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https://www.readbyqxmd.com/read/28644925/does-low-body-mass-index-predict-the-hospital-mortality-of-adult-western-or-asian-patients
#1
Charlene Compher, Takashi Higashiguchi, Jianchun Yu, Gordon L Jensen
BACKGROUND: Some strategies for screening and assessment of malnutrition include a low but variable body mass index (BMI) cutoff, while others do not. The purpose of this systematic review was to investigate published data for Western and Asian hospital samples to determine how the prevalence of low BMI is associated with increased hospital mortality. METHOD: A PubMed search of the past 10 years (2006-2016) was conducted with the terms "BMI," "malnutrition," "adult," "outcome," and "hospital" or "ICU" for articles published in English...
June 1, 2017: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28627189/-nitrogenous-content-in-parenteral-nutrition-a-four-year-experience-in-a-general-hospital-critically-ill-patient-specificity
#2
Juan Luis Villalobos-Gámez, Carlos Lara-Ramos, Yolanda Domínguez-Rivas, Antonio Vallejo-Báez, Francisco Cota-Delgado, Efrén Márquez-Fernández, José Manuel García-Almeida, José Antonio López-Medina, Rosalía Rioja-Vázquez, Albert Santacreu-Regí, Francisca Rius-Díaz, Alfredo Mínguez-Mañanes
INTRODUCTION: There have been several studies focusing on caloric intake during the last years, while protein content relevance has been underestimated. Some recent evidence has shown that protein deficiency has also an impact on patient outcomes. We have studied the nitrogen (N) content in parenteral nutrition (PN) bags administered to adult patients in a Spanish tertiary level hospital for four years. MATERIAL AND METHODS: Patients who received parenteral nutrition in the general ward and Intensive Care Unit (ICU) were recorded...
June 5, 2017: Nutrición Hospitalaria: Organo Oficial de la Sociedad Española de Nutrición Parenteral y Enteral
https://www.readbyqxmd.com/read/28625248/-core-knowledge-and-skill-based-approach-to-subspecialty-construction-in-critical-intensive-care-medicine-with-distinct-chinese-peculiarity
#3
Lijun Wang, Fang Tian
With the rapid development of critical care medicine (CCM) in China, there are increases in the number of intensive care units (ICUs), the scale of one center ICU and the team. Subspecialty construction of CCM is of great concerns for personnel training as well as discipline development, and is currently one of the urgent problems that need to be resolved. Experience of CCM subspecialty construction from Europe and the United States is lacking and it is necessary to propose some opinions on innovation to construct CCM subspecialties with Chinese characteristics...
June 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28625194/preoperative-malnutrition-is-associated-with-increased-mortality-and-adverse-outcomes-after-paediatric-cardiac-surgery
#4
Faith Ross, Gregory Latham, Denise Joffe, Michael Richards, Jeremy Geiduschek, Michael Eisses, Douglas Thompson, Monique Radman
BACKGROUND: Malnutrition is common in children with CHD and is likely to place them at an increased risk for adverse surgical outcomes. We sought to evaluate the impact of preoperative malnutrition on outcomes after paediatric cardiac surgery. METHODS: We conducted a retrospective analysis of patients from age 0 to 5 years undergoing cardiac surgery at Seattle Children's Hospital from 2006 to 2015. We used regression modelling to examine the impact of malnutrition on surgical outcomes...
June 19, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28608513/out-of-office-hours-elective-surgical-intensive-care-admissions-and-their-associated-complications
#5
David J R Morgan, Kwok Ming Ho, Yang Jian Ong, Marlene L Kolybaba
BACKGROUND: The 'weekend' effect is a controversial theory that links reduced staffing levels, staffing seniority and supportive services at hospitals during 'out-of-office hours' time periods with worsening patient outcomes. It is uncertain whether admitting elective surgery patients to intensive care units (ICU) during 'out-of-office hours' time periods mitigates this affect through higher staffing ratios and seniority. METHODS: Over a 3-year period in Western Australia's largest private hospital, this retrospective nested-cohort study compared all elective surgical patients admitted to the ICU based on whether their admission occurred 'in-office hours' (Monday-Friday 08...
