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https://www.readbyqxmd.com/read/28926994/the-metabolic-response-to-stress-and-infection-in-critically-ill-children-the-opportunity-of-an-individualized-approach
#1
REVIEW
Valentina De Cosmi, Gregorio Paolo Milani, Alessandra Mazzocchi, Veronica D'Oria, Marco Silano, Edoardo Calderini, Carlo Agostoni
The metabolic response to stress and infection is closely related to the corresponding requirements of energy and nutrients. On a general level, the response is driven by a complex endocrine network and related to the nature and severity of the insult. On an individual level, the effects of nutritional interventions are highly variable and a possible source of complications. This narrative review aims to discuss the metabolic changes in critically-ill children and the potential of developing personalized nutritional interventions...
September 18, 2017: Nutrients
https://www.readbyqxmd.com/read/28921175/routine-gastric-residual-volume-measurement-and-energy-target-achievement-in-the-picu-a-comparison-study
#2
Lyvonne N Tume, Anna Bickerdike, Lynne Latten, Simon Davies, Madeleine H Lefèvre, Gaëlle W Nicolas, Frédéric V Valla
Critically ill children frequently fail to achieve adequate energy intake, and some care practices, such as the measurement of gastric residual volume (GRV), may contribute to this problem. We compared outcomes in two similar European Paediatric Intensive Care Units (PICUs): one which routinely measures GRV (PICU-GRV) to one unit that does not (PICU-noGRV). An observational pilot comparison study was undertaken. Eighty-seven children were included in the study, 42 (PICU-GRV) and 45 (PICU-noGRV). There were no significant differences in the percentage of energy targets achieved in the first 4 days of PICU admission although PICU-noGRV showed more consistent delivery of median (and IQR) energy targets and less under and over feeding for PICU-GRV and PICU-noGRV: day 1 37 (14-72) vs 44 (0-100), day 2 97 (53-126) vs 100 (100-100), day 3 84 (45-112) vs 100 (100-100) and day 4 101 (63-124) vs 100 (100-100)...
September 18, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/28917227/pharmacoeconomics-of-parenteral-nutrition-in-surgical-and-critically-ill-patients-receiving-structured-triglycerides-in-china
#3
Guo Hao Wu, Alexandra Ehm, Marco Bellone, Lorenzo Pradelli
BACKGROUND AND OBJECTIVES: A prior meta-analysis showed favorable metabolic effects of structured triglyceride (STG) lipid emulsions in surgical and critically ill patients compared with mixed medium-chain/long-chain triglycerides (MCT/LCT) emulsions. Limited data on clinical outcomes precluded pharmacoeconomic analysis. We performed an updated meta-analysis and developed a cost model to compare overall costs for STGs vs MCT/LCTs in Chinese hospitals. METHODS AND STUDY DESIGN: We searched Medline, Embase, Wanfang Data, the China Hospital Knowledge Database, and Google Scholar for clinical trials comparing STGs to mixed MCT/LCTs in surgical or critically ill adults published between October 10, 2013 and September 19, 2015...
2017: Asia Pacific Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/28917226/energy-intake-in-the-first-week-in-an-emergency-intensive-care-unit-may-not-influence-clinical-outcomes-in-critically-ill-overweight-japanese-patients
#4
Satomi Ichimaru, Maren Sono, Ryutaro Seo, Koichi Ariyoshi, Teruyoshi Amagai
BACKGROUND AND OBJECTIVES: The American Society for Parenteral and Enteral Nutrition recommends hypocaloric feeding for critically ill patients with a BMI of >=30.0 kg/m2. However, the cut-off value of obesity in Japan is BMI >25.0 kg/m2, due to the higher prevalence of type 2 diabetes mellitus, and cardiovascular risk factors, even at a lower BMI than in Western populations. Thus, the optimal energy intake for critically ill, overweight Asian patients is unknown. METHODS AND STUDY DESIGN: A retrospective chart review was conducted in patients with BMI of >=25...
