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Protein catabolism intensive care

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https://www.readbyqxmd.com/read/28933744/energy-and-protein-in-critically-ill-patients-with-aki-a-prospective-multicenter-observational-study-using-indirect-calorimetry-and-protein-catabolic-rate
#1
Alice Sabatino, Miriam Theilla, Moran Hellerman, Pierre Singer, Umberto Maggiore, Maria Barbagallo, Giuseppe Regolisti, Enrico Fiaccadori
The optimal nutritional support in Acute Kidney Injury (AKI) still remains an open issue. The present study was aimed at evaluating the validity of conventional predictive formulas for the calculation of both energy expenditure and protein needs in critically ill patients with AKI. A prospective, multicenter, observational study was conducted on adult patients hospitalized with AKI in three different intensive care units (ICU). Nutrient needs were estimated by different methods: the Guidelines of the European Society of Parenteral and Enteral Nutrition (ESPEN) for both calories and proteins, the Harris-Benedict equation, the Penn-State and Faisy-Fagon equations for energy...
July 26, 2017: Nutrients
https://www.readbyqxmd.com/read/28796827/impact-of-ghrelin-on-body-composition-and-muscle-function-in-a-long-term-rodent-model-of-critical-illness
#2
Neil E Hill, Kevin G Murphy, Saima Saeed, Rahul Phadke, Darren Chambers, Duncan R Wilson, Stephen J Brett, Mervyn Singer
BACKGROUND: Patients with multiple injuries or sepsis requiring intensive care treatment invariably develop a catabolic state with resultant loss of lean body mass, for which there are currently no effective treatments. Recovery can take months and mortality is high. We hypothesise that treatment with the orexigenic and anti-inflammatory gastric hormone, ghrelin may attenuate the loss of body mass following critical illness and improve recovery. METHODS: Male Wistar rats received an intraperitoneal injection of the fungal cell wall derivative zymosan to induce a prolonged peritonitis and consequent critical illness...
2017: PloS One
https://www.readbyqxmd.com/read/28487264/optimizing-protein-intake-and-nitrogen-balance-opinib-in-adult-critically-ill-patients-a-study-protocol-for-a-randomized-controlled-trial
#3
Matteo Danielis, Giulia Lorenzoni, Laura Cavaliere, Mariangela Ruffolo, Luca Peressoni, Amato De Monte, Rodolfo Muzzi, Fabio Beltrame, Dario Gregori
BACKGROUND: Adequate nutrition of critically ill patients plays a key role in the modulation of metabolic response to stress. OBJECTIVE: This paper presents the development of a protocol for a randomized controlled trial (RCT) aimed at comparing clinical outcomes of patients in the intensive care unit (ICU) administered with standard and protein-fortified diet. Together with the RCT study protocol, the results of the observational analysis conducted to assess the feasibility of the RCT are presented...
May 9, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/28474243/-preoperative-fasting-period-of-fluids-in-bariatric-surgery
#4
P Simon, U-C Pietsch, R Oesemann, A Dietrich, H Wrigge
BACKROUND: Aspiration of stomach content is a severe complication during general anaesthesia. The DGAI (German Society for Anesthesiology and Intensive Care Medicine) guidelines recommend a fasting period for liquids of 2 h, with a maximum of 400 ml. Preoperative fasting can affect the patients' recovery after surgery due to insulin resistance and higher protein catabolism as a response to surgical stress. OBJECTIVES: The aim of the study was to compare a liberal fasting regimen consisting of up to 1000 ml of liquids until 2 h before surgery with the DGAI recommendation...
July 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28388378/protein-turnover-and-metabolism-in-the-elderly-intensive-care-unit-patient
#5
Stuart M Phillips, Roland N Dickerson, Frederick A Moore, Douglas Paddon-Jones, Peter J M Weijs
Many intensive care unit (ICU) patients do not achieve target protein intakes particularly in the early days following admittance. This period of iatrogenic protein undernutrition contributes to a rapid loss of lean, in particular muscle, mass in the ICU. The loss of muscle in older (aged >60 years) patients in the ICU may be particularly rapid due to a perfect storm of increased catabolic factors, including systemic inflammation, disuse, protein malnutrition, and reduced anabolic stimuli. This loss of muscle mass has marked consequences...
