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Nutrition and critical care

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https://www.readbyqxmd.com/read/29143891/in-search-of-the-ideal-promotility-agent-optimal-use-of-currently-available-promotility-agents-for-nutrition-therapy-of-the-critically-ill-patient
#1
REVIEW
Sarah J Diamond, Endashaw Omer, Laszlo Kiraly
PURPOSE OF REVIEW: Enteral nutrition therapy is essential in the management of critically ill patients. Prokinetic agents have been used successfully to aid in the delivery of nutrition and improve feeding tolerance in patients in the intensive care unit (ICU). The aim of this report is to review the existing promotility agents available for use in the critically ill as well as outline the role of potential investigative drugs in order to provide a guide to the management of this difficult and important clinical dilemma...
November 16, 2017: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/29143766/assessment-of-micronutrient-status-in-critically-ill-children-challenges-and-opportunities
#2
REVIEW
Duy T Dao, Lorenzo Anez-Bustillos, Bennet S Cho, Zhilling Li, Mark Puder, Kathleen M Gura
Micronutrients refer to a group of organic vitamins and inorganic trace elements that serve many functions in metabolism. Assessment of micronutrient status in critically ill children is challenging due to many complicating factors, such as evolving metabolic demands, immature organ function, and varying methods of feeding that affect nutritional dietary intake. Determination of micronutrient status, especially in children, usually relies on a combination of biomarkers, with only a few having been established as a gold standard...
October 28, 2017: Nutrients
https://www.readbyqxmd.com/read/29143474/chronic-intestinal-pseudo-obstruction-progress-in-management
#3
REVIEW
G Di Nardo, T B Karunaratne, S Frediani, R De Giorgio
Chronic intestinal pseudo-obstruction (CIPO) is a severe form of gastrointestinal dysmotility (often due to derangement of the innervation/smooth muscle/interstitial cells of Cajal) with recurrent episodes of intestinal subocclusion mimicking a mechanical obstruction. Because of its complexity and heterogeneity, CIPO is often misdiagnosed or remains unrecognized until advanced stages. Management is a critical aspect in CIPO patient care. So far, most prokinetic drugs have not proven efficacy in restoring intestinal propulsion, thus nutritional support, fluid/electrolyte replacement, and antibiotics are the mainstay of treatment...
December 2017: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/29141590/health-nutrition-and-development-of-children-born-preterm-and-low-birth-weight-in-rural-rwanda-a-cross-sectional-study
#4
Catherine M Kirk, Jean Claude Uwamungu, Kim Wilson, Bethany L Hedt-Gauthier, Neo Tapela, Peter Niyigena, Christian Rusangwa, Merab Nyishime, Evrard Nahimana, Fulgence Nkikabahizi, Christine Mutaganzwa, Eric Ngabireyimana, Francis Mutabazi, Hema Magge
BACKGROUND: As care for preterm and low birth weight (LBW) infants improves in resource-limited settings, more infants are surviving the neonatal period. Preterm and (LBW) infants are at high-risk of nutritional and medical comorbidities, yet little is known about their developmental outcomes in low-income countries. This study evaluated the health, nutritional, and developmental status of preterm/LBW children at ages 1-3 years in Rwanda. METHODS: Cross-sectional study of preterm/LBW infants discharged between October 2011 and October 2013 from a hospital neonatal unit in rural Rwanda...
November 15, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/29130725/-eighth-jes%C3%A3%C2%BAs-culebras-lecture-critical-care-nutrition-and-hyperglycemia-a-close-relationship
#5
Alfonso Mesejo
Critically ill patients show a metabolic response to injury that affects carbohydrate metabolism, causing hyperglycemia and an increase in glycemic variability that makes the critically ill patient susceptible to infection, resulting in morbidity and mortality increase. Also, severe hypoglycemia was detected as a consequence of intensive insulin treatment that provokes deleterious effects in their clinical evolution, so a correct monitoring of plasma glucose would contribute to reduce morbidity and mortality...
October 24, 2017: Nutrición Hospitalaria: Organo Oficial de la Sociedad Española de Nutrición Parenteral y Enteral
https://www.readbyqxmd.com/read/29130288/optimising-early-neonatal-nutrition-using-translational-research-methodology
#6
Denise Page, Melissa Gilroy, Elizabeth Hurrion, Lisa Clark, Shelley Wilkinson
AIM: Preterm birth has been described as a 'nutritional emergency', with these infants often born with minimal nutrition reserves. Failure to provide adequate early nutrition jeopardises growth and neurodevelopment. Consensual nutrition guidelines exist for infants who weigh <1500 g; however, audits have identified shortfalls in their adherence, consequently highlighting an evidence-practice gap. This work aimed to identify the barriers to the delivery of early optimal nutrition in a tertiary-level Neonatal Critical Care Unit to inform an implementation project to ensure best practice care...
