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Parenteral nutrition for critically ill patients

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https://www.readbyqxmd.com/read/28179737/updates-in-nutrition-support-for-critically-ill-adult-patients
#1
Diana Wells Mulherin, Sarah V Cogle
Specialized nutrition support is often employed in critically ill patients who are unable to maintain volitional intake. The Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.) recently updated guidelines for the provision of nutrition support in critically ill patients. The purpose of this review is to summarize key changes from the previous guidelines as they relate to recently published literature, which will aid the hospital pharmacist in optimizing nutrition support therapies in the critical care setting...
January 2017: Hospital Pharmacy
https://www.readbyqxmd.com/read/28169021/supplemental-parenteral-nutrition-in-intensive-care-patients-a-cost-saving-strategy
#2
Lorenzo Pradelli, Séverine Graf, Claude Pichard, Mette M Berger
BACKGROUND & AIMS: The Swiss supplemental parenteral nutrition (SPN) study demonstrated that optimised energy provision combining enteral nutrition (EN) and SPN reduces nosocomial infections in critically ill adults who fail to achieve targeted energy delivery with EN alone. To assess the economic impact of this strategy, we performed a cost-effectiveness analysis using data from the SPN study. METHODS: Multivariable regression analyses were performed to characterise the relationships between SPN, cumulative energy deficit, nosocomial infection, and resource consumption...
January 25, 2017: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28168570/early-enteral-nutrition-in-critically-ill-patients-esicm-clinical-practice-guidelines
#3
REVIEW
Annika Reintam Blaser, Joel Starkopf, Waleed Alhazzani, Mette M Berger, Michael P Casaer, Adam M Deane, Sonja Fruhwald, Michael Hiesmayr, Carole Ichai, Stephan M Jakob, Cecilia I Loudet, Manu L N G Malbrain, Juan C Montejo González, Catherine Paugam-Burtz, Martijn Poeze, Jean-Charles Preiser, Pierre Singer, Arthur R H van Zanten, Jan De Waele, Julia Wendon, Jan Wernerman, Tony Whitehouse, Alexander Wilmer, Heleen M Oudemans-van Straaten
PURPOSE: To provide evidence-based guidelines for early enteral nutrition (EEN) during critical illness. METHODS: We aimed to compare EEN vs. early parenteral nutrition (PN) and vs. delayed EN. We defined "early" EN as EN started within 48 h independent of type or amount. We listed, a priori, conditions in which EN is often delayed, and performed systematic reviews in 24 such subtopics. If sufficient evidence was available, we performed meta-analyses; if not, we qualitatively summarized the evidence and based our recommendations on expert opinion...
February 6, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28151828/nutrition-in-the-critically-ill-patient
#4
Kristine W A C Koekkoek, Arthur R H van Zanten
PURPOSE OF REVIEW: To summarize recent relevant studies regarding nutrition during critical illness and provide recommendations for clinical practice. RECENT FINDINGS: Recently acquired knowledge regarding nutritional status and risk assessment, body composition, gastric residual volume, prokinetics, tube positioning, enteral vs parenteral nutrition, nutritional dose and timing of initiation, pharmaconutrition, dysbiosis and probiotics are discussed. SUMMARY: Body composition especially lean body mass is associated with clinical outcomes...
February 1, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28129265/parenteral-and-enteral-nutrition-in-surgical-critical-care-plasma-metabolomics-demonstrates-divergent-effects-on-nitrogen-fatty-acid-ribonucleotide-and-oxidative-metabolism
#5
Brodie A Parent, Max Seaton, Danijel Djukovic, Haiwei Gu, Brittany Wheelock, Daniel Raftery, Grant E O'Keefe
BACKGROUND: Artificial nutrition support is central to the care of critically ill patients and is primarily provided enterally (EN). There are circumstances when parenteral nutrition (PN) is considered necessary. We are uncertain how each of these approaches confer clinical benefits beyond simply providing calories. We sought to better understand how each of these techniques influence metabolism in critically-ill patients using a broad-based metabolomics approach. Metabolic responses to EN and PN may differ in ways that could help us understand how to optimize use of these therapies...
