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Total parenteral nutrition, medical, ICU

So Young Park, Jason Phua, Masaji Nishimura, Yiyun Deng, Yan Kang, Keiichi Tada, Younsuck Koh
OBJECTIVES: To compare physicians' perceptions and practice of end-of-life care in the ICU in three East Asian countries cultures similarly rooted in Confucianism. DESIGN: A structured and scenario-based survey of physicians who managed ICU patients from May 2012 to December 2012. SETTING: ICUs in China, Korea, and Japan. SUBJECTS: Specialists who are either intensivists or nonintensivist primary attending physicians in charge of patients (195 in China, 186 in Korea, 224 in Japan)...
April 6, 2018: Critical Care Medicine
Silvia Corcione, Roberto Angilletta, Stefania Raviolo, Claudia Filippini, Lucina Fossati, Giovanni Di Perri, Rossana Cavallo, Francesco Giuseppe De Rosa
BACKGROUND: The incidence of C. difficile infection (CDI) and of bloodstream infection (BSI) caused by Candida spp., ESBL-E-producing Enterobacteriaceae (ESBL-E) and carbapenemase-producing K. pneumoniae (CP-Kp) is associated with high mortality. METHODS: We conducted a single centre retrospective study on patients admitted to Molinette Hospital, Turin, Italy, from January 2013 to April 2015 with CDI or BSI caused by Candida, ESBL-E or CP-Kp. For each patient demographic, clinical and microbiological data were collected...
February 2018: European Journal of Internal Medicine
Arezu Charsizadeh, Hossein Mirhendi, Bahram Nikmanesh, Hamid Eshaghi, Koichi Makimura
Invasive candidiasis is a major cause of morbidity and mortality in children. However, limited data are available on the epidemiology of this infection in paediatric settings in Iran. The aim of this study was to determine the prevalence, microbial epidemiology, risk factors and clinical outcomes associated with candidaemia in intensive care units at the Children's Medical Center, Tehran, Iran. All blood and other normally sterile specimen cultures positive for Candida species were included. Isolates were identified by morphological and molecular methods...
January 2018: Mycoses
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
Seo Eun Yeon, Sun Jung Kim, Ju Hee Kim, Hae-Yun Chung, Se Hee Na, Song Mi Lee
A 30-year-old female patient, 18 weeks gestational age, with no prior medical history was admitted to hospital complaining severe right upper quadrant pain. The patient was admitted to intensive care unit (ICU) after emergency surgery to treat intraperitoneal hemorrhage caused by rupture of liver hematoma. Despite the absence of high blood pressure, the patient was diagnosed with hemolysis, elevated liver enzymes, and low platelet count (HELLP) syndrome on the basis of abnormal levels of blood aspartate aminotransferase/alanine aminotransferase, lactate dehydrogenase, total bilirubin, direct bilirubin, C-reactive protein (CRP) and platelet along with liver damage and proteinuria...
April 2017: Clinical Nutrition Research
Martin Padar, Gerli Uusvel, Liis Starkopf, Joel Starkopf, Annika Reintam Blaser
AIM: To determine the effects of implementing an enteral feeding protocol on the nutritional delivery and outcomes of intensive care patients. METHODS: An uncontrolled, observational before-and-after study was performed in a tertiary mixed medical-surgical intensive care unit (ICU). In 2013, a nurse-driven enteral feeding protocol was developed and implemented in the ICU. Nutrition and outcome-related data from patients who were treated in the study unit from 2011-2012 (the Before group) and 2014-2015 (the After group) were obtained from a local electronic database, the national Population Registry and the hospital's Infection Control Service...
February 4, 2017: World Journal of Critical Care Medicine
Çiğdem Banu Çetin, Deniz Özer Türk, Şebnem Şenol, Gönül Dinç Horasan, Özlem Tünger
BACKGROUND/AIM: Colistin is used as a salvage therapy for multidrug-resistant and extremely drug-resistant gram-negative bacterial infections. Our aim was to evaluate colistin efficiency and toxicity in the treatment of these resistant gram-negative bacterial infections. MATERIALS AND METHODS: This is a retrospective study carried out in a tertiary care hospital during 2011-2013. Study data were collected from the medical records and consultations of the infectious diseases clinic...
