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https://www.readbyqxmd.com/read/28098623/greater-protein-and-energy-intake-may-be-associated-with-improved-mortality-in-higher-risk-critically-ill-patients-a-multicenter-multinational-observational-study
#1
Charlene Compher, Jesse Chittams, Therese Sammarco, Michele Nicolo, Daren K Heyland
OBJECTIVES: Controversy exists about the value of greater nutritional intake in critically ill patients, possibly due to varied patient nutritional risk. The objective of this study was to investigate whether clinical outcomes vary by protein or energy intake in patients with risk evaluated by the NUTrition Risk in the Critically Ill score. DESIGN: Prospective observational cohort. SETTING: A total of 202 ICUs. PATIENTS: A total of 2,853 mechanically ventilated patients in ICU greater than or equal to 4 days and a subset of 1,605 patients in ICU greater than or equal to 12 days...
February 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28089618/24-hour-protein-arginine-and-citrulline-metabolism-in-fed-critically-ill-children-a-stable-isotope-tracer-study
#2
Carlijn T I de Betue, Xiomara C Garcia Casal, Dick A van Waardenburg, Stephen M Schexnayder, Koen F M Joosten, Nicolaas E P Deutz, Marielle P K J Engelen
BACKGROUND & AIMS: The reference method to study protein and arginine metabolism in critically ill children is measuring plasma amino acid appearances with stable isotopes during a short (4-8 h) time period and extrapolate results to 24-h. However, 24-h measurements may be variable due to critical illness related factors and a circadian rhythm could be present. Since only short duration stable isotope studies in critically ill children have been conducted before, the aim of this study was to investigate 24-h appearance of specific amino acids representing protein and arginine metabolism, with stable isotope techniques in continuously fed critically ill children...
January 4, 2017: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28079529/leveraging-the-skills-of-nurses-and-the-power-of-language-nutrition-to-ensure-a-better-future-for-children
#3
Ashley Darcy Mahoney, Lauren Head Zauche, Sunny Hallowell, Arianne Weldon, Jennifer Stapel-Wax
BACKGROUND: Early language exposure is critical for language acquisition and significantly influences a child's literacy skills. However, preterm infants may experience language deprivation in the neonatal intensive care unit. Nurses are vital to helping parents understand their critical role in early language development. PURPOSE: To discuss the impact of language-rich interactions and interventions that promote early language exposure, or Language Nutrition, by parents and caregivers on the long-term developmental, language, and educational outcomes of high-risk infants...
January 11, 2017: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
https://www.readbyqxmd.com/read/28077899/a-double-blind-randomized-clinical-trial-comparing-the-effect-of-neostigmine-and-metoclopramide-on-gastric-residual-volume-of-mechanically-ventilated-icu-patients
#4
Afshin Gholipour Baradari, Abbas Alipour, Abolfazl Firouzian, Laleh Moarab, Amir Emami Zeydi
BACKGROUND: In critically ill patients, enteral feeding through the nasogastric tube is the method of choice for nutritional support. Gastrointestinal feeding intolerance and disturbed gastric emptying are common challenges in these patients. The aim of this study was to compare the effect of Neostigmine and Metoclopramide on gastric residual volume (GRV) in mechanically ventilated ICU patients. METHODS: In a double blind, randomized clinical trial, a total of 60 mechanically ventilated ICU patients with GRV >120 mL (3 hours after the last gavage), were randomly assigned into two groups A and B...
December 2016: Acta Informatica Medica: AIM
https://www.readbyqxmd.com/read/28067569/optimizing-postoperative-handover-to-the-intensive-care-unit-at-a-tertiary-centre
#5
Shankar Kumar, Andrew R McKean, Andrew Ramwell, Carolyn Johnston, Susannah Leaver
BACKGROUND: Comprehensive handover of patients transferred from operating theatre to the intensive care unit is crucial in ensuring ongoing quality and safety of care. Handover in this setting poses unique challenges, yet few studies have considered or tested approaches to improve the process. A quality improvement project was undertaken to assess and improve the quality of information transfer during the handover of postoperative patients to the general intensive care unit at a tertiary centre...
January 2, 2017: British Journal of Hospital Medicine
https://www.readbyqxmd.com/read/28065217/early-enteral-combined-with-parenteral-nutrition-treatment-for-severe-traumatic-brain-injury-effects-on-immune-function-nutritional-status-and-outcomes-%C3%A2
#6
Fan Ming-Chao, Wang Qiao-Ling, Fang Wei, Jiang Yun-Xia, Li Lian-di, Sun Peng, Wang Zhi-Hong
Objective To compare the conjoint effect of enteral nutrition (EN) and parenteral nutrition (PN) with single EN or PN on immune function, nutritional status, complications and clinical outcomes of patients with severe traumatic brain injury (STBI). Methods A prospective randomized control trial was carried out from January 2009 to May 2012 in Neurological Intensive Care Unit (NICU). Patients of STBI who met the enrolment criteria (Glasgow Coma Scale score 6~8; Nutritional Risk Screening ≥3) were randomly divided into 3 groups and were admi- nistrated EN, PN or EN+PN treatments respectively...
