Jpen Parenter Enter
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Jpen Parenter Enter · Sep 2011
Treatment of hypertriglyceridemia in patients receiving parenteral nutrition.
This study aims to evaluate whether withdrawal of a soy oil-based lipid emulsion from the parenteral nutrition (PN) regimen in humans is associated with improved triglyceride and liver enzyme concentrations. ⋯ Short-term withdrawal of the lipid fraction in the PN mixture is associated with a significant reduction of plasma triglyceride concentration. Reintroduction was related to an increase of triglyceride concentration. In addition, liver enzyme abnormalities and leukocyte count reduced, whereas albumin levels increased, suggesting that even short withdrawal of the lipid emulsion diminished hepatocellular damage and systemic inflammation.
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Jpen Parenter Enter · Sep 2011
Comparative StudyBody composition (sarcopenia) in obese patients: implications for care in the intensive care unit.
The study of body composition is a rapidly evolving science. In today's environment, there is a great deal of interest in assessing body composition, especially in the obese subject, as a guide to clinical and nutrition interventions. ⋯ The recognition of patients with sarcopenic obesity has identified a potential high-risk patient population. These body composition abnormalities may have even greater importance in the intensive care patient.
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Jpen Parenter Enter · Sep 2011
Nutrition and metabolic complications after bariatric surgery and their treatment.
The increase in the number of bariatric procedures annually suggests that these patients will constitute an increasing portion of obese patients who require hospital and intensive care. Currently, little prospective information is available regarding the course of bariatric surgery patients requiring intensive care. Knowledge of the type of bariatric operation performed and an understanding of its anatomy and physiology are useful to provide optimal care to these patients, particularly when considering potential nutrition complications and their diagnosis and treatment. In this article, the authors describe nutrition problems that may be present and potentially affect the course of a hospitalized and/or critically ill patient who has previously undergone a bariatric operation.
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Jpen Parenter Enter · Sep 2011
Obesity epidemic: overview, pathophysiology, and the intensive care unit conundrum.
Obesity is one of the leading causes of preventable death in the United States, second only to smoking. The annual number of deaths attributed to obesity is estimated to be as high as 400,000. Nearly 70% of the adult U. ⋯ Obesity in general is associated with increased all-cause mortality and cause-specific mortality (from cardiovascular, diabetic, hepatic, and neoplastic causes). Yet despite increased overall mortality rates, current evidence suggests that when these same patients are admitted to the intensive care unit (ICU), the obesity provides some protection against mortality. At present, there is no clear explanation for this obesity conundrum in critical illness.
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Jpen Parenter Enter · Sep 2011
Review"CAN WE FEED?" A mnemonic to merge nutrition and intensive care assessment of the critically ill patient.
As care of the critically ill patient grows more complex, so does the breadth of knowledge required of the intensivist to deliver quality service. Nutrition is one area of many where the complexity of care has grown and the opportunity for improving patient outcomes has become evident. The use of mnemonics has proven successful in compartmentalizing information that must be considered in complex decision-making processes. ⋯ Energy requirements (E) are determined using conventional weight-based equations, indirect calorimetry, or combinations of both techniques. The more practical aspects of support that follow include formula selection (F), enteral access (E), efficacy (E), and the determination of tolerance (D). With careful consideration of these components through the use of the mnemonic "CAN WE FEED?" the intensivist can successfully implement a nutrition plan, and the clinical nutritionist can appreciate where nutrition therapy appropriately intervenes in the initial resuscitation and management of the critically ill patient.