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Nutrition in icu

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https://www.readbyqxmd.com/read/29353120/phase-angle-assessment-in-critically-ill-cancer-patients-relationship-with-the-nutritional-status-prognostic-factors-and-death
#1
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/29351143/nutrition-in-the-icu-new-trends-versus-old-fashioned-standard-enteral-feeding
#2
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/29342203/biological-pathways-underlying-the-association-of-red-cell-distribution-width-and-adverse-clinical-outcome-results-of-a-prospective-cohort-study
#3
Giedre Zurauskaite, Marc Meier, Alaadin Voegeli, Daniel Koch, Sebastian Haubitz, Alexander Kutz, Luca Bernasconi, Andreas Huber, Mario Bargetzi, Beat Mueller, Philipp Schuetz
BACKGROUND: Red cell distribution width (RDW) predicts disease outcome in several patient populations, but its prognostic value in addition to other disease parameters in unselected medical inpatients remains unclear. Our aim was to investigate the association of admission RDW levels and mortality adjusted for several disease pathways in unselected medical patients from a previous multicenter study. METHODS: We included consecutive adult, medical patients at the time point of hospital admission through the emergency department into this observational, cohort study...
2018: PloS One
https://www.readbyqxmd.com/read/29341970/does-the-use-of-indirect-calorimetry-change-outcome-in-the-icu-yes-it-does
#4
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/29330610/nutrition-delivery-of-a-model-based-icu-glycaemic-control-system
#5
Kent W Stewart, J Geoffrey Chase, Christopher G Pretty, Geoffrey M Shaw
BACKGROUND: Hyperglycaemia is commonplace in the adult intensive care unit (ICU), associated with increased morbidity and mortality. Effective glycaemic control (GC) can reduce morbidity and mortality, but has proven difficult. STAR is a proven, effective model-based ICU GC protocol that uniquely maintains normo-glycaemia by changing both insulin and nutrition interventions to maximise nutrition in the context of GC in the 4.4-8.0 mmol/L range. Hence, the level of nutrition it provides is a time-varying estimate of the patient-specific ability to take up glucose...
January 10, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29323761/chronic-critical-illness-application-of-what-we-know
#6
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
#7
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
#8
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/29306205/relevance-of-and-aspen-criteria-of-malnutrition-to-predict-hospital-mortality-in-critically-ill-patients-a-prospective-study
#9
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/29301555/improving-partnerships-with-family-members-of-icu-patients-study-protocol-for-a-randomized-controlled-trial
#10
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/29300728/intensive-insulin-therapy-increases-glutathione-synthesis-rate-in-surgical-icu-patients-with-stress-hyperglycemia
#11
Gianni Biolo, Benedetta Massolino, Filippo Giorgio Di Girolamo, Nicola Fiotti, Filippo Mearelli, Sara Mazzucco, Carlos Bertuzzi, Renzo Lazzarini, Alfonso Colombatti, Marcello De Cicco
OBJECTIVE: The glutathione system plays an essential role in antioxidant defense after surgery. We assessed the effects of intensive insulin treatment (IIT) on glutathione synthesis rate and redox balance in cancer patients, who had developed stress hyperglycemia after major surgery. METHODS: We evaluated 10 non-diabetic cancer patients the day after radical abdominal surgery combined with intra-operative radiation therapy. In each patient, a 24-hr period of IIT, aimed at tight euglycemic control, was preceded, or followed, by a 24-hr period of conventional insulin treatment (CIT) (control regimen)...
2018: PloS One
https://www.readbyqxmd.com/read/29297385/tailoring-nutrition-therapy-to-illness-and-recovery
#12
REVIEW
Paul E Wischmeyer
Without doubt, in medicine as in life, one size does not fit all. We do not administer the same drug or dose to every patient at all times, so why then would we live under the illusion that we should give the same nutrition at all times in the continuum of critical illness? We have long lived under the assumption that critical illness and trauma lead to a consistent early increase in metabolic/caloric need, the so-called "hypermetabolism" of critical illness. What if this is incorrect? Recent data indicate that early underfeeding of calories (trophic feeding) may have benefits and may require consideration in well-nourished patients...