November 17, 2016: Turkish Journal of Medical Sciences
Ari Joffe, Natalie Anton, Laurance Lequier, Ben Vandermeer, Lisa Tjosvold, Bodil Larsen, Lisa Hartling
BACKGROUND: Nutritional support in the critically ill child has not been well investigated and is a controversial topic within paediatric intensive care. There are no clear guidelines as to the best form or timing of nutrition in critically ill infants and children. This is an update of a review that was originally published in 2009. . OBJECTIVES: The objective of this review was to assess the impact of enteral and parenteral nutrition given in the first week of illness on clinically important outcomes in critically ill children...
May 27, 2016: Cochrane Database of Systematic Reviews
Jan Blaha, Barbara Barteczko-Grajek, Pawel Berezowicz, Jiri Charvat, Jiri Chvojka, Teodoro Grau, Jonathan Holmgren, Ulrich Jaschinski, Petr Kopecky, Jan Manak, Mette Moehl, Jonathan Paddle, Marcello Pasculli, Johan Petersson, Sirak Petros, Danilo Radrizzani, Vinodkumar Singh, Joel Starkopf
BACKGROUND: Glycaemia control (GC) remains an important therapeutic goal in critically ill patients. The enhanced Model Predictive Control (eMPC) algorithm, which models the behaviour of blood glucose (BG) and insulin sensitivity in individual ICU patients with variable blood samples, is an effective, clinically proven computer based protocol successfully tested at multiple institutions on medical and surgical patients with different nutritional protocols. eMPC has been integrated into the B...
January 22, 2016: BMC Anesthesiology
Hans Jorgen Stensvold, Kenneth Strommen, Astri M Lang, Tore G Abrahamsen, Eline Kjorsvik Steen, Are H Pripp, Arild E Ronnestad
IMPORTANCE: Efforts to optimize early parenteral nutrition (PN) in extremely low-birth-weight (ELBW) infants to promote growth and development may increase hyperglycemia risk. Recent studies have identified an association between early hyperglycemia and adverse outcomes in ELBW infants. OBJECTIVES: To examine the prevalence of early hyperglycemia and clinical outcomes among ELBW infants before (2002-2005) and after (2006-2011) the implementation of an early enhanced PN protocol and to assess the independent effects of early enhanced PN and early hyperglycemia on mortality...
November 2015: JAMA Pediatrics
Brodie Parent, Marilyn Shelton, Megan Nordlund, Shahram Aarabi, Grant O'Keefe
BACKGROUND: Multidisciplinary nutrition teams can help guide the use of parenteral nutrition (PN), thereby reducing infectious risk, morbidity, and associated costs. Starting in 2007 at Harborview Medical Center, weekly multidisciplinary meetings were established to review all patients receiving PN. This study reports on observed changes in utilization from 2005-2010. MATERIALS AND METHODS: All patients who received PN from 2005-2010 were followed prospectively...
November 2016: JPEN. Journal of Parenteral and Enteral Nutrition
Brian J Schwender, Stuart R Gordon, Timothy B Gardner
OBJECTIVES: Intra-abdominal fungal infections (AFIs) complicating acute pancreatitis arise in the context of pancreatic necrosis. Our goal was to determine which risk factors contribute to AFI in patients with acute pancreatitis. METHODS: Records were reviewed from 479 nontransfer patients admitted to our medical center with acute pancreatitis from 1985 to 2009. Using multivariable regression models, we identified risk factors for AFI. RESULTS: Of 479 patients admitted with acute pancreatitis, 17 patients were subsequently found to have an AFI and 3 of these patients died...
July 2015: Pancreas
F Álvarez-Lerma, S Grau, C López, J D Jiménez, M V Trasmonte, M Nieto, G Parra, E Herrero
OBJECTIVES: To determine the reasons of prescription, the characteristics of patients and factors that affected the outcome of critically ill patients treated with micafungin (MCF) during their stay in Spanish ICUs. MATERIAL AND METHODS: Observational, retrospective and multicenter study. Patients admitted to the ICU between March 2011 and October 2012 (20-month period) treated with MCF for any reason were included in the study. Severity of patients at the beginning of treatment was measured with the APACHE II, SOFA, Child-Pugh and MELD scores...
November 2015: Medicina Intensiva
Ramazan Coşkun, Kürşat Gündoğan, Süleyman Baldane, Muhammet Güven, Murat Sungur
AIM: To determine the overall and comparative incidence of refeeding hypophosphatemia (RH) between enteral and parenteral nutrition in general adult intensive care unit (ICU) patients. MATERIALS AND METHODS: This study was performed as a retrospective analysis. A total of 117 patients who received enteral and parenteral nutrition were included in the study. Demographic characteristics, type of nutrition, daily energy intake, and serum phosphorus levels before and after the initiation of the nutrition were recorded for 7 days...
