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nutrition in icu patients

Bianca Abreu Dos Santos de Oliveira, Elenir Rose Jardim Cury Pontes, Teresa Cristina Abranches Rosa
INTRODUCTION: Patients in intensive care status are in nutritional threat and frequently present innutrition, therefore monitoring the nutritional offer becomes indispensable. AIM: To purpose a control and monitoring form of enteral nutritional therapy and to evaluate its resoluteness. METHODS: Observational, analytical and retrospective study performed in intensive care patients receiving an enteral diet exclusively and/or associated with the oral/parenteral route, from January to April 2015 and from January to April 2016...
January 10, 2018: Nutrición Hospitalaria: Organo Oficial de la Sociedad Española de Nutrición Parenteral y Enteral
Sara Bermejo de Las Heras, Licia De la Calle de la Rosa, Javier Arias Díaz, Manuel Giner, Antonio Luis Blesa Malpica
BACKGROUND: Malnutrition is particularly prevalent among intensive care unit (ICU) patients, being associated with poor clinical results. Enteral nutrition (EN) offers multiple benefits on critically ill patients and its monitoring was established by the Spanish Society of Critical Care (SEMICYUC) as a clinical quality indicator (CQI; EN patients correctly monitorized / all EN patients, as %). However, no results have been published on its regulated monitoring. OBJECTIVES: Assessing CQI's compliance, identifying difficulties and possibilities for its use...
January 10, 2018: Nutrición Hospitalaria: Organo Oficial de la Sociedad Española de Nutrición Parenteral y Enteral
Jose C Jara-Aguirre, Steven W Smeets, Amy M Wockenfus, Brad S Karon
OBJECTIVE: Evaluate the effects of blood gas sample contamination with total parenteral nutrition (TPN)/lipid emulsion and dextrose 50% (D50) solutions on blood gas and electrolyte measurement; and determine whether glucose concentration can predict blood gas sample contamination with TPN/lipid emulsion or D50. DESIGN AND METHODS: Residual lithium heparin arterial blood gas samples were spiked with TPN/lipid emulsion (0 to 15%) and D50 solutions (0 to 2.5%). Blood gas (pH, pCO2, pO2), electrolytes (Na+, K+ ionized calcium) and hemoglobin were measured with a Radiometer ABL90...
March 16, 2018: Clinical Biochemistry
Charalampos Seretis, Panagiota Kaisari, Kasun Wanigasooriya, Umar Shariff, Haney Youssef
PURPOSE: Malnutrition results in a significant increase in postoperative morbidity and mortality after abdominal surgery. Apart from the anthropometric assessments, malnutrition can be also assessed using laboratory scores, with the most widely used being Onodera's Prognostic Nutritional Index (PNI). The purpose of our study was to assess if the presence of malnutrition as calculated by the Onodera's PNI was associated with higher postoperative morbidity after elective colorectal cancer resection...
January 2018: Journal of B.U.ON.: Official Journal of the Balkan Union of Oncology
Christina Rollins, Emily Bailey, Jacqueline Gregoire, Tim Milner
Clinical simulation training provides a realistic environment for students and healthcare professionals to strengthen and broaden skills and abilities. This type of learning experience creates a controlled environment in which learners may attain new skills or further develop skills that positively impact patient outcomes. Although few studies exist regarding the use of clinical simulation training and nutrition support practitioners, preliminary data following a small-bowel feeding tube (SBFT) insertion workshop for intensive care unit registered nurses and registered dietitian nutritionists showed potential use in this realm...
March 12, 2018: Nutrition in Clinical Practice
Taylor J Jackson, Burt Yaszay, Joshua M Pahys, Anuj Singla, Firoz Miyanji, Suken A Shah, Paul D Sponseller, Peter O Newton, John M Flynn, Patrick J Cahill
BACKGROUND: For large scoliosis, 2 strategies to maximize correction include intraoperative traction and/or anterior release. It is unclear which patients will benefit the most form either approach. The purpose of our study is to compare the radiographic, perioperative clinical outcomes, and health-related quality of life (HRQoL) outcomes of 2 approaches when used in severe neuromuscular scoliosis in the setting of cerebral palsy (CP). METHODS: In total, 23 patients with minimum 2-year follow-up, major curves ≥100 degrees, and in whom treatment included posterior spinal fusion were evaluated...
March 8, 2018: Journal of Pediatric Orthopedics
Xiujuan Xu, Geng Zhang, Mahong Hu, Chunlian Ji, Jianbiao Meng, Zhizhen Lai, Muhua Dai, Lisha Pang, Wei Zhang
OBJECTIVE: To study the influence of clinical nutritional support on the effects of mechanical ventilation (MV), and to find the factors affecting the outcome of patients undergoing MV. METHODS: A case-control study was conducted. The clinical data of 235 patients undergoing MV admitted to intensive care unit (ICU) of Tongde Hospital of Zhejiang Province from January 2015 to June 2017 were retrospectively analyzed. The patients were divided into two groups according to whether weaning successfully within 7 days...
