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Nutritional critical ill

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https://www.readbyqxmd.com/read/29456363/inadvertent-central-arterial-catheterization-an-unusual-cause-of-ischemic-stroke
#1
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
https://www.readbyqxmd.com/read/29447346/penalized-estimation-of-complex-non-linear-exposure-lag-response-associations
#2
Andreas Bender, Fabian Scheipl, Wolfgang Hartl, Andrew G Day, Helmut Küchenhoff
We propose a novel approach for the flexible modeling of complex exposure-lag-response associations in time-to-event data, where multiple past exposures within a defined time window are cumulatively associated with the hazard. Our method allows for the estimation of a wide variety of effects, including potentially smooth and smoothly time-varying effects as well as cumulative effects with leads and lags, taking advantage of the inference methods that have recently been developed for generalized additive mixed models...
February 12, 2018: Biostatistics
https://www.readbyqxmd.com/read/29440285/nutrient-intake-in-the-first-two-weeks-of-life-and-brain-growth-in-preterm-neonates
#3
Juliane Schneider, Céline J Fischer Fumeaux, Emma G Duerden, Ting Guo, Justin Foong, Myriam Bickle Graz, Patric Hagmann, M Mallar Chakravarty, Petra S Hüppi, Lydie Beauport, Anita C Truttmann, Steven P Miller
BACKGROUND: Optimizing early nutritional intake in preterm neonates may promote brain health and neurodevelopment through enhanced brain maturation. Our objectives were (1) to determine the association of energy and macronutrient intake in the first 2 weeks of life with regional and total brain growth and white matter (WM) maturation, assessed by 3 serial MRI scans in preterm neonates; (2) to examine how critical illness modifies this association; and (3) to investigate the relationship with neurodevelopmental outcomes...
February 13, 2018: Pediatrics
https://www.readbyqxmd.com/read/29432297/should-fecal-microbial-transplantation-be-used-in-the-icu
#4
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...
February 9, 2018: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/29430446/models-of-disuse-muscle-atrophy-therapeutic-implications-in-critically-ill-patients
#5
REVIEW
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
https://www.readbyqxmd.com/read/29427748/the-non-thyroidal-illness-syndrome-is-associated-with-postoperative-surgical-site-infections-in-enterocutaneous-fistulae
#6
Huajian Ren, Jianan Ren, Gefei Wang, Zhiwu Hong, Guosheng Gu, Jun Chen, Xiuwen Wu, Qiongyuan Hu, Guanwei Li
BACKGROUND: Non-thyroidal illness syndrome (NTIS) is common in critically ill patients and associated with adverse outcomes. Many enterocutaneous fistula (ECF) patients still suffer NTIS prior to definitive surgery. This study was designed to explore the association between preoperative NTIS and postoperative outcomes in ECF patients. METHODS: A total of 264 ECF patients who underwent definitive surgery from April 2014 to November 2016 were studied. Thyroid hormones were tested for each patient before surgery, and the patients were divided into two groups (NTIS group and euthyroid group) according to the presence of NTIS...
February 7, 2018: International Journal of Surgery
https://www.readbyqxmd.com/read/29419661/hyperglycemia-is-associated-with-cardiac-complications-in-elderly-nondiabetic-patients-receiving-total-parenteral-nutrition
#7
Jinling Ma, Meng Gao, Rong Pan, Lei He, Lei Zhao, Jie Liu, Hongbin Liu
Adverse outcomes have been associated with hyperglycemia in patients receiving total parenteral nutrition (TPN). The relationship may be characteristic in elderly patients. However, limited data are available about the relationship between TPN-related hyperglycemia and cardiac adverse outcome in elderly patients without previously known diabetes. This study aims to identify whether there is an association between hyperglycemia and 45-day cardiac adverse outcomes in critically and noncritically ill elderly nondiabetic patients receiving TPN...
February 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29416148/assessment-of-malnutrition-and-enteral-feeding-practices-in-the-critically-ill-a-single-centre-observational-study
#8
Prashant P Verghese, Ashu Sara Mathai, Valsamma Abraham, Paramdeep Kaur
Background and Aims: Early identification of malnutrition among hospitalised patients is essential to institute appropriate patient-specific nutritional strategies. This study was conducted to evaluate the nutritional status of medical patients at admission to the adult intensive care unit (ICU) and to identify factors which prevent attainment of daily feeding goals in them. Methods: This was a 1 year prospective, observational study on 200 medical adult ICU patients...
