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Sepsis and artificial nutrition

Hiroyuki Tamiya, Hideo Yasunaga, Hiroki Matusi, Kiyohide Fushimi, Masahiro Akishita, Sumito Ogawa
BACKGROUND: Proper artificial nutrition for patients who are unable to eat normally is an ongoing, unresolved concern in geriatric medicine and home medical care. Controversy surrounds prognostic differences between parenteral and enteral nutrition, 2 methods for artificial nutrition. OBJECTIVES: Short-term outcomes of parenteral and enteral nutrition for patients who are unable to eat normally were compared and analyzed. DESIGN: Data were acquired from patients selected from a national inpatient database covering 1057 hospitals in Japan...
November 2015: American Journal of Clinical Nutrition
Hardy Krause, Hans-Jürgen Hass, Ralf Böttger, Claudia Gerloff, Anke Rissmann, Frank Meyer
UNLABELLED: The aim of the study was to assess the value of the today's appropriate approach, preterm delivery in the 34th week of gestation by Caesarean section and subsequent surgical intervention at the perinatal center, in daily practice of pediatric surgery with regard to early postoperative and mid-term outcome. MATERIAL AND METHODS: Over the time period of 9 years, all consecutive cases diagnosed with gastroschisis at the perinatal center, University Hospital of Magdeburg, were born by Caesarean section within the 34th week of gestation followed by surgical intervention...
July 1, 2015: Polski Przeglad Chirurgiczny
Richard D Fremont, Todd W Rice
Sepsis is a common disease seen in critically ill patients. Many patients with sepsis are unable to provide nutrition for themselves, and therefore initiating artificial nutrition has become part of routine care for these patients. However, studies investigating the optimal route, composition, volume, and duration of nutrition in critically ill patients with sepsis are lacking. The best recommendations have to be extrapolated from studies in heterogeneous populations of critically ill patients or in those with syndromes such as acute lung injury or acute respiratory distress syndrome (ARDS) where sepsis is a common predisposing etiology...
June 2015: Nutrition in Clinical Practice
Jolita Bekhof, Boudewijn J Kollen, Sjef van de Leur, Joke H Kok, Irma H L M van Straaten
BACKGROUND: Glucosuria in preterm infants is often measured using a visually readable reagent strip, e.g., when monitoring total parenteral nutrition or during sepsis or when treating with corticosteroids. However, the specific circumstances in a neonatal intensive care unit (NICU), such as the use of diapers and the high temperature in incubators, could affect its reliability. OBJECTIVES: To evaluate the reliability of the semi-quantitative measurement of glucosuria under the specific circumstances of a NICU setting...
December 2014: Pediatrics and Neonatology
Stig Bengmark
About 25 million individuals undergo high risk surgery each year. Of these about 3 million will never return home from hospital, and the quality of life for many of those who return is often significantly impaired. Furthermore, many of those who manage to leave hospital have undergone severe life-threatening complications, mostly infections/sepsis. The development is strongly associated with the level of systemic inflammation in the body, which again is entirely a result of malfunctioning GI microbiota, a condition called dysbiosis, with deranged composition and function of the gastrointestinal microbiota from the mouth to the anus and impaired ability to maintain intact mucosal membrane functions and prevent leakage of toxins-bacterial endotoxins and whole or debris of bacteria, but also foods containing proteotoxins gluten, casein and zein and heat-induced molecules such as advanced glycation end products (AGEs) and advanced lipoxidation end products (ALEs)...
December 2012: Hepatobiliary Surgery and Nutrition
Akahito Sako, Hideo Yasunaga, Hiromasa Horiguchi, Kiyohide Fushimi, Hidekatsu Yanai, Naomi Uemura
BACKGROUND: PEG is widely used; however, large-scale data for PEG have been lacking. OBJECTIVE: To estimate the prevalence of placement of gastrostomy and jejunostomy tubes and to elucidate the patient background characteristics and their associations with in-hospital mortality. DESIGN: A retrospective analysis of the Japanese administrative claims database. SETTING: Japanese acute-care hospitals. PATIENTS: A total of 64,219 patients who underwent gastrostomy or jejunostomy tube insertion between July and December, 2007 to 2010, were identified among 11...
July 2014: Gastrointestinal Endoscopy
Clara Vaquerizo Alonso, Alfonso Mesejo, José Acosta Escribano, Sergio Ruiz Santana
INTRODUCTION AND OBJECTIVES: some relevant aspects related to parenteral nutrition in the Spanish ICUs are still unclear. These aspects include: caloric and protein intake, total volume, glycemic control, the type of lipid emulsion used or the comparison of different formulations. Our objective is to know the clinical practice patterns of artificial nutrition therapeutics, particularly of parenteral nutrition in the Spanish ICUs. MATERIAL AND METHODS: twelve representative ICU's participated in a nutrition survey from January to March 2012...