March 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
Nicolino Ambrosino, Michele Vitacca
Background: Progress in management has improved hospital mortality of patients admitted to the intensive care units, but also the prevalence of those patients needing weaning from prolonged mechanical ventilation, and of ventilator assisted individuals. The result is a number of difficult clinical and organizational problems for patients, caregivers and health services, as well as high human and financial resources consumption, despite poor long-term outcomes. An effort should be made to improve the management of these patients...
2018: Multidisciplinary Respiratory Medicine
D Dante Yeh, Eva Fuentes, Sadeq A Quraishi, Jarone Lee, Haytham M A Kaafarani, Peter Fagenholz, Kathryn Butler, Marc DeMoya, Yuchiao Chang, George Velmahos
BACKGROUND: Failure to provide adequate nutrition in the intensive care unit (ICU) may be particularly harmful for patients with prolonged critical illness. We hypothesized that early nutrition inadequacy is more influential for those requiring a longer ICU stay versus those requiring a shorter stay. METHODS: We enrolled 280 adult patients with prolonged surgical ICU stay who were receiving enteral nutrition for >72 hours. Subjects were divided into 2 groups: shortICU (<14 days) and longICU (≥14 days)...
January 2018: JPEN. Journal of Parenteral and Enteral Nutrition
Pilar Anton-Martin, Michael Papacostas, Elisabeth Lee, Paul A Nakonezny, Michael L Green
BACKGROUND: Malnutrition is associated with an increased risk of mortality in patients admitted to the intensive care unit. Children requiring extracorporeal membrane oxygenation (ECMO) support represent an extremely ill subset of this population. There is a lack of data on the impact of nutrition state on survival in this cohort. We examined the association between being underweight and in-hospital mortality among children supported with ECMO. MATERIALS AND METHODS: This article reports on an observational retrospective cohort study performed among neonatal and pediatric patients supported with ECMO in a tertiary children's hospital from May 1996 through June 2013...
January 2018: JPEN. Journal of Parenteral and Enteral Nutrition
Ayse Gulsah Atasever, Perihan Ergin Ozcan, Kamber Kasali, Taner Abdullah, Gunseli Orhun, Evren Senturk
Background: Gastrointestinal (GI) motility disorders in intensive care patients remain relatively unexplored. Nowadays, the frequency, risk factors and complications of GI dysfunction during enteral nutrition (EN) become more questionable. Aim: To evaluate the frequency, risk factors and complications of GI dysfunction during EN in the first 2 weeks of the intensive care unit (ICU) stay and to identify precautions to prevent the development of GI dysfunction and avoid complications...
2018: Therapeutics and Clinical Risk Management
Anna Patkova, Vera Joskova, Eduard Havel, Simona Najpaverova, Daniela Uramova, Miroslav Kovarik, Zdenek Zadak, Miloslav Hronek
OBJECTIVE: The association between energy metabolism and prognosis in polytrauma patients has not yet been defined. The aim of this study was to describe energy metabolism and analyze the prognostic value of respiratory quotient (RQ) and nonprotein respiratory quotient (npRQ) in fasting polytrauma patients (fPP) and polytrauma patients with nutritional support (nsPP). METHODS: Twenty-two polytrauma patients (before and after parenteral nutrition administration) and 22 healthy controls (after overnight fasting) were examined on day 4 (median) after admission to the intensive care unit...
November 7, 2017: Nutrition
Bethan Jenkins, Philip C Calder, Luise V Marino
BACKGROUND & AIMS: Critically ill adults have increased nutrition risk. Prior to procedures patients are often fasted, leading to nutritional deficits. The use of fasting guidelines may therefore help reduce deficits from accumulating. The aim of this work was to determine the impact on nutrition support delivery following the implementation of fasting guidelines in addition to characterizing staff knowledge of the guidelines. DESIGN: Retrospective data were collected on n = 74 patients at two different time points; prior to launch of fasting guidelines and post launch, with regards to estimated nutritional requirements, nutritional targets, volume of enteral nutrition (EN) delivered and periods of fasting...
February 15, 2018: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
Michael T Vest, Paul Kolm, James Bowen, Jillian Trabulsi, Shannon L Lennon, Mary Shapero, Patty McGraw, James Halbert, Claudine Jurkovitz
BACKGROUND: Clinical practice guidelines recommend enteral nutrition for most patients receiving mechanical ventilation. However, recently published evidence on the effect of enteral nutrition on mortality, particularly for patients who are well nourished, is conflicting. OBJECTIVES: To examine the association between enteral feeding and hospital mortality in critically ill patients receiving mechanical ventilation and to determine if body mass index mediates this relationship...
