Current opinion in critical care
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Curr Opin Crit Care · Aug 2021
ReviewIndirect calorimetry in critical illness: a new standard of care?
Review recent literature on the role of indirect calorimetry in critical care nutrition management. ⋯ Personalized ICU care demands objective data to guide therapy. This includes use of indirect calorimetry to determine energy expenditure and guide ICU nutrition therapy. Long-awaited new innovations in indirect calorimetry technology should finally lead to indirect calorimetry to becoming a fundamental component of modern ICU standard of care and clinical research moving forward.
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Curr Opin Crit Care · Aug 2021
ReviewBioelectric impedance analysis for body composition measurement and other potential clinical applications in critical illness.
Insight into body composition is of great value in the ICU. Bioelectric impedance analysis (BIA) is the most applicable bedside technique. However, bioimpedance has not been validated in the critically ill, and the interpretation of the measurements poses challenges. This review discusses the potential clinical applications of BIA and explores caveats and solutions to its use in the intensive care setting. ⋯ There are currently too many uncertainties and discrepancies regarding interpretation of bioimpedance in critical illness, to justify therapeutic consequences. However, there are several promising areas of research, concerning some of the most urgent clinical problems in intensive care, emphasizing the need to evaluate further the use and interpretation of bioimpedance in the intensive care setting.
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Curr Opin Crit Care · Aug 2021
ReviewVitamin D in critical care: where are we now and what is next?
To summarize the recent evidence on the role of vitamin D deficiency in critically ill patients and emerging data claiming a role of vitamin D in COVID-19. ⋯ Although research on this topic is still ongoing, it appears reasonable to recommend at least the standard vitamin dose for the healthy population (600--800 IU of native vitamin D3). Many questions remain on the actual role, the best metabolite, regime, and so forth. However, the role for vitamin D in bone health is clear. Elderly ICU survivors have a high risk for osteoporosis/fractures, so at least in this population, an optimal vitamin D status should be targeted.