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Nutrition , critical care, emergency

Liane Rabinowich, Julia Wendon, William Bernal, Oren Shibolet
AIM: To assess the practice of caring for acute liver failure (ALF) patients in varying geographic locations and medical centers. METHODS: Members of the European Acute Liver Failure Consortium completed an 88-item questionnaire detailing management of ALF. Responses from 22 transplantation centers in 11 countries were analyzed, treating between 300 and 500 ALF cases and performing over 100 liver transplants (LT) for ALF annually. The questions pertained to details of the institution and their clinical activity, standards of care, referral and admission, ward- based care versus intensive care unit (ICU) as well as questions regarding liver transplantation - including criteria, limitations, and perceived performance...
September 7, 2016: World Journal of Gastroenterology: WJG
Colin D Gause, Madoka Hayashi, Courtney Haney, Daniel Rhee, Omar Karim, Brian W Weir, Dylan Stewart, Jeffrey Lukish, Henry Lau, Fizan Abdullah, Estelle Gauda, Howard I Pryor
BACKGROUND/PURPOSE: Premature neonates can develop intraabdominal conditions requiring emergent bowel resection and enterostomy. Parenteral nutrition (PN) is often required, but results in cholestasis. Mucous fistula refeeding allows for functional restoration of continuity. We sought to determine the effect of refeeding on nutrition intake, PN dependence, and PN associated hepatotoxicity while evaluating the safety of this practice. METHODS: A retrospective review of neonates who underwent bowel resection and small bowel enterostomy with or without mucous fistula over 2years was undertaken...
November 2016: Journal of Pediatric Surgery
Ariane Boumendil, Maguy Woimant, Jean-Pierre Quenot, François-Xavier Rooryck, Foued Makhlouf, Youri Yordanov, Samuel Delerme, Khalil Takun, Patrick Ray, Marie-Clément Kouka, Claire Poly, Maité Garrouste-Orgeas, Caroline Thomas, Tabasome Simon, Sylvie Azerad, Guillaume Leblanc, Dominique Pateron, Bertrand Guidet
BACKGROUND: The benefit of ICU admission for elderly patients remains controversial. This report highlights the methodology, the feasibility of and the ethical and logistical constraints in designing and conducting a cluster-randomized trial of intensive care unit (ICU) admission for critically ill elderly patients. METHODS: We designed an interventional open-label cluster-randomized controlled trial in 24 centres in France. Clusters were healthcare centres with at least one emergency department (ED) and one ICU...
December 2016: Annals of Intensive Care
Fawaz Al-Mufti, Elie Dancour, Krishna Amuluru, Charles Prestigiacomo, Stephan A Mayer, E Sander Connolly, Jan Claassen, Joshua Z Willey, Philip M Meyers
Acute ischemic stroke continues to be one of the leading causes of morbidity and mortality worldwide. Recent advances in mechanical thrombectomy techniques combined with prereperfusion computed tomographic angiography for patient selection have revolutionized stroke care in the past year. Peri- and postinterventional neurocritical care of the patient who has had an emergent large-vessel occlusion is likely an equally important contributor to the outcome but has been relatively neglected. Critical periprocedural management issues include streamlining care to speed intervention, blood pressure optimization, reversal of anticoagulation, management of agitation, and selection of anesthetic technique (ie, general vs monitored anesthesia care)...
July 19, 2016: Journal of Intensive Care Medicine
Jayshil J Patel, Martin D Rosenthal, Keith R Miller, Panna Codner, Laszlo Kiraly, Robert G Martindale
Obesity is a leading cause of preventable death worldwide. The prevalence of obesity has been increasing and is associated with an increased risk for other co-morbidities. In the critical care setting, nearly one third of patients are obese. Obese critically ill patients pose significant physical and on-physical challenges to providers, including optimization of nutrition therapy. Intuitively, obese patients would have worse critical care-related outcome. On the contrary, emerging data suggests that critically ill obese patients have improved outcomes, and this phenomenon has been coined "the obesity paradox...
September 2016: Current Gastroenterology Reports
Tetsuro Tominaga, Takashi Nonaka, Hiroaki Takeshita, Yuichiro Honda, Hiroki Nagura, Toshio Shiraishi, Masaki Kunizaki, Yorihisa Sumida, Shigekazu Hidaka, Terumitsu Sawai, Takeshi Nagayasu
INTRODUCTION: Surgeons often perform surgery for patients who are critically ill. Intensive care unit (ICU)-acquired weakness (ICUAW) is a condition in which systemic and prolonged muscle weakness occurs and causes worse short-term and long-term outcomes. PRESENTATION OF CASE: A 60-year-old woman with sudden nausea and vomiting presented to our hospital and developed shock. Abdominal CT showed thickness of the descending colon and ascites. She was diagnosed with sepsis due to descending colon cancer...