March 2018: American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses
W A C Kristine Koekkoek, C H Coralien van Setten, Laura E Olthof, J C N Hans Kars, Arthur R H van Zanten
BACKGROUND & AIMS: Optimal protein intake during critical illness is unknown. Conflicting results on nutritional support during the first week of ICU stay have been published. We addressed timing of protein intake and outcomes in ICU patients requiring prolonged mechanical ventilation. METHODS: We retrospectively collected nutritional and clinical data on the first 7 days of ICU admission of adult critically ill patients, who were mechanically ventilated in our ICU for at least 7 days and admitted between January 1st 2011 and December 31st 2015...
February 17, 2018: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
Kate Fetterplace, Adam M Deane, Audrey Tierney, Lisa Beach, Laura D Knight, Thomas Rechnitzer, Adrienne Forsyth, Marina Mourtzakis, Jeffrey Presneill, Christopher MacIsaac
Background: Current guidelines for the provision of protein for critically ill patients are based on incomplete evidence, due to limited data from randomised controlled trials. The present pilot randomised controlled trial is part of a program of work to expand knowledge about the clinical effects of protein delivery to critically ill patients. The primary aim of this pilot study is to determine whether an enteral feeding protocol using a volume target, with additional protein supplementation, delivers a greater amount of protein and energy to mechanically ventilated critically ill patients than a standard nutrition protocol...
2018: Pilot and Feasibility Studies
Astrid Ruiz-Margáin, Alessandra Pohlmann, Patrick Ryan, Robert Schierwagen, Luis A Chi-Cervera, Christian Jansen, Osvely Mendez-Guerrero, Nayelli C Flores-García, Jennifer Lehmann, Aldo Torre, Ricardo Ulises Macías-Rodríguez, Jonel Trebicka
OBJECTIVE: Acute-on-chronic liver failure (ACLF) develops in acute decompensation of cirrhosis and shows high mortality. In critically ill patients, early diagnosis of ACLF could be important for therapeutic decisions (e.g. renal replacement, artificial liver support, liver transplantation). This study evaluated fibroblast growth factor 21 (FGF21), as a marker of mitochondrial dysfunction in the context of ACLF. DESIGN: The study included 154 individuals (112 critically patients and 42 healthy controls) divided into a training and a validation cohort...
February 24, 2018: Liver Transplantation
Jeanine J Sol, Moniek van de Loo, Marit Boerma, Klasien A Bergman, Albertine E Donker, Mark A H B M van der Hoeven, Christiaan V Hulzebos, Ronny Knol, K Djien Liem, Richard A van Lingen, Enrico Lopriore, Monique H Suijker, Daniel C Vijlbrief, Remco Visser, Margreet A Veening, Mirjam M van Weissenbruch, C Heleen van Ommen
BACKGROUND: In critically ill (preterm) neonates, central venous catheters (CVCs) are increasingly used for administration of medication or parenteral nutrition. A serious complication, however, is the development of catheter-related thrombosis (CVC-thrombosis), which may resolve by itself or cause severe complications. Due to lack of evidence, management of neonatal CVC-thrombosis varies among neonatal intensive care units (NICUs). In the Netherlands an expert-based national management guideline has been developed which is implemented in all 10 NICUs in 2014...
February 23, 2018: BMC Pediatrics
Heitor Pons Leite, Lúcio Flávio Peixoto de Lima, José Augusto de A C Taddei, Ângela Tavares Paes
OBJECTIVE: To test the hypothesis that low blood thiamine concentrations in malnourished critically ill children are associated with higher risk of 30-d mortality. METHODS: Prospective cohort study in 202 consecutively admitted children who had whole blood thiamine concentrations assessed on admission and on days 5 and 10 of intensive care unit (ICU) stay. The primary outcome variable was 30-d mortality. Mean blood thiamine concentrations within the first 10 d of ICU stay, age, sex, malnutrition, C-reactive protein concentration, Pediatric Index of Mortality 2 score, and severe sepsis/septic shock were the main potential exposure variables for outcome...
April 2018: Nutrition
Sören Verstraete, Ilse Vanhorebeek, Esther van Puffelen, Inge Derese, Catherine Ingels, Sascha C Verbruggen, Pieter J Wouters, Koen F Joosten, Jan Hanot, Gonzalo G Guerra, Dirk Vlasselaers, Jue Lin, Greet Van den Berghe
BACKGROUND: Children who have suffered from critical illnesses that required treatment in a paediatric intensive care unit (PICU) have long-term physical and neurodevelopmental impairments. The mechanisms underlying this legacy remain largely unknown. In patients suffering from chronic diseases hallmarked by inflammation and oxidative stress, poor long-term outcome has been associated with shorter telomeres. Shortened telomeres have also been reported to result from excessive food consumption and/or unhealthy nutrition...
February 21, 2018: Critical Care: the Official Journal of the Critical Care Forum
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