November 20, 2016: Chinese Medical Sciences Journal, Chung-kuo i Hsüeh K'o Hsüeh Tsa Chih
https://www.readbyqxmd.com/read/28049258/the-impact-of-implementation-of-an-enteral-feeding-protocol-on-the-improvement-of-enteral-nutrition-in-critically-ill-adults
#7
Seoung-Hyun Kim, Chi-Min Park, Jeong-Meen Seo, Mingew Choi, Dae-Sang Lee, Dong Kyung Chang, Miyong Rha, Soyoung Yu, Seonhye Lee, Eunmee Kim, Young Yun Cho
BACKGROUND AND OBJECTIVES: The optimal delivery of enteral nutrition (EN) may improve clinical outcomes in critically ill patients; thus, optimal EN protocols should be developed. The purpose of this study was to evaluate the impact of implementing an EN protocol on the improvement of EN practices and on the clinical outcomes of critically ill patients. METHODS AND STUDY DESIGN: This was a retrospective study with prospectively collected data. Multidisciplinary working group developed an evidence-based EN protocol based on an extensive review of literature and existing guidelines...
January 2017: Asia Pacific Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/28049256/initial-energy-supplementation-in-critically-ill-patients-receiving-enteral-nutrition-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#8
Feng Tian, Xuejin Gao, Chao Wu, Li Zhang, Xianfeng Xia, Xinying Wang
BACKGROUND AND OBJECTIVES: Here we systematically reviewed and quantitatively analyzed randomized controlled trials (RCTs) to compare the important initial outcomes of critically ill adults receiving low- and highenergy enteral nutrition. METHODS AND STUDY DESIGN: RCTs comparing low- and high-energy supplementation in critically ill adults receiving enteral nutrition admitted to the intensive care unit for an expected stay of >48 h were included. Abstracts submitted to major scientific meetings were included and the primary endpoint was mortality...
January 2017: Asia Pacific Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/28045772/nutritional-practices-and-growth-in-premature-infants-after-surgical-necrotizing-enterocolitis
#9
Grace C Lin, Daniel T Robinson, Steven Olsen, Kristina M Reber, Mohannad Moallem, Robert DiGeronimo, Cecilia Mulroy, Ankur Datta, Karna Murthy
OBJECTIVE: To describe the nutritional provisions received by infants with surgical NEC and the associated effects on short-term growth. STUDY DESIGN: Through the Children's Hospitals Neonatal Database we identified infants born ≤32 weeks' gestation with surgical NEC from 5 regional neonatal intensive care units over 4 years. Excluded infants had isolated intestinal perforation and died <14 days post-operatively. Infants were stratified by their median parenteral protein dose (low (LP) or high (HP) protein) over the first post-operative week...
December 30, 2016: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28045704/neonatal-peripherally-inserted-central-catheter-practices-and-providers-results-from-the-neonatal-picc1-survey
#10
Elizabeth Sharpe, Latoya Kuhn, David Ratz, Sarah L Krein, Vineet Chopra
BACKGROUND: Neonatal intensive care units (NICUs) commonly utilize peripherally inserted central catheters (PICCs) to provide nutrition and long-term medications to premature and full-term infants. However, little is known about PICC practices in these settings. PURPOSE: To assess PICC practices, policies, and providers in NICUs. METHODS: The Neonatal PICC1 Survey was conducted through the use of the electronic mailing list of a national neonatal professional organization's electronic membership community...
December 29, 2016: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
https://www.readbyqxmd.com/read/28025639/evaluation-of-bone-metabolism-in-critically-ill-patients-using-ctx-and-pinp
#11
Alexandra Gavala, Konstantinos Makris, Anna Korompeli, Pavlos Myrianthefs
Background. Prolonged immobilization, nutritional and vitamin D deficiency, and specific drug administration may lead to significant bone resorption. Methods and Patients. We prospectively evaluated critically ill patients admitted to the ICU for at least 10 days. Demographics, APACHE II, SOFA scores, length of stay (LOS), and drug administration were recorded. Blood collections were performed at baseline and on a weekly basis for five consecutive weeks. Serum levels of PINP, β-CTx, iPTH, and 25(OH)vitamin D were measured at each time-point...
2016: BioMed Research International
https://www.readbyqxmd.com/read/28005459/proceedings-of-the-2016-clinical-nutrition-week-research-workshop-the-optimal-dose-of-protein-provided-to-critically-ill-patients
#12
Daren K Heyland, Olav Rooyakers, Marina Mourtzakis, Renee D Stapleton
Recent literature has created considerable confusion about the optimal amount of protein/amino acids that should be provided to the critically ill patient. In fact, the evidentiary basis that directly tries to answer this question is relatively small. As a clinical nutrition research community, there is an urgent need to develop the optimal methods to assess the impact of exogenous protein/amino acid administration in the intensive care unit setting. That assessment can be conducted at various levels: (1) impact on stress response pathways, (2) impact on muscle synthesis and protein balance, (3) impact on muscle mass and function, and (4) impact on the patient's recovery...
