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https://www.readbyqxmd.com/read/29356030/protein-in-the-hospital-gaining-perspective-and-moving-forward
#1
Adam J Kuchnia, Levi Teigen, Emily Nagel, Gerdien Ligthart-Melis, Urvashi Mulasi, Peter Weijs, Carrie P Earthman
Provision of adequate protein is crucial for optimizing outcomes in hospitalized patients. However, the methodologies upon which current recommendations are based have limitations, and little is known about true requirements in any clinical population. In this tutorial, we aim to give clinicians an understanding of how current protein recommendations were developed, an appreciation for the limitations of these recommendations, and an overview of more sophisticated approaches that can be applied to better define protein requirements...
January 22, 2018: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/29353120/phase-angle-assessment-in-critically-ill-cancer-patients-relationship-with-the-nutritional-status-prognostic-factors-and-death
#2
Tatiana Cathoud do Amaral Paes, Kátia Cansanção Correa de Oliveira, Patrícia de Carvalho Padilha, Wilza Arantes Ferreira Peres
PURPOSE: To evaluate the relationship between phase angle (PA) and nutritional status and the prognostic significance of PA in critically ill cancer patients. METHODS: 31 patients that had been admitted to the intensive care unit (ICU) of a center on oncology were evaluated. Their PA was obtained from their bioelectrical impedance within 48 h of the ICU admission. The logistic regression analysis of Cox was used in order to identify the independent predictors of the outcomes...
January 10, 2018: Journal of Critical Care
https://www.readbyqxmd.com/read/29351778/a-qualitative-analysis-of-men-s-involvement-in-maternal-and-child-health-as-a-policy-intervention-in-rural-central-malawi
#3
Elizabeth Mkandawire, Sheryl L Hendriks
BACKGROUND: Men's involvement in maternal and child health presents an opportunity for the advancement of maternal and child nutrition as men often play a key role in decision-making particularly regarding women's reproductive health. While most research on men's involvement in maternal and child health has focused on men's participation in antenatal care, this study focuses specifically on men's involvement in maternal and child nutrition. The purpose of the study is to explore how men's involvement is conceptualised in rural Central Malawi, highlighting the key factors influencing men's involvement in maternal and child health...
January 19, 2018: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29351143/nutrition-in-the-icu-new-trends-versus-old-fashioned-standard-enteral-feeding
#4
Kristine W A C Koekkoek, Arthur R H van Zanten
PURPOSE OF REVIEW: The narrative review aims to summarize the relevant studies from the last 2 years and provide contextual information to understand findings. RECENT FINDINGS: Recent ICU studies have provided insight in the pathophysiology and time course of catabolism, anabolic resistance, and metabolic and endocrine derangements interacting with the provision of calories and proteins.Early provision of high protein intake and caloric overfeeding may confer harm...
January 18, 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29348280/marked-cachexia-in-probable-invasive-pulmonary-aspergillosis-with-bronchopleural-fistula
#5
Christiana Page, Laura Blazy, Melanie Jenkins, Rosalba Spiritoso
A 49-year-old man with a medical history of diabetes and heavy smoking was admitted to intensive care with severe bilateral pneumonia associated with marked cachexia. He developed a complex right-sided bronchopleural fistula and was transferred to our tertiary centre for consideration of surgical intervention.Despite escalation of antibiotic therapy, he did not improve and further investigations led to a diagnosis of invasive pulmonary aspergillosis. Definitive treatment plans required a right pneumonectomy; however, given the severity of cachexia, he remained unable to undergo such a large operation...
January 17, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29341970/does-the-use-of-indirect-calorimetry-change-outcome-in-the-icu-yes-it-does
#6
Elisabeth De Waele, Patrick M Honoré, Manu L N G Malbrain
PURPOSE OF REVIEW: To review the recent findings on metabolic monitoring and possible beneficial effects of an adequate nutrition therapy, based on indirect calorimetry as the golden standard to predict energy expenditure. RECENT FINDINGS: in the last decades, major steps are taken in the field of metabolism and nutrition, evolving from nutrition as a baseline support to a therapeutic intervention. The aspect of energy expenditure is of cardinal importance, and technical possibilities have impressively improved: from the first 'calorimetre' in 1789 to the new generation, clinical applicable indirect calorimeters and the high accuracy and easy use model reaching high technology readiness level [Oshima et al...
