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Nutrition in critical care

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https://www.readbyqxmd.com/read/29447346/penalized-estimation-of-complex-non-linear-exposure-lag-response-associations
#1
Andreas Bender, Fabian Scheipl, Wolfgang Hartl, Andrew G Day, Helmut Küchenhoff
We propose a novel approach for the flexible modeling of complex exposure-lag-response associations in time-to-event data, where multiple past exposures within a defined time window are cumulatively associated with the hazard. Our method allows for the estimation of a wide variety of effects, including potentially smooth and smoothly time-varying effects as well as cumulative effects with leads and lags, taking advantage of the inference methods that have recently been developed for generalized additive mixed models...
February 12, 2018: Biostatistics
https://www.readbyqxmd.com/read/29440285/nutrient-intake-in-the-first-two-weeks-of-life-and-brain-growth-in-preterm-neonates
#2
Juliane Schneider, Céline J Fischer Fumeaux, Emma G Duerden, Ting Guo, Justin Foong, Myriam Bickle Graz, Patric Hagmann, M Mallar Chakravarty, Petra S Hüppi, Lydie Beauport, Anita C Truttmann, Steven P Miller
BACKGROUND: Optimizing early nutritional intake in preterm neonates may promote brain health and neurodevelopment through enhanced brain maturation. Our objectives were (1) to determine the association of energy and macronutrient intake in the first 2 weeks of life with regional and total brain growth and white matter (WM) maturation, assessed by 3 serial MRI scans in preterm neonates; (2) to examine how critical illness modifies this association; and (3) to investigate the relationship with neurodevelopmental outcomes...
February 13, 2018: Pediatrics
https://www.readbyqxmd.com/read/29430446/models-of-disuse-muscle-atrophy-therapeutic-implications-in-critically-ill-patients
#3
REVIEW
Esther Barreiro
Skeletal muscle weakness is common in the intensive care units (ICU). Approximately 50% of patients under mechanical ventilation for more than 7 days show signs of ICU-acquired muscle weakness. In these patients, muscle weakness may be the result of axonal polyneuropathy, myopathy or a combination of both. The commonest risk factors in patients with ICU-acquired weakness (AW) are the severity and duration of the systemic inflammatory response, duration of the stay in the ICU and of mechanical ventilation, hyperglycemia, hypoalbuminemia, parenteral nutrition, and administration of corticosteroids and of neuromuscular blocking agents...
January 2018: Annals of Translational Medicine
https://www.readbyqxmd.com/read/29416148/assessment-of-malnutrition-and-enteral-feeding-practices-in-the-critically-ill-a-single-centre-observational-study
#4
Prashant P Verghese, Ashu Sara Mathai, Valsamma Abraham, Paramdeep Kaur
Background and Aims: Early identification of malnutrition among hospitalised patients is essential to institute appropriate patient-specific nutritional strategies. This study was conducted to evaluate the nutritional status of medical patients at admission to the adult intensive care unit (ICU) and to identify factors which prevent attainment of daily feeding goals in them. Methods: This was a 1 year prospective, observational study on 200 medical adult ICU patients...
January 2018: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/29413208/nutrition-options-in-critical-care-unit-patients
#5
REVIEW
Teresa D Welch
Critically ill patients have increased metabolic requirements and must rely on the administration of nutritional therapy to meet those demands. Yet, according to research almost half of all hospitalized patients are not fed, are underfed, or are malnourished while in the hospital. This article demonstrates the importance of early feedings in critical care unit, and the available options open to nurses supporting initiation and management of early feedings. Enteral nutrition has proven to be an important therapeutic strategy for improving the outcomes of critically ill patients and the critical care nurse plays an integral role in their success...
March 2018: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/29413014/the-need-to-reassess-dietary-fiber-requirements-in-healthy-and-critically-ill-patients
#6
REVIEW
Stephen J D O'Keefe
This article provides evidence that current dietary fiber intake levels may be insufficient to maintain colonic mucosal health and defense, and reduce inflammation and cancer risk in otherwise healthy people. Current commercial tube feeds generally overlook the metabolic needs of the colon and may predispose patients to dysbiosis, bacterial overgrowth with pathogens such as Clostridium difficile, and acute colitis. These results raise concern about the wide-scale use of prophylactic antibiotics in the intensive care unit and the use of elemental, fiber-depleted tube feeds...
March 2018: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/29405771/biomarker-definitions-and-their-applications
#7
Robert M Califf
Biomarkers are critical to the rational development of medical therapeutics, but significant confusion persists regarding fundamental definitions and concepts involved in their use in research and clinical practice, particularly in the fields of chronic disease and nutrition. Clarification of the definitions of different biomarkers and a better understanding of their appropriate application could result in substantial benefits. This review examines biomarker definitions recently established by the U.S. Food and Drug Administration and the National Institutes of Health as part of their joint Biomarkers, EndpointS, and other Tools (BEST) resource...
