Malnutrition as an independent predictor of clinical outcome in critically ill children

Nutrition ◽  
2012 ◽  
Vol 28 (3) ◽  
pp. 267-270 ◽  
Author(s):  
Fernanda de Souza Menezes ◽  
Heitor Pons Leite ◽  
Paulo Cesar Koch Nogueira
Vox Sanguinis ◽  
2013 ◽  
Vol 104 (4) ◽  
pp. 342-349 ◽  
Author(s):  
O. Karam ◽  
J. Lacroix ◽  
N. Robitaille ◽  
P. C. Rimensberger ◽  
M. Tucci

Critical Care ◽  
2013 ◽  
Vol 17 (S2) ◽  
Author(s):  
P Demaret ◽  
M Tucci ◽  
T Ducruet ◽  
H Trottier ◽  
J Lacroix

2021 ◽  
pp. 1-13
Author(s):  
Rawan Alraish ◽  
Sebastian G. Wicha ◽  
Otto R. Frey ◽  
Anka C. Roehr ◽  
Johann Pratschke ◽  
...  

BACKGROUND: Critically ill patients commonly suffer from infections that require antimicrobial therapy. In previous studies, liver dysfunction was shown to have an essential impact on the dose selection in these patients. This pilot study aims to assess the influence of liver dysfunction, measured by the novel LiMAx test, on clinical outcomes in critically ill patients treated with linezolid. METHODS: Twenty-nine critically ill patients were included and treated with linezolid. Indications for linezolid therapy were secondary or tertiary peritonitis (46.7%), bloodstream infection (6.7%) and 46.7% were other infections with gram-positive bacteria. Linezolid Cmin, maximal liver function capacity (LiMAx test) and plasma samples were collected while linezolid therapy was in a steady-state condition. Furthermore, potential factors for the clinical outcome were investigated using logistic regression analysis. Clinical cure was defined as the resolution or significant improvement of clinical symptoms without using additional antibiotic therapy or intervention. RESULTS: Cured patients presented lower median linezolid Cmin yet a significantly higher mean LiMAx-value compared to the clinical failure group (1.9 mg/L vs. 5.1 mg/L) (349 μg/kg/h vs. 131 μg/kg/h). In the logistic regression model, LiMAx < 178 μg/kg/h was the only independent predictor of clinical failure with a sensitivity of 77% and specificity of 93%. CONCLUSIONS: The LiMAx test predicts clinical failure more precisely than linezolid trough levels in critically ill surgical patients. Therefore liver failure may have a stronger impact on the outcome of critically ill surgical patients than low linezolid Cmin. While linezolid Cmin failed to predict patient’s outcome, LiMAx results were the only independent predictor of clinical failure.


2016 ◽  
Vol 17 (2) ◽  
pp. e50-e57 ◽  
Author(s):  
Heitor Pons Leite ◽  
Alessandra Vaso Rodrigues da Silva ◽  
Simone Brasil de Oliveira Iglesias ◽  
Paulo Cesar Koch Nogueira

2021 ◽  
Vol 8 (5) ◽  
pp. 849
Author(s):  
Vivek Parasher ◽  
Sachin Shaha ◽  
Rahul Khatri ◽  
Samarth Yadav ◽  
Sayan Das ◽  
...  

Background: In the treatment of critically ill children needing specialized airway, respiratory, and hemodynamic assistance, intensive care has become very necessary and is typically admitted into the pediatric intensive care unit (PICU) in order to ensure a better result than if the patients were admitted to other sections of the hospital. To audit admissions and their findings are significant, which may help to change procedures after extensive introspection if appropriate, leading to improved patient outcomes. Objective were to examine pattern of admission and clinical outcome of patients admitted in the pediatric intensive care unit of a rural tertiary health care centre.Methods: Information retrieved included age, sex, diagnosis, outcome, morbidity and mortality profile of patients admitted in PICU in the last five years.Results: A total of 2810 patients were admitted into PICU. (1444) 51.3% were infants, and (1366) 48.6% patients aged 1-18 years. Their ages ranged from one month to 18 years, with the mean age being 40.01 ± 45.79 months. There were 1948 (69.3%) male and 862 (30.3%) female patients giving an M: F ratio of 2.27:1. The overall mortality rate was 2.4%.Conclusions: In our PICU, mortality is low. We believe that the treatment of critically ill patients with desirable results is significantly facilitated by a well-equipped intensive care unit with advanced and creative intensive care in order to improve cost-effective patient care and prevent needless stretching of the PICU services, an extension of the pediatric wards is advocated.


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