January 15, 2018: Current Opinion in Clinical Nutrition and Metabolic Care
https://www.readbyqxmd.com/read/29335014/cost-effectiveness-study-of-early-versus-late-parenteral-nutrition-in-critically-ill-children-pepanic-preplanned-secondary-analysis-of-a-multicentre-randomised-controlled-trial
#7
Esther van Puffelen, Suzanne Polinder, Ilse Vanhorebeek, Pieter Jozef Wouters, Niek Bossche, Guido Peers, Sören Verstraete, Koen Felix Maria Joosten, Greet Van den Berghe, Sascha Cornelis Antonius Theodorus Verbruggen, Dieter Mesotten
BACKGROUND: The multicentre randomised controlled PEPaNIC trial showed that withholding parenteral nutrition (PN) during the first week of critical illness in children was clinically superior to providing early PN. This study describes the cost-effectiveness of this new nutritional strategy. METHODS: Direct medical costs were calculated with use of a micro-costing approach. We compared the costs of late versus early initiation of PN (n = 673 versus n = 670 patients) in the Belgian and Dutch study populations from a hospital perspective, using Student's t test with bootstrapping...
January 15, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29324561/nursing-minimum-data-sets-for-documenting-nutritional-care-for-adults-in-primary-healthcare-a-scoping-review
#8
Sasja Jul Håkonsen, Preben Ulrich Pedersen, Merete Bjerrum, Ann Bygholm, Micah D J Peters
OBJECTIVE: To identify all published nutritional screening instruments that have been validated in the adult population in primary healthcare settings and to report on their psychometric validity. INTRODUCTION: Within health care, there is an urgent need for the systematic collection of nursing care data in order to make visible what nurses do and to facilitate comparison, quality assurance, management, research and funding of nursing care. To be effective, nursing records should accurately and comprehensively document all required information to support safe and high quality care of patients...
January 2018: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/29323761/chronic-critical-illness-application-of-what-we-know
#9
REVIEW
Martin D Rosenthal, Amir Y Kamel, Cameron M Rosenthal, Scott Brakenridge, Chasen A Croft, Frederick A Moore
Over the last decade, chronic critical illness (CCI) has emerged as an epidemic in intensive care unit (ICU) survivors worldwide. Advances in ICU technology and implementation of evidence-based care bundles have significantly decreased early deaths and have allowed patients to survive previously lethal multiple organ failure (MOF). Many MOF survivors, however, experience a persistent dysregulated immune response that is causing an increasingly predominant clinical phenotype called the persistent inflammation, immunosuppression, and catabolism syndrome (PICS)...
January 11, 2018: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/29323759/barriers-and-solutions-to-delivery-of-intensive-care-unit-nutrition-therapy
#10
REVIEW
Michelle Kozeniecki, Heather Pitts, Jayshil J Patel
Despite recommendations for early enteral nutrition (EN) in critically ill patients, numerous factors contribute to incomplete delivery of EN, including insufficient nutrition risk screening in critically ill patients, underutilization of enteral feeding protocols, fixed rate-based enteral infusion targets with frequent EN interruption, and suboptimal provider practices regarding nutrition support therapy. The purpose of this narrative review is to identify common barriers to optimizing and delivering nutrition in critically ill patients, and suggest strategies and solutions to overcome barriers...
January 11, 2018: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/29319723/characteristics-and-outcomes-of-intensive-care-unit-survivors-experience-of-a-multidisciplinary-outpatient-clinic-in-a-teaching-hospital
#11
Péricles A D Duarte, Jaquilene Barreto Costa, Silvana Trilo Duarte, Sheila Taba, Claudia Regina Felicetti Lordani, Erica Fernanda Osaku, Claudia Rejane Lima Macedo Costa, Dalas Cristina Miglioranza, Daniela Prochnow Gund, Amaury Cesar Jorge
OBJECTIVES: To describe the experience of an outpatient clinic with the multidisciplinary evaluation of intensive care unit survivors and to analyze their social, psychological, and physical characteristics in a low-income population and a developing country. METHODS: Retrospective cohort study. Adult survivors from a general intensive care unit were evaluated three months after discharge in a post-intensive care unit outpatient multidisciplinary clinic over a period of 6 years (2008-2014) in a University Hospital in southern Brazil...