April 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28388374/summary-points-and-consensus-recommendations-from-the-international-protein-summit
#6
Ryan T Hurt, Stephen A McClave, Robert G Martindale, Juan B Ochoa Gautier, Jorge A Coss-Bu, Roland N Dickerson, Daren K Heyland, L John Hoffer, Frederick A Moore, Claudia R Morris, Douglas Paddon-Jones, Jayshil J Patel, Stuart M Phillips, Saúl J Rugeles, Menaka Sarav Md, Peter J M Weijs, Jan Wernerman, Jill Hamilton-Reeves, Craig J McClain, Beth Taylor
The International Protein Summit in 2016 brought experts in clinical nutrition and protein metabolism together from around the globe to determine the impact of high-dose protein administration on clinical outcomes and address barriers to its delivery in the critically ill patient. It has been suggested that high doses of protein in the range of 1.2-2.5 g/kg/d may be required in the setting of the intensive care unit (ICU) to optimize nutrition therapy and reduce mortality. While incapable of blunting the catabolic response, protein doses in this range may be needed to best stimulate new protein synthesis and preserve muscle mass...
April 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28388373/protein-kinetics-and-metabolic-effects-related-to-disease-states-in-the-intensive-care-unit
#7
Robert G Martindale, Daren K Heyland, Saúl J Rugeles, Jan Wernerman, Peter J M Weijs, Jayshil J Patel, Stephen A McClave
Evaluating protein kinetics in the critically ill population remains a very difficult task. Heterogeneity in the intensive care unit (ICU) population and wide spectrum of disease processes creates complexity in assessing protein kinetics. Traditionally, protein has been delivered in the context of total energy. Focus on energy delivery has recently come into question, as the importance of supplemental protein in patient outcomes has been shown in several recent trials. The ICU patient is prone to catabolism, immobilization, and impaired immunity, which is a perfect storm for massive loss of lean body tissue with a unidirectional flow of amino acids from muscle to immune tissue for immunoglobulin production, as well as liver for gluconeogenesis and acute phase protein synthesis...
April 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28387014/weak-by-the-machines-muscle-motor-protein-dysfunction-a-side-effect-of-intensive-care-unit-treatment
#8
REVIEW
O Friedrich, S Diermeier, L Larsson
Intensive care interventions involve periods of mechanical ventilation, sedation and complete mechanical silencing of patients. Critical illness myopathy (CIM) is an ICU-acquired myopathy that is associated with limb muscle weakness, muscle atrophy, electrical silencing of muscle and motor proteinopathy. The hallmark of CIM is a preferential muscle myosin loss due to increased catabolic and reduced anabolic activity. The ubiquitin proteasome pathway plays an important role, apart from recently identified novel mechanisms affecting non-lysosomal protein degradation or autophagy...
April 7, 2017: Acta Physiologica
https://www.readbyqxmd.com/read/28375520/global-gene-expression-profile-of-acinetobacter-baumannii-during-bacteremia
#9
Gerald L Murray, Kirill Tsyganov, Xenia P Kostoulias, Dieter M Bulach, David Powell, Darren J Creek, John D Boyce, Ian T Paulsen, Anton Y Peleg
Background.: Acinetobacter baumannii is a pathogen of major importance in intensive care units worldwide, with the potential to cause problematic outbreaks and acquire high-level resistance to antibiotics. There is an urgent need to understand the mechanisms of A. baumannii pathogenesis for the future development of novel targeted therapies. In this study we performed an in vivo transcriptomic analysis of A. baumannii isolated from a mammalian host with bacteremia. Methods...
February 15, 2017: Journal of Infectious Diseases
https://www.readbyqxmd.com/read/28284293/persistent-inflammation-immunosuppression-and-catabolism-syndrome
#10
REVIEW
Juan C Mira, Scott C Brakenridge, Lyle L Moldawer, Frederick A Moore
Following advances in critical care, in-hospital multiple organ failure-related mortality is declining. Consequently, incidence of chronic critical illness is increasing. These patients linger in the intensive care unit, have high resource utilization, and poor long-term outcomes. Within this population, the authors propose that a substantial subset of patients have a new phenotype: persistent inflammation, immunosuppression, and catabolism syndrome. There is evidence that myelodysplasia with expansion of myeloid-derived suppressor cells, innate and adaptive immune suppression, and protein catabolism with malnutrition are major contributors...