November 2017: Nutrition & Dietetics: the Journal of the Dietitians Association of Australia
https://www.readbyqxmd.com/read/29128300/enteral-versus-parenteral-early-nutrition-in-ventilated-adults-with-shock-a-randomised-controlled-multicentre-open-label-parallel-group-study-nutrirea-2
#7
Jean Reignier, Julie Boisramé-Helms, Laurent Brisard, Jean-Baptiste Lascarrou, Ali Ait Hssain, Nadia Anguel, Laurent Argaud, Karim Asehnoune, Pierre Asfar, Frédéric Bellec, Vlad Botoc, Anne Bretagnol, Hoang-Nam Bui, Emmanuel Canet, Daniel Da Silva, Michael Darmon, Vincent Das, Jérôme Devaquet, Michel Djibre, Frédérique Ganster, Maité Garrouste-Orgeas, Stéphane Gaudry, Olivier Gontier, Claude Guérin, Bertrand Guidet, Christophe Guitton, Jean-Etienne Herbrecht, Jean-Claude Lacherade, Philippe Letocart, Frédéric Martino, Virginie Maxime, Emmanuelle Mercier, Jean-Paul Mira, Saad Nseir, Gael Piton, Jean-Pierre Quenot, Jack Richecoeur, Jean-Philippe Rigaud, René Robert, Nathalie Rolin, Carole Schwebel, Michel Sirodot, François Tinturier, Didier Thévenin, Bruno Giraudeau, Amélie Le Gouge
BACKGROUND: Whether the route of early feeding affects outcomes of patients with severe critical illnesses is controversial. We hypothesised that outcomes were better with early first-line enteral nutrition than with early first-line parenteral nutrition. METHODS: In this randomised, controlled, multicentre, open-label, parallel-group study (NUTRIREA-2 trial) done at 44 French intensive-care units (ICUs), adults (18 years or older) receiving invasive mechanical ventilation and vasopressor support for shock were randomly assigned (1:1) to either parenteral nutrition or enteral nutrition, both targeting normocaloric goals (20-25 kcal/kg per day), within 24 h after intubation...
November 8, 2017: Lancet
https://www.readbyqxmd.com/read/29115861/postnatal-overnutrition-affects-metabolic-and-vascular-function-reflected-by-physiological-and-histological-changes-in-the-aorta-of-adult-wistar-rats
#8
Gerardo Sánchez-García, Laura Del Bosque-Plata, Enrique Hong
Rigorous nutritional care during early life leads to healthy adulthood. Cardiovascular and metabolic disorders, the most prevalent clinical challenges worldwide, are epidemiologically linked to poor nutritional habits throughout life. We aimed to understand whether postnatal overnutrition (PO) initiated during lactation affects metabolic markers and vascular function later in life. To test this hypothetical effect, we studied a PO Wistar rat model based on adjusting litter size at the third day of age to three pups and eight for the control group (C)...
November 8, 2017: Clinical and Experimental Hypertension: CHE
https://www.readbyqxmd.com/read/29114408/a-different-approach-to-the-nutritional-therapy-in-intensive-care-units-nutrition-software-icnus
#9
REVIEW
Mois Bahar
Critically ill patients receive nutritional support in addition to extensive organ support therapies in the intensive care units. The transcription of the data obtained by multiple devices from a wide spectrum of usage areas is a challenging process and is prone to errors. Software specifically designed for usage in intensive care units do offer numerous advantages. Primarily, it facilitates to improve the management of time and workflow for the benefit of patients. Therefore, we believed that a different approach was needed for the nutritional regime of our critically ill patients...
October 2017: Turkish Journal of Anaesthesiology and Reanimation
https://www.readbyqxmd.com/read/29103714/ethyl-cellulose-rumen-protected-methionine-alleviates-inflammation-and-oxidative-stress-and-improves-neutrophil-function-during-the-periparturient-period-and-early-lactation-in-holstein-dairy-cows
#10
F Batistel, J M Arroyo, C I M Garces, E Trevisi, C Parys, M A Ballou, F C Cardoso, J J Loor
The periparturient period is the most critical phase in the productive cycle of dairy cows and is characterized by impairment of the immune system. Our objective was to evaluate the effect of feeding ethyl-cellulose rumen-protected methionine (RPM) starting at d -28 from expected parturition through 60 d in milk on biomarkers of inflammation, oxidative stress, and liver function as well as leukocyte function. Sixty multiparous Holstein cows were used in a block design and assigned to either a control or the control plus ethyl-cellulose RPM (Mepron, Evonik Nutrition & Care GmbH)...
