inadvertently placed CVC into the right common carotid artery. A 57-year-old male presented to our institution for left hemiplegia and seizures 2 days after a CVC was placed...
January 2018: Journal of Neurosciences in Rural Practice
Pasinee Kanaprach, Nutkridta Pongsakul, Nopporn Apiwattanakul, Chatchai Muanprasat, Sarayut Supapannachart, Pracha Nuntnarumit, Somchai Chutipongtanate
BACKGROUND: Donor human milk is considered the next best nutrition following mother's own milk to prevent neonatal infection and necrotizing enterocolitis in preterm infants who are admitted at neonatal intensive care unit. However, donor milk biofunctionalities after preparative processes have rarely been documented. OBJECTIVE: To evaluate biofunctionalities preserved in donor milk after preparative processes by cell-based assays. MATERIALS AND METHODS: Ten pools of donor milk were produced from 40 independent specimens...
February 16, 2018: Breastfeeding Medicine: the Official Journal of the Academy of Breastfeeding Medicine
Stephen A McClave, Jayshil Patel, Neal Bhutiani
PURPOSE OF REVIEW: Maintaining gut barrier defenses, modulating immune responses, and supporting the role of commensal microbiota are major factors influencing outcome in critical illness. Of these, maintaining a commensal 'lifestyle' and preventing the emergence of a virulent pathobiome may be most important in reducing risk of infection and multiple organ failure. RECENT FINDINGS: The polymeric formulas utilized for enteral nutrition in the ICU are absorbed high in the gastrointestinal tract and may not reach the microbial burden in the cecum where their effect is most needed...
April 2018: Current Opinion in Critical Care
Esther Barreiro
Skeletal muscle weakness is common in the intensive care units (ICU). Approximately 50% of patients under mechanical ventilation for more than 7 days show signs of ICU-acquired muscle weakness. In these patients, muscle weakness may be the result of axonal polyneuropathy, myopathy or a combination of both. The commonest risk factors in patients with ICU-acquired weakness (AW) are the severity and duration of the systemic inflammatory response, duration of the stay in the ICU and of mechanical ventilation, hyperglycemia, hypoalbuminemia, parenteral nutrition, and administration of corticosteroids and of neuromuscular blocking agents...
January 2018: Annals of Translational Medicine
Stephen J D O'Keefe
This article provides evidence that current dietary fiber intake levels may be insufficient to maintain colonic mucosal health and defense, and reduce inflammation and cancer risk in otherwise healthy people. Current commercial tube feeds generally overlook the metabolic needs of the colon and may predispose patients to dysbiosis, bacterial overgrowth with pathogens such as Clostridium difficile, and acute colitis. These results raise concern about the wide-scale use of prophylactic antibiotics in the intensive care unit and the use of elemental, fiber-depleted tube feeds...
March 2018: Gastroenterology Clinics of North America
Qiang Li, Xueni Li, Yuxin Leng, Xi Zhu, Gaiqi Yao
OBJECTIVE: To assess the nutritional status of severe malnutrition patients with anorexia nervosa by multi-frequency bioelectrical impedance technique, and to provide the basis for nutritional support therapy. METHODS: A prospective study was conducted. Twenty-six severe malnutrition patients with anorexia nervosa, body mass index (BMI) ≤ 16 kg/m2 admitted to intensive care unit (ICU) of Peking University Third Hospital and general three ward of Peking University Sixth Hospital from June 1st to September 30th, 2017 were enrolled...
February 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
Shengqiang Yang, Jinggang Liu, Wenbao Yang, Jiyin Yuan, Suqiu Meng, Maoling Liang, Qibiao Shi
OBJECTIVE: To investigate the effect of early mobilization on diaphragmatic function in patients with mechanical ventilation (MV). METHODS: Sixty chronic obstructive pulmonary disease with acute exacerbation (AECOPD) patients with respiratory failure (RF) and underwent MV admitted to intensive care unit (ICU) of Huxi Affiliated Hospital of Jining Medical College from January 2016 to January 2017 were enrolled. The patients were divided into treatment group (n = 30) and control group (n = 30) by randomly number table method...
February 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
Martin D Rosenthal, Phil Carrott, Frederick A Moore
PURPOSE OF REVIEW: This review is to discuss the role of autophagy in the critically ill patient population. As the understanding of autophagy continues to expand and evolve, there are certain controversies surrounding whether intensivist should allow the benefit of autophagy to supersede gold standard of insulin therapy or early nutritional support. RECENT FINDINGS: The review is relevant as the current literature seems to support under-feeding patients, and perhaps the reason these studies were positive could be prescribed to the mechanisms of autophagy...
April 2018: Current Opinion in Critical Care
Saman Khalatbari-Soltani, Carlos de Mestral, Pedro Marques-Vidal
BACKGROUND & AIMS: How undernutrition is reported in hospital discharge data is not understood. To assess trends in reported undernutrition and its management among hospitalized patients in Switzerland, and the association between reported undernutrition and in-hospital mortality, acquired infection, intensive care unit stay (ICU), and length of hospital stay (LOS). METHODS: Data from the Swiss hospital discharge databases from 1998 to 2014 (n = 13,297,188 hospitalizations, 52...
February 1, 2018: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
Liisa MacGowan, Elizabeth Smith, Charmaine Elliott-Hammond, Barnaby Sanderson, Dennis Ong, Kathleen Daly, Nicholas A Barrett, Kevin Whelan, Danielle E Bear
BACKGROUND: The use of veno-venous extracorporeal membrane oxygenation (vv-ECMO) is increasing in adults with severe respiratory failure. Observational data suggest that there are significant challenges to providing adequate nutrition support for patients on vv-ECMO. We aimed to describe firstly the nutrition support practices in a large single-centre providing vv-ECMO to adults and secondly any association with clinical outcome. METHODS: We conducted a retrospective review of patients receiving vv-ECMO on the Intensive Care Unit (ICU) of a large London teaching hospital...
January 26, 2018: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
Marlena A Fox, Jessica L Elefritz, Brandon M Huang, Charles Hunley
OBJECTIVE: To evaluate the efficacy and safety of lurasidone compared with quetiapine for treatment of delirium in critically ill patients. DESIGN: Prospective, observational cohort study. SETTING: Single-center community teaching hospital. PATIENTS: Forty adult intensive care unit (ICU) patients with delirium (Confusion Assessment Method in the ICU positive), tolerating enteral nutrition, and without active alcohol withdrawal or prior use of atypical antipsychotics...
January 1, 2018: Journal of Intensive Care Medicine
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