2016: International Journal of Surgery Case Reports
Melissa Van Arsdall, Ikram Haque, Yuying Liu, J Marc Rhoads
Twenty years ago, there was profound, international interest in developing oral human, bovine, or chicken egg-derived immunoglobulin (Ig) for the prevention and nutritional treatment of childhood malnutrition and gastrointestinal disease, including acute diarrhea and necrotizing enterocolitis. Although such Ig products were shown to be effective, with both nutritional and antidiarrheal benefits, interest waned because of their cost and because of the perceived risk of bovine serum encephalitis (BSE). BSE is no longer considered a barrier to use of oral Ig, because the WHO has declared the United States to be BSE-free since the early 2000s...
May 2016: Advances in Nutrition
Juan Carlos Flores Cano, Macarena Lizama Calvo, Natalie Rodríguez Zamora, María Eugenia Ávalos Anguita, Mónica Galanti De La Paz, Salesa Barja Yañez, Carlos Becerra Flores, Carolina Sanhueza Sepúlveda, Ana María Cabezas Tamayo, Jorge Orellana Welch, Gisela Zillmann Geerdts, Rosa María Antilef, Alfonso Cox Melane, Marcelo Valle Maluenda, Nelson Vargas Catalán
"Children with special health care needs" (CSHCN) is an emerging and heterogeneous group of paediatric patients, with a wide variety of medical conditions and with different uses of health care services. There is consensus on how to classify and assess these patients according to their needs, but not for their specific diagnosis. Needs are classified into 6 areas: a) specialised medical care; b) use or need of prescription medication; c) special nutrition; d) dependence on technology; e) rehabilitation therapy for functional limitation; and f) special education services...
May 2016: Revista Chilena de Pediatría
Nai Ming Lai, Nathorn Chaiyakunapruk, Nai An Lai, Elizabeth O'Riordan, Wilson Shu Cheng Pau, Sanjay Saint
BACKGROUND: The central venous catheter (CVC) is essential in managing acutely ill patients in hospitals. Bloodstream infection is a major complication in patients with a CVC. Several infection control measures have been developed to reduce bloodstream infections, one of which is impregnation of CVCs with various forms of antimicrobials (either with an antiseptic or with antibiotics). This review was originally published in June 2013 and updated in 2016. OBJECTIVES: Our main objective was to assess the effectiveness of antimicrobial impregnation, coating or bonding on CVCs in reducing clinically-diagnosed sepsis, catheter-related blood stream infection (CRBSI), all-cause mortality, catheter colonization and other catheter-related infections in adult participants who required central venous catheterization, along with their safety and cost effectiveness where data were available...
2016: Cochrane Database of Systematic Reviews
G Lopez-Nava, M Galvao, I Bautista-Castaño, J P Fernandez-Corbelle, M Trell
BACKGROUND AND STUDY AIMS: Bariatric endoscopy has emerged as an aid in the nonsurgical treatment of obesity. The objective of this study is to critically provide the results and follow-up of endoscopic sleeve gastroplasty 1 year after the procedure. PATIENTS AND METHODS: Prospective single-center follow-up study of 25 patients (5 men, 20 women) who underwent flexible endoscopic suturing for endoluminal gastric volume reduction. A multidisciplinary team provided post-procedure care...
February 2016: Endoscopy International Open
Lise Bernard, Béatrice Roche, Marie Batisse, Salwan Maqdasy, Daniel Terral, Valérie Sautou, Igor Tauveron
RATIONALE, AIMS AND OBJECTIVES: In non-critically ill patients, the use of an insulin syringe pump allows the management of temporary situations during which other therapies cannot be used (failure of subcutaneous injections, awaiting advice from the diabetes team, emergency situations, prolonged corticosteroid therapy, initiation of an artificial nutrition, need for a fasting status, etc.). To manage the risks related to this «never event», the use of a standard validated protocol for insulin administration and monitoring is an essential prerequisite...
October 2016: Journal of Evaluation in Clinical Practice
Huee Jin Park, Kyung Hoon Kim, Hyuk Jin Lee, Eui Cheol Jeong, Kee Won Kim, Dong In Suh
Compartment syndrome is a rare but devastating condition that can result in permanent neuromuscular or soft tissue injuries. Extravasation injuries, among the iatrogenic causes of compartment syndrome, occur under a wide variety of circumstances in the inpatient setting. Total parenteral nutrition via a peripheral route is an effective alternative for the management of critically ill children who do not obtain adequate nutrition via the oral route. However, there is an inherent risk of extravasation, which can cause compartment syndrome, especially when detected at a later stage...
