Search Tag: Nutrition
2024 21 Mar
In an interesting session today at #ISICEM24, Dr Annika Reintam Blaser, an intensivist at Lucerne Cantonal Hospital in Switzerland, discussed future research on optimising feeding for critically ill patients. She highlighted the accumulating evidence over the past 15 years suggesting that feeding might have harmful effects on critically ill patients....Read more
2022 14 Oct
An overview of the benefits of early enteral nutrition, clinical evidence and recommendations, reasons for delayed enteral feeding in critically ill patients and optimal solutions. Early enteral nutrition is proven to improve clinical outcomes and reduce acute care costs. Nutrition clinicians support the belief that enteral nutrition is...Read more
2022 25 May
An overview of nutritional targets and their impact on critically ill patients and the need to use a systematic approach to nutritional support for optimal patient outcomes. Critically ill patients are often hypermetabolic and catabolic and are at a higher risk of underfeeding. Nutritional support for these patients can prevent energy...Read more
2022 10 May
In a new review, the authors identify the pros and cons of indirect calorimetry to estimate resting energy expenditure and define individual nutritional energy targets among critically ill patients. Indirect calorimetry (IC) is a monitoring tool that provides factual information on metabolism. There is significant evidence to show an important...Read more
2021 23 Nov
An overview of the physiological aspects of indirect calorimetry, its limitations in use, the available literature and future prospects for tailored nutrition. Introduction Medical nutrition therapy (MNT) is an essential part of patient care in the intensive care unit (ICU) setting. Similar to mechanical ventilation and haemodynamic...Read more
2020 24 Nov
This article summarises the current nutrition evidence in the phase of recovery that occurs following critical illness. Introduction It is plausible that the importance of nutrition may differ across different phases of illness. Reflecting this, the most recently updated clinical nutrition practice guidelines for critical care from the...Read more
2020 19 May
This article discusses the nutritional implications for critically ill patients admitted to intensive care for the management of COVID-19, and considers the inflammatory metabolic processes, nutrition-impacting symptoms, medical therapy, and the impact of a pandemic on staff resourcing and remote practice. Introduction The global...Read more
2020 15 Jan
Subject Index for Volume 19, issues 1-4, 2019. Issue Pages Link Issue 1 1-64 https://iii.hm/10cv Issue 2 65-128 https://iii.hm/10cw Issue 3 129-192 https://iii.hm/10cx Issue 4 193-256 https://iii.hm/10cy Acute Respiratory Distress Syndrome Use of sedation...Read more
2019 01 Dec
Patients who are malnourished or at nutritional risk do tend to have poorer outcomes compared to patients who are relatively healthier when they undergo surgery or are sick. Poorly nourished patients do not have the reserves to fight off illness, and in many cases, are also immunosuppressed with delayed wound healing. Malnutrition is a major public...Read more
2019 26 Sep
The critically ill patient is often unable to feed by mouth. This condition, in some patients, can range from days to months. It is imperative that these patients receive macronutrients either through enteral or parenteral nutrition. If they don't, there is a risk of an energy deficit that could lead to loss of lean body mass and subsequently, other...Read more
2019 26 Sep
ESPEN guidelines for nutrition in critical illness have shifted from optimistic anticipative nutritional pharmacotherapy towards cautious and balanced metabolic support. This important new orientation in ICU nutrition management is a consequence of recent strong RCT-based evidence. Introduction Recently, the new ESPEN guidelines for critically...Read more
2019 10 Sep
Clinical evidence shows that overfeeding critically ill patients is associated with poor outcomes. Obesity is a major challenge in ICU patients because of the comorbidities and anomalies associated with it. Determining an appropriate dose of enteral nutrition is difficult in this patient population and the risk of overfeeding quite high. An...Read more
2019 08 Jul
In a commentary published in JAMA Internal Medicine 01 July 2019, Neal Barnard, M.D., emphasised the importance for physicians today to be more familiar with nutrition knowledge. Dr. Barnard, Physicians Committee for Responsible Medicine president, explained how some of the main health concerns – diabetes, obesity, heart disease and some cancers...Read more
2019 19 Jun
Patients in the ICU tend to achieve clinical improvement within 3 to 7 days of stay. However, there is a subset of patients who progress to chronic critical illness. This is usually characterised by low-grade persistent inflammation and protein catabolism, also referred to as Persistent Inflammatory Catabolism Syndrome (PICS). PICS patients...Read more
2019 02 Apr
Optimal protein intake during critical illness is unknown. In order to achieve a personalised nutritional approach, Dutch researchers conducted the PROTein INtake and clinical outcomes of adult critically ill patients on prolonged mechanical VENTilation (PROTINVENT) study. The study’s primary aim was to determine the best timing and dose of protein...Read more
2019 28 Mar
The American Society for Parenteral and Enteral Nutrition (ASPEN) has elected Duke Anesthesiology’s Paul Wischmeyer, MD, an honorary fellow. The FASPEN award is one of ASPEN’s highest honors as a society. It recognizes Dr. Wischmeyer’s exceptional achievement in practice and his research contributions to the clinical nutrition field, as well as his...Read more
2018 16 Mar
This symposium explored controversial aspects of the nutritional management of patients in the ICU. There are new concepts and old controversies such as the role of permissive underfeeding and the optimal timing of nutrient delivery. Glucose control is also one such area where there is still no widespread agreement on optimal targets for blood...Read more
2018 16 Mar
There is still no widespread agreement around optimal targets for glucose control in the ICU: some clinicians maintain that glucose control is unnecessary and harmful, while others claim that blood glucose control is essential to improve prognosis. 1-3 Those who favour liberal glycaemic control assert that hyperglycaemia is simply a beneficial adaptation...Read more
2018 16 Mar
As has been pointed out, the benefits of tight glycaemic control in the ICU have by no means been clearly established or accepted. In 2010 a meta-analysis of seven prospective randomised studies concluded that intensive insulin therapy in mixed ICU patients was not supported by evidence. 19 Today we understand that hyperglycaemia, hypoglycaemia,...Read more
2018 16 Mar
As recently as 2010, the view of metabolic requirements for patients admitted to ICU was that all patients had the same metabolic needs and could therefore be managed with the same nutritional product. In general, critically ill patients were fed along the same lines as healthy people in the ratio of around 50% carbohydrates, 35% lipids and 15% protein....Read more
2018 16 Mar
There are many new concepts and old controversies surrounding nutrition in critical care such as: the role of trophic feeding, permissive underfeeding, the use of immune modulating agents, and the optimal timing of nutrient delivery. However, enteral nutrition and protein delivery have consistently been found to be beneficial. Traditionally,...Read more
2017 15 Sep
Optimising nutrition and metabolism post-ICU for recovery of functional lean body mass and quality of life. In-hospital mortality following intensive care unit (ICU) care has consistently declined in recent years (Kaukonen et al. 2014). However, these data reveal many of these ICU “survivors” are not returning home to functional lives after...Read more
2016 30 Nov
As a neurointensivist with a strong interest in nutritional support, I was delighted to trial a new integrated nutritional module. We know that nutrition really matters to our ICU patients in the context of first indicators. For example, our research group recently published a paper about two patients with viral meningoencephalitis. Invasive neuromonitoring...Read more