September 2013: Nutrición Hospitalaria: Organo Oficial de la Sociedad Española de Nutrición Parenteral y Enteral
P G Vaughan-Shaw, J Saunders, T Smith, A T King, M A Stroud
INTRODUCTION: Oedema is observed frequently following surgery and may be associated with worse outcomes. To date, no study has investigated the role of oedema in the emergency surgical patient. This study assesses the incidence of oedema following emergency abdominal surgery and the value of early postoperative oedema measurement in predicting clinical outcome. METHODS: A prospective cohort study of patients undergoing emergency abdominal surgery at a university unit over a two-month period was undertaken...
September 2013: Annals of the Royal College of Surgeons of England
Mirna Marques, Sarah Perre, Annelies Aertgeerts, Sarah Derde, Fabian Güiza, Michael P Casaer, Greet Hermans, Greet Van den Berghe, Lies Langouche
INTRODUCTION: We previously reported that in artificially-fed critically ill patients, adipose tissue reveals an increase in small adipocytes and accumulation of M2-macrophages. We hypothesized that nutrient-independent factors of critical illness explain these findings, and that the M2-macrophage accumulation may not be limited to adipose tissue. METHODS: In a long-term cecal ligation and puncture (CLP) mouse model of sepsis, we compared the effect of parenteral nutrition (CLP-fed, n = 13) with nutrient restriction (CLP-restricted, n = 11) on body composition, adipocyte size and macrophage accumulation in adipose tissue, liver and lungs...
2013: Critical Care: the Official Journal of the Critical Care Forum
Ruth Kleinpell, Leanne Aitken, Christa A Schorr
Sepsis is a serious worldwide health care condition that is associated with high mortality rates, despite improvements in the ability to manage infection. New guidelines for the management of sepsis were recently released that advocate for implementation of care based on evidence-based practice for both adult and pediatric patients. Critical care nurses are directly involved in the assessment of patients at risk for developing sepsis and in the treatment of patients with sepsis and can, therefore, affect outcomes for critically ill patients...
May 2013: American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses
G Elke, E Kuhnt, M Ragaller, D Schädler, I Frerichs, F M Brunkhorst, M Löffler, K Reinhart, N Weiler
INTRODUCTION: The optimal nutritional strategy remains controversial, particularly in severely septic patients. Our aim was to analyze the effect of three nutritional strategies--enteral (EN), parenteral (PN), and combined nutrition (EN+PN)--on the outcome of patients with severe sepsis or septic shock. PATIENTS AND METHODS: This secondary analysis of the prospective, randomized-controlled, multicenter "Intensive Insulin Therapy and Pentastarch Resuscitation in Severe Sepsis (VISEP)" trial only included patients with a length of stay in the intensive care unit (ICU) of more than 7 days...
April 2013: Medizinische Klinik, Intensivmedizin und Notfallmedizin
Francisca Joly, Yves Panis
Optimised home parenteral nutrition is still, after 35 years of progress, the "gold standard "for benign but chronic intestinal failure. better recognition of chronic intestinal failure, in its multiple facets, is needed to improve Home Parenteral Nutrition by adding associated treatments such as intestinal trophic factors, rehabilitative surgery (reestablishment of colonic continuity, reverse jejunal segment in severe short gut type II) and/or reconstructive surgery (intestinal transplantation for end-stage intestinal failure)...
February 2012: Bulletin de L'Académie Nationale de Médecine
Stig Bengmark
Health care-induced diseases constitute a fast-increasing problem. Just one type of these health care-associated infections (HCAI) constitutes the fourth leading cause of death in Western countries. About 25 million individuals worldwide are estimated each year to undergo major surgery, of which approximately 3 million will never return home from the hospital. Furthermore, the quality of life is reported to be significantly impaired for the rest of the lives of those who, during their hospital stay, suffered life-threatening infections/sepsis...
January 2013: Nutrients
Jean Reignier, Emmanuelle Mercier, Amelie Le Gouge, Thierry Boulain, Arnaud Desachy, Frederic Bellec, Marc Clavel, Jean-Pierre Frat, Gaetan Plantefeve, Jean-Pierre Quenot, Jean-Baptiste Lascarrou
IMPORTANCE: Monitoring of residual gastric volume is recommended to prevent ventilator-associated pneumonia (VAP) in patients receiving early enteral nutrition. However, studies have challenged the reliability and effectiveness of this measure. OBJECTIVE: To test the hypothesis that the risk of VAP is not increased when residual gastric volume is not monitored compared with routine residual gastric volume monitoring in patients receiving invasive mechanical ventilation and early enteral nutrition...