June 12, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28602752/analysis-of-complications-of-prone-position-in-acute-respiratory-distress-syndrome-quality-standard-incidence-and-related-factors
#6
E Jové Ponseti, A Villarrasa Millán, D Ortiz Chinchilla
INTRODUCTION: The monitoring system based on standards of quality allows clinicians to evaluate and improve the patient's care. According to the quality indicators recommended by Sociedad Española de Medicina Intensiva Crítica y Unidades Coronarias, and due to the importance of prone position (PP) as a treatment in patients with acute respiratory distress syndrome, it is fundamental to keep accurate record of serious adverse events occurring during the prone position procedure and its posterior analysis...
June 8, 2017: Enfermería Intensiva
https://www.readbyqxmd.com/read/28601441/evaluation-and-handling-of-constipation-in-critical-patients
#7
J Pérez-Sánchez, J Fernández-Boronat, E Martínez-Méndez, M L Marín-Cagigas, D Mota-Puerto, M C Pérez-Román, G Martínez-Estalella
OBJECTIVE: To evaluate the effectiveness of nursing care against constipation and to identify, analyze and evaluate causes and consequences. METHODOLOGY: Observational, descriptive and prospective study in polyvalent ICU tertiary hospital (2013-2015). INCLUSION CRITERIA: >18 years, stay >7 days, connected to respiratory support, with nasogastric tube and enteral or mixed nutrition. Patients with gastrointestinal pathology, encephalopathic and jejunostomy/ileostomy were excluded...
June 7, 2017: Enfermería Intensiva
https://www.readbyqxmd.com/read/28599979/relationship-of-energy-and-protein-adequacy-with-60-day-mortality-in%C3%A2-mechanically-ventilated-critically-ill-patients-a-prospective-observational-study
#8
Zheng-Yii Lee, Ibrahim Noor Airini, Mohd-Yusof Barakatun-Nisak
BACKGROUND & AIMS: The effect of provision of full feeding or permissive underfeeding on mortality in mechanically ventilated critically ill patients in the intensive care unit (ICU) is still controversial. This study investigated the relationship of energy and protein intakes with 60-day mortality, and the extent to which ICU length of stay and nutritional risk status influenced this relationship. METHODS: This is a prospective observational study conducted among critically ill patients aged ≥18 years, intubated and mechanically ventilated within 48 h of ICU admission and stayed in the ICU for at least 72 h...
May 19, 2017: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28599676/a-randomized-trial-of-supplemental-parenteral-nutrition-in-underweight-and-overweight-critically-ill-patients-the-top-up-pilot-trial
#9
Paul E Wischmeyer, Michel Hasselmann, Christine Kummerlen, Rosemary Kozar, Demetrios James Kutsogiannis, Constantine J Karvellas, Beth Besecker, David K Evans, Jean-Charles Preiser, Leah Gramlich, Khursheed Jeejeebhoy, Rupinder Dhaliwal, Xuran Jiang, Andrew G Day, Daren K Heyland
BACKGROUND: Nutrition guidelines recommendations differ on the use of parenteral nutrition (PN), and existing clinical trial data are inconclusive. Our recent observational data show that amounts of energy/protein received early in the intensive care unit (ICU) affect patient mortality, particularly for inadequate nutrition intake in patients with body mass indices (BMIs) of <25 or >35. Thus, we hypothesized increased nutrition delivery via supplemental PN (SPN) + enteral nutrition (EN) to underweight and obese ICU patients would improve 60-day survival and quality of life (QoL) versus usual care (EN alone)...