January 2018: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/29415733/semi-automated-ultrasound-guidance-applied-to-nasogastrojejunal-tube-replacement-for-enteral-nutrition-in-critically-ill-adults
#9
Ying Li, Yu Ye, Yang Mei, Haiying Ruan, Yuan Yu
BACKGROUND AND OBJECTIVE: At present, the enteral nutrition approaches via nose and duodenum (or nose and jejunum) are the preferred method of nutritional support in the medical engineering field, given the superiority of in line with physiological processes and no serious complication. In this study, the authors adopted saline as the acoustic window, and gave enteral nutrition support to critically ill patients, via the nasogastrojejunal approach guided by semi-automated ultrasound. These above patients benefited a lot from this kind of nutrition support treatment, and we aimed to report the detailed information...
February 7, 2018: Biomedical Engineering Online
https://www.readbyqxmd.com/read/29413208/nutrition-options-in-critical-care-unit-patients
#10
REVIEW
Teresa D Welch
Critically ill patients have increased metabolic requirements and must rely on the administration of nutritional therapy to meet those demands. Yet, according to research almost half of all hospitalized patients are not fed, are underfed, or are malnourished while in the hospital. This article demonstrates the importance of early feedings in critical care unit, and the available options open to nurses supporting initiation and management of early feedings. Enteral nutrition has proven to be an important therapeutic strategy for improving the outcomes of critically ill patients and the critical care nurse plays an integral role in their success...
March 2018: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/29413014/the-need-to-reassess-dietary-fiber-requirements-in-healthy-and-critically-ill-patients
#11
REVIEW
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
https://www.readbyqxmd.com/read/29409542/to-eat-or-to-breathe-the-answer-is-both-nutritional-management-during-noninvasive-ventilation
#12
EDITORIAL
Pierre Singer, Sornwichate Rattanachaiwong
Treating respiratory distress is a priority when managing critically ill patients. Non-invasive ventilation (NIV) is increasingly used as a tool to prevent endotracheal intubation. Providing oral or enteral nutritional support during NIV may be perceived as unsafe because of the possible risk of aspiration so that these patients are frequently denied adequate caloric and protein intake. Newly available therapies, such as high-flow nasal oxygen (HFNO) may allow for more appropriate oral feeding.
February 6, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29408912/effect-of-maternal-height-on-caesarean-section-and-neonatal-mortality-rates-in-sub-saharan-africa-an-analysis-of-34-national-datasets
#13
Esther Arendt, Neha S Singh, Oona M R Campbell
RATIONALE: The lifecycle perspective reminds us that the roots of adult ill-health may start in-utero or in early childhood. Nutritional and infectious disease insults in early life, the critical first 1000 days, are associated with stunting in childhood, and subsequent short adult stature. There is limited or no opportunity for stunted children above 2 years of age to experience catch-up growth. Some previous research has shown short maternal height to lead to adverse birth outcomes...
2018: PloS One
https://www.readbyqxmd.com/read/29402368/-efficacy-and-safety-of-simulated-artificial-pancreas-in-modulating-stress-hyperglycemia-in-critically-ill-patients-a-prospective-randomized-controlled-study
#14
Zhongliang Yang, Guoqiang Tao, Meifeng Guo, Baoling Sun, Liang Gong, Yong Ding, Shuming Ye, Weidong Liu, Xiuyun Yang
OBJECTIVE: To explore efficacy and safety of simulated artificial pancreas in modulating stress hyperglycemia in critically ill patients. METHODS: A prospective randomized controlled study was performed. Seventy-two critically ill patients with stress hyperglycemia, aged 18-85 years, acute physiology and chronic health evaluation II (APACHE II) score over 15, two consecutive random blood glucose 11.1 mmol/L or higher, glycated hemoglobin (HbA1C) below 0.065, unable to eat food for 3 days after inclusion, or only accepting parenteral nutrition, admitted to intensive care unit (ICU) in Shanghai Punan Hospital of Pudong New District from January 1st, 2015 to June 30th, 2017 were enrolled...