December 28, 2017: Critical Care: the Official Journal of the Critical Care Forum
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
#13
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/29290518/enteral-nutrition-improves-clinical-outcome-and-reduces-costs-of-acute-mesenteric-ischaemia-after-recanalisation-in-the-intensive-care-unit
#14
Shuofei Yang, Jianming Guo, Qihong Ni, Jiaquan Chen, Xiangjiang Guo, Guanhua Xue, Meng Ye, Lan Zhang
BACKGROUND: Little data evaluate the enteral nutrition (EN) for patients with acute mesenteric ischaemia (AMI) in the intensive care unit (ICU). This study assessed the outcomes of EN for recanalised AMI patients in the ICU. METHODS: In this retrospective study, 183 AMI patients with mesenteric recanalisation admitted to two surgical ICUs were included. Patients were divided into EN (EN within first week, n = 95) and total parenteral nutrition (TPN) group (TPN in 1st week, n = 88)...
December 20, 2017: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/29289386/mortality-risk-factors-in-elderly-patients-in-intensive-care-without-limitation-of-therapeutic-effort
#15
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/29285609/functional-compromise-cohort-study-fccs-sarcopenia-is-a-strong-predictor-of-mortality-in-the-intensive-care-unit
#16
P A de Hoogt, K W Reisinger, J J W Tegels, J W A M Bosmans, F Tijssen, J H M B Stoot
BACKGROUND: Functional compromise in elderly patients is considered to be a significant contributing factor in increased postoperative morbidity and mortality. It is described as a state of reduced physiologic reserves including, e.g., sarcopenia, cachexia, malnutrition and frailty with increased susceptibility to adverse health outcomes. Aim of this study was to investigate the association of sarcopenia with mortality in ICU patients. METHODS: A retrospective analysis of a total of 687 patients admitted to the ICU from January 2013 until December 2014 was performed...
December 29, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/29284566/surviving-fournier-s-gangrene-multivariable-analysis-and-a-novel-scoring-system-to-predict-length-of-stay
#17
Saum B Ghodoussipour, Daniel Gould, Jacob Lifton, Ido Badash, Aaron Krug, Gus Miranda, Jeffrey Loh-Doyle, Joseph Carey, Hooman Djaladat, Leo Doumanian, David Ginsberg
BACKGROUND: There is no contemporary scoring system to predict hospital length of stay and morbidity in Fournier's gangrene. A retrospective study was conducted to formulate a scoring system to predict duration of hospitalization, resource utilization, need for reconstruction, morbidity and mortality. METHODS: A retrospective chart review was performed on 54 patients treated for FG from 2010-2016 at LAC+USC Medical Center, the largest public hospital in Los Angeles County...
December 14, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
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/29280641/-assessment-of-the-clinical-quality-indicator-early-enteral-nutrition-in-intensive-care-units
#19
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
https://www.readbyqxmd.com/read/29280129/-preliminary-discussion-of-therapeutic-strategies-in-persistent-inflammation-immunosuppression-catabolism-syndrome
#20
Heyi Su, Zhenhui Guo
So far, there is still lack of effective treatment to control persistent inflammation immunosuppression catabolism syndrome (PICS) appeared generally in those chronic critical illnesses (CCI) patients, restricted by the development of medicine and scientific research nowadays. Because the uncontrolled PICS aggravates continuously, ICU stay of the CCI patients has been obviously prolonging and the late mortality elevates greatly. So exploring effective therapeutic strategies is obviously pressing. With the characteristics in PICS such as that elderly with sepsis or severe trauma tops the list of morbidity, progressing illness is difficult to intervent and various pathology changes occur simultaneously, the fundamental principle of treatment, "Focal screening, early control, joint intervention" must be followed...
December 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
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