Validation of the Society of Critical Care Medicine and American Society for Parenteral and Enteral Nutrition Recommendations for Caloric Provision to Critically Ill Obese Patients

2015 ◽  
Vol 40 (5) ◽  
pp. 713-721 ◽  
Author(s):  
Kris M. Mogensen ◽  
Benjamin Y. Andrew ◽  
Jasmine C. Corona ◽  
Malcolm K. Robinson
Keyword(s):  
Critical Care ◽  
Enteral Nutrition ◽  
Critically Ill ◽  
Critical Care Medicine ◽  
Obese Patients ◽  
American Society

scholarly journals Updates in Nutrition Support for Critically III Adult Patients

2017 ◽  
Vol 52 (1) ◽  
pp. 17-26 ◽  
Author(s):  
Diana Wells Mulherin ◽  
Sarah V. Cogle
Keyword(s):  
Critical Care ◽  
Enteral Nutrition ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Care Setting ◽  
Hospital Pharmacist ◽  
Critical Care Medicine ◽  
Critical Care Setting ◽  
Nutrition Support ◽  
American Society

Specialized nutrition support is often employed in critically ill patients who are unable to maintain volitional intake. The Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.) recently updated guidelines for the provision of nutrition support in critically ill patients. The purpose of this review is to summarize key changes from the previous guidelines as they relate to recently published literature, which will aid the hospital pharmacist in optimizing nutrition support therapies in the critical care setting.

“Do not do” recommendations of the working groups of the Spanish Society of Intensive and Critical Care Medicine and Coronary Units (SEMICYUC) for the management of critically ill patients

2018 ◽  
Vol 42 (7) ◽  
pp. 425-443
Author(s):  
F.J. González de Molina Ortiz ◽  
F. Gordo Vidal ◽  
A. Estella García ◽  
P. Morrondo Valdeolmillos ◽  
J.F. Fernández Ortega ◽  
...  
Keyword(s):  
Critical Care ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Critical Care Medicine ◽  
Spanish Society ◽  
Working Groups

Critical-care medicine and the acute-care laboratory

1990 ◽  
Vol 36 (8) ◽  
pp. 1552-1556 ◽  
Author(s):  
J R Hall
Keyword(s):  
Critical Care ◽  
Data Management ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Ex Vivo ◽  
Hospital Costs ◽  
Cost Effective ◽  
Critical Care Medicine ◽  
Time Utilization

Abstract Critical-care medicine today is practiced by anesthesiologists, internists, pediatricians, and surgeons. Outcome from today's management of critically ill patients is very good, yet associated costs are very high. Over one-half of the hospital costs of critically ill patients emanates from the intensive-care unit (ICU), although the ICU stay accounts for less than 20% of their time in the hospital. Outside of the operating room, the ICU is the most expensive location for patient care in the hospital, and laboratory tests are the most expensive single item. Plans for cost containment should incorporate the following: more effective data management, education of practitioners about appropriateness and costs of tests, conversion from laboratory measurements to appropriate in vivo and ex vivo measurements, and real-time utilization assessment. To provide high-quality, cost-effective critical care in the future, laboratorians and clinicians must work together today to meet the challenges of technology, data management, and staff education.

The Year in Review: Critical Care Medicine

2001 ◽  
Vol 14 (1) ◽  
pp. 70-85
Author(s):  
Maria I. Rudis ◽  
David Q. Hoang
Keyword(s):  
Critical Care ◽  
Cardiovascular Diseases ◽  
Infectious Diseases ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Treatment Guidelines ◽  
Neuromuscular Blocking ◽  
Critical Care Medicine ◽  
Icu Patients ◽  
Adult Intensive Care Unit

