Clinical nutrition : official journal of the European Society of Parenteral and Enteral Nutrition
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Infections are an important cause of morbidity and mortality in patients in intensive care units (ICUs). Fungal infections have increased substantially over recent years and fungi have become one of the important pathogens in ICU patients. This study tests the hypothesis that the incidence of fungal infections is lower in critically ill patients under mechanical ventilation receiving enteral rather than total parenteral nutrition. ⋯ No significant decrease in the incidence of fungal infections in critically ill patients receiving SDD was observed between those receiving enteral and total parenteral nutrition.
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Within a prospective study on costs in 45 Italian intensive units we reviewed nutrition support practice given during critical illness. ⋯ In Italian ICUs, in complex critically ill patients, nutrition is consistently given in critical illness, gut is widely used except in abdominal surgery patients.
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Randomized Controlled Trial Clinical Trial
Glutamine-enriched enteral nutrition increases in vitro interferon-gamma production but does not influence the in vivo specific antibody response to KLH after severe trauma. A prospective, double blind, randomized clinical study.
Severe trauma leads to an immune suppression, characterized by a Type 2 T-lymphocyte response, contributing to the susceptibility of infectious complications. Plasma concentrations of glutamine (GLN), the preferred fuel for immunocompetent cells, severely decrease after trauma. Since administering glutamine-enriched enteral nutrition (EN) reduces infectious complications in trauma patients, we compared the effect of glutamine-enriched EN with an isocaloric, isonitrogenous enteral control (Con) feeding, on the Type 1 and 2 T-lymphocyte responses. ⋯ In conclusion, trauma caused a suppressed in vitro cellular immune response presented by a low IFN-gamma production and depressed the IgG and IgM response to KLH directly after trauma. Glutamine increased IFN-gamma production (d14), maintained a normal IL-4 production, but was not acquired for the development of KLH-specific humoral response on d14, in sync suggesting that dietary glutamine supports the restoration of the Type-1 T-lymphocyte responsiveness.
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Clinical Trial Controlled Clinical Trial
Higher calorie prescription improves nutrient delivery during the first 5 days of enteral nutrition.
It is unclear whether prescribing a higher amount of calories by enteral nutrition (EN) increases actual delivery. This prospective controlled study aimed at comparing the progression of EN of two study populations with different levels of calorie prescriptions, during the first 5 days of EN. ⋯ Increasing the levels of EN prescriptions improved calorie and protein deliveries. While the mean energy delivery over 5 days was sufficient to cover requirements, the protein delivery by EN was insufficient, despite our nutritional support team.
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Little is known about the nutritional status of critically ill children during hospitalisation in and after discharge from an intensive care unit. We set up a prospective, observational study to evaluate the nutritional status of children in an intensive care unit from admission up to 6 months after discharge. A secondary aim was identifying patient characteristics that influence the course of the various anthropometric parameters. ⋯ While malnutrition is a major problem in pediatric intensive care units, most children have good long-term outcome in terms of nutritional status after discharge.