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Vitamins intensive care

Alexander Koch, Lukas Bündgens, Ulf Herbers, Christian Trautwein, Frank Tacke
The goals of nutritional therapy for critically ill patients are the enteral or parenteral provision of calories, proteins, electrolytes, vitamins, trace elements and fluids. The metabolism of critically ill patients is characterized by a catabolic stress condition, which is caused by a systemic inflammatory response and is associated with an increased infection rate, occurrence of multiple organ failure and increased mortality.Traditionally, nutritional therapy has been considered as an "adjunctive" therapy for critically ill patients with the primary goal of providing energy to maintain muscle mass...
December 2018: Deutsche Medizinische Wochenschrift
Pascal L Langlois, William Manzanares, Neill K J Adhikari, François Lamontagne, Christian Stoppe, Aileen Hill, Daren K Heyland
Vitamin C, an enzyme cofactor and antioxidant, could hasten the resolution of inflammation, oxidative stress, and microvascular dysfunction. While observational studies have demonstrated that critical illness is associated with low levels of vitamin C, randomized controlled trials (RCTs) of vitamin C, alone or in combination with other antioxidants, have yielded contradicting results. We searched MEDLINE, EMBASE, CINAHL, and the Cochrane Central Register of Controlled Trials (inception to December 2017) for RCTs comparing vitamin C, by enteral or parenteral routes, with placebo or none, in intensive care unit (ICU) patients...
November 19, 2018: JPEN. Journal of Parenteral and Enteral Nutrition
P Nair, B Venkatesh, D J Hoechter, H Buscher, S Kerr, J R Center, J A Myburgh
The prevalence of vitamin D deficiency in critical illness is known to be high and associated with adverse clinical outcomes. Patients receiving extracorporeal membrane oxygenation (ECMO) may be at increased risk of vitamin D deficiency due to high severity of acute illness. Challenges with drug dosing in ECMO patients are recognised due to increased volume of distribution and drug absorption to circuit components. To describe the prevalence of vitamin D deficiency in ECMO patients and the effect of intramuscular dosing of cholecalciferol on levels of vitamin D metabolites, and to compare these data with intensive care unit (ICU) patients not receiving ECMO, two prospective studies were performed sequentially: an observational study of 100 consecutive ICU patients and an interventional study assessing effects of intramuscular cholecalciferol in 50 ICU patients...
November 2018: Anaesthesia and Intensive Care
Mojtaba Hedayat Yaghoobi, Abbas Taher, Mohamad Ali Seifrabie, Mohammadmahdi Sabahi, Farshid Rahimi-Bashar
BACKGROUND AND OBJECTIVE: Vitamin D deficiency is considered one of the most common nutritional deficiencies associated with weakened immune system and increased likelihood of sepsis. The current study was conducted to investigate the association between serum vitamin D level and the severity and prognosis of ventilator associated pneumonia (VAP) in inpatients in intensive care unit (ICU). METHODS: Eighty-four consecutive patients with VAP were enrolled in this observational, prospective study conducted in the ICU of Besat Hospital, Hamadan...
November 15, 2018: Romanian Journal of Internal Medicine, Revue Roumaine de Médecine Interne
E G Rey, J L Finkelstein, D Erickson
Folate is an essential vitamin to the development of a fetus in early pregnancy. Maternal folate supplementation around the time of conception has been shown to decrease the risk of neural tube defects (NTDs), a class of serious birth defects. The closure of the neural tube before the 28th day after conception necessitates that the folate intake must take place before most women know that they are pregnant. Therefore, screening women of reproductive age for folate status would allow for an improved understanding of the need for supplementation in women who could become pregnant as well as the effectiveness of current supplementation and fortification recommendations...
July 2018: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
Lisa Marie Wiesholler, Christa Genslein, Alexandra Schroter, Thomas Hirsch
A nanoengineered interface fabricated by self-assembly enables the online determination of vitamin B12 via a simple luminescence readout in serum without any pretreatment. The interplay of Tm3+ -doped NaYF4 nanoparticles (UCNPs) and a gold nanotriangle array prepared by nanosphere lithography on a glass slide is responsible for an efficient NIR to UV upconversion. Hot spots of the gold assembly generate local electromagnetic-field enhancement, favoring the four-photon upconversion process at the low-power excitation of approximately 13 W·cm-2 ...
November 28, 2018: Analytical Chemistry
Mervat A M Youssef, Asmaa M Zahran, Al Montasser Hussien, Khalid I Elsayh, Eman A Askar, Hekmat Saad Farghaly
BACKGROUND: Vitamin D has regulatory effects on different cells of the immune system and low levels are associated with several immune-mediated diseases. AIM: To investigate the association between neonatal 25-hydroxy vitamin D (25-OHD) level and the expression of lymphocyte activation markers (HLA-DR, CD69, CD25, CD45RA) on T-lymphocyte subpopulations and its impact in neonatal infection. METHODS: 25-OHD level was measured in the cord blood of 56 neonates and their mothers using an enzyme immune-assay method...
