Jpen Parenter Enter
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Jpen Parenter Enter · May 2013
The effect of body mass index on the outcome of critically ill surgical patients.
The incidence of obesity is rising, and an increasing number of obese patients are admitted to surgical intensive care units (SICUs). However, it is not clear whether obesity is an independent risk factor for increased morbidity and mortality in SICU patients. We examined the effect of obesity on morbidity and mortality in patients admitted to the SICU in this study. ⋯ Obesity does not affect the mortality of patients admitted to the SICU. We conclude that obesity cannot be used as an independent predictive mortality outcome variable in patients admitted to the SICU.
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Jpen Parenter Enter · May 2013
Review Meta AnalysisThe effects of probiotics in early enteral nutrition on the outcomes of trauma: a meta-analysis of randomized controlled trials.
The role of probiotics in trauma patients remains unclear. We undertook a meta-analysis of published randomized controlled trials (RCTs) to assess the effects of probiotics on the clinical outcomes of trauma patients. ⋯ The use of probiotics is associated with a reduction in the incidence of nosocomial infections, VAP, and length of ICU stay but is not associated with an overall mortality advantage. However, the results should be interpreted cautiously due to the heterogeneity among study designs. Further large-scale, well-designed RCTs are needed.
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Jpen Parenter Enter · May 2013
Observational StudyIntra-abdominal pressure as a prognostic factor for tolerance of enteral nutrition in critical patients.
The purpose of this study is to establish a relationship between tolerance of enteral nutrition (EN) and intra-abdominal pressure (IAP) in critical patients, establish an objective measure for monitoring tolerance, and determine a threshold value for IAP. ⋯ In critically ill patients, there is a relation between IAP values and the tolerance of EN. The baseline IAP with the APACHE II score can predict the tolerance of EN.
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Jpen Parenter Enter · May 2013
Observational StudyMalnutrition may worsen the prognosis of critically ill children with hyperglycemia and hypoglycemia.
To determine whether hyperglycemia and hypoglycemia are associated with higher mortality, longer length of intensive care unit (ICU) stay, and fewer ventilator-free days in critically ill children while taking into account the clinical severity and nutrition status. ⋯ Compared with the well nourished, malnourished patients with hyperglycemia are at a greater risk of mortality, independent of clinical severity. Hypoglycemia was shown to be associated with mortality, longer length of ICU stay, and fewer ventilator-free days only in malnourished patients.
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Jpen Parenter Enter · May 2013
Catheter-related complications in cancer patients on home parenteral nutrition: a prospective study of over 51,000 catheter days.
Although home parenteral nutrition (HPN) is often indicated in cancer patients, many physicians are concerned about the risks potentially associated with the use of central venous access devices (VADs) in these patients. The aim of this prospective study was to investigate the actual incidence of VAD-related complications in cancer patients on HPN. ⋯ In cancer patients, HPN can be safely carried out with a low incidence of complications. Also, VADs are not equal in terms of complication rates, and strict adherence to meticulous insertion policies may effectively reduce catheter-related complications.