November 2015: Korean Journal of Pediatrics
Dick D Chamla, Shaffiq Essajee, Mark Young, Scott Kellerman, Ronnie Lovich, Nandita Sugandhi, Anouk Amzel, Chewe Luo
INTRODUCTION: Integration of HIV into child survival platforms is an evolving territory with multiple connotations. Most literature on integration of HIV into other health services focuses on adults; however promising practices for children are emerging. These include the Double Dividend (DD) framework, a new programming approach with dual goal of improving paediatric HIV care and child survival. In this commentary, the authors discuss why integrating HIV testing, treatment and care into child survival platforms is important, as well as its potential to advance progress towards global targets that call for, by 2020, 90% of children living with HIV to know their status, 90% of those diagnosed to be on treatment and 90% of those on treatment to be virally suppressed (90-90-90)...
2015: Journal of the International AIDS Society
Kaori Mizumoto, Genki Murakami, Kenro Oshidari, Laksono Trisnantoro, Nobuo Yoshiike
Asia has recorded the fastest economic growth in the world. However, some countries are still struggling with economic stagnation and poverty. Even in the emerging countries, there are economic disparities between urban and rural areas within a country. Reflecting the situations, nutritional issues in Asia came to be the antithetical situation of excess and insufficiency. The rate of overweight and obesity keeps increasing, especially in emerging countries. Meanwhile, underweight is still a critical problem in the region...
2015: Journal of Nutritional Science and Vitaminology
Scott B Ickes, Rachel B Trichler, Bradley C Parks
BACKGROUND: There is growing awareness that the necessary solutions for improving nutrition outcomes are multisectorial. As such, investments are increasingly directed toward "nutrition-sensitive" approaches that not only address an underlying or basic determinant of nutrition but also seek to achieve an explicit nutrition goal or outcome. Understanding how and where official development assistance (ODA) for nutrition is invested remains an important but complex challenge, as development projects components vary in their application to nutrition outcomes...
December 2015: Food and Nutrition Bulletin
Dan Wang, Xiaoquan Lai, Chenxi Liu, Yuqi Xiong, Xinping Zhang
BACKGROUND & AIMS: Nutritional support for patients in the intensive-care unit (ICU) is a part of standard care which promotes medical quality and decreases nosocomial infection. Supplemental parenteral nutrition (SPN) approach (enteral nutrition (EN) combined with parenteral nutrition (PN) when EN alone is insufficient) has become one major concern in nutrition research field. This research aims to explore the following relationships: (i) the relationship between SPN and nosocomial infection, (ii) the relationship between early and late SPN initiation and the development of nosocomial infection...
2015: Nutrition Journal
Marieke Vossenaar, Liza Hernández, Gabriela Montenegro-Bethancourt, María José Soto-Méndez, Odilia I Bermudez, Noel W Solomons
BACKGROUND: Meals served at government-run day care centers must be nutritionally adequate to ensure good health and proper development of preschool-aged children. They can provide a controlled opportunity to complement the daily diet of children in vulnerable populations. OBJECTIVE: To determine the nutrient adequacy and leading food sources of nutrients provided by the diet served in government-sponsored day care centers. METHODS: Estimated daily energy and nutrient intakes of a theoretical 40-day day care center menu were calculated, and the nutrient adequacy was assessed...
September 2015: Food and Nutrition Bulletin
Wai Keung Cheung, Lai Sheung Chau, Iun Ieng Laurinda Mak, Mei Yi Wong, Sai Leung Wong, Agnes Fung Yee Tiwari
BACKGROUND: The Surviving Sepsis Campaign promotes the use of norepinephrine as the first-line inotropic support for patients presenting with severe sepsis or septic shock in cases of persistent hypotension, despite adequate fluid resuscitation. However, there is little published evidence on how much noradrenaline is administered to such patients when admitted to the intensive care unit (ICU). The authors report the clinical management of this group of patients, with a special focus on the total amount and duration of norepinephrine infusion required...
December 2015: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
Nancy J Wise
INTRODUCTION: Healthy eating among pregnant adolescents is essential for the well-being of developing adolescent females and their fetuses, as well as for the prevention of adult chronic illness. Understanding factors that influence and prohibit healthy eating, along with preferences for nutrition education in the pregnant adolescent population, is critical when designing and implementing appropriate nutrition education programs. The purpose of this study was to collect individual viewpoints of pregnant adolescents to facilitate the development of a nutrition intervention...
July 2015: Journal of Midwifery & Women's Health
Sana Alkhawaja, Claudio Martin, Ronald J Butler, Femida Gwadry-Sridhar
BACKGROUND: Nutritional support is an essential component of critical care. Malnutrition has been associated with poor outcomes among patients in intensive care units (ICUs). Evidence suggests that in patients with a functional gut, nutrition should be administered through the enteral route. One of the main concerns regarding use of the enteral route is the reduction in gastric motility that is often responsible for limited caloric intake. This increases the risk of aspiration pneumonia as well...
2015: Cochrane Database of Systematic Reviews
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