January 26, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28102514/carbapenemase-producing-klebsiella-pneumoniae-bloodstream-infection-in-critically-ill-patients-risk-factors-and-predictors-of-mortality
#6
M Papadimitriou-Olivgeris, F Fligou, C Bartzavali, A Zotou, A Spyropoulou, K Koutsileou, S Vamvakopoulou, N Sioulas, V Karamouzos, E D Anastassiou, I Spiliopoulou, M Christofidou, M Marangos
A significant increase in carbapenemase-producing Klebsiella pneumoniae (CP-Kp) bacteraemias has been observed worldwide. The objective of the present work was to study the risk factors and predictors of mortality of CP-Kp bacteraemias among critically ill patients. During a 4-year period (2012-3015), a matched 1:2 case-control study was conducted. Klebsiella pneumoniae was identified by Vitek 2 technology. Antibiotic susceptibility was performed by the agar disc diffusion method and Etest. The presence of the bla KPC, bla VIM and bla NDM genes was confirmed by polymerase chain reaction (PCR)...
January 19, 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/28049258/the-impact-of-implementation-of-an-enteral-feeding-protocol-on-the-improvement-of-enteral-nutrition-in-critically-ill-adults
#7
Seoung-Hyun Kim, Chi-Min Park, Jeong-Meen Seo, Mingew Choi, Dae-Sang Lee, Dong Kyung Chang, Miyong Rha, Soyoung Yu, Seonhye Lee, Eunmee Kim, Young Yun Cho
BACKGROUND AND OBJECTIVES: The optimal delivery of enteral nutrition (EN) may improve clinical outcomes in critically ill patients; thus, optimal EN protocols should be developed. The purpose of this study was to evaluate the impact of implementing an EN protocol on the improvement of EN practices and on the clinical outcomes of critically ill patients. METHODS AND STUDY DESIGN: This was a retrospective study with prospectively collected data. Multidisciplinary working group developed an evidence-based EN protocol based on an extensive review of literature and existing guidelines...
January 2017: Asia Pacific Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/28004327/nutritional-and-bioenergetic-considerations-in-critically-ill-patients-with-acute-neurological-injury
#8
Peter A Abdelmalik, Susan Dempsey, Wendy Ziai
The brain, due to intensive cellular processes and maintenance of electrochemical gradients, is heavily dependent on a constant supply of energy. Brain injury, and critical illness in general, induces a state of increased metabolism and catabolism, which has been proven to lead to poor outcomes. Of all the biochemical interventions undertaken in the ICU, providing nutritional support is perhaps one of the most undervalued, but potentially among the safest, and most effective interventions. Adequate provisions of calories and protein have been shown to improve patient outcomes, and guidelines for the nutritional support of the critically ill patient are reviewed...
December 21, 2016: Neurocritical Care
https://www.readbyqxmd.com/read/27966301/colistin-efficacy-in-the-treatment-of-multidrug-resistant-and-extremelydrug-resistant-gram-negative-bacterial-infections
#9
Çiğdem Banu Çetin, Deniz Özer Türk, Şebnem Şenol, Gönül Dinç Horasan, Özlem Tünger
BACKGROUND/AIM: Colistin is used as a salvage therapy for multidrug-resistant and extremely drug-resistant gram-negative bacterial infections. Our aim was to evaluate colistin efficiency and toxicity in the treatment of these resistant gram-negative bacterial infections. MATERIALS AND METHODS: This is a retrospective study carried out in a tertiary care hospital during 2011-2013. Study data were collected from the medical records and consultations of the infectious diseases clinic...
