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Nutritional critical ill

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https://www.readbyqxmd.com/read/28822398/variability-in-perioperative-fasting-practices-negatively-impacts-nutritional-support-of-critically-ill-intubated-patients
#1
Molly J Douglas, David Ciraulo
The aim of the study was to quantify nutritional losses related to pre- and postoperative fasts in critically ill intubated patients and to explore whether shorter fasts are safe and appropriate in this population. A retrospective review of mechanically ventilated adults undergoing surgery more than 24 hours after admission to a Level I trauma center over 15 months was done, which yielded 132 procedures and 81 unique patients. Ninety per cent of preoperative periods and 43 per cent of postoperative periods were affected by nonmedical barriers to feeding...
August 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28820608/skeletal-muscle-ultrasound-in-critical-care-a-tool-in-need-of-translation
#2
Marina Mourtzakis, Selina Parry, Bronwen Connolly, Zudin Puthucheary
With the emerging interest in documenting and understanding muscle atrophy and function in critically ill patients and survivors, ultrasonography has transformational potential in measuring muscle quantity and quality. Here, we discuss the importance of quantifying skeletal muscle in the ICU setting. We also identify the merits and limitations of various modalities that are capable of accurately and precisely measuring muscularity. Ultrasound is emerging as a potentially powerful tool for skeletal muscle quantification; however, there are key challenges that need to be addressed in future work to ensure useful interpretation and comparability of results across diverse observational and interventional studies...
August 18, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28816919/enteral-nutrition-practices-in-critically-ill-children-requiring-noninvasive-positive-pressure-ventilation
#3
Matthew K Leroue, Ryan J Good, Heather E Skillman, Angela S Czaja
OBJECTIVES: Evaluate the practice of providing enteral nutrition in critically ill children requiring noninvasive positive pressure ventilation. DESIGN: Retrospective cohort study. SETTING: PICU within a quaternary care children's hospital. PATIENTS: PICU patients older than 30 days requiring noninvasive positive pressure ventilation for greater than or equal to 24 hours from August 2014 to June 2015. Invasive mechanical ventilation prior to noninvasive positive pressure ventilation and inability to receive enteral nutrition at baseline were additional exclusionary criteria...
August 12, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28813205/combining-2-commonly-adopted-nutrition-instruments-in-the-critical-care-setting-is-superior-to-administering-either-one-alone
#4
Charles Chin Han Lew, Ka Po Cheung, Mary Foong Fong Chong, Ai Ping Chua, Robert J L Fraser, Michelle Miller
BACKGROUND: This study aimed to determine the agreement between the modified Nutrition Risk in Critically ill Score (mNUTRIC) and the Subjective Global Assessment (SGA) and compare their ability in discriminating and quantifying mortality risk independently and in combination. METHODS: Between August 2015 and October 2016, all patients in a Singaporean hospital received the SGA within 48 hours of intensive care unit admission. Nutrition status was dichotomized into presence or absence of malnutrition...
August 1, 2017: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28811717/modified-b-ultrasound-method-for-measurement-of-antral-section-only-to-assess-gastric-function-and-guide-enteral-nutrition-in-critically-ill-patients
#5
Ying Liu, Ya-Kun Gao, Lei Yao, Li Li
AIM: To establish a modified B-ultrasound method of measuring the antral section only to assess gastric motility in healthy people, and evaluate its application in guiding enteral nutrition (EN) in critically ill patients. METHODS: First, 30 healthy volunteers were selected. The modified B-ultrasound method and the traditional B-ultrasound method were applied to assess gastric function. The correlation of indices of gastric function between the two groups was analyzed statistically...
July 28, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28802288/efficacy-and-safety-of-pectin-supplemented-enteral-nutrition-in-intensive-care-a-randomized-controlled-trial
#6
Fengchan Xi, Xingwei Xu, Shanjun Tan, Tao Gao, Jialiang Shi, Yanxi Kong, Wenkui Yu, Jieshou Li, Ning Li
BACKGROUND AND OBJECTIVES: Enteral nutrition (EN) can improve clinical outcomes as an important treatment in critically ill patients. However, when patients suffer from gastrointestinal function disorders, intestinal intolerance occurs and EN administration may be delayed and even fails to perform. Pectin, a structural heteropolysaccharide, could protect gastrointestinal function from disorders in many gastrointestianl diseases. The present study aimed to determine whether pectin-supplemented EN was safe and improved clinical outcomes in intensive care unit (ICU) patients...
