Determination of Nutrition Risk and Status in Critically Ill Patients: What Are Our Considerations?

2018 ◽  
Vol 34 (1) ◽  
pp. 96-111 ◽  
Author(s):  
Zheng-Yii Lee ◽  
Daren K. Heyland
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Nutrition Risk

scholarly journals Full versus Trophic Feeds in Critically Ill Adults with High and Low Nutritional Risk Scores: A Randomized Controlled Trial

Nutrients ◽  
2020 ◽  
Vol 12 (11) ◽  
pp. 3518
Author(s):  
Chen-Yu Wang ◽  
Pin-Kuei Fu ◽  
Wen-Cheng Chao ◽  
Wei-Ning Wang ◽  
Chao-Hsiu Chen ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Hospital Stay ◽  
Clinical Outcomes ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Controlled Trial ◽  
Risk Scores ◽  
Nutrition Risk ◽  
Randomized Controlled ◽  
Trophic Feeding

Although energy intake might be associated with clinical outcomes in critically ill patients, it remains unclear whether full or trophic feeding is suitable for critically ill patients with high or low nutrition risk. We conducted a prospective study to determine which feeding energy intakes were associated with clinical outcomes in critically ill patients with high or low nutrition risk. This was an investigator-initiated, single center, single blind, randomized controlled trial. Critically ill patients were allocated to either high or low nutrition risk based on their Nutrition Risk in the Critically Ill score, and then randomized to receive either the full or the trophic feeding. The feeding procedure was administered for six days. No significant differences were observed in hospital, 14-day and 28-day mortalities, the length of ventilator dependency, or ICU and hospital stay among the four groups. There were no associations between energy and protein intakes and hospital, 14-day and 28-day mortalities in any of the four groups. However, protein intake was positively associated with the length of hospital stay and ventilator dependency in patients with low nutrition risk receiving trophic feeding. Full or trophic feeding in critically ill patients showed no associations with clinical outcomes, regardless of nutrition risk.

scholarly journals Comparison of Feeding Efficiency and Hospital Mortality between Small Bowel and Nasogastric Tube Feeding in Critically Ill Patients at High Nutritional Risk

Nutrients ◽  
2020 ◽  
Vol 12 (7) ◽  
pp. 2009
Author(s):  
Wei-Ning Wang ◽  
Chen-Yu Wang ◽  
Chiann-Yi Hsu ◽  
Pin-Kuei Fu
Keyword(s):  
Small Bowel ◽  
Enteral Nutrition ◽  
Hospital Mortality ◽  
Critically Ill ◽  
Energy Intake ◽  
Nasogastric Tube ◽  
Critically Ill Patients ◽  
Nutritional Risk ◽  
Nutrition Risk ◽  
Achievement Rate

Nasogastric tube enteral nutrition (NGEN) should be initiated within 48 h for patients at high nutritional risk. However, whether small bowel enteral nutrition (SBEN) should be routinely used instead of NGEN to improve hospital mortality remains unclear. We retrospectively analyzed 113 critically ill patients with modified Nutrition Risk in Critically Ill (mNUTRIC) score ≥ 5 and feeding volume < 750 mL/day in the first week of their stay in the intensive care unit (ICU). Age, sex, mNUTRIC score, and Acute Physiology and Chronic Health Evaluation II (APACHE II) score were matched in the SBEN (n = 48) and NGEN (n = 65) groups. Through a univariate analysis, factors associated with hospital mortality were SBEN group (hazard ratio (HR), 0.56; 95% confidence interval (CI), 0.31–1.00), Simplified Organ Failure Assessment (SOFA) score on day 7 (HR, 1.12; 95% CI, 1.03–1.22), and energy intake achievement rate < 65% (HR, 2.53; 95% CI, 1.25–5.11). A multivariate analysis indicated that energy intake achievement rate < 65% on the third follow-up day (HR, 2.29; 95% CI, 1.12–4.69) was the only factor independently associated with mortality. We suggest initiation of SBEN on the seventh ICU day before parenteral nutrition initiation for critically ill patients at high nutrition risk.