February 2018: Experimental Biology and Medicine
https://www.readbyqxmd.com/read/29402370/-impact-of-permissive-underfeeding-versus-standard-enteral-feeding-on-outcomes-in-critical-patients-requiring-mechanical-ventilation-a-prospective-randomized-controlled-study
#8
Nianbin Ma, Mingfu Shen, Zhen Wan, Sijun Pan, Xian Liu, Zhongxiang Yao
OBJECTIVE: To compare the impact of permissive underfeeding versus standard enteral feeding on outcomes in critical patients requiring mechanical ventilation (MV). METHODS: A prospective randomized controlled study was conducted. Eighty-two patients requiring MV admitted to intensive care unit (ICU) of Anji People's Hospital from January 2015 to March 2017 were enrolled, and they were randomly divided into the permissive underfeeding group (n = 40, non-protein heat was 52...
February 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29402368/-efficacy-and-safety-of-simulated-artificial-pancreas-in-modulating-stress-hyperglycemia-in-critically-ill-patients-a-prospective-randomized-controlled-study
#9
Zhongliang Yang, Guoqiang Tao, Meifeng Guo, Baoling Sun, Liang Gong, Yong Ding, Shuming Ye, Weidong Liu, Xiuyun Yang
OBJECTIVE: To explore efficacy and safety of simulated artificial pancreas in modulating stress hyperglycemia in critically ill patients. METHODS: A prospective randomized controlled study was performed. Seventy-two critically ill patients with stress hyperglycemia, aged 18-85 years, acute physiology and chronic health evaluation II (APACHE II) score over 15, two consecutive random blood glucose 11.1 mmol/L or higher, glycated hemoglobin (HbA1C) below 0.065, unable to eat food for 3 days after inclusion, or only accepting parenteral nutrition, admitted to intensive care unit (ICU) in Shanghai Punan Hospital of Pudong New District from January 1st, 2015 to June 30th, 2017 were enrolled...
February 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29394142/hypermetabolism-and-nutritional-support-in-sepsis
#10
John C Alverdy
BACKGROUND: Surgical metabolism has been a founding field of investigation in surgery without which the boundaries of critical care, trauma, and surgical oncology could not have advanced. Traditionally, understanding the shifts in electrolytes, carbohydrates, fats, and amino acids that could explain the rapidly evolving proteolysis after catabolic stress and tumor growth has been a major focus of research that led to our current approach to maintaining homeostasis over the course of major surgical intervention and injury...
February 2, 2018: Surgical Infections
https://www.readbyqxmd.com/read/29391121/safety-and-efficacy-of-electromagnetic-guided-bedside-placement-of-nasoenteral-feeding-tubes-versus-standard-placement
#11
Husam Shadid, Maureen Keckeisen, Ali Zarrinpar
Although enteral feeding in critically ill patients has been shown to be beneficial, reliable postpyloric placement of feeding tubes remains a challenge. The standard of care involves blind placement, frequently requiring multiple attempts, and radiographs. To evaluate the effect of electromagnetic-guided bedside placement in reducing time to establishment of feeding, lung placement, use of radiography, and cost, we initiated a prospective trial using electromagnetic-guided bedside placement and compared them to a retrospective cohort...
October 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/29389741/defining-anabolic-resistance-implications-for-delivery-of-clinical-care-nutrition
#12
Robert W Morton, Daniel A Traylor, Peter J M Weijs, Stuart M Phillips
PURPOSE OF REVIEW: Skeletal muscle mass with aging, during critical care, and following critical care is a determinant of quality of life and survival. In this review, we discuss the mechanisms that underpin skeletal muscle atrophy and recommendations to offset skeletal muscle atrophy with aging and during, as well as following, critical care. RECENT FINDINGS: Anabolic resistance is responsible, in part, for skeletal muscle atrophy with aging, muscle disuse, and during disease states...
January 31, 2018: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/29384315/the-efficacy-of-parenteral-fish-oil-in-critical-illness-patients-with-sepsis-a-prospective-non-randomized-observational-study
#13
Wen-Si Li, Zhang-Zhang Chen, Yi-Jun Zheng, Ming Zhong, Jie-Fei Ma, Li-Zhen Xuan, Jie-Qiong Song, Qian-Zhou Lv, Du-Ming Zhu
BACKGROUND AND OBJECTIVES: To investigate the clinical outcomes in septic patients receiving parenteral fish oil. METHODS AND STUDY DESIGN: A prospective, non-randomized, observational clinical study was carried out in 112 patients with sepsis from March, 2013 to May, 2015 in the surgical intensive care unit (SICU) of a tertiaryreferral hospital. The patients were put into one of two groups; either the control or the study group. Patients received the standard treatment of sepsis based on guidelines in the control group...
2018: Asia Pacific Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/29382502/-advances-in-early-childhood-development-from-neurons-to-big-scale-programs
#14
REVIEW
Rafael Pérez-Escamilla, Antonio Rizzoli-Córdoba, Aranzazú Alonso-Cuevas, Hortensia Reyes-Morales
Early childhood development (ECD) is the basis of countries' economic and social development and their ability to meet the Sustainable Development Goals (SDGs). Gestation and the first three years of life are critical for children to have adequate physical, psychosocial, emotional and cognitive development for the rest of their lives. Nurturing care and protection of children during gestation and early childhood are necessary for the development of trillions of neurons and trillions of synapses necessary for development...