December 2017: Clinics
https://www.readbyqxmd.com/read/29308749/-2017-clinical-breakthroughs-in-critical-care-medicine
#12
Wei Huang
New achievements in critical care medicine 2017 may include updating of "Surviving Sepsis Campaign" international guideline. Comparing evaluation of sequential (sepsis-related) organ failure assessment (SOFA) and quick sequential organ failure assessment (qSOFA), combination therapies with steroid, vitamin B1 and vitamin C in patients with sepsis, identification of endophenotype of sepsis, as well phenotype of acute respiratory distress syndrome (ARDS). However, it is also need to mention some of negative trials, such as levosimendan in patients undergoing cardiac surgery, low-dose immunoglobulin G and polymyxin B hemoperfusion for patient with septic shock, and enteral versus parenteral early nutrition in ventilated adults with shock...
January 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29306205/relevance-of-and-aspen-criteria-of-malnutrition-to-predict-hospital-mortality-in-critically-ill-patients-a-prospective-study
#13
G D Ceniccola, T P Holanda, R S F Pequeno, V S Mendonça, A B M Oliveira, L S F Carvalho, I de Brito-Ashurst, W M C Araújo
PURPOSE: Malnutrition is prevalent in the intensive care units (ICU), yet, there is a paucity of validated assessment tools. Subsequently, this study evaluates the validity of the malnutrition AND-ASPEN tool as an ICU mortality predictor. METHODS: Patients admitted to a large mixed ICU (72 beds) from 2014 to 2016, were followed during stay and had electronic health records on sex, age, Apache II and baseline nutrition assessment collected at admission. Patients with shortstay (<48h) and missing data were excluded...
December 21, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29304748/revisiting-the-link-between-cognitive-decline-and-masticatory-dysfunction
#14
Chia-Shu Lin
Age-related decline in cognitive functions and dementia are major challenges in geriatric healthcare. Accumulating evidence from clinical, epidemiological and animal research suggests that tooth loss may be a risk factor for the decline of cognitive functions. This issue highlights the role of the brain-stomatognathic axis in geriatric medicine. Whether input from the stomatognathic apparatus can affect the brain remains an open debate. By revisiting the evidence published in the past five years, we argue that the hypothesis regarding the association between cognitive decline and masticatory dysfunction should be carefully interpreted...
January 5, 2018: BMC Geriatrics
https://www.readbyqxmd.com/read/29301555/improving-partnerships-with-family-members-of-icu-patients-study-protocol-for-a-randomized-controlled-trial
#15
Daren K Heyland, Judy Davidson, Yoanna Skrobik, Amanda Roze des Ordons, Lauren J Van Scoy, Andrew G Day, Virginia Vandall-Walker, Andrea P Marshall
BACKGROUND: Over the last decade, health care delivery has shifted to partnering with patients and their families to improve health and quality of care, and to lower costs. Partnering with family members (FMs) of critically ill patients who lack capacity is particularly important for improving experiences and outcomes for both patients and FMs. How best to apply such partnering strategies, however, is yet unknown. The IMPACT trial will evaluate two interventions that enable partnerships with families of critically ill patients, each in a distinct content area, but similar in that they empower and support FMs...
January 4, 2018: Trials
https://www.readbyqxmd.com/read/29295506/association-between-malnutrition-and-28-day-mortality-and-intensive-care-length-of-stay-in-the-critically-ill-a-prospective-cohort-study
#16
Charles Chin Han Lew, Gabriel Jun Yung Wong, Ka Po Cheung, Ai Ping Chua, Mary Foong Fong Chong, Michelle Miller
There is limited evidence for the association between malnutrition and mortality as well as Intensive Care Unit length-of-stay (ICU-LOS) in critically ill patients. We aimed to examine the aforementioned associations by conducting a prospective cohort study in an ICU of a Singapore tertiary hospital. Between August 2015 and October 2016, all adult patients with ≥ 24 h of ICU-LOS were included. The 7-point Subjective Global Assessment (7-point SGA) was used to determine patients' nutritional status within 48 h of ICU admission...
