Clinical nutrition : official journal of the European Society of Parenteral and Enteral Nutrition
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Malnutrition can significantly affect clinical outcomes in critically ill children. In view of the limitations of anthropometry, nutrition-related serum biomarkers have been used to assess the degree of malnutrition in the pediatric intensive care unit. The aim of this review is to critically appraise the use of nutrition-related serum biomarkers in predicting clinical outcomes in critically ill children. ⋯ Current medical literature does not provide convincing data to demonstrate any association between nutrition-related serum biomarkers and clinical outcomes in critically ill children. Further research is required to identify novel and clinically robust nutrition-related biomarkers.
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The assessment of metabolic parameters related to energy expenditure has a proven value for weight management; however these measurements remain too difficult and costly for monitoring individuals at home. The objective of this study is to evaluate the accuracy of a new pocket-sized metabolic analyzer device for assessing energy expenditure at rest (REE) and during sedentary activities (EE). The new device performs indirect calorimetry by measuring an individual's oxygen consumption (VO2) and carbon dioxide production (VCO2) rates, which allows the determination of resting- and sedentary activity-related energy expenditure. ⋯ The findings demonstrate that the new pocket-sized metabolic analyzer device is accurate for determining VO2, VCO2, and energy expenditure.
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Nutritional assessment of critically ill patients has created controversy. However, it is well established that malnourished patients who are severely ill have worse outcomes than well-nourished patients. Therefore, assessing patients' nutritional status may be useful in predicting which patients may experience increased morbidity and mortality. ⋯ SGA, an inexpensive and quick nutritional assessment method conducted at the bedside, is a reliable tool for predicting outcomes in critically ill patients.
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Review Meta Analysis
The presence and effect of bias in trials of early enteral nutrition in critical care.
Randomized trials suggest that early enteral nutrition is beneficial in critically ill adults. However, methodologic bias can overestimate benefit. ⋯ The benefits attributed to early enteral nutrition were either seen only in trials with high risks of bias or may result from residual risks of bias.
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Review Meta Analysis
Does intravenous fish oil benefit patients post-surgery? A meta-analysis of randomised controlled trials.
Supplementation of fish oil (FO) containing lipid emulsions has been associated with a reduction in the length of hospital stay, infections and liver dysfunction in patients undergoing major surgery. We carried out a meta-analysis and subgroup analysis to examine randomised clinical trial (RCT)-based evidence of the aforementioned effects. ⋯ FO-enriched lipid emulsions are likely to reduce infections, the length of hospital stay and liver dysfunction without influencing mortality and may be a safe and preferable choice in post-surgery patients. Further well-designed trials should be performed to determine whether FO lipid emulsions reduce mortality in patients undergoing hepatic surgery, especially liver transplantation, and the cost effectiveness of such treatment.