June 9, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28599662/a-randomized-controlled-pilot-study-to-evaluate-the-effect-of-an-enteral-formulation-designed-to-improve-gastrointestinal-tolerance-in-the-critically-ill-patient-the-spirit-trial
#10
Stephan M Jakob, Lukas Bütikofer, David Berger, Michael Coslovsky, Jukka Takala
BACKGROUND: Diarrhea is frequent in patients in intensive care units (ICU) and is associated with discomfort and complications and may increase the length of stay and nursing workload. METHODS: This was a prospective, double-blind, randomized, controlled single-center pilot study to assess the incidence and frequency of diarrhea and the respective effects of a modified enteral diet (intervention: Peptamen® AF, rich in proteins, medium chain triglycerides and fish oil) compared to a standard diet (control: Isosource® Energy) in 90 randomized adult patients (intervention, n = 46; control, n = 44) with an ICU stay ≥5 days and tube feeding ≥3 days...
June 10, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28589617/recording-patient-body-weight-in-hospitals-are-we-doing-well-enough
#11
REVIEW
Kate Flentje, Colin Knight, Ingrid Stromfeldt, Anindita Chakrabarti, N Deborah Friedman
Recording patient weight is a standard practice for all hospital admissions, with this measurement influencing other daily practices that rely on the delivery of safe and effective patient care. Patient weight is important in the areas of medication prescribing, fluid balance and assessment of nutrition. In particular, prescribing narrow therapeutic index medications may result in significant harm as a potential consequence of inaccurate dosing. Despite its importance, it is evident that body weight measurements are recorded in only 13...
June 7, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28585162/omega-3-supplementation-in-patients-with-sepsis-a-systematic-review-and-meta-analysis-of-randomized-trials
#12
Clara Lu, Sunjay Sharma, Lauralyn McIntyre, Andrew Rhodes, Laura Evans, Saleh Almenawer, Lori Leduc, Derek C Angus, Waleed Alhazzani
BACKGROUND: Nutritional supplementation of omega-3 fatty acids has been proposed to modulate the balance of pro- and anti-inflammatory mediators in sepsis. If proved to improve clinical outcomes in critically ill patients with sepsis, this intervention would be easy to implement. However, the cumulative evidence from several randomized clinical trials (RCTs) remains unclear. METHODS: We searched the Cochrane Library, MEDLINE, and EMBASE through December 2016 for RCTs on parenteral or enteral omega-3 supplementation in adult critically ill patients diagnosed with sepsis or septic shock...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28584426/use-of-nutrition-risk-in-critically-ill-nutric-score-to-assess-nutritional-risk-in-mechanically-ventilated-patients-a-prospective-observational-study
#13
M S Kalaiselvan, M K Renuka, A S Arunkumar
CONTEXT: Nutritional risk assessment must be done on all critically ill patients. Malnutrition in intensive care unit (ICU) patients is associated with adverse clinical outcomes. Traditional scoring systems cannot be used for screening in mechanically ventilated (MV) patients because these patients are unable to provide information on their history of food intake and weight loss. The Nutrition Risk in Critically ill (NUTRIC) score is the appropriate nutritional assessment tool in MV patients...
May 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28582805/enteral-nutritional-support-in-non-icu-hospitalized-patients-current-practice-in-mexico
#14
Arianne I Lupián-Angulo, Luis A Ortíz-Reyes, Lilia Castillo-Martínez, Aurora E Serralde-Zúñiga
BACKGROUND AND OBJECTIVES: Patients receiving >=80% of their energy requirements by enteral nutrition (EN) have better clinical outcomes; unfortunately, there are discrepancies between the amount prescribed and amount received. The aim of this study was to explore the nutritional clinical practice, determine the adequacy and identify reasons for underfeeding. METHODS AND STUDY DESIGN: A retrospective study was conducted in hospitalized, non-intensive care unit, adult patients receiving EN for >=72 h...
2017: Asia Pacific Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/28561252/general-care-of-the-pregnant-patient-in-the-intensive-care-unit
#15
Timothy M E Crozier
Pregnant women represent a small subset of all intensive care unit (ICU) admissions and may require intensive care for "obstetric" or "nonobstetric" reasons. Women may be admitted to the ICU at any stage of pregnancy or in the postpartum period. Pregnancy may be discovered at the time of admission to the ICU. Pregnancy impacts on ICU care in a variety of ways and requires a multidisciplinary approach to management. Pregnancy is associated with considerable physiological changes that affect most organ systems, including an expansion in blood volume, an increase in minute ventilation, and an increased risk of thrombosis...