2017: Asia Pacific Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/28794234/deep-immune-profiling-of-an-arginine-enriched-nutritional-intervention-in-patients-undergoing-surgery
#7
Nima Aghaeepour, Cindy Kin, Edward A Ganio, Kent P Jensen, Dyani K Gaudilliere, Martha Tingle, Amy Tsai, Hope L Lancero, Benjamin Choisy, Leslie S McNeil, Robin Okada, Andrew A Shelton, Garry P Nolan, Martin S Angst, Brice L Gaudilliere
Application of high-content immune profiling technologies has enormous potential to advance medicine. Whether these technologies reveal pertinent biology when implemented in interventional clinical trials is an important question. The beneficial effects of preoperative arginine-enriched dietary supplements (AES) are highly context specific, as they reduce infection rates in elective surgery, but possibly increase morbidity in critically ill patients. This study combined single-cell mass cytometry with the multiplex analysis of relevant plasma cytokines to comprehensively profile the immune-modifying effects of this much-debated intervention in patients undergoing surgery...
August 9, 2017: Journal of Immunology: Official Journal of the American Association of Immunologists
https://www.readbyqxmd.com/read/28779878/adult-classical-homocystinuria-requiring-parenteral-nutrition-pitfalls-and-management
#8
REVIEW
Christel Tran, Luisa Bonafé, Jean-Marc Nuoffer, Julie Rieger, Mette M Berger
BACKGROUND: Homocystinuria due to cystathionine beta synthase (CBS) deficiency presents with a wide clinical spectrum. Treatment by the enteral route aims at reducing homocysteine levels by using vitamin B6, possibly methionine-restricted diet, betaine and/or folate and vitamin B12 supplementation. Currently no nutritional guidelines exist regarding parenteral nutrition (PN) under acute conditions. METHODS: Exhaustive literature search was performed, in order to identify the relevant studies describing the pathogenesis and nutritional intervention of adult classical homocystinuria requiring PN...
July 25, 2017: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28771622/effectiveness-of-enteral-feeding-protocol-on-clinical-outcomes-in-critically-ill-patients-a-before-and-after-study
#9
Qian Li, Zhongheng Zhang, Bo Xie, Xiaowei Ji, Jiahong Lu, Ronglin Jiang, Shu Lei, Shihao Mao, Lijun Ying, Di Lu, Xiaoshui Si, Mingxia Ji, Jianxing He, Mengyan Chen, Wenjuan Zheng, Jiao Wang, Jing Huang, Junfeng Wang, Yaling Ji, Guodong Chen, Jianhua Zhu, Yadi Shao, Ronghai Lin, Chao Zhang, Weiwen Zhang, Jian Luo, Tianzheng Lou, Xuwei He, Kun Chen, Wei Peng, Renhua Sun
BACKGROUND AND OBJECTIVE: Enteral nutrition (EN) feeding protocol was proposed to have positive impact on critically ill patients. However, current studies showed conflicting results. The present study aimed to investigate whether enteral feeding protocol was able to improve clinical outcomes in critically ill patients. METHODS: A before (stage 1) and after (stage 2) interventional study was performed in 10 tertiary care hospitals. All patients expected to stay in the intensive care unit (ICU) for over three days were potentially eligible...
2017: PloS One
https://www.readbyqxmd.com/read/28768564/exploring-beliefs-about-dietary-supplement-use-focus-group-discussions-with-dutch-adults
#10
Emília Margit Pajor, Anke Oenema, Sander Matthijs Eggers, Hein de Vries
OBJECTIVE: Although dietary supplement use is increasing in Europe and the USA, little research involving adults' beliefs regarding dietary supplements has been conducted. Therefore, the present study aimed to explore and compare users' and non-users' beliefs towards dietary supplements. DESIGN: Thirteen focus group discussions were conducted of which seven groups were dietary supplement users and six groups were non-users. Based on the socio-cognitive factors of the Integrated Change Model, a semi-structured topic guide was set up...