2014: Turkish Journal of Medical Sciences
Ersin Gürkan Dumlu, Mesut Özdedeoğlu, Birkan Bozkurt, Mehmet Tokaç, Abdussamed Yalçin, Levent Öztürk, Mehmet Kiliç
BACKGROUND/AIM: Malnutrition is a common medical condition among intensive care unit patients. It should be monitored carefully, since early management of malnutrition can dramatically improve the medical condition of the patients. A general consideration of enteral feeding shows that it is much more useful than parenteral administration, because it is more physiological and poses a lower risk of hyperalimentation. MATERIALS AND METHODS: In this retrospective study, we scanned all files and personal information of patients hospitalized in intensive care units between 2009 and 2012 due to various medical conditions...
2014: Turkish Journal of Medical Sciences
Jun Ho Lee, Sun Kyun Ro, Hyun Ju Lee, Hyun Kyung Park, Won-Sang Chung, Young Hak Kim, Jeong Ho Kang, Hyuck Kim
BACKGROUND: We aimed to evaluate the efficacy and safety of early surgical ligation (within 15 days of age) over late surgical ligation (after 15 days of age) by a comparative analysis of very low birth weight (VLBW) infants undergoing surgical correction for symptomatic patent ductus arteriosus (PDA) over the course of 6 years in our hospital. METHODS: We retrospectively reviewed all the medical records in the neonatal intensive care unit at Hanyang University Seoul Hospital, from March 2007 to May 2013, to identify VLBW infants (< 1,500 g) who underwent surgical PDA ligation...
October 2014: Korean Journal of Thoracic and Cardiovascular Surgery
Selma O Algra, Felix Haas, Kenneth J Poskitt, Floris Groenendaal, Antonius N J Schouten, Nicolaas J G Jansen, Anthony Azakie, Sanjiv Gandhi, Andrew Campbell, Steven P Miller, Patrick S McQuillen, Linda S de Vries
OBJECTIVE: To determine whether prenatal diagnosis lowers the risk of preoperative brain injury by assessing differences in the incidence of preoperative brain injury across centers. STUDY DESIGN: From 2 prospective cohorts of newborns with complex congenital heart disease studied by preoperative cerebral magnetic resonance imaging, one cohort from the University Medical Center Utrecht (UMCU) and a combined cohort from the University of California San Francisco (UCSF) and University of British Columbia (UBC), patients with aortic arch obstruction were selected and their imaging and clinical course reviewed...
December 2014: Journal of Pediatrics
Akram Niknajad, Morteza Ghojazadeh, Niloufar Sattarzadeh, Fazileh Bashar Hashemi, Farid Dezham Khoy Shahgholi
INTRODUCTION: Improved survival of very low birth weight (VLBW) premature infants requires urgent intensive care, professional nursing and medical care. On the other hand, long hospital stay period imposes emotional and economic burdens on the family and society. Therefore, it is necessary to clarify the most important factors affecting their hospitalization duration to lessen unwanted outcomes of premature birth and to eliminate or relieve the problems. METHODS: In a descriptive-analytical study, 170 low birth weight premature infants were assessed in a regular daily follow-up in Alzahra Hospital, Tabriz, Iran...
June 2012: Journal of Caring Sciences
Turki M Alkharfy, Rubana Ba-Abbad, Anjum Hadi, Badr H Sobaih, Khalid M AlFaleh
BACKGROUND/AIM: Development of hepatic dysfunction is a well-recognized complication of total parenteral nutrition in preterm infants. Previous studies reported the incidence of total parenteral nutrition-associated cholestasis and described possible contributing factors to its pathogenesis, but little is done trying to determine its possible predictive risk factors. The aims of this study was to determine the incidence of total parenteral nutrition-associated cholestasis and to develop a possible predictive model for its occurrence...
September 2014: Saudi Journal of Gastroenterology: Official Journal of the Saudi Gastroenterology Association
C L Hvas, K Farrer, E Donaldson, B Blackett, H Lloyd, C Forde, G Garside, P Paine, S Lal
BACKGROUND/OBJECTIVES: Parenteral nutrition (PN) should be provided to the malnourished patient if enteral feeding is insufficient or unsafe. A nutrition support team (NST) may improve PN services. We compared the use and complications of hospital PN before and after the implementation of an NST. SUBJECTS/METHODS: All inpatients referred for PN outside of the intensive care unit and the intestinal failure unit were prospectively included from 2009 to 2012. The NST was introduced in 2010...
December 2014: European Journal of Clinical Nutrition
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