Nutrition
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Multicenter Study
Nutritional status and nutrition support in critically ill children in Spain: Results of a multicentric study.
Critically ill children are often malnourished and require nutrition support (NS). Early enteral nutrition (EEN) seems to be safe in critically ill patients. However, there is a scarcity of data about the management of EEN in sick pediatric patients. The aim of this study was to analyze the nutritional status, NS characteristics, macronutrient supply, and associations between NS and outcomes in critically ill children in Spain. ⋯ Malnutrition was prevalent among critically ill children in Spain. Being overweight was associated with a shorter PICU LOS. EEN was safe and was associated with a higher caloric intake; however, it is rarely used in PICUs in Spain.
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The use of easily accessible methods to estimate skeletal muscle mass (SMM) in patients with cirrhosis is often limited by the presence of edema and ascites, precluding a reliable diagnosis of sarcopenia. The aim of this study was to design predictive models using variables derived from anthropometric and/or biochemical measures to estimate SMM; and to validate their applicability in diagnosing sarcopenia in patients with cirrhosis. ⋯ Our simple and inexpensive models provided a practical and safe approach to diagnosing sarcopenia patients with cirrhosis along with an estimate of their mortality risk when other reference methods are unavailable.
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High-flow nasal-cannula (HFNC) oxygen therapy is increasingly used in the management of respiratory distress. Since this treatment may be required for many days and may impair nutritional intake, this study planned to observe the energy and protein intake of individuals receiving this therapy. ⋯ Administration of HFNC oxygen therapy was associated with significant underfeeding. In order to reach optimal caloric and protein intake, parenteral nutrition may be considered.
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Aggressive nutrition therapy is essential to improve nutrition and function in patients with malnutrition and sarcopenia. Malnutrition and sarcopenia negatively affect functional recovery and activities of daily living. Nutrition improvement is associated with better functional recovery. ⋯ Aggressive nutrition therapy should be combined with aggressive exercise and rehabilitation. Enhanced nutritional therapy combined with rehabilitation in patients with cerebrovascular disease, hip fracture, or acute disease is recommended in the 2018 clinical practice guidelines for rehabilitation nutrition. Further evidence for aggressive nutrition therapy is however required.
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The 2019 coronavirus disease (COVID-19) pandemic has disproportionally affected a variety of patients with underlying risk factors such as respiratory and cardiovascular diseases, diabetes, obesity, and black race. Vitamin D deficiency, which can result in a compromised immune response, has been also linked to increased risk and increased morbidities associated with COVID-19. In the absence of large-scale longitudinal studies to determine the strength of association between vitamin deficiency and COVID-19, cross-sectional studies of large patient cohorts can be used. ⋯ Vitamin D deficiency is significantly associated with increased risk for COVID-19.