Background: There have been significant recent advances in the pharmacotherapeutic management of critically ill patients. The purpose of this article is to review and discuss the most pertinent published literature in the areas of neurology, cardiovascular diseases, infectious diseases, nephrology, hematology, and gastroenterology as it pertains to critical care in order to provide an update for the critical care practitioner. Methods: We performed a Medline search from July 1999 to December 2000 utilizing terms relating to the pharmacotherapy of the specific aforementioned topics in critical care medicine. We focused on English-language clinical studies performed in adult intensive care unit (ICU) patients. From these articles we selected those that would have a practical impact on drug therapy in the ICU or the development of drug usage guidelines for critically ill patients. Review articles were generally not included. Results: The following topics were found to be either new developments or of potentially significant impact in the management of adult critically ill patients. In the area of neurology, advances were found with respect to optimization of regimens for sedative and neuromuscular blocking agents, validation of sedation scales and tools, and in the treatment of head injury patients. In the cardiovascular diseases, most studies related to the hemodynamic support of septic shock. We focus on developments in fluid resuscitation, optimization of global and regional oxygen transport variables, the repositioning of vasopressor agents, and a return to the use of steroids. Given the high mortality rate associated with the development of acute renal failure in the ICU, there has been a consistent attempt to develop preventative and treatment strategies for these patients, including optimization of antimicrobial dosing methods. Several epidemiological and longitudinal studies document changes in multi-drug antimicrobial resistance patterns. The use of treatment guidelines for antimicrobials in the critically ill improves outcomes in most patients. Significant attention has focused on the characterization of anemia in the ICU and the development of alternative pharmacological strategies in its treatment. Finally, in gastroenterology, the main focus has been the investigation of methods to optimize the delivery of enteral nutrition given its proven benefits in critically ill patients. Conclusions: Significant advances in the areas of neurological, cardiovascular, infectious diseases, renal, hematological, and gastrointestinal issues in the pharmacotherapy of critically ill patients have been published over the course of the past year. Many of these studies have yielded data that may be incorporated into the pharmacotherapeutic management of ICU patients, hence maximizing outcomes.

scholarly journals Impact of Enteral Nutrition Formulations Containing Dietary Fiber on Diarrhea Outcomes in Hospitalized Critical Care Patients: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 842-842
Author(s):  
Kelly Cara ◽  
Andrew Beauchesne ◽  
Taylor Wallace ◽  
Mei Chung
Keyword(s):  
Systematic Review ◽  
Critical Care ◽  
Enteral Nutrition ◽  
Dietary Fiber ◽  
Critically Ill ◽  
Random Effects ◽  
Critically Ill Patients ◽  
Outcome Data ◽  
Meta Analyses ◽  
Critical Care Patients

Abstract Objectives The objective is to conduct a systematic review on the safety of using enteral nutrition formulations containing dietary fiber in hospitalized critical care patients. Methods This systematic review was conducted in accordance with the Cochrane Handbook for Systematic Reviews of Interventions (Version 6.1,2020). Searches were implemented in four databases on 4/20/20. Results were limited to English language studies conducted in humans. Any clinical study design or case study measuring adverse events (e.g., diarrhea and mortality) or health outcomes (as defined in each study) associated with enteral nutrition interventions containing dietary fiber in adult critically ill patients was considered. Random effects meta-analyses were conducted on outcomes assessed by three or more included studies. Results Altogether, 18 articles were included, and 11 randomized controlled trials assessed diarrhea outcomes (i.e., diarrhea score and number or frequency of events). Six studies used the Hart and Dobb (1988) diarrhea score, and random effects meta-analyses showed the mean diarrhea scores were lower for fiber compared to non-fiber groups (n = 4, pooled mean difference: −2.78, 95% confidence interval: −4.10, −1.47). Five of seven reported group comparisons showed fewer diarrhea events for fiber compared with non-fiber groups, although the overall difference was not statistically significant (n = 7, pooled risk ratio: 0.68, 95% CI: 0.45, 1.02). For three studies using other or unspecified scoring methods, pooled results showed significantly fewer diarrhea events in the fiber groups compared to non-fiber groups (n = 3, pooled RR: 0.42, 95% CI: 0.20, 0.89). Studies reported no difference in incidence of mortality due to fiber interventions (n = 7, pooled RR: 0.99, 95% CI: 0.66, 1.48). Risk of bias for diarrhea outcomes was high due to missing outcome data, and there was some concern for bias due to randomization, measurement of the outcome, and selection of reported results. Conclusions Enteral nutrition formulas with fiber may help reduce incidence and severity of diarrhea in critically ill patients without increasing incidence of mortality. As these results are subject to bias, more high-quality studies are needed to verify this conclusion. Funding Sources This study was supported by funding from an unrestricted educational grant from Nestle Health Sciences.

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