March 2017: Boletín Médico del Hospital Infantil de México
https://www.readbyqxmd.com/read/29379834/breast-cancer-screening-in-the-high-risk-population
#15
REVIEW
Mary M Vecchio
The risk for developing breast cancer can be influenced by a number of critical factors. An individual's age, gender, personal and family health history, nutritional status, level of physical activity, environmental exposures, and substance use can significantly shift the recommended screening guidelines format from the general risk population to a high-risk population. It is essential for health-care providers to become proficient in obtaining a complete cancer genetic risk assessment to accurately identify those who may be at high risk...
January 2018: Asia-Pacific Journal of Oncology Nursing
https://www.readbyqxmd.com/read/29377333/permissive-or-trophic-enteral-nutrition-and-full-enteral-nutrition-had-similar-effects-on-clinical-outcomes-in-intensive-care-a-systematic-review-of-randomized-clinical-trials
#16
REVIEW
Camila F A Silva, Simone G de Vasconcelos, Thales A da Silva, Flávia M Silva
The aim of this study was to systematically review the effect of permissive underfeeding/trophic feeding on the clinical outcomes of critically ill patients. A systematic review of randomized clinical trials to evaluate the mortality, length of stay, and mechanical ventilation duration in patients randomized to either hypocaloric or full-energy enteral nutrition was performed. Data sources included PubMed and Scopus and the reference lists of the articles retrieved. Two independent reviewers participated in all phases of this systematic review as proposed by the Cochrane Handbook, and the review was reported according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines...
January 26, 2018: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/29374489/stress-ulcer-prophylaxis-in-intensive-care-unit-patients-receiving-enteral-nutrition-a-systematic-review-and-meta-analysis
#17
Hui-Bin Huang, Wei Jiang, Chun-Yao Wang, Han-Yu Qin, Bin Du
BACKGROUND: Pharmacologic stress ulcer prophylaxis (SUP) is recommended in critically ill patients with high risk of stress-related gastrointestinal (GI) bleeding. However, as to patients receiving enteral feeding, the preventive effect of SUP is not well-known. Therefore, we performed a meta-analysis of randomized controlled trials (RCTs) to evaluate the effect of pharmacologic SUP in enterally fed patients on stress-related GI bleeding and other clinical outcomes. METHODS: We searched PubMed, Embase, and the Cochrane database from inception through 30 Sep 2017...
January 28, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29361959/supplemental-parenteral-nutrition-versus-usual-care-in-critically-ill-adults-a-pilot-randomized-controlled-study
#18
Emma J Ridley, Andrew R Davies, Rachael Parke, Michael Bailey, Colin McArthur, Lyn Gillanders, D James Cooper, Shay McGuinness
BACKGROUND: In the critically ill, energy delivery from enteral nutrition (EN) is often less than the estimated energy requirement. Parenteral nutrition (PN) as a supplement to EN may increase energy delivery. We aimed to determine if an individually titrated supplemental PN strategy commenced 48-72 hours following ICU admission and continued for up to 7 days would increase energy delivery to critically ill adults compared to usual care EN delivery. METHODS: This study was a prospective, parallel group, phase II pilot trial conducted in six intensive care units in Australia and New Zealand...
January 23, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29360610/early-nutritional-inadequacy-is-associated-with-psoas-muscle-deterioration-and-worse-clinical-outcomes-in-critically-ill-surgical-patients
#19
Daniel Dante Yeh, Luis Alfonso Ortiz-Reyes, Sadeq A Quraishi, Nalin Chokengarmwong, Laura Avery, Haytham M A Kaafarani, Jarone Lee, Peter Fagenholz, Yuchiao Chang, Marc DeMoya, George Velmahos
PURPOSE: To explore whether psoas cross sectional area (CSA) and density (Hounsfield Units, HU) are associated with nutritional adequacy and clinical outcomes in surgical intensive care unit patients. MATERIALS AND METHODS: Subjects with at least one CT scan within 72h of ICU admission were included. Demographic, nutritional, radiographic, and outcomes data were collected. Psoas muscle CSA and HU were assessed at the L4-L5 intervertebral disk level. Change (Δ) in CSA and HU overall and per day were calculated...
January 3, 2018: Journal of Critical Care
https://www.readbyqxmd.com/read/29358479/advocacy-for-improving-nutrition-in-the-first-1000-days-to-support-childhood-development-and-adult-health
#20
Sarah Jane Schwarzenberg, Michael K Georgieff
Maternal prenatal nutrition and the child's nutrition in the first 2 years of life (1000 days) are crucial factors in a child's neurodevelopment and lifelong mental health. Child and adult health risks, including obesity, hypertension, and diabetes, may be programmed by nutritional status during this period. Calories are essential for growth of both fetus and child but are not sufficient for normal brain development. Although all nutrients are necessary for brain growth, key nutrients that support neurodevelopment include protein; zinc; iron; choline; folate; iodine; vitamins A, D, B6, and B12; and long-chain polyunsaturated fatty acids...
January 22, 2018: Pediatrics
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