2017: Asia Pacific Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/28901335/enteral-versus-parenteral-nutrition-in-critically-ill-patients-with-severe-pancreatitis-a-meta-analysis
#5
REVIEW
H Yao, C He, L Deng, G Liao
Whether enteral nutrition (EN) is superior to parenteral nutrition (PN) in critically ill patients with severe acute pancreatitis remains unknown. The objective of this meta-analysis was to assess the effects of EN versus PN on clinical outcomes in a subgroup of pancreatitis patients. Relevant randomized controlled trials (RCTs) were searched in Scopus, PubMed and Web of Science from inception to August 2016. Ultimately, five RCTs including 348 patients were enrolled in this analysis. Compared with PN, EN was associated with a significant reduction in overall mortality (risk ratio (RR)=0...
September 13, 2017: European Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/28900017/omega-3-fatty-acids-and-inflammatory-processes-from-molecules-to-man
#6
REVIEW
Philip C Calder
Inappropriate, excessive or uncontrolled inflammation contributes to a range of human diseases. Inflammation involves a multitude of cell types, chemical mediators and interactions. The present article will describe nutritional and metabolic aspects of omega-6 (n-6) and omega-3 (n-3) fatty acids and explain the roles of bioactive members of those fatty acid families in inflammatory processes. Eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are n-3 fatty acids found in oily fish and fish oil supplements...
September 12, 2017: Biochemical Society Transactions
https://www.readbyqxmd.com/read/28883187/requirements-analysis-for-a-clinical-decision-support-system-aiming-at-improving-the-artificial-nutrition-of-critically-ill-patients
#7
Christina Schüttler, Marc Hinderer, Stefan Kraus, Anne-Katharina Lang, Hans-Ulrich Prokosch, Ixchel Castellanos
BACKGROUND: Nutrition support is an important aspect regarding the care of critically ill patients. Malnutrition affects the recovery process negatively. However, the impact on the clinical outcome is often underestimated in complex clinical settings due to several factors hindering optimization of nutrition. OBJECTIVE: To identify the requirements for a clinical decision support system that enables the medical staff to improve its patients' nutritional status. METHODS: A literature review and interviews with two senior physicians were conducted to refine the requirements for the support system as well as to determine the inclusion criteria for a subsequent intervention study...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28876693/continuation-of-feeds-in-the-unstable-burns-patient
#8
A L Rooi, A Muganza, E A Ndobe, M Nel
BACKGROUND: Early enteral nutrition (EEN) and the continuation of enteral nutrition (EN) are critical factors in burn patients, who typically have higher nutritional needs due to their post-injury hypercatabolic state and their additional need for nutrients to aid in the healing of wounds and skin grafts. In the critically ill patient, EN is the preferred mode of administration; however, controversy exists regarding the concomitant use of EN and intravenous vasopressor agents in the haemodynamically unstable patient...
June 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28870483/influence-of-an-%C3%AF-3-fatty-acid-enriched-enteral-diet-with-and-without-added-glutamine-on-the-metabolic-response-to-injury-in-a-rat-model-of-prolonged-acute-catabolism
#9
Gabrielle Ventura, Murielle Bortolotti, Nathalie Neveux, Xavier Gusmini, Samir Nakib, Gilles Sarfati, Luc Cynober, Jean-Pascal De Bandt
OBJECTIVE: In critically ill patients, acute injury alters gut function, causing greater risk for sepsis and malnutrition. Peptide-enriched diets may promote nitrogen absorption, whereas ω3-enriched diets reduce alterations in gut barrier function. The aim of this study was to assess the effectiveness of a peptide- and ω3-enriched diet on the metabolic response to injury and the gut barrier function in a model of prolonged catabolism in the rat. Given the intestinal trophic effect of glutamine, we tested for a synergistic effect of glutamine...
October 2017: Nutrition
https://www.readbyqxmd.com/read/28870480/propofol-sedation-substantially-increases-the-caloric-and-lipid-intake-in-critically-ill-patients
#10
Mélanie Charrière, Emma Ridley, Jennifer Hastings, Oliver Bianchet, Carlos Scheinkestel, Mette M Berger
OBJECTIVE: The amount of lipid delivered to patients varies considerably depending on the non-nutritional intake from sedation, and on the feeding solution. The aim of this study was to quantify the magnitude and proportion of lipids and energy provided from propofol sedation in intensive care unit (ICU) patients. METHODS: This was a retrospective analysis of prospectively collected data in consecutive patients admitted to the ICUs of two university hospitals. Inclusion criterion included an ICU stay >5 d...
