Nutrition , critical care, emergency

BACKGROUND: Resuscitative endovascular balloon occlusion of the aorta (REBOA) can temporarily control arterial hemorrhage in torso trauma; however, the abdominal visceral blood flow is also blocked by REBOA. The aim of this study was to evaluate the influence of REBOA on gastrointestinal function. METHODS: A retrospective review identified all trauma patients admitted to our trauma center between 2008 and 2019. We used propensity score matching analysis to compare the gastrointestinal function between subjects who underwent REBOA and those who did not...

The increasing worldwide prevalence of cardiovascular diseases (CVDs) highlights the need to understand the complex relationships between lipid abnormalities and elevated cardiovascular risk. This review thoroughly investigates the complex terrain of lipid abnormalities, highlighting their crucial significance in developing CVDs. Dyslipidemia, which is closely connected to atherosclerosis, is a significant risk factor for CVDs, including coronary artery disease, myocardial infarction, and stroke. This review thoroughly examines the intricate relationship between lipoproteins, cholesterol metabolism, and the inflammatory cascade, providing a detailed comprehension of the mechanisms that contribute to atherogenic processes...

Acute pancreatitis is a gastrointestinal emergency where diagnosis is based on typical symptoms, increased serum lipase concentration, and abdominal imaging. Local complications and organ failure in severe acute pancreatitis regularly necessitate treatment in the intensive care unit and are associated with increased mortality rates. Only optimal interdisciplinary treatment can improve the prognosis of patients with severe acute pancreatitis. This article gives guidance on the initial diagnostic and etiological examinations as well as on the evaluation of organ failure and the severity assessment according to common classification systems...

BACKGROUND: Nutrition risk is prevalent in intensive care unit (ICU) settings and related to poor prognoses. We aimed to evaluate the concurrent and predictive validity of different nutrition risk screening tools in the ICU. METHODS: Data were collected between 2019 and 2022 in six ICUs (n = 450). Nutrition risk was evaluated by modified Nutrition Risk in Critically ill (mNUTRIC), Nutritional Risk Screening (NRS-2002), Malnutrition Screening Tool (MST), Malnutrition Universal Screening Tool (MUST), and Nutritional Risk in Emergency (NRE-2017)...

INTRODUCTION: Early enteral nutrition (EN) is a nutritional strategy for reducing the incidence of in-hospital infections. However, the benefits of early EN, under targeted temperature management (TTM) in patients with out-of-hospital cardiac arrest (OHCA), remain unclear. We aimed to evaluate the effect of early EN on the infective complications of OHCA patients who underwent TTM. METHODS: We retrospectively searched the clinical databases of two adult emergency tertiary referral hospitals in southern Taiwan and identified patients admitted for OHCA who underwent TTM between 2017 and 2022...

Ketogenic metabolic therapy (KMT) is a medical nutrition therapy to address certain health and disease conditions. It is increasingly used for many non-communicable diseases that are rooted in abnormal metabolic health. Since chronic kidney disease (CKD) is commonly caused by overnutrition leading to hyperglycemia, insulin resistance and diabetes mellitus, the carbohydrate restriction inherent in KMT may offer a therapeutic option. Numerous studies have found that various forms of KMT are safe for individuals with CKD and may lead to improvement of renal function...

OBJECTIVES: The association between protein intake and the need for mechanical ventilation (MV) is controversial. We aimed to investigate the associations between protein intake and outcomes in ventilated critically ill patients. DESIGN: Analysis of a subset of a large international point prevalence survey of nutritional practice in ICUs. SETTING: A total of 785 international ICUs. PATIENTS: A total of 12,930 patients had been in the ICU for at least 96 hours and required MV by the fourth day after ICU admission at the latest...

In the 1970s, acute peritoneal dialysis (PD) was widely accepted for the treatment of acute kidney injury (AKI), but this practice has declined in favor of extracorporeal therapies, mainly in developed world. The lack of familiarity with the use of PD in critically ill patients has also led to a lack of use even among those receiving maintenance PD. Renewed interest in the use of PD for AKI therapy has emerged due to its increasing use in low- and middle-income countries due to its lower cost and minimal infrastructural requirements...

BACKGROUND: Stratifying residents at increased risk for fractures in long-term care facilities (LTCFs) can potentially improve awareness and facilitate the delivery of targeted interventions to reduce risk. Although several fracture risk assessment tools exist, most are not suitable for individuals entering LTCF. Moreover, existing tools do not examine risk profiles of individuals at key periods in their aged care journey, specifically at entry into LTCFs. PURPOSE: Our objectives were to identify fracture predictors, develop a fracture risk prognostic model for new LTCF residents and compare its performance to the Fracture Risk Assessment in Long term care (FRAiL) model using the Registry of Senior Australians (ROSA) Historical National Cohort, which contains integrated health and aged care information for individuals receiving long term care services...