April 2017: Critical Care Clinics
https://www.readbyqxmd.com/read/28244700/the-influence-of-protein-provision-in-the-early-phase-of-intensive-care-on-clinical-outcomes-for-critically-ill-patients-on-mechanical-ventilation
#11
Joo Han Song, Ho Sun Lee, Song Yee Kim, Eun Young Kim, Jie Ye Jung, Young Ae Kang, Moo Suk Park, Young Sam Kim, Se Kyu Kim, Joon Chang, Kyung Soo Chung
BACKGROUND AND OBJECTIVES: Mechanically ventilated patients often face progressive and rapid losses of body mass and muscle because of hypermetabolism and increased protein catabolism. To investigate the impact of adequate nutritional provision during the early phase of intensive care unit (ICU) admission on the clinical outcomes in patients with medical illnesses receiving mechanical ventilation support. METHODS AND STUDY DESIGN: Two hundred and eleven mechanically ventilated patients admitted to a 30-bed medical ICU were included...
March 2017: Asia Pacific Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/28166447/nutrition-support-for-persistent-inflammation-immunosuppression-and-catabolism-syndrome
#12
Frederick A Moore, Stuart M Phillips, Craig J McClain, Jayshil J Patel, Robert G Martindale
Despite tremendous advances in critical care, multiple-organ failure continues to be a significant problem. However, in recent years, far fewer patients with multiple-organ failure die early, but many experience ongoing immune dysregulation and are developing persistent inflammation, immunosuppression, and catabolism syndrome (PICS). Most PICS patients are discharged to nonhome destinations, fail to rehabilitate, and succumb to indolent death. From a nutrition perspective, patients with PICS experience persistent inflammation-induced cachexia despite evidenced-based recommended intensive care unit nutrition support...
April 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28004327/nutritional-and-bioenergetic-considerations-in-critically-ill-patients-with-acute-neurological-injury
#13
Peter A Abdelmalik, Susan Dempsey, Wendy Ziai
The brain, due to intensive cellular processes and maintenance of electrochemical gradients, is heavily dependent on a constant supply of energy. Brain injury, and critical illness in general, induces a state of increased metabolism and catabolism, which has been proven to lead to poor outcomes. Of all the biochemical interventions undertaken in the ICU, providing nutritional support is perhaps one of the most undervalued, but potentially among the safest, and most effective interventions. Adequate provisions of calories and protein have been shown to improve patient outcomes, and guidelines for the nutritional support of the critically ill patient are reviewed...
December 21, 2016: Neurocritical Care
https://www.readbyqxmd.com/read/28000453/prognostic-value-of-severity-by-various-visceral-proteins-in-critically-ill-patients-with-sirs-during-7-days-of-stay
#14
Hicham Bouharras-El Idrissi, Jorge Molina-López, Lourdes Herrera-Quintana, Álvaro Domínguez-García, Gabriela Lobo-Támer, Irene Pérez-Moreno, Antonio Pérez-de la Cruz, Elena Planells-Del Pozo
INTRODUCTION: Critically ill patients typically develop a catabolic stress state as a result of a systemic inflammatory response (SIRS) that alters clinical-nutritional biomarkers, increasing energy demands and nutritional requirements. OBJECTIVE: To evaluate the status of albumin, prealbumin and transferrin in critically ill patients and the association between these clinical-nutritional parameters with the severity during a seven day stay in intensive care unit (ICU)...
November 29, 2016: Nutrición Hospitalaria: Organo Oficial de la Sociedad Española de Nutrición Parenteral y Enteral
https://www.readbyqxmd.com/read/27803805/nutrition-in-critical-illness-a-current-conundrum
#15
REVIEW
L John Hoffer, Bruce R Bistrian
Critically ill people are unable to eat. What's the best way to feed them? Nutrition authorities have long recommended providing generous amounts of protein and calories to critically ill patients, either intravenously or through feeding tubes, in order to counteract the catabolic state associated with this condition. In practice, however, patients in modern intensive care units are substantially underfed. Several large randomized clinical trials were recently carried out to determine the clinical implications of this situation...