October 2017: Nutrition
https://www.readbyqxmd.com/read/28866139/impact-of-caloric-intake-in-critically-ill-patients-with-and-without-refeeding-syndrome-a-retrospective-study
#11
Laura E Olthof, W A C Kristine Koekkoek, Coralien van Setten, Johannes C N Kars, Dick van Blokland, Arthur R H van Zanten
BACKGROUND & AIMS: Refeeding syndrome comprises metabolic disturbances that occur after the reintroduction of feeding after prolonged fasting. Standard care consists of correcting fluid and electrolytes imbalances. Energy intake during refeeding syndrome is heavily debated. This study addresses the effect of caloric intake on outcome during the management of refeeding syndrome. METHODS: A retrospective study among critically ill invasive mechanically ventilated patients admitted for >7 days to a medical-surgical ICU...
August 10, 2017: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28865339/enteral-nutrition-as-stress-ulcer-prophylaxis-in-critically-ill-patients-a-randomized-controlled-exploratory-study
#12
Karim El-Kersh, Bilal Jalil, Stephen A McClave, Rodrigo Cavallazzi, Juan Guardiola, Karen Guilkey, Annuradha K Persaud, Stephen P Furmanek, Brian E Guinn, Timothy L Wiemken, Mohamed Saad
PURPOSE: We investigated whether early enteral nutrition alone may be sufficient prophylaxis against stress-related gastrointestinal (GI) bleeding in mechanically ventilated patients. MATERIALS AND METHODS: Prospective, double blind, randomized, placebo-controlled, exploratory study that included mechanically ventilated patients in medical ICUs of two academic hospitals. Intravenous pantoprazole and early enteral nutrition were compared to placebo and early enteral nutrition as stress-ulcer prophylaxis...
August 26, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28861270/phosphate-disturbance-in-critically-ill-children-incidence-associated-risk-factors-and-clinical-outcomes
#13
Ahmed Nabih El Shazly, Doaa Refaey Soliman, Effat Hussien Assar, Eman Gamal Behiry, Ibrahim Abd El Naby Gad Ahmed
BACKGROUND: Hypophosphatemia is one of the common disorders that develop in critically ill patients. It has potential complications and is often unrecognized in those patients. OBJECTIVE: Determining the incidence of hypophosphatemia in critically ill children, its association with clinical outcomes and the possible risk factors. METHODS: 50 patients were enrolled in the study. Levels of serum phosphate were measured on day 1 and day 7 of PICU (Pediatric intensive care unit) stay...
September 2017: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/28860332/negative-pressure-ventilation-in-pediatric-acute-respiratory-failure
#14
Amanda B Hassinger, Ryan K Breuer, Kirsten Nutty, Chang-Xing Ma, Omar S Al Ibrahim
BACKGROUND: The objective of this work was to describe the use of negative-pressure ventilation (NPV) in a heterogeneous critically ill, pediatric population. METHODS: A retrospective chart review was conducted of all patients admitted to a pediatric ICU with acute respiratory failure supported with NPV from January 1, 2012 to May 15, 2015. RESULTS: Two hundred thirty-three subjects at a median age of 15.5 months were supported with NPV for various etiologies, most commonly bronchiolitis (70%)...
August 31, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28841893/the-role-of-nutritional-support-in-the-physical-and-functional-recovery-of-critically-ill-patients-a-narrative-review
#15
REVIEW
Danielle E Bear, Liesl Wandrag, Judith L Merriweather, Bronwen Connolly, Nicholas Hart, Michael P W Grocott
The lack of benefit from randomised controlled trials has resulted in significant controversy regarding the role of nutrition during critical illness in terms of long-term recovery and outcome. Although methodological caveats with a failure to adequately appreciate biological mechanisms may explain these disappointing results, it must be acknowledged that nutritional support during early critical illness, when considered alone, may have limited long-term functional impact.This narrative review focuses specifically on recent clinical trials and evaluates the impact of nutrition during critical illness on long-term physical and functional recovery...
