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Nutrition and critical care

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https://www.readbyqxmd.com/read/29351143/nutrition-in-the-icu-new-trends-versus-old-fashioned-standard-enteral-feeding
#1
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/29348280/marked-cachexia-in-probable-invasive-pulmonary-aspergillosis-with-bronchopleural-fistula
#2
Christiana Page, Laura Blazy, Melanie Jenkins, Rosalba Spiritoso
A 49-year-old man with a medical history of diabetes and heavy smoking was admitted to intensive care with severe bilateral pneumonia associated with marked cachexia. He developed a complex right-sided bronchopleural fistula and was transferred to our tertiary centre for consideration of surgical intervention.Despite escalation of antibiotic therapy, he did not improve and further investigations led to a diagnosis of invasive pulmonary aspergillosis. Definitive treatment plans required a right pneumonectomy; however, given the severity of cachexia, he remained unable to undergo such a large operation...
January 17, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29341970/does-the-use-of-indirect-calorimetry-change-outcome-in-the-icu-yes-it-does
#3
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/29335014/cost-effectiveness-study-of-early-versus-late-parenteral-nutrition-in-critically-ill-children-pepanic-preplanned-secondary-analysis-of-a-multicentre-randomised-controlled-trial
#4
Esther van Puffelen, Suzanne Polinder, Ilse Vanhorebeek, Pieter Jozef Wouters, Niek Bossche, Guido Peers, Sören Verstraete, Koen Felix Maria Joosten, Greet Van den Berghe, Sascha Cornelis Antonius Theodorus Verbruggen, Dieter Mesotten
BACKGROUND: The multicentre randomised controlled PEPaNIC trial showed that withholding parenteral nutrition (PN) during the first week of critical illness in children was clinically superior to providing early PN. This study describes the cost-effectiveness of this new nutritional strategy. METHODS: Direct medical costs were calculated with use of a micro-costing approach. We compared the costs of late versus early initiation of PN (n = 673 versus n = 670 patients) in the Belgian and Dutch study populations from a hospital perspective, using Student's t test with bootstrapping...
January 15, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29324561/nursing-minimum-data-sets-for-documenting-nutritional-care-for-adults-in-primary-healthcare-a-scoping-review
#5
Sasja Jul Håkonsen, Preben Ulrich Pedersen, Merete Bjerrum, Ann Bygholm, Micah D J Peters
OBJECTIVE: To identify all published nutritional screening instruments that have been validated in the adult population in primary healthcare settings and to report on their psychometric validity. INTRODUCTION: Within health care, there is an urgent need for the systematic collection of nursing care data in order to make visible what nurses do and to facilitate comparison, quality assurance, management, research and funding of nursing care. To be effective, nursing records should accurately and comprehensively document all required information to support safe and high quality care of patients...
January 2018: JBI Database of Systematic Reviews and Implementation Reports
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/29304748/revisiting-the-link-between-cognitive-decline-and-masticatory-dysfunction
#10
Chia-Shu Lin
Age-related decline in cognitive functions and dementia are major challenges in geriatric healthcare. Accumulating evidence from clinical, epidemiological and animal research suggests that tooth loss may be a risk factor for the decline of cognitive functions. This issue highlights the role of the brain-stomatognathic axis in geriatric medicine. Whether input from the stomatognathic apparatus can affect the brain remains an open debate. By revisiting the evidence published in the past five years, we argue that the hypothesis regarding the association between cognitive decline and masticatory dysfunction should be carefully interpreted...
January 5, 2018: BMC Geriatrics
https://www.readbyqxmd.com/read/29301555/improving-partnerships-with-family-members-of-icu-patients-study-protocol-for-a-randomized-controlled-trial
#11
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/29295506/association-between-malnutrition-and-28-day-mortality-and-intensive-care-length-of-stay-in-the-critically-ill-a-prospective-cohort-study
#12
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/29289386/mortality-risk-factors-in-elderly-patients-in-intensive-care-without-limitation-of-therapeutic-effort
#13
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/29284322/maximizing-nutrition-support-practice-and-measuring-adherence-to-nutrition-support-guidelines-in-a-canadian-tertiary-care-icu
#14
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/29283404/key-clinical-factors-predicting-adipokine-and-oxidative-stress-marker-concentrations-among-normal-overweight-and-obese-pregnant-women-using-artificial-neural-networks
#15
Mario Solis-Paredes, Guadalupe Estrada-Gutierrez, Otilia Perichart-Perera, Araceli Montoya-Estrada, Mario Guzmán-Huerta, Héctor Borboa-Olivares, Eyerahi Bravo-Flores, Arturo Cardona-Pérez, Veronica Zaga-Clavellina, Ethel Garcia-Latorre, Gabriela Gonzalez-Perez, José Alfredo Hernández-Pérez, Claudine Irles
Maternal obesity has been related to adverse neonatal outcomes and fetal programming. Oxidative stress and adipokines are potential biomarkers in such pregnancies; thus, the measurement of these molecules has been considered critical. Therefore, we developed artificial neural network (ANN) models based on maternal weight status and clinical data to predict reliable maternal blood concentrations of these biomarkers at the end of pregnancy. Adipokines (adiponectin, leptin, and resistin), and DNA, lipid and protein oxidative markers (8-oxo-2'-deoxyguanosine, malondialdehyde and carbonylated proteins, respectively) were assessed in blood of normal weight, overweight and obese women in the third trimester of pregnancy...