October 30, 2018: Paediatrics and International Child Health
Michael Zhang, David F Jativa
Background: Low plasma levels of vitamin C are associated with adverse outcomes, including increased mortality, in critically ill patients. Several trials have suggested that the administration of intravenous vitamin C in this setting may have beneficial effects, such as reducing the incidence of organ failure and improving survival. However, these studies have generally involved combination therapies consisting of vitamin C along with other antioxidants, confounding the effects of vitamin C alone...
2018: SAGE Open Medicine
R Seckold, E Fisher, M deBock, B R King, C E Smart
Dietary management has been a mainstay of care in Type 1 diabetes since before the discovery of insulin when severe carbohydrate restriction was advocated. The use of insulin facilitated re-introduction of carbohydrate into the diet. Current management guidelines focus on a healthy and varied diet with consideration of glycaemic load, protein and fat. As a result of frustration with glycaemic outcomes, low-carbohydrate diets have seen a resurgence in popularity. To date, low-carbohydrate diets have not been well studied in the management of Type 1 diabetes...
October 25, 2018: Diabetic Medicine: a Journal of the British Diabetic Association
Karin Amrein, Alja Papinutti, Erwin Mathew, Greisa Vila, Dhruv Parekh
The prevalence of vitamin D deficiency in intensive care units ranges typically between 40 and 70 %. There are many reasons for being or becoming deficient in the ICU. Hepatic, parathyroid and renal dysfunction aditionally increase the risk for developing vitamin D deficiency. Moreover, therapeutic interventions like fluid resuscitation, dialysis, surgery, extracorporeal membrane oxygenation, cardiopulmonary bypass and plasma exchange may significantly reduce vitamin D levels. Many observational studies have consistently shown an association between low vitamin D levels and poor clinical outcomes in critically ill adults and children, including excess mortality and morbidity such as acute kidney injury, acute respiratory failure, duration of mechanical ventilation and sepsis...
October 1, 2018: Endocrine Connections
Denice S Feig, Rosa Corcoy, Lois E Donovan, Kellie E Murphy, Jon F R Barrett, J Johanna Sanchez, Tim Wysocki, Katrina Ruedy, Craig Kollman, George Tomlinson, Helen R Murphy
OBJECTIVE: To compare glycemic control, quality of life, and pregnancy outcomes of women using insulin pumps and multiple daily injection therapy (MDI) during the Continuous Glucose Monitoring in Type 1 Diabetes Pregnancy Trial (CONCEPTT). RESEARCH DESIGN AND METHODS: This was a prespecified analysis of CONCEPTT involving 248 pregnant women from 31 centers. Randomization was stratified for pump versus MDI and HbA1c . The primary outcome was change in HbA1c from randomization to 34 weeks' gestation...
October 16, 2018: Diabetes Care
Ana Ojeda-Rodríguez, Itziar Zazpe, Lydia Morell-Azanza, María J Chueca, Maria Cristina Azcona-Sanjulian, Amelia Marti
High rates of childhood obesity require integral treatment with lifestyle modifications that achieve weight loss. We evaluated a lifestyle intervention on nutrient adequacy and diet quality in children and adolescents with abdominal obesity. A randomized controlled trial was performed on 107 participants, assigned either to a usual care group or to an intensive care group that followed a moderate hypocaloric Mediterranean diet and received nutritional education. Intake adequacy was evaluated using Dietary Reference Intakes and diet quality through the Diet Quality Index for Adolescents (DQI-A), the Healthy Lifestyle Diet-Index (HLD-I) and the Mediterranean Diet Quality Index (KIDMED)...
October 13, 2018: Nutrients
Eugene Ng, Amanda D Loewy
Newborns are at risk for vitamin K deficiency bleeding (VKDB) caused by inadequate prenatal storage and deficiency of vitamin K in breast milk. Systematic review of evidence to date suggests that a single intramuscular (IM) injection of vitamin K at birth effectively prevents VKDB. Current scientific data suggest that single or repeated doses of oral (PO) vitamin K are less effective than IM vitamin K in preventing VKDB. The Canadian Paediatric Society and the College of Family Physicians of Canada recommend routine IM administration of a single dose of vitamin K at 0...
October 2018: Canadian Family Physician Médecin de Famille Canadien
Karolina Brook, Tiffany M N Otero, D Dante Yeh, Cecilia Canales, Donna Belcher, Sadeq A Quraishi
BACKGROUND: Vitamin D status is associated with length of stay (LOS) and discharge destination in critically ill patients. To further understand this relationship, we investigated whether admission 25-hydroxyvitaminD (25OHD) levels are associated with discharge functional status in the intensive care unit (ICU). METHODS: In this retrospective study, data from 2 surgical ICUs at a large teaching hospital were analyzed. 25OHD levels were measured within 24 hours of ICU admission and Functional Status Score for the ICU (FSS-ICU) was calculated within 24 hours of ICU discharge for all patients...