August 26, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28841885/current-clinical-nutrition-practices-in-critically-ill-patients-in-latin-america-a-multinational-observational-study
#16
Karin Papapietro Vallejo, Carolina Méndez Martínez, Alfredo A Matos Adames, Vanessa Fuchs-Tarlovsky, Guillermo Carlos Contreras Nogales, Roger Enrique Riofrio Paz, Mario Ignacio Perman, Maria Isabel Toulson Davisson Correia, Dan Linetzky Waitzberg
BACKGROUND: Malnutrition in critically ill adults in the intensive care unit (ICU) is associated with a significantly elevated risk of mortality. Adequate nutrition therapy is crucial to optimise outcomes. Currently, there is a paucity of such data in Latin America. Our aims were to characterise current clinical nutrition practices in the ICU setting in Latin America and evaluate whether current practices meet caloric and protein requirements in critically ill patients receiving nutrition therapy...
August 25, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28838507/magnetic-twin-stent-for-short-term-palliation-of-acquired-nonmalignant-tracheoesophageal-fistula
#17
Áron Altorjay, Miklós Rüll, Ágnes Sárkány
Through a tracheostomy with a rigid esophagoscope in the esophagus, the authors simultaneously placed self-made magnetic twin stents in a critically ill patient with high tracheoesophageal fistula. The operation took 17 minutes. Oral nutrition was started immediately. The stents were checked and changed after the months 3, 7, and 14. At 18 months, a tracheal resection and esophageal reconstruction through a partial median sternotomy was completed successfully. The magnetic twin stent technique can temporize critically ill patients with an acquired nonmalignant tracheoesophageal fistula until they become operable...
September 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28828964/clinical-nutrition-and-gastrointestinal-dysfunction-in-critically-ill-stroke-patients
#18
Robert Patejdl, Matthias Kästner, Stephan Kolbaske, Matthias Wittstock
Background Data on the epidemiology and risk factors of altered gastrointestinal motility (AGIM) is virtually lacking for patients suffering from non-traumatic neurologic diseases and stroke. This study investigated whether patterns of AGIM differ between patients with stroke and other severe acute brain diseases. Methods Clinical records of stroke and non-stroke patients treated at a neurological intensive care unit (ICU) were reviewed at day 1-5 and at day 10 after admission. The data was analyzed for the course of enteral/parenteral nutrition and for and for signs and symptoms of gastrointestinal dysfunction...
August 22, 2017: Neurological Research
https://www.readbyqxmd.com/read/28822398/variability-in-perioperative-fasting-practices-negatively-impacts-nutritional-support-of-critically-ill-intubated-patients
#19
Molly J Douglas, David Ciraulo
The aim of the study was to quantify nutritional losses related to pre- and postoperative fasts in critically ill intubated patients and to explore whether shorter fasts are safe and appropriate in this population. A retrospective review of mechanically ventilated adults undergoing surgery more than 24 hours after admission to a Level I trauma center over 15 months was done, which yielded 132 procedures and 81 unique patients. Ninety per cent of preoperative periods and 43 per cent of postoperative periods were affected by nonmedical barriers to feeding...
August 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28820608/skeletal-muscle-ultrasound-in-critical-care-a-tool-in-need-of-translation
#20
Marina Mourtzakis, Selina Parry, Bronwen Connolly, Zudin Puthucheary
With the emerging interest in documenting and understanding muscle atrophy and function in critically ill patients and survivors, ultrasonography has transformational potential in measuring muscle quantity and quality. Here, we discuss the importance of quantifying skeletal muscle in the ICU setting. We also identify the merits and limitations of various modalities that are capable of accurately and precisely measuring muscularity. Ultrasound is emerging as a potentially powerful tool for skeletal muscle quantification; however, there are key challenges that need to be addressed in future work to ensure useful interpretation and comparability of results across diverse observational and interventional studies...
August 18, 2017: Annals of the American Thoracic Society
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