December 23, 2017: Nutrients
https://www.readbyqxmd.com/read/29289386/mortality-risk-factors-in-elderly-patients-in-intensive-care-without-limitation-of-therapeutic-effort
#17
S E Giannasi, M S Venuti, A D Midley, N Roux, C Kecskes, E San Román
OUTCOME: To determine mortality prognostic factors in elderly patients who are admitted to intensive care units (ICUs) due to acute critical illness. DESIGN: A prospective cohort study was carried out. SETTING: A polyvalent Intensive Care Unit at a University Hospital in Argentina. PATIENTS OR PARTICIPANTS: We included 249 patients over 65years of age who were consecutively admitted to the ICU and required mechanical ventilation for more than 48hours, between January 2011 and December 2012...
December 27, 2017: Medicina Intensiva
https://www.readbyqxmd.com/read/29284322/maximizing-nutrition-support-practice-and-measuring-adherence-to-nutrition-support-guidelines-in-a-canadian-tertiary-care-icu
#18
Michele E McCall, Alice Adamo, Katherine Latko, Ashley K Rieder, Nicole Durand, Tova Nathanson
OBJECTIVE: New comprehensive guidelines for nutrition support (NS) in the intensive care unit (ICU) can be used to improve quality of care and benchmark current practice. The objective of this study was to (a) compare NS practices in our medical/surgical ICU (MSICU) to 18 recommendations described in the Canadian Clinical Practice Guidelines and Society of Critical Care Medicine/American Society of Parenteral and Enteral Nutrition guidelines, (b) determine the percentage of goal calories and protein delivered, and (c) identify the barriers to successful NS delivery...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29283404/key-clinical-factors-predicting-adipokine-and-oxidative-stress-marker-concentrations-among-normal-overweight-and-obese-pregnant-women-using-artificial-neural-networks
#19
Mario Solis-Paredes, Guadalupe Estrada-Gutierrez, Otilia Perichart-Perera, Araceli Montoya-Estrada, Mario Guzmán-Huerta, Héctor Borboa-Olivares, Eyerahi Bravo-Flores, Arturo Cardona-Pérez, Veronica Zaga-Clavellina, Ethel Garcia-Latorre, Gabriela Gonzalez-Perez, José Alfredo Hernández-Pérez, Claudine Irles
Maternal obesity has been related to adverse neonatal outcomes and fetal programming. Oxidative stress and adipokines are potential biomarkers in such pregnancies; thus, the measurement of these molecules has been considered critical. Therefore, we developed artificial neural network (ANN) models based on maternal weight status and clinical data to predict reliable maternal blood concentrations of these biomarkers at the end of pregnancy. Adipokines (adiponectin, leptin, and resistin), and DNA, lipid and protein oxidative markers (8-oxo-2'-deoxyguanosine, malondialdehyde and carbonylated proteins, respectively) were assessed in blood of normal weight, overweight and obese women in the third trimester of pregnancy...
December 28, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/29280641/-assessment-of-the-clinical-quality-indicator-early-enteral-nutrition-in-intensive-care-units
#20
Licia De la Calle de la Rosa, Sara Bermejo de Las Heras, Antonio Blesa, Manuel Giner, Javier Arias Díaz
BACKGROUND: Early enteral nutrition (EN) offers multiple benefits on critically ill patients and its monitoring was established as a clinical quality indicator (CQI) for intensive care units (ICU) by the Spanish Society of Critical Care (SEMICYUC). However, no results have been published on the systematized monitoring of this CQI. OBJECTIVE: To assess the compliance of the CQI "Early EN" at ICU. METHODS: A retrospective longitudinal study was conducted on 386 consecutive ICU patients receiving EN...
November 17, 2017: Nutrición Hospitalaria: Organo Oficial de la Sociedad Española de Nutrición Parenteral y Enteral
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