October 7, 2018: Nutrition in Clinical Practice
Claire Harris, Mercedeh Kiaii, Wynnie Lau, Myriam Farah
Background: Calcific uremic arteriolopathy (CUA), also known as calciphylaxis, is a rare but life-threatening condition predominately occurring in patients with end-stage renal disease on dialysis. In the absence of randomized clinical trials to guide management, clinicians must rely on observational data. We have previously reported the outcomes of our multi-intervention management in seven patients and now present a larger series of patients with extended follow-up. Methods: We performed a retrospective analysis of all patients diagnosed with CUA at a single academic center between 2008 and 2017...
October 2018: Clinical Kidney Journal
G Justus Hofmeyr, Theresa A Lawrie, Álvaro N Atallah, Maria Regina Torloni
BACKGROUND: Pre-eclampsia and eclampsia are common causes of serious morbidity and death. Calcium supplementation may reduce the risk of pre-eclampsia, and may help to prevent preterm birth. This is an update of a review last published in 2014. OBJECTIVES: To assess the effects of calcium supplementation during pregnancy on hypertensive disorders of pregnancy and related maternal and child outcomes. SEARCH METHODS: We searched Cochrane Pregnancy and Childbirth's Trials Register, ClinicalTrials...
October 1, 2018: Cochrane Database of Systematic Reviews
Mehtap Pehlivanlar-Kucuk, Ahmet O Kucuk, Cagatay E Ozturk, Mehmet C Er, Fatma Ulger
BACKGROUND: Uric acid is synthesized from xanthine via xanthine oxidase as an end-product of purine metabolism. Uric acid is a major non-enzymatic antioxidant in the blood, and it exerts a protective action on vitamin C. There are a limited number of ICU studies related to uric acid, which is a valuable prognostic biomarker. This study aimed to evaluate the utility of uric acid as a biomarker in predicting the outcomes of critically ill patients. METHODS: This prospective, multi-centered cohort study included 128 patients from two different intensive care units who met the study inclusion criteria between May 2017 and October 2017...
September 1, 2018: Clinical Laboratory
Ulrich Mayr, Leonie Fahrenkrog-Petersen, Gonzalo Batres-Baires, Sebastian Rasch, Alexander Herner, Roland M Schmid, Wolfgang Huber, Tobias Lahmer
INTRODUCTION: A 25-hydroxyvitamin D, 25(OH)D, deficiency is common among critically ill patients and correlated with increased mortality. Furthermore, deficiency is associated with advanced liver disease. However, there are no studies available comparing the dimensions and consequences of a 25(OH)D deficiency between patients with and without liver cirrhosis in the setting of intensive care units (ICUs). This study focuses on differences in 25(OH)D status between critically ill noncirrhosis patients and patients with cirrhosis (primary end point), hypothesizing that deficiency and its impact on mortality risk are even more pronounced in patients with cirrhosis...
October 1, 2018: Journal of Intensive Care Medicine
Phuong Vo, Claire Koppel, Janice A Espinola, Jonathan M Mansbach, Juan C Celedón, Kohei Hasegawa, Megan Bair-Merritt, Carlos A Camargo
OBJECTIVE: To investigate the association between circulating 25-hydroxyvitamin D [25(OH)D] status at admission and disease severity among infants hospitalized for bronchiolitis and to determine whether the association differs by the form of 25(OH)D-total, bioavailable or free 25(OH)D. STUDY DESIGN: We conducted a 17-center prospective cohort study of 1016 US infants <12 months old hospitalized with bronchiolitis. Vitamin D status was defined by total 25(OH)D levels, and by calculated levels of bioavailable and free 25(OH)D...
September 20, 2018: Journal of Pediatrics
Kathryn E Smith, Caitlin S Brown, Bridget M Manning, Teresa May, Richard R Riker, Patricia A Lerwick, Timothy L Hayes, Gilles L Fraser
STUDY OBJECTIVE: High-dose intravenous vitamin C is a potential treatment option for patients with sepsis and may interfere with point-of-care (POC) blood glucose (BG) testing. This study aimed to determine if vitamin C dosing used for sepsis affected POC BG level results. DESIGN: Prospective observational pilot study. SETTING: Intensive care unit in a large academic tertiary care medical center. PATIENTS: Five consecutive critically ill adults hospitalized between April 1 and June 1, 2017, who received two or more doses of intravenous vitamin C 1500 mg for the treatment of sepsis and had at least two paired POC BG levels and laboratory venous BG levels measured within 1 hour of each other during vitamin C therapy...
September 19, 2018: Pharmacotherapy
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