Crit Care Resusc
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Haemodynamic instability is frequently considered a contraindication to enteral feeding. However, gastrointestinal function and the success of enteral feeding have never been formally examined in patients with shock. ⋯ Despite delayed gastric emptying, protocoldirected enteral feeding can be considered in patients with septic shock.
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To evaluate the impact of a recruitment manoeuvre (RM) on haemodynamics, gas exchange, and oxygen transport in patients with acute lung injury (ALI) an acute respiratory distress syndrome (ARDS) under mechanical ventilation. ⋯ In our small series of patients with ALI/ARDS ventilated with high levels of PEEP, the RM failed to improve oxygen exchange and induced deleterious effects on haemodynamics.
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Metformin, a widely used hypoglycaemic agent in type 2 diabetes mellitus, is uncommonly associated with lactic acidosis, a serious condition with high mortality. ⋯ MALA is a not uncommon cause of ICU admission. Gastrointestinal symptoms predominate in MALA, and the condition is associated with significant morbidity and mortality.
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To determine whether a detailed feeding algorithm improved nutrition support of critically ill patients compared with a standard feeding protocol. ⋯ Introduction of a detailed feeding algorithm resulted in earlier commencement of nutrition support and increased numbers of patients reaching goal rates in less time. To improve nutritional adequacy, the algorithm needs to be modified to account for unavoidable interruptions during ICU stay.