January 16, 2013: JAMA: the Journal of the American Medical Association
Uroghupatei P Iyegha, Javariah I Asghar, Elizabeth B Habermann, Alain Broccard, Craig Weinert, Greg Beilman
BACKGROUND: Specialty-trained intensivist involvement in the care of critically ill patients has been associated with improved outcomes; however, the factors contributing to this observation are unknown. We hypothesized that intensivist-led ICU care would result in decreased mortality, length of stay, and rate of deep venous thrombosis/pulmonary embolism along with improved compliance with ICU process measures. STUDY DESIGN: We performed a retrospective review of 847 patients using the October 2008 transition at a regional medical center from an open ICU to a model in which board-certified intensivists assume primary responsibility or co-management of all critically ill patients...
March 2013: Journal of the American College of Surgeons
Yingwang Ye, Qingping Wu, Jumei Zhang, He Jiang, Wang Hu
UNLABELLED: Cronobacter are opportunistic food-borne pathogens associated with meningitis, sepsis, and necrotizing enterocolitis. Little attempt has focused on detection of viable cell of Cronobacter spp. in dry aquatic products, which were frequently used for raw materials of infant foods due to high nutrition. In this paper, one-step reverse transcription polymerase chain reaction (RT-PCR) was developed for detection of viable Cronobacter spp. in dry aquatic products. Specificity test indicated that clearly expected amplicon in size 469 bp was amplified from RNA of Cronobacter, but not from RNA of negative controls and DNA of Cronobacter strains...
November 2012: Journal of Food Science
Lorenzo D'Antiga, Olivier Goulet
Intestinal failure (IF) is a condition in which severe intestinal malabsorption mandates artificial nutrition through a parenteral route. Causes of severe protracted IF include short bowel syndrome, congenital diseases of enterocyte development, and severe motility disorders (total or subtotal aganglionosis or chronic intestinal pseudo-obstruction syndrome). IF can result in nutritional failure, defined as the long-term failure to nourish a child by natural or artificial means. Today, IF-associated liver disease is the most common cause of parenteral nutrition (PN) failure, but catheter-related sepsis and extensive vascular thrombosis may also jeopardize the health of those receiving PN...
February 2013: Journal of Pediatric Gastroenterology and Nutrition
Omer Kilic, Demet Demirkol, Raif Ucsel, Agop Citak, Metin Karabocuoglu
PURPOSE: The aims of this study were to determine the prevalence of hypophosphatemia and to discuss the clinical implications of hypophosphatemia in critically ill children. MATERIALS AND METHODS: A retrospective review of the medical records of children admitted to the pediatric intensive care unit from December 2006 to December 2007 was conducted. RESULTS: In 60.2% (n = 71) of the patients, any serum phosphorous level at admission and at the third day or seventh day after admission to pediatric intensive care unit was in hypophosphatemic range...
October 2012: Journal of Critical Care
G Lambe, C Russell, C West, R Kalaiselvan, D A J Slade, I D Anderson, J S Watson, G L Carlson
BACKGROUND: Reconstruction of massive contaminated abdominal wall defects associated with enteroatmospheric fistulation represents a technical challenge. An effective technique that allows closure of intestinal fistulas and reconstruction of the abdominal wall, with a good functional and cosmetic result, has yet to be described. The present study is a retrospective review of simultaneous reconstruction of extensive gastrointestinal tract fistulation and large full-thickness abdominal wall defects, using a novel pedicled subtotal thigh flap...
July 2012: British Journal of Surgery
Stig Bengmark
Septic morbidity associated with advanced surgical and medical treatments is unacceptably high, and so is the incidence of complications occurring in connection with acute emergencies such as severe trauma and severe acute pancreatitis. Only considering the US, it will annually affect approximately (app) 300 million (mill) of a population of almost one million inhabitants and cause the death of more than 200,000 patients, making sepsis the tenth most common cause of death in the US. Two major factors affect this, the lifestyle-associated increased weakness of the immune defense systems, but more than this the artificial environment associated with modern treatments such as mechanical ventilation, use of tubes, drains, intravascular lines, artificial nutrition and extensive use of synthetic chemical drugs, methods all known to reduce or eliminate the human microbiota and impair immune functions and increase systemic inflammation...
February 2012: Nutrients
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