Critical care medicine
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Critical care medicine · Dec 2008
Protein and calorie prescription for children and young adults receiving continuous renal replacement therapy: a report from the Prospective Pediatric Continuous Renal Replacement Therapy Registry Group.
Few published reports describe nutrition provision for critically ill children and young adults with acute kidney injury receiving continuous renal replacement therapy. The goals of this study were to describe feeding practices in pediatric continuous renal replacement therapy and to evaluate factors associated with over- and under-prescription of protein and calories. ⋯ Protein prescription in pediatric continuous renal replacement therapy may be inadequate. Inter-center variation exists with respect to nutrition prescription. Feeding practice standardization and research in pediatric acute kidney injury nutrition are essential to begin providing evidence-based feeding recommendations.
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Critical care medicine · Dec 2008
Low insulin-like growth factor-1 and hypocholesterolemia as mortality predictors in acute kidney injury in the intensive care unit.
To assess the role of insulin-like growth factor-1 and cholesterol as predictors of acute kidney injury mortality in intensive care unit patients. ⋯ Decreased levels of insulin-like growth factor-1 and cholesterol were clearly related to higher mortality. The close correlation of insulin-like growth factor-1 with nutritional status, its serum stability, and short-half life makes it a suitable candidate for an early and sensitive marker for intensive care unit acute kidney injury mortality.
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Critical care medicine · Dec 2008
Clinical and economic outcomes of involving pharmacists in the direct care of critically ill patients with infections.
To determine whether the absence or presence of clinical pharmacists in intensive care units (ICUs) results in differences in mortality rates, length of ICU stay, and ICU charges for Medicare patients with nosocomial-acquired infections, community-acquired infections, and sepsis. ⋯ The involvement of clinical pharmacists in the care of critically ill Medicare patients with infections is associated with improved clinical and economic outcomes. Hospitals should consider employing clinical ICU pharmacists.
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Critical care medicine · Dec 2008
Role of proinflammatory activity contained in gastric juice from intensive care unit patients to induce lung injury in a rabbit aspiration model.
Although aspiration pneumonitis is a severe complication in patients hospitalized in intensive care units, its pathogenesis is poorly understood. The aim of this study was to determine whether the intensity of lung injury and inflammation developing after aspiration during mechanical ventilation differed depending on the inflammatory activity of intensive care unit patients' gastric fluid. ⋯ Gastric juice from critically ill patients is proinflammatory and stimulates human pulmonary cells in vitro. A human gastric juice with high proinflammatory activity is more "toxic" to the lung than one with low proinflammatory activity in a ventilated rabbit model, an effect that is independent of pH and particulate matter content.
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Critical care medicine · Dec 2008
Allicin, a major component of garlic, inhibits apoptosis in vital organs in rats with trauma/hemorrhagic shock.
Allicin is believed to be the main component responsible for the biological activity of garlic. The regulation of cell apoptosis may have therapeutic potential for trauma/hemorrhagic shock, and previous studies have demonstrated that allicin exerts protective effects against tissue ischemia-reperfusion injury. Therefore, this study examined the effects of allicin on apoptosis-related organ damage, induced by trauma/hemorrhagic shock. ⋯ Allicin attenuates tissue injury and inhibits trauma/hemorrhagic shock- and reperfusion-induced apoptosis in several important organs via the p38 mitogen-activated protein kinase signal transduction pathway that functions to stimulate the activation of nuclear factor-kappaB, caspase-3 and -9, but not of extracellular signal-regulated kinase 1 mitogen-activated protein kinase.