November 2, 2017: Journal of Dairy Science
https://www.readbyqxmd.com/read/29095016/hospital-malnutrition-screening-at-admission-malnutrition-increases-mortality-and-length-of-stay
#11
Elisabet Leiva Badosa, Maria Badia Tahull, Núria Virgili Casas, Gema Elguezabal Sangrador, Concepción Faz Méndez, Ignacio Herrero Meseguer, Àngels Izquierdo González, Rafael López Urdiales, Francisco Javier Oca Burguete, María Tubau Molas, Concepció Vilarasau Farré, Josep Manel Llop Talaveron
INTRODUCTION: Malnutrition is common in patients admitted to hospital and is associated with morbidity and mortality. We conducted a study to assess the prevalence of nutritional risk, risk factors associated and its consequences in a third-level hospital. METHODS: This is a prospective nutritional screening study of hospitalized patients evaluated within the first 72 hours of admission, by Malnutrition Universal Screening Tool (MUST) and Short Nutritional Assessment Questionnaire (SNAQ) screening tests...
July 28, 2017: Nutrición Hospitalaria: Organo Oficial de la Sociedad Española de Nutrición Parenteral y Enteral
https://www.readbyqxmd.com/read/29061391/delivery-of-full-predicted-energy-from-nutrition-and-the-effect-on-mortality-in-critically-ill-adults-a-systematic-review-and-meta-analysis-of-randomised-controlled-trials
#12
Emma J Ridley, Andrew R Davies, Carol L Hodgson, Adam Deane, Michael Bailey, D Jamie Cooper
BACKGROUND: The amount of energy required to improve clinical outcomes in critically ill adults is unknown. OBJECTIVE: The aim of this systematic review and meta-analysis was to evaluate the impact of near target energy delivery to critically ill adults on mortality and other clinically relevant outcomes. DESIGN: Following PRISMA guidelines, MEDLINE, EMBASE, CINHAL and the Cochrane Library were searched for randomised controlled trials evaluating nutrition interventions in adult critical care populations...
October 9, 2017: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/29059691/identifying-trends-in-undiagnosed-diabetes-in-u-s-adults-by-using-a-confirmatory-definition-a-cross-sectional-study
#13
Elizabeth Selvin, Dan Wang, Alexandra K Lee, Richard M Bergenstal, Josef Coresh
Background: A common belief is that one quarter to one third of all diabetes cases remain undiagnosed. However, such prevalence estimates may be overstated by epidemiologic studies that do not use confirmatory testing, as recommended by clinical diagnostic criteria. Objective: To provide national estimates of undiagnosed diabetes by using a confirmatory testing strategy, in line with clinical practice guidelines. Design: Cross-sectional study...
October 24, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/29049016/skeletal-muscle-ultrasonography-in-nutrition-and-functional-outcome-assessment-of-critically-ill-children-experience-and-insights-from-pediatric-disease-and-adult-critical-care-studies-formula-see-text
#14
Chengsi Ong, Jan Hau Lee, Melvin K S Leow, Zudin A Puthucheary
Evidence suggests that critically ill children develop muscle wasting, which could affect outcomes. Muscle ultrasound has been used to track muscle wasting and association with outcomes in critically ill adults but not children. This review aims to summarize methodological considerations of muscle ultrasound, structural findings, and possibilities for its application in the assessment of nutrition and functional outcomes in critically ill children. Medline, Embase, and CINAHL databases were searched up until April 2016...
September 2017: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/29045423/candidemia-in-non-icu-surgical-wards-comparison-with-medical-wards
#15
MULTICENTER STUDY
Antonio Vena, Emilio Bouza, Maricela Valerio, Belén Padilla, José Ramón Paño-Pardo, Mario Fernández-Ruiz, Ana Díaz Martín, Miguel Salavert, Alessandra Mularoni, Mireia Puig-Asensio, Patricia Muñoz
Candidemia acquired outside critical care or hematological areas has received much attention in recent years; however, data on candidemia in surgical departments are very scarce. Our objectives were to describe episodes of candidemia diagnosed in surgical wards and to compare them with episodes occurring in medical wards. We performed a post hoc analysis of a prospective, multicenter study implemented in Spain during 2010-2011 (CANDIPOP project). Of the 752 episodes of candidemia, 369 (49.1%) occurred in patients admitted to surgical wards (165, 21...