August 3, 2017: Public Health Nutrition
https://www.readbyqxmd.com/read/28760108/retrospective-evaluation-of-glycemic-control-with-basal-bolus-or-neutral-protamine-hagedorn-insulin-regimens-in-patients-receiving-continuous-enteral-nutrition-therapy-in-medicine-wards
#11
Dema Hijaze, Auryan Szalat
Reasonable glycemic control is difficult to achieve in patients with diabetes mellitus (DM) receiving continuous enteral nutrition therapy (CENT). There are no solid evidence-based medicine guidelines regarding this issue in these patients. The purpose of this study was to determine if the use of a basal-bolus insulin regimen is more effective than neutral protamine Hagedorn (NPH) insulin alone in controlling blood glucose in non-critically ill patients with DM receiving CENT. We performed a retrospective, records-based review comparing basal-bolus with NPH insulin regimen in these patients, hospitalized in the internal medicine wards in our hospital...
August 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28754485/prevalence-and-incidence-of-pressure-injuries-in-pediatric-hospitals-in-the-city-of-s%C3%A3-o-paulo-sp-brazil
#12
Donata Maria de Souza Pellegrino, Julieta Maria Ferreira Chacon, Leila Blanes, Lydia Masako Ferreira
OBJECTIVE: To identify the incidence and prevalence of pressure injuries (PIs) in children admitted to hospitals in the city of São Paulo, and assess the association between sociodemographic and clinical characteristics with hospital-acquired pressure injuries (HAPIs). MATERIALS AND METHODS: A total of 543 children were evaluated, and their sociodemographic and clinical data were recorded. Student's t, Wilcoxon, chi-square, and Fisher's exact tests were used to assess associations between risk factors and the occurrence of HAPIs...
July 12, 2017: Journal of Tissue Viability
https://www.readbyqxmd.com/read/28742432/controversies-surrounding-critical-care-nutrition-an-appraisal-of-permissive-underfeeding-protein-and-outcomes
#13
Jayshil J Patel, Robert G Martindale, Stephen A McClave
Over the past few years, numerous studies have called into question the optimal dose, timing, composition, and advancement rate of nutrition during the early acute phase of critical illness. These studies suggest permissive underfeeding with slow advancement may be more beneficial than aggressive full feeding. These counterintuitive results were possibly explained by enhanced autophagy, less hyperglycemia, or prevention of refeeding syndrome. This review underscores the controversies surrounding permissive underfeeding, aims to answer whether permissive underfeeding is appropriate for all critically ill patients, describes the impact of optimal protein delivery on critical care outcomes, discusses nutrition risk, and cogitates on the impact of nutrition on critical care outcomes...
July 1, 2017: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28737574/is-there-a-role-for-enterohormones-in-the-gastroparesis-of-critically-ill-patients
#14
Carlos A Santacruz, Amanda Quintairos, Claudia Righy, Ilaria A Crippa, Lucio Couto, Virginie Imbault, Mongkolpun Wasineeart, Mathieu De Ryckere, Jean-Charles Preiser
OBJECTIVES: Delayed gastric emptying occurs in critically ill patients and impairs the delivery, digestion, and absorption of enteral feeding. A pathophysiologic role of the enterohormones peptide YY and ghrelin is supported by preclinical data. To compare the circulating plasma levels of peptide YY and ghrelin in control subjects and in critically ill patients, during feeding and fasting, and to search for a correlation with gastric emptying. DESIGN: A prospective observational trial...
July 21, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28727945/micronutrient-alterations-during-continuous-renal-replacement-therapy-in-critically-ill-adults-a-retrospective-study
#15
Amir Y Kamel, Nisha J Dave, Vivian M Zhao, Daniel P Griffith, Michael J Connor, Thomas R Ziegler
BACKGROUND: Continuous renal replacement therapy (CRRT) is commonly used to provide renal replacement therapy in the intensive care unit. Limited published data suggest that CRRT may lead to depletion of water-soluble vitamins and trace elements. The goal of this study was to identify the incidence of trace element and vitamin deficiencies in critically ill patients during CRRT. MATERIALS AND METHODS: This study is based on a retrospective chart review of patients who were referred to Emory University Hospital's nutrition support services and had at least 1 serum micronutrient level measured during CRRT (thiamin, pyridoxine, ascorbic acid, folate, zinc, and copper) between April 1, 2009, and June 1, 2012...