December 28, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/29280641/-assessment-of-the-clinical-quality-indicator-early-enteral-nutrition-in-intensive-care-units
#16
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/29278447/early-initiated-feeding-versus-early-reached-target-enteral-nutrition-in-critically-ill-children-an-observational-study-in-paediatric-intensive-care-units-in-turkey
#17
Soyhan Baǧci, Elif Keleş, Feyza Girgin, Dinçer R Yıldızdaş, Özden Ö Horoz, Nilüfer Yalındağ, Murat Tanyıldız, Benan Bayrakçi, Gökhan Kalkan, Başak N Akyıldız, Alper Köker, Tolga Köroğlu, Ayşe B Anıl, Neslihan Zengin, Ener Ç Dinleyici, Eylem Kıral, Oğuz Dursun, Süleyman Tolga Yavuz, Peter Bartmann, Andreas Müller
AIM: Although early enteral nutrition (EN) is strongly associated with lower mortality in critically ill children, there is no consensus on the definition of early EN. The aim of this study was to evaluate our current practice supplying EN and to identify factors that affect both the initiation of feeding within 24 h after paediatric intensive care unit (PICU) admission and the adequate supply of EN in the first 48 h after PICU admission in critically ill children. METHODS: We conducted a prospective, multicentre, observational study in nine PICUs in Turkey...
December 26, 2017: Journal of Paediatrics and Child Health
https://www.readbyqxmd.com/read/29274643/increased-efficacy-and-safety-of-enteral-nutrition-support-with-a-protocol-asnet-in-noncritical-patients-a-randomized-controlled-trial
#18
Luis Alfonso Ortíz-Reyes, Lilia Castillo-Martínez, Arianne Itzel Lupián-Angulo, Daniel Dante Yeh, Héctor Isaac Rocha-González, Aurora Elizabeth Serralde-Zúñiga
BACKGROUND: Unintentional underfeeding is common in patients receiving enteral nutrition (EN), and is associated with increased risk of malnutrition complications. Protocols for EN in critically ill patients have been shown to enhance adequacy, resulting in better clinical outcomes; however, outside of intensive care unit (ICU) settings, the influence of a protocol for EN is unknown. OBJECTIVE: To evaluate the efficacy and safety of implementing an EN protocol in a noncritical setting...
January 2018: Journal of the Academy of Nutrition and Dietetics
https://www.readbyqxmd.com/read/29245235/impact-and-outcomes-of-nutritional-support-team-intervention-in-patients-with-gastrointestinal-disease-in-the-intensive-care-unit
#19
Yong Eun Park, Soo Jung Park, Yehyun Park, Jae Hee Cheon, Tae Il Kim, Won Ho Kim
Nutritional support has become an important intervention for critically ill patients. Many studies have reported on the effects of nutritional support for the patients within the intensive care unit (ICU); however, no studies have specifically assessed patients with gastrointestinal diseases who may have difficulty absorbing enteral nutrition (EN) in the ICU.Sixty-two patients with gastrointestinal disease were admitted to the ICU between August 2014 and August 2016 at a single tertiary university hospital...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29244842/intensive-care-treatments-associated-with-favorable-discharge-outcomes-in-argentine-children-with-severe-traumatic-brain-injury-for-the-south-american-guideline-adherence-group
#20
Monica S Vavilala, Silvia B Lujan, Qian Qiu, Michael J Bell, Nicolás M Ballarini, Nahuel Guadagnoli, María Alejandra Depetris, Gabriela A Faguaga, Gloria M Baggio, Leonardo O Busso, Mirta E García, Osvaldo R González Carrillo, Paula L Medici, Silvia S Sáenz, Elida E Vanella, Carly K Farr, Gustavo J Petroni
OBJECTIVE: Little is known about the critical care management of children with traumatic brain injury (TBI) in low middle income countries. We aimed to identify indicators of intensive care unit (ICU) treatments associated with favorable outcomes in Argentine children with severe TBI. METHODS: We conducted a secondary analysis of data from patients previously enrolled in a prospective seven center study of children with severe TBI who were admitted to an ICU in one of the seven study centers...
2017: PloS One
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