December 1, 2016: JPEN. Journal of Parenteral and Enteral Nutrition
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/28000452/phase-angle-and-onodera-s-prognostic-nutritional-index-in-critically-ill-patients
#15
Karina Marques Vermeulen, Leilane Lilian Araújo Leal, Mariana Câmara Martins Bezerra Furtado, Sancha Helena de Lima Vale, Lúcia Leite Lais
INTRODUCTION: Assessing severity and nutritional prognosis in critical patients has become increasingly important in recent years, since these parameters are related to morbidity/mortality and used to guide therapeutic options. OBJECTIVE: Determine nutritional prognosis through the Phase Angle (PA) and Onodera's Prognostic Nutritional Index (OPNI) and its relationship with severity, hospitalization time and mortality of critically ill patients. METHODS: Descriptive cross-sectional study, involving adult patients hospitalized in an 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/27997410/influence-of-nutrition-therapy-on-the-intestinal-microbiome
#16
Monika A Krezalek, Andrew Yeh, John C Alverdy, Michael Morowitz
PURPOSE OF REVIEW: This review describes the relationship between nutritional therapies and the intestinal microbiome of critically ill patients. RECENT FINDINGS: The intestinal microbiome of the critically ill displays a near complete loss of health-promoting microbiota with overgrowth of virulent healthcare-associated pathogens. Early enteral nutrition within 24 h of admission to the ICU has been advocated in medical and surgical patients to avoid derangements of the intestinal epithelium and the microbiome associated with starvation...
December 16, 2016: Current Opinion in Clinical Nutrition and Metabolic Care
https://www.readbyqxmd.com/read/27982165/lymphocyte-count-as-a-sign-of-immunoparalysis-and-its-correlation-with-nutritional-status-in-pediatric-intensive-care-patients-with-sepsis-a-pilot-study
#17
Talita Freitas Manzoli, Artur Figueiredo Delgado, Eduardo Juan Troster, Werther Brunow de Carvalho, Ana Caroline Barreto Antunes, Desirée Mayara Marques, Patrícia Zamberlan
OBJECTIVES: Developing malnutrition during hospitalization is well recognized worldwide, and children are at a relatively higher risk for malnutrition than adults. Malnutrition can lead to immune dysfunction, which is associated with a higher mortality rate due to sepsis, the most frequent cause of death in pediatric intensive care units (PICUs). The aim of this study was to investigate whether malnourished patients are more likely to have relative or absolute lymphopenia and, consequently, worse prognoses...
November 1, 2016: Clinics
https://www.readbyqxmd.com/read/27976489/improving-the-quality-of-nurse-influenced-patient-care-in-the-intensive-care-unit
#18
Lynsey J Sutton, Rebecca J Jarden
BACKGROUND: Quality of care is a major focus in the intensive care unit (ICU). AIM: To describe a nurse-initiated quality improvement (QI) project that improved the care of critically ill patients in a New Zealand tertiary ICU. DESIGN: A framework for QI was developed and implemented as part of a practice change initiative. METHODS: Audit data were collected, analysed and reported across seven nurse-influenced patient care standards...
December 14, 2016: Nursing in Critical Care
https://www.readbyqxmd.com/read/27966301/colistin-efficacy-in-the-treatment-of-multidrug-resistant-and-extremelydrug-resistant-gram-negative-bacterial-infections
#19
Çiğdem Banu Çetin, Deniz Özer Türk, Şebnem Şenol, Gönül Dinç Horasan, Özlem Tünger
BACKGROUND/AIM: Colistin is used as a salvage therapy for multidrug-resistant and extremely drug-resistant gram-negative bacterial infections. Our aim was to evaluate colistin efficiency and toxicity in the treatment of these resistant gram-negative bacterial infections. MATERIALS AND METHODS: This is a retrospective study carried out in a tertiary care hospital during 2011-2013. Study data were collected from the medical records and consultations of the infectious diseases clinic...
November 17, 2016: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/27957725/glutamine-fish-oil-and-antioxidants-in-critical-illness-metaplus-trial-post-hoc-safety-analysis
#20
Zandrie Hofman, Sophie Swinkels, Arthur R H van Zanten
BACKGROUND: The role of plasma glutamine, fish oil and antioxidants concentrations in the treatment effect of immune-modulating high-protein versus high-protein enteral nutrition on 6-month mortality in critically ill patients is explored, as unexpected negative outcomes of recent large randomized controlled trials on immune-modulating nutrients have raised questions about safety of these interventions. METHODS: Post hoc analysis of the MetaPlus randomized controlled trial which was performed in a total of 301 medical, surgical and trauma critically ill patients in fourteen European intensive care units...
December 2016: Annals of Intensive Care
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