July 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28724042/hyperglycemia-in-critical-patients-determinants-of-insulin-dose-choice
#16
Aline Klitzke Paliosa, Cassiano Teixeira, Regis Goulart Rosa, Carine Raquel Blatt
Objective: To identify factors that can determine the choice of intermittent subcutaneous regular insulin dose in critically ill patients with hyperglycemia. Method: Cross-sectional study in a general adult ICU with 26 beds, data collected between September and October 2014. The variables analyzed were: sex, age, previous diagnosis of diabetes mellitus, use of corticosteroids, use of lactulose, sepsis, fasting, enteral nutrition, use of dextrose 5% in water, NPH insulin prescription and blood glucose level...
May 2017: Revista da Associação Médica Brasileira
https://www.readbyqxmd.com/read/28720241/the-physician-nurse-collaboration-in-feeding-critically-ill-patients-a-multicenter-survey
#17
Binbin Mei, Wenting Wang, Meifen Shen, Feifei Cui, Zunjia Wen, Jianping Ding
AIMS: Describe physician-nurse collaboration in feeding critically ill patients and explore the influence factors related to this collaboration, which can provide information for clinical practice and future studies. BACKGROUND: Appropriate nutrition support is essential and significant for critically ill patients, and the importance of physician-nurse collaboration in other fields has been confirmed, yet there are limited studies put insights into the status of physician-nurse collaboration in feeding critically ill patients...
August 2017: Applied Nursing Research: ANR
https://www.readbyqxmd.com/read/28710148/energy-protein-carbohydrate-and-lipid-intakes-and-their-effects-on-morbidity-and-mortality-in-critically-ill-adult-patients-a-systematic-review
#18
REVIEW
Anna Patkova, Vera Joskova, Eduard Havel, Miroslav Kovarik, Monika Kucharova, Zdenek Zadak, Miloslav Hronek
The guidelines for nutritional support in critically ill adult patients differ in various aspects. The optimal amount of energy and nutritional substrates supplied is important for reducing morbidity and mortality, but unfortunately this is not well known, because the topic is complex and every patient is individual. The aim of this review was to gather recent pertinent information concerning the nutritional support of critically ill patients in the intensive care unit (ICU) with respect to the energy, protein, carbohydrate, and lipid intakes and the effect of their specific utilization on morbidity and mortality...
July 2017: Advances in Nutrition
https://www.readbyqxmd.com/read/28701844/effect-of-calories-delivered-on-clinical-outcomes-in-critically-ill-patients-systemic-review-and-meta-analysis
#19
Legese Chelkeba, Mojtaba Mojtahedzadeh, Zeleke Mekonnen
INTRODUCTION: International guidelines are promoting early enteral nutrition (EN) as a means of feeding critically ill adult patients to improve clinical outcomes. The question of how much calorie intake is enough to improve the outcomes still remained inconclusive. Therefore, we carried out a meta-analysis to evaluate the effect of low calorie (LC) versus high calorie (HC) delivery on critically ill patients' outcomes. METHODS: We included randomized clinical trials (RCTs) that compared LC EN with or without supplemental parenteral nutrition with HC delivery in this meta-analysis irrespective of the site of nutritional delivery in the gastrointestinal tract...
June 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28699602/importance-of-target-calorie-intake-in-hospitalized-patients
#20
Ferda Akbay Harmandar, Ismail Gömceli, Başak Oğuz Yolcular, Ayhan Hilmi Çekin
BACKGROUND/AIMS: To evaluate the feasibility and clinical outcome of a nutritional algorithm based on target calorie intake commenced as enteral nutrition (EN) alone or in combination with supplemental parenteral nutrition (SPN) among hospitalized patients. MATERIALS AND METHODS: In total, 301 hospitalized patients who were provided with nutritional support, including EN (n=125) or EN+SPN (n=176), due to various medical conditions during their hospitalization were included in this study conducted at Antalya Training and Research Hospital...
July 2017: Turkish Journal of Gastroenterology: the Official Journal of Turkish Society of Gastroenterology
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