November 17, 2016: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/27934650/parenteral-or-enteral-arginine-supplementation-safety-and-efficacy
#10
REVIEW
Martin D Rosenthal, Phillip W Carrott, Jayshil Patel, Laszlo Kiraly, Robert G Martindale
Arginine supplementation has the potential to improve the health of patients. Its use in hospitalized patients has been a controversial topic in the nutrition literature, especially concerning supplementation of septic patients. In this article, we review the relevant literature both for and against the use of arginine in critically ill, surgical, and hospitalized patients. The effect of critical illness on arginine metabolism is reviewed, as is its use in septic and critically ill patients. Although mounting evidence supports immunonutrition, there are only a few studies that suggest that this is safe in patients with severe sepsis...
December 2016: Journal of Nutrition
https://www.readbyqxmd.com/read/27834985/clinical-outcome-of-critically-ill-patients-with-thrombocytopenia-and-hypophosphatemia-in-the-early-stage-of-sepsis
#11
Evgeni Brotfain, Andrei Schwartz, Avi Boniel, Leonid Koyfman, Matthew Boyko, Ruslan Kutz, Moti Klein
BACKGROUND: Hypophosphatemia and thrombocytopenia may both be independent risk factors for the development of multiple organ failure and correlate well with the severity of sepsis. In the present study we wanted to analyze the potential clinical role and prognostic significance of both early hypophosphatemia and thrombocytopenia on clinical outcomes of critically ill ICU patients with severe sepsis. METHODS: We analyzed the clinical data, including the outcome of critically ill ICU patients with severe sepsis who presented during a 5 year period with early hypophosphatemia and thrombocytopenia...
2016: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/27833924/vitamin-d-deficiency-in-critically-ill-patients-with-traumatic-injuries
#12
Roland N Dickerson, Jonathan R Van Cleve, Joseph M Swanson, George O Maish, Gayle Minard, Martin A Croce, Rex O Brown
BACKGROUND: Vitamin D depletion has been associated with increased rate of infections, lengthened hospital stay, and worsened mortality for critically ill patients. The purpose of this study was to evaluate the prevalence and variables associated with vitamin D deficiency in critically ill patients with severe traumatic injuries. METHODS: Critically ill adult patients admitted to the trauma intensive care unit (ICU) between June 2013 and June 2014, referred to the nutrition support service for enteral or parenteral nutrition, and had a serum 25-hydroxyvitamin D (25-OH vitamin D) concentration determination were retrospectively evaluated...
2016: Burns and trauma
https://www.readbyqxmd.com/read/27805537/-when-enteral-nutrition-is-not-possible-in-intensive-care-patients-whether-to-wait-or-use-parenteral-nutrition
#13
Q L M Habes, P Pickkers
- Overfeeding of critically ill patients is associated with a higher incidence of infections and an increased length of ventilation. However, trophic nutrition or permissive underfeeding appears to have no negative effect on the patient and may even provide a survival benefit.- Initiation of enteral nutrition within 24-48 hours after Intensive Care Unit (ICU) admission may reduce the number of complications and increase the chance of survival.- Total parenteral nutrition is associated with a higher risk of infections than enteral nutrition...
2016: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/27759967/quality-indicators-for-enteral-and-parenteral-nutrition-therapy-application-in-critically-ill-patients-at-nutritional-risk
#14
Ronaldo Sousa Oliveira Filho, Lia Mara Kauchi Ribeiro, Lucia Caruso, Patricia Azevedo Lima, Náglia Raquel Teixeira Damasceno, Francisco García Soriano
INTRODUCTION: Quality Indicators for Nutritional Therapy (QINT) allow a practical assessment of nutritional therapy (NT) quality. OBJECTIVE: To apply and monitor QINT for critically ill patients at nutritional risk. METHODS: Cross sectional study including critically ill patients > 18 years old, at nutritional risk, on exclusive enteral (ENT) or parenteral nutritional therapy (PNT) for > 72 hours. After three consecutive years, 9 QINT were applied and monitored...