April 2017: Seminars in Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28548991/protein-nutrition-and-exercise-survival-kit-for-critically-ill
#16
Peter J M Weijs
PURPOSE OF REVIEW: Protein delivery as well as exercise of critically ill in clinical practice is still a highly debated issue. Here we discuss only the most recent updates in the literature concerning protein nutrition and exercise of the critically ill. RECENT FINDINGS: By lack of randomized controlled trial (RCTs) in protein nutrition we discuss four post-hoc analyses of nutrition studies and one experimental study in mice. Studies mainly confirm some insights that protein and energy effects are separate and that the trajectory of the patient in the ICU might change these effects...
May 25, 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28537514/novel-family-centered-intervention-to-improve-nutrition-in-patients-recovering-from-critical-illness-a-feasibility-study
#17
Andrea P Marshall, Margot Lemieux, Rupinder Dhaliwal, Hilda Seyler, Kristen N MacEachern, Daren K Heyland
BACKGROUND: Critically ill patients are at increased risk of developing malnutrition-related complications because of physiological changes, suboptimal delivery, and reduced intake. Strategies to improve nutrition during critical illness recovery are required to prevent iatrogenic underfeeding and risk of malnutrition. The purpose of this study was to assess the feasibility and acceptability of a novel family-centered intervention to improve nutrition in critically ill patients. MATERIALS AND METHODS: A 3-phase, prospective cohort feasibility study was conducted in 4 intensive care units (ICUs) across 2 countries...
June 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28531142/optimal-energy-delivery-rather-than-the-implementation-of-a-feeding-protocol-may-benefit-clinical-outcomes-in-critically-ill-patients
#18
Chen-Yu Wang, Chun-Te Huang, Chao-Hsiu Chen, Mei-Fen Chen, Shiu-Lan Ching, Yi-Chia Huang
Malnutrition is common in intensive care units (ICU), and volume based feeding protocols have been proposed to increase nutrient delivery. However, the volume based approach compared to trophic feeding has not been proven entirely successful in critically ill patients. Our study aimed to compare the clinical outcomes both before and after the implementation of the feeding protocol, and to also evaluate the effects of total energy delivery on outcomes in these patients. We retrospectively collected all patient data, one year before and after the implementation of the volume-based feeding protocol, in the ICU at Taichung Veterans General Hospital...
May 21, 2017: Nutrients
https://www.readbyqxmd.com/read/28530846/monitoring-nutrition-in-critical-illness-what-can-we-use
#19
Suzie Ferrie, Erica Tsang
BACKGROUND: Nutrition monitoring in the context of critical care presents unique challenges. Traditionally used anthropometric and biochemical markers may be difficult to obtain or confounded by factors such as fluid status and the inflammatory response. A previous survey identified 15 parameters in common use, all of which have confounding influences during critical illness. MATERIALS AND METHODS: A literature search was conducted to assess current use of commonly used nutrition-monitoring parameters and to explore other possible methods that might be more useful...
May 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28526141/total-parenteral-and-enteral-nutrition-in-the-icu-evolving-concepts
#20
REVIEW
Amir O Elhassan, Lien B Tran, Richard C Clarke, Sumit Singh, Alan D Kaye
Appropriate nutrition in the hospital setting, particularly in critically ill patients, has long been tied to improving clinical outcomes. During critical illness, inflammatory mediators and cytokines lead to the creation of a catabolic state to facilitate the use of endogenous energy sources to meet increased energy demands. This process results in increasing the likelihood of overfeeding. The literature has revealed exponential advances in understanding the molecular basis of nutritional support and evolution of clinical protocols aimed at treating artificial nutritional support as a therapeutic intervention, preventing loss of lean body mass and metabolic deterioration to improve clinical outcomes in the critically ill...
June 2017: Anesthesiology Clinics
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