2016: F1000Research
https://www.readbyqxmd.com/read/27403176/comparison-between-total-parenteral-nutrition-vs-partial-parenteral-nutrition-on-serum-lipids-among-chronic-ventilator-dependent-patients-a-multi-center-study
#16
Rojan Radpay, Mahtab Poor Zamany Nejat Kermany, Badiozaman Radpay
BACKGROUND: Malnutrition is very common among chronically hospitalized patients, especially those in the intensive care unit (ICU). Identifying the patients at risk and providing suitable nutritional support can prevent and/or overcome malnutrition in them. Total parenteral nutrition (TPN) and partial parenteral nutrition (PPN) are two common routes to deliver nutrition to hospitalized patients. We conducted a multicenter, prospective double blind randomized controlled trial to evaluate the benefits and compare their adverse effects of each method...
2016: Tanaffos
https://www.readbyqxmd.com/read/27352307/the-impact-of-macro-and-micronutrients-on-predicting-outcomes-of-critically-ill-patients-requiring-continuous-renal-replacement-therapy
#17
Kittrawee Kritmetapak, Sadudee Peerapornratana, Nattachai Srisawat, Nicha Somlaw, Narisorn Lakananurak, Thasinas Dissayabutra, Chayanat Phonork, Asada Leelahavanichkul, Khajohn Tiranathanagul, Paweena Susantithapong, Passisd Loaveeravat, Nattachai Suwachittanont, Thaksa-On Wirotwan, Kearkiat Praditpornsilpa, Kriang Tungsanga, Somchai Eiam-Ong, Piyawan Kittiskulnam
Critically ill patients with acute kidney injury (AKI) who receive renal replacement therapy (RRT) have very high mortality rate. During RRT, there are markedly loss of macro- and micronutrients which may cause malnutrition and result in impaired renal recovery and patient survival. We aimed to examine the predictive role of macro- and micronutrients on survival and renal outcomes in critically ill patients undergoing continuous RRT (CRRT). This prospective observational study enrolled critically ill patients requiring CRRT at Intensive Care Unit of King Chulalongkorn Memorial Hospital from November 2012 until November 2013...
2016: PloS One
https://www.readbyqxmd.com/read/27272101/anabolic-and-anticatabolic-agents-in-critical-care
#18
Mile Stanojcic, Celeste C Finnerty, Marc G Jeschke
PURPOSE OF REVIEW: A complex network of hormones and other effectors characterize the hypermetabolic response in critical illness; these mediators work together to induce numerous pathophysiologic alterations. Increased incidence of infection, multiorgan failure, long-term debilitation, delays in rehabilitation, and death result from an inability to meet the prohibitively elevated protein and energy requirements, which occur during illness and can persist for several years. Pharmacologic interventions have been successfully utilized to attenuate particular aspects of the hypermetabolic response; these modalities are a component of managing critically ill patients - including those patients with severe burns...
August 2016: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/26706914/autophagy-a-novel-therapeutic-target-for-diabetic-nephropathy
#19
REVIEW
Shinji Kume, Daisuke Koya
Diabetic nephropathy is a leading cause of end stage renal disease and its occurance is increasing worldwide. The most effective treatment strategy for the condition is intensive treatment to strictly control glycemia and blood pressure using renin-angiotensin system inhibitors. However, a fraction of patients still go on to reach end stage renal disease even under such intensive care. New therapeutic targets for diabetic nephropathy are, therefore, urgently needed. Autophagy is a major catabolic pathway by which mammalian cells degrade macromolecules and organelles to maintain intracellular homeostasis...
December 2015: Diabetes & Metabolism Journal
https://www.readbyqxmd.com/read/26260782/computational-modeling-to-predict-nitrogen-balance-during-acute-metabolic-decompensation-in-patients-with-urea-cycle-disorders
#20
Erin L MacLeod, Kevin D Hall, Peter J McGuire
Nutritional management of acute metabolic decompensation in amino acid inborn errors of metabolism (AA IEM) aims to restore nitrogen balance. While nutritional recommendations have been published, they have never been rigorously evaluated. Furthermore, despite these recommendations, there is a wide variation in the nutritional strategies employed amongst providers, particularly regarding the inclusion of parenteral lipids for protein-free caloric support. Since randomized clinical trials during acute metabolic decompensation are difficult and potentially dangerous, mathematical modeling of metabolism can serve as a surrogate for the preclinical evaluation of nutritional interventions aimed at restoring nitrogen balance during acute decompensation in AA IEM...
January 2016: Journal of Inherited Metabolic Disease
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