September 20, 2016: Nutrición Hospitalaria: Organo Oficial de la Sociedad Española de Nutrición Parenteral y Enteral
https://www.readbyqxmd.com/read/27746430/maintaining-enteral-nutrition-in-the-severely-ill-using-a-newly-developed-nasojejunal-feeding-tube-with-gastric-decompression-function
#15
Ezekiel Toh Yoon, Kazuki Nishihara, Hirohiko Murata
For nutritional support of critically ill patients, the enteral route is preferred over the parenteral route. Although nasojejunal feeding can be superior to gastric feeding when gastrointestinal symptoms occur, it does not necessarily solve the problem of large gastric residual volumes. We report the successful use of a newly developed nasojejunal feeding tube with gastric decompression function in an 84-year-old man with severe pneumonia. After gastric feeding was considered not well tolerated, the use of this tube improved the delivery of nutrition until the patient was stable enough to undergo percutaneous endoscopic gastrostomy...
2016: Internal Medicine
https://www.readbyqxmd.com/read/27742594/physicochemical-stability-and-compatibility-testing-of-levetiracetam-in-all-in-one-parenteral-nutrition-admixtures-in-daily-practice
#16
C Aeberhard, C Steuer, C Saxer, A Huber, Z Stanga, S Mühlebach
BACKGROUND: Parenteral antiepileptic drugs are frequently used in critically ill patients for seizure control therapy or prevention. Many of these patients require additional parenteral nutrition (PN). Therefore, a parallel infusion of the frequently used antiepileptic drug levetiracetam (LEV) is interesting in terms of the restricted i.v. lines (e.g., neonates). The potential interactions of the complex PN admixture with the drug product and the appropriate admixing of a drug at effective dosages require physicochemical lab assessments to obtain specific and reliable pharmaceutical documentation for the intended admixing...
January 1, 2017: European Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/27732742/calcium-administration-is-associated-with-adverse-outcomes-in-critically-ill-patients-receiving-parenteral-nutrition-results-from-a-natural-experiment-created-by-a-calcium-gluconate-shortage
#17
Bryan Dotson, Patrick Larabell, Jasmine U Patel, Kristoffer Wong, Lina Qasem, William Arthur, Chaim Leiberman, Peter Whittaker, Steven D Tennenberg
STUDY OBJECTIVE: Parenteral calcium is frequently administered to critically ill patients. However, animal studies demonstrate that calcium administration during critical illness heightens inflammation and leads to shock, organ dysfunction, and mortality. We sought to evaluate the association between calcium administration and adverse outcomes in critically ill patients receiving parenteral nutrition (PN). DESIGN: Retrospective cohort examined before and during a calcium gluconate shortage...
October 12, 2016: Pharmacotherapy
https://www.readbyqxmd.com/read/27702711/optimal-nutrition-therapy-in-paediatric-critical-care-in-the-asia-pacific-and-middle-east-a-consensus
#18
REVIEW
Jan Hau Lee, Elizabeth Rogers, Yek Kee Chor, Rujipat Samransamruajkit, Pei Lin Koh, Mohamad Miqdady, Ali Ibrahim Al-Mehaidib, Antonius Pudjiadi, Sunit Singhi, Nilesh M Mehta
BACKGROUND AND OBJECTIVES: Current practices and available resources for nutrition therapy in paediatric intensive care units (PICUs) in the Asia Pacific-Middle East region are expected to differ from western countries. Existing guidelines for nutrition management in critically ill children may not be directly applicable in this region. This paper outlines consensus statements developed by the Asia Pacific-Middle East Consensus Working Group on Nutrition Therapy in the Paediatric Critical Care Environment...
December 2016: Asia Pacific Journal of Clinical Nutrition
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
#19
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/27633585/corrigendum
#20
(no author information available yet)
McClave SA, Taylor BE, Martindale RG, et al. Guidelines for the provision and assessment of nutrition support therapy in the adult critically ill patient: Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.). J Parenter Enteral Nutr. 2016;40(2):159-211. (Original DOI: 10.1177/0148607115621863).
November 2016: JPEN. Journal of Parenteral and Enteral Nutrition
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