February 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29401174/autophagy-should-it-play-a-role-in-icu-management
#15
Martin D Rosenthal, Phil Carrott, Frederick A Moore
: The purpose of 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. This 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...
February 3, 2018: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/29391121/safety-and-efficacy-of-electromagnetic-guided-bedside-placement-of-nasoenteral-feeding-tubes-versus-standard-placement
#16
Husam Shadid, Maureen Keckeisen, Ali Zarrinpar
Although enteral feeding in critically ill patients has been shown to be beneficial, reliable postpyloric placement of feeding tubes remains a challenge. The standard of care involves blind placement, frequently requiring multiple attempts, and radiographs. To evaluate the effect of electromagnetic-guided bedside placement in reducing time to establishment of feeding, lung placement, use of radiography, and cost, we initiated a prospective trial using electromagnetic-guided bedside placement and compared them to a retrospective cohort...
October 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/29389741/defining-anabolic-resistance-implications-for-delivery-of-clinical-care-nutrition
#17
Robert W Morton, Daniel A Traylor, Peter J M Weijs, Stuart M Phillips
PURPOSE OF REVIEW: Skeletal muscle mass with aging, during critical care, and following critical care is a determinant of quality of life and survival. In this review, we discuss the mechanisms that underpin skeletal muscle atrophy and recommendations to offset skeletal muscle atrophy with aging and during, as well as following, critical care. RECENT FINDINGS: Anabolic resistance is responsible, in part, for skeletal muscle atrophy with aging, muscle disuse, and during disease states...
January 31, 2018: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/29384315/the-efficacy-of-parenteral-fish-oil-in-critical-illness-patients-with-sepsis-a-prospective-non-randomized-observational-study
#18
Wen-Si Li, Zhang-Zhang Chen, Yi-Jun Zheng, Ming Zhong, Jie-Fei Ma, Li-Zhen Xuan, Jie-Qiong Song, Qian-Zhou Lv, Du-Ming Zhu
BACKGROUND AND OBJECTIVES: To investigate the clinical outcomes in septic patients receiving parenteral fish oil. METHODS AND STUDY DESIGN: A prospective, non-randomized, observational clinical study was carried out in 112 patients with sepsis from March, 2013 to May, 2015 in the surgical intensive care unit (SICU) of a tertiaryreferral hospital. The patients were put into one of two groups; either the control or the study group. Patients received the standard treatment of sepsis based on guidelines in the control group...
2018: Asia Pacific Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/29377333/permissive-or-trophic-enteral-nutrition-and-full-enteral-nutrition-had-similar-effects-on-clinical-outcomes-in-intensive-care-a-systematic-review-of-randomized-clinical-trials
#19
REVIEW
Camila F A Silva, Simone G de Vasconcelos, Thales A da Silva, Flávia M Silva
The aim of this study was to systematically review the effect of permissive underfeeding/trophic feeding on the clinical outcomes of critically ill patients. A systematic review of randomized clinical trials to evaluate the mortality, length of stay, and mechanical ventilation duration in patients randomized to either hypocaloric or full-energy enteral nutrition was performed. Data sources included PubMed and Scopus and the reference lists of the articles retrieved. Two independent reviewers participated in all phases of this systematic review as proposed by the Cochrane Handbook, and the review was reported according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines...
January 26, 2018: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/29374489/stress-ulcer-prophylaxis-in-intensive-care-unit-patients-receiving-enteral-nutrition-a-systematic-review-and-meta-analysis
#20
Hui-Bin Huang, Wei Jiang, Chun-Yao Wang, Han-Yu Qin, Bin Du
BACKGROUND: Pharmacologic stress ulcer prophylaxis (SUP) is recommended in critically ill patients with high risk of stress-related gastrointestinal (GI) bleeding. However, as to patients receiving enteral feeding, the preventive effect of SUP is not well-known. Therefore, we performed a meta-analysis of randomized controlled trials (RCTs) to evaluate the effect of pharmacologic SUP in enterally fed patients on stress-related GI bleeding and other clinical outcomes. METHODS: We searched PubMed, Embase, and the Cochrane database from inception through 30 Sep 2017...
January 28, 2018: Critical Care: the Official Journal of the Critical Care Forum
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