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Icu nutrition

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17 papers 0 to 25 followers
Yaseen M Arabi, Abdulaziz S Aldawood, Hasan M Al-Dorzi, Hani M Tamim, Samir H Haddad, Gwynne Jones, Lauralyn McIntyre, Othman Solaiman, Maram H Sakkijha, Musharaf Sadat, Shihab Mundekkadan, Anand Kumar, Sean M Bagshaw, Sangeeta Mehta
RATIONALE: The optimal nutritional strategy for critically ill adults at high nutritional risk is unclear. OBJECTIVE: In patients with different baseline nutritional risk, we examined the effect of permissive underfeeding with full protein intake compared to standard feeding on 90-day mortality. METHODS: This is a post-hoc analysis of the PermiT (Permissive Underfeeding versus Target Enteral Feeding in Adult Critically Ill Patients) trial...
September 2, 2016: American Journal of Respiratory and Critical Care Medicine
Kim Lewis, Zuhoor Alqahtani, Lauralyn Mcintyre, Saleh Almenawer, Fayez Alshamsi, Andrew Rhodes, Laura Evans, Derek C Angus, Waleed Alhazzani
BACKGROUND: Intolerance to enteral nutrition is common in critically ill adults, and may result in significant morbidity including ileus, abdominal distension, vomiting and potential aspiration events. Prokinetic agents are prescribed to improve gastric emptying. However, the efficacy and safety of these agents in critically ill patients is not well-defined. Therefore, we conducted a systematic review and meta-analysis to determine the efficacy and safety of prokinetic agents in critically ill patients...
August 15, 2016: Critical Care: the Official Journal of the Critical Care Forum
Saúl Rugeles, Luis Gabriel Villarraga-Angulo, Aníbal Ariza-Gutiérrez, Santiago Chaverra-Kornerup, Pieralessandro Lasalvia, Diego Rosselli
PURPOSE: Appropriate caloric intake in critically ill patients receiving enteral nutrition is controversial. This study evaluates the impact of different caloric regimens on severity of organ failure measured with Sequential Organ Failure Assessment (SOFA). MATERIALS AND METHODS: We conducted a randomized prospective controlled trial. Study population included adult intensive care unit (ICU) patients expected to require enteral nutrition for more than 96 hours. Goals in the intervention group were hypocaloric (15 kcal/kg per day) enteral nutrition compared to normocaloric (25 kcal/kg per day) enteral nutrition, both with hyperproteic intake (1...
October 2016: Journal of Critical Care
Marianne J Chapman, Adam M Deane, Stephanie L O'Connor, Nam Q Nguyen, Robert J L Fraser, Duncan B Richards, Kimberley E Hacquoil, Lakshmi S Vasist Johnson, Matthew E Barton, George E Dukes
BACKGROUND: The promotility agents currently available to treat gastroparesis and feed intolerance in the critically ill are limited by adverse effects. The aim of this study was to assess the pharmacodynamic effects and pharmacokinetics of single doses of the novel gastric promotility agent motilin agonist camicinal (GSK962040) in critically ill feed-intolerant patients. METHODS: A prospective, randomized, double-blind, parallel-group, placebo-controlled, study was performed in mechanically ventilated feed-intolerant patients [median age 55 (19-84), 73 % male, APACHE II score 18 (5-37) with a gastric residual volume ≥200 mL]...
2016: Critical Care: the Official Journal of the Critical Care Forum
Joshua A Englert, Angela J Rogers
Sepsis is characterized by profound changes in systemic and cellular metabolism that disrupt normal metabolic homeostasis. These metabolic changes can serve as biomarkers for disease severity. Lactate, a metabolite of anaerobic metabolism, is the most widely used ICU biomarker and it is incorporated into multiple management algorithms. Technological advances now make broader metabolic profiling possible, with early studies identifying metabolic changes associated with sepsis mortality. Finally, given the marked changes in metabolism in sepsis and the association of worse prognosis in patients with severe metabolic derangements, we summarize the seminal trials conducted to optimize nutrition in the ICU...
June 2016: Clinics in Chest Medicine
William Manzanares, Pascal L Langlois, Gil Hardy
PURPOSE OF REVIEW: Purpose of the review is to summarize recent research addressing the role of intravenous lipid emulsions (IVLEs) in the critically ill. RECENT FINDINGS: Soybean oil-based IVLEs, which are high in the omega-6 polyunsaturated fatty acids, have been largely used in parenteral nutrition over the last several decades. However, it is now generally accepted that the higher content of phytosterols and polyunsaturated fatty acids in soybean oil IVLE may adversely affect the immunological and inflammatory status of the critically ill...
August 2016: Current Opinion in Critical Care
Taku Oshima, Pierre Singer, Claude Pichard
PURPOSE OF REVIEW: The review focuses on the use of parenteral nutrition and enteral nutrition in critically ill patients to optimize the nutrition care throughout the ICU stay. The key message is: you have the choice! RECENT FINDINGS: Enteral nutrition has been recommended for critically ill patients, whereas parenteral nutrition has been considered harmful and to be avoided. However, recent studies have challenged this theory. They demonstrated that enteral nutrition is frequently associated with energy and protein undernutrition, whereas parenteral nutrition becomes deleterious only if overfeeding is induced...
August 2016: Current Opinion in Critical Care
Peter J M Weijs
PURPOSE OF REVIEW: Protein delivery in the critically ill still is a highly debated issue. Here, we discuss only the most recent updates in the literature concerning protein nutrition of the critically ill. RECENT FINDINGS: Up to now, there are no randomized controlled trials (RCTs) published on enteral provision of protein that were randomized for protein level of intake. In the past year, there have been two new observational studies published, one of which in critically ill children...