2017: PloS One
https://www.readbyqxmd.com/read/28992064/estimating-the-comparative-effectiveness-of-feeding-interventions-in-the-paediatric-intensive-care-unit-a-demonstration-of-longitudinal-targeted-maximum-likelihood-estimation
#16
Noémi Kreif, Linh Tran, Richard Grieve, Bianca deStavola, Robert C Tasker, Maya Petersen
Longitudinal data sources offer new opportunities for the evaluation of sequential interventions. To adjust for time-dependent confounding in these settings, longitudinal targeted maximum likelihood based estimation (TMLE), a double-robust method that can be coupled with machine learning, has been proposed. This paper provides a tutorial in applying longitudinal TMLE, in contrast to inverse probability of treatment weighting and g-computation based on iterative conditional expectations. We apply these methods to estimate the causal effect of nutritional interventions on clinical outcomes of critically ill children...
June 24, 2017: American Journal of Epidemiology
https://www.readbyqxmd.com/read/28986026/nutrition-prevention-and-management-of-nutritional-failure-in-cystic-fibrosis
#17
Jillian S Sullivan, Maria R Mascarenhas
Close monitoring of nutritional status is critical to the overall health of a patient with CF. As part of routine CF care, measurement of weight and height (and calculation of weight/length or BMI as appropriate) should be performed and analyzed at each visit. Early recognition of nutritional risk is imperative and evaluation with a multidisciplinary team should be performed to assess for caloric intake, caloric malabsorption, and other causes of poor weight gain and growth. Many tools are available to use for intervention, including oral supplementation, behavioral interventions, medications, nutritional therapies, and enteral tube feeding...
November 2017: Journal of Cystic Fibrosis: Official Journal of the European Cystic Fibrosis Society
https://www.readbyqxmd.com/read/28973065/effect-of-systematic-intensive-care-unit-triage-on-long-term-mortality-among-critically-ill-elderly-patients-in-france-a-randomized-clinical-trial
#18
RANDOMIZED CONTROLLED TRIAL
Bertrand Guidet, Guillaume Leblanc, Tabassome Simon, Maguy Woimant, Jean-Pierre Quenot, Olivier Ganansia, Maxime Maignan, Youri Yordanov, Samuel Delerme, Benoit Doumenc, Muriel Fartoukh, Pierre Charestan, Pauline Trognon, Bertrand Galichon, Nicolas Javaud, Anabela Patzak, Maïté Garrouste-Orgeas, Caroline Thomas, Sylvie Azerad, Dominique Pateron, Ariane Boumendil
Importance: The high mortality rate in critically ill elderly patients has led to questioning of the beneficial effect of intensive care unit (ICU) admission and to a variable ICU use among this population. Objective: To determine whether a recommendation for systematic ICU admission in critically ill elderly patients reduces 6-month mortality compared with usual practice. Design, Setting, and Participants: Multicenter, cluster-randomized clinical trial of 3037 critically ill patients aged 75 years or older, free of cancer, with preserved functional status (Index of Independence in Activities of Daily Living ≥4) and nutritional status (absence of cachexia) who arrived at the emergency department of one of 24 hospitals in France between January 2012 and April 2015 and were followed up until November 2015...
October 17, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28958185/targeting-the-endothelial-glycocalyx-in-acute-critical-illness-as-a-challenge-for-clinical-and-laboratory-medicine
#19
Vladimir Cerny, David Astapenko, Florian Brettner, Jan Benes, Radomir Hyspler, Christian Lehmann, Zdenek Zadak
The purpose of this manuscript is to review the role of endothelial glycocalyx (EG) in the field of critical and perioperative medicine and to discuss possible future directions for investigations in this area. Under physiological conditions, EG has several well-defined functions aimed to prevent the disruption of vessel wall integrity. Under pathological conditions, the EG represent one of the earliest sites of injury during inflammation. EG structure and function distortion contribute to organ dysfunction related to sepsis, trauma, or global ischemia of any origin...
August 2017: Critical Reviews in Clinical Laboratory Sciences
https://www.readbyqxmd.com/read/28955418/a-qualitative-study-of-health-education-experiences-and-self-management-practices-among-patients-with-type-2-diabetes-at-malamulo-adventist-hospital-in-thyolo-district-malawi
#20
Temidayo Ogunrinu, Thelma Gamboa-Maldonado, R Ndinda Ngewa, Jasmine Saunders, Jamie Crounse, James Misiri
BACKGROUND: The aim of this study was to understand the perceptions and experiences of health education and self-management practices on Malamulo Adventist Hospital type 2 diabetic patients. METHODS: In this qualitative study, key informant interviews (KIIs; n=4) and focus group discussions (3 FGDs; n=16) were conducted amongst type 2 diabetes patients who had been treated at Malamulo Adventist Hospital in southern Malawi at least once. Key informant interviews and focus group discussions were audio recorded, transcribed verbatim and translated for analysis...
June 2017: Malawi Medical Journal: the Journal of Medical Association of Malawi
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