Determination of 1,3-β-D-glucan in the peritoneal fluid for the diagnosis of intra-abdominal candidiasis in critically ill patients: a pilot study

2018 ◽  
Vol 84 (12) ◽  
Author(s):  
Emmanuel Novy ◽  
François-Xavier Laithier ◽  
Marie-Claire Machouart ◽  
Eliane Albuisson ◽  
Philippe Guerci ◽  
...  
Keyword(s):  
Pilot Study ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Peritoneal Fluid ◽  
Abdominal Candidiasis

SUN-LB644: Nutritional Risk Assessment in Critically Ill Patients Using Nutrition Risk in Critically Ill (NUTRIC) Score

2019 ◽  
Vol 38 ◽  
pp. S298-S299
Author(s):  
R. Kalavathy ◽  
Sumaya Ahmed Al Araj ◽  
Nazneen Zara ◽  
Yousuf Altair ◽  
Khadra Omer
Keyword(s):  
Risk Assessment ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Nutritional Risk ◽  
Nutrition Risk

Analytical comparison of ELISA and mass spectrometry for quantification of serum hepcidin in critically ill patients

Bioanalysis ◽  
2021 ◽  
Author(s):  
Constance Delaby ◽  
Jérôme Vialaret ◽  
Christophe Hirtz ◽  
Thibaud Lefebvre ◽  
Matthias Herkert ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Deficiency Anemia ◽  
Altman Analysis ◽  
Elisa Kit ◽  
Kappa Test ◽  
Serum Hepcidin ◽  
Good Agreement

Aim: To compare methods of quantifying serum hepcidin (based on MS and ELISA) and their ability to diagnose true iron deficiency anemia in critically ill patients. Materials & methods: Serum hepcidin was measured in 119 critically ill patients included in the HEPCIDANE clinical trial, using either an ultra-sensitive ELISA kit (from DRG) or two different MS methods. Results: The results show a good correlation between the different methods studied. The Bland–Altman analysis and the Kappa test for clinical groups show a good or very good agreement between the different tests. Conclusion: ELISA or MS show a satisfactory commutability to quantify serum hepcidin. This is of great importance for the determination of therapeutic strategies in iron deficiency.

scholarly journals NUTRIC and Modified NUTRIC are Accurate Predictors of Outcome in End-Stage Liver Disease: A Validation in Critically Ill Patients with Liver Cirrhosis

Nutrients ◽  
2020 ◽  
Vol 12 (7) ◽  
pp. 2134
Author(s):  
Ulrich Mayr ◽  
Julia Pfau ◽  
Marina Lukas ◽  
Ulrike Bauer ◽  
Alexander Herner ◽  
...  
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Area Under Curve ◽  
Nutritional Risk ◽  
Predictors Of Outcome ◽  
Discriminative Ability ◽  
Nutrition Risk ◽  
Prognostic Accuracy ◽  
Cirrhotic Patients ◽  
End Stage

Malnutrition in critically ill patients with cirrhosis is a frequent but often overlooked complication with high prognostic relevance. The Nutrition Risk in Critically ill (NUTRIC) score and its modified variant (mNUTRIC) were established to assess the nutrition risk of intensive care unit patients. Considering the high mortality of cirrhosis in critically ill patients, this study aims to evaluate the discriminative ability of NUTRIC and mNUTRIC to predict outcome. We performed a retro-prospective evaluation in 150 Caucasian cirrhotic patients admitted to our ICU. Comparative prognostic analyses between NUTRIC and mNUTRIC were assessed in 114 patients. On ICU admission, a large proportion of 65% were classified as high NUTRIC (6–10) and 75% were categorized as high mNUTRIC (5–9). High nutritional risk was linked to disease severity and poor outcome. NUTRIC was moderately superior to mNUTRIC in prediction of 28-day mortality (area under curve 0.806 vs. 0.788) as well as 3-month mortality (area under curve 0.839 vs. 0.819). We found a significant association of NUTRIC and mNUTRIC with MELD, CHILD, renal function, interleukin 6 and albumin, but not with body mass index. NUTRIC and mNUTRIC are characterized by high prognostic accuracy in critically ill patients with cirrhosis. NUTRIC revealed a moderate advantage in prognostic ability compared to mNUTRIC.

Nutrition and Nutritional Support in Critically Ill Patients

1993 ◽  
Vol 8 (1) ◽  
pp. 16-33 ◽  
Author(s):  
Diana S. Dark ◽  
Susan K. Pingleton
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Nutritional Support ◽  
Nutritional Assessment ◽  
Hospitalized Patients ◽  
Critically Ill Patient ◽  
Nutritional Needs

The use of intravenous nutritional support has increased dramatically in the last 20 years. Although it is not without controversy, administration of nutritional support is common practice in hospitalized patients including critically ill patients. Malnutrition continues to be reported in a significant number of hospitalized patients. The incidence of malnutrition in critically ill patients may be even higher than that reported in hospitalized patients overall. The consequences of malnutrition in a critically ill patient may be severe. Nutritional assessment and nutritional support can present special challenges to the intensivist. Techniques of nutritional assessment in critically ill patients are evaluated. Guidelines for the determination of the nutritional needs of these patients are outlined. Methods of delivery of nutritional support in critically ill patients are reviewed. Complications of nutritional support are discussed.

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