Gastrointestinal (GI) cancers constitute over 25% of global cancer cases annually, with hepato-pancreato-biliary (HPB) cancers presenting particularly poor prognosis and challenging surgical treatments. While advancements in clinical care have improved post-operative outcomes over time, surgery for HPB cancers remains associated with high morbidity and mortality rates. Patients with HPB cancer are often older, diagnosed at later stages, and have a higher prevalence of co-morbid conditions, leading to reduced life expectancy, suboptimal post-operative recovery, and increased recurrence risk...

Patients with critical illnesses are at higher risk of comorbidities, which can include bone mineral density loss, bone turnover marker increase, and fragility fractures. Patients admitted to intensive care units (ICUs) have a higher risk of bone fractures. Since hypermetabolism is a characteristic of ICU patients, such patients are often rapidly affected by systemic deterioration, which often results in systemic wasting disease. Major risk factors for ICU-related bone loss include physical restraint, inflammation, neuroendocrine stress, malnutrition, and medications...

Frailty and sarcopenia are frequently observed in patients with end-stage liver disease. Frailty is a complex condition that arises from deteriorations across various physiological systems, including the musculoskeletal, cardiovascular, and immune systems, resulting in a reduced ability of the body to withstand stressors. This condition is associated with declined resilience and increased vulnerability to negative outcomes, including disability, hospitalization, and mortality. In cirrhotic patients, frailty is influenced by multiple factors, such as hyperammonemia, hormonal imbalance, malnutrition, ascites, hepatic encephalopathy, and alcohol intake...

BACKGROUND: Nosocomial infections are infections incubating or not present at the time of admission to a hospital and manifest 48 hours after hospital admission. The specific factors contributing to the risk of infection during hospitalization remain unclear, particularly for the hospitalized population of the United Kingdom. OBJECTIVE: The aim of this systematic literature review was to explore the risk factors of nosocomial infections in hospitalized adult patients in the United Kingdom...

BACKGROUND AND AIMS: The diagnosis of malnutrition in post-critical COVID-19 patients is challenging as a result of the high prevalence of obesity, as well as the variability and previously reported inconsistencies across currently available assessment methods. Bioelectrical impedance vector analysis (BIVA) with phase angle (PhA) and nutritional ultrasound (NU® ) are emerging techniques that have been proven successful in assessing body composition with high precision in previous studies...

Bariatric surgery (BS) has emerged as an efficient approach for addressing obesity, offering long-term benefits encompassing substantial weight loss and improving metabolic disorders. Many women of childbearing age opt for BS to enhance their health and well-being. The weight loss achieved through these procedures can positively impact pregnancy outcomes, but it's crucial to consider potential drawbacks. Micronutrient deficiencies, such as anemia resulting from iron or vitamin B12 deficiency, are a legitimate concern...

INTRODUCTION: There are few scores for mortality prediction in acute respiratory distress syndrome (ARDS) incorporating comprehensive ventilatory, acute physiological, organ dysfunction, oxygenation, and nutritional parameters. This study aims to determine the risk factors of ARDS mortality from the above-mentioned parameters at 48 h of invasive mechanical ventilation (IMV), which are feasible across most intensive care unit settings. METHODS: Prospective, observational, single-center study with 150 patients with ARDS defined by Berlin definition, receiving IMV with lung protective strategy...

Stress induced hyperglycemia is the body's protect response against strong (patho-physiological and/or psychological) stress, sometimes the blood glucose level is too high due to out of the body's adjustment. Renal glucose threshold (about 9 mmol/L) is a window of glucose leak from capillary to interstitial tissue. It is important to keep blood glucose level < 9 mmol/L, for reducing vascular sclerosis as well as organs hypoperfusion, meanwhile pay attention to preventing more dangerous hypoglycemia. Glucose, as the main energy substrate, should be daily supply and its metabolism should be monitored...

The Chinese Society of Critical Care Medicine (CSCCM) has developed the clinical practice guidelines of nutrition assessment and monitoring for patients in adult intensive care unit (ICU) of China. This guideline focuses on nutrition assessment and metabolic monitoring to achieve the optimal and individualized nutrition therapy for critical ill patients. This guideline was made by experts in critical care medicine and evidence-based medicine methodology and was developed after a thorough system review and summary of relevant trials or studies published from 2000 to July 2023...

BACKGROUND: The presence of gastrointestinal dysfunction is an outcome-relevant complication in critically ill ICU patients. AIMS, MATERIALS AND METHODS: The following review aims to show the importance of gastrointestinal dysfunction. Multimodal therapy for gastroparesis and paralytic ileus is discussed. CONCLUSION: Erythromycin and metoclopramide are options for gastroparesis, while neostigmine is commonly used for paralytic ileus.

OBJECTIVE: Exploring protein requirements for critically ill patients has become prominent. On the other hand, considering the significant impact of coma therapy and targeted temperature management (TTM) on the brain as well as systemic metabolisms, protein requirements may plausibly be changed by treatment application. However, there is currently no research on protein requirements following the application of these treatments. Therefore, the aim of this study is to elucidate changes in patients' protein requirements during the application of TTM and coma therapy...