August 2016: Current Opinion in Critical Care
Gunnar Elke, Arthur R H van Zanten, Margot Lemieux, Michele McCall, Khursheed N Jeejeebhoy, Matthias Kott, Xuran Jiang, Andrew G Day, Daren K Heyland
BACKGROUND: Enteral nutrition (EN) is recommended as the preferred route for early nutrition therapy in critically ill adults over parenteral nutrition (PN). A recent large randomized controlled trial (RCT) showed no outcome differences between the two routes. The objective of this systematic review was to evaluate the effect of the route of nutrition (EN versus PN) on clinical outcomes of critically ill patients. METHODS: An electronic search from 1980 to 2016 was performed identifying relevant RCTs...
April 29, 2016: Critical Care: the Official Journal of the Critical Care Forum
Jayshil J Patel, Panna Codner
Critical illness predisposes individuals to highly variable metabolic and immune responses, leading to muscle mass loss, impaired healing, immobility, and susceptibility to infections and cognitive impairment. Recommendations for nutrition in critically ill patients are supported by observational studies, small randomized controlled trials, and mechanistic data. There is no standardization of nutritional therapy in critically ill patients and controversies in the type, quantity, and timing of nutrition support persist...
April 2016: Critical Care Clinics
Nurten Ozen, Nuran Tosun, Levent Yamanel, Neriman Defne Altintas, Guldem Kilciler, Volkan Ozen
PURPOSE: This study aimed to evaluate the effects of not measuring gastric residual volume (GRV) in intensive care patients on a mechanical ventilator and receiving enteral feeding on the feeding intolerance, gastroesophageal reflux (GER) risk, and nutritional adequacy. METHODS: This randomized clinical study was performed in 2 medical intensive care units of 2 university hospitals in Ankara, Turkey. The patients were randomized into 2 groups. In the group with GRV monitoring, GRV was measured 3 times a day, and the GRV threshold was accepted as 250 mL...
June 2016: Journal of Critical Care
Harshel G Parikh, Asaf Miller, Marianne Chapman, John L Moran, Sandra L Peake
OBJECTIVES: To determine the effect of calorie delivery on hospital mortality among critically ill adults receiving enteral nutrition (EN). Secondary outcomes included the effect of calorie delivery on intensive care unit and hospital length of stay (LOS), duration of mechanical ventilation (MV) and incidence of new-onset pneumonia. METHODS: We identified randomised clinical trials of EN, with or without supplemental parenteral nutrition (PN), involving adult ICU patients for whom mortality data were available, and when there was a significant difference in calorie supplementation between intervention arms (P < 0...
March 2016: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
Taku Oshima, Michael Hiesmayr, Claude Pichard
PURPOSE OF REVIEW: The difficulties to feed the patients adequately with enteral nutrition alone have drawn the attention of the clinicians toward the use of parenteral nutrition, although recommendations by the recent guidelines are conflicting. This review focuses on the intrinsic role of parenteral nutrition, its new indication, and modalities of use for the critically ill patients. RECENT FINDINGS: A recent trial demonstrated that selecting either parenteral nutrition or enteral nutrition for early nutrition has no impact on clinical outcomes...
March 2016: Current Opinion in Clinical Nutrition and Metabolic Care
Jiri Cyrany, Stanislav Rejchrt, Marcela Kopacova, Jan Bures
Percutaneous endoscopic gastrostomy (PEG) is a widely used method of nutrition delivery for patients with long-term insufficiency of oral intake. The PEG complication rate varies from 0.4% to 22.5% of cases, with minor complications being three times more frequent. Buried bumper syndrome (BBS) is a severe complication of this method, in which the internal fixation device migrates alongside the tract of the stoma outside the stomach. Excessive compression of tissue between the external and internal fixation device of the gastrostomy tube is considered the main etiological factor leading to BBS...
January 14, 2016: World Journal of Gastroenterology: WJG
Beth E Taylor, Stephen A McClave, Robert G Martindale, Malissa M Warren, Debbie R Johnson, Carol Braunschweig, Mary S McCarthy, Evangelia Davanos, Todd W Rice, Gail A Cresci, Jane M Gervasio, Gordon S Sacks, Pamela R Roberts, Charlene Compher
No abstract text is available yet for this article.
February 2016: Critical Care Medicine
Lee-Anne S Chapple, Marianne J Chapman, Kylie Lange, Adam M Deane, Daren K Heyland
BACKGROUND: Critical illness following head injury is associated with a hypermetabolic state but there are insufficient epidemiological data describing acute nutrition delivery to this group of patients. Furthermore, there is little information describing relationships between nutrition and clinical outcomes in this population. METHODS: We undertook an analysis of observational data, collected prospectively as part of International Nutrition Surveys 2007-2013, and extracted data obtained from critically ill patients with head trauma...
2016: Critical Care: the Official Journal of the Critical Care Forum
Taku Oshima, Claude Pichard
This review emphasizes the benefits of parenteral nutrition (PN) in critically ill patients, when prescribed for relevant indications, in adequate quantities, and in due time. Critically ill patients are at risk of energy deficit during their ICU stay, a condition which leads to unfavorable outcomes, due to hypercatabolism secondary to the stress response and the difficulty to optimize feeding. Indirect calorimetry is recommended to define the energy target, since no single predictive equation accurately estimates energy expenditure...
2015: Critical Care: the Official Journal of the Critical Care Forum
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