scholarly journals Comparison of the effects of continuous versus intermittent enteral feeding on plasma leptin and ghrelin levels in Intensive Care Units

2017 ◽  
Vol 30 (4) ◽  
pp. 409-418
Author(s):  
Özgür YAĞAN ◽  
Nilay TAŞ ◽  
Sema Nur AYYILDIZ ◽  
Murat KARAKAHYA ◽  
Tevfik NOYAN
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Enteral Nutrition ◽  
White Blood Cells ◽  
Categorical Variables ◽  
Intermittent Feeding ◽  
Protein Levels ◽  
Reactive Protein ◽  
Significant Difference ◽  
Over Time

ABSTRACT Objective: The aim of this prospective randomized trial is to verify whether there is an association between the methods of administration of enteral nutrition and the leptin and ghrelin hormones, which have a major role in the regulation of energy metabolism. Methods: This study enrolled 38 enteral-fed patients aged 18 to 85 in the Intensive Care Unit. The patients were prospectively randomized to receive either continuous infusion (n=19) or intermittent feeding (n=18) of enteral nutrition. In addition to routine biochemical assays, blood samples were taken from the patients for leptin and ghrelin analyses on the 1th, 7th, and 14th days of enteral nutrition. Results: There was no statistically significant difference between the groups regarding descriptive statistics and categorical variables such as underlying diseases, complications, steroid use and others (p>0.05). The decrease in the number of white blood cells and in creatinine and C-reactive protein levels over time were statistically significant (p=0.010, p=0.026, p<0.001 respectively). There was no statistically significant difference between the groups with respect to leptin and ghrelin levels (p=0.982 and p=0.054). Leptin levels did not change over time; however, the ghrelin levels of both groups were significantly higher on the 7th and 14th days than on the first day of analysis (p=0.003). Conclusion: This study revealed that both continuous and intermittent enteral nutrition feeding regimens were well tolerated in Intensive Care Unit patients showing minor complications. The method of administration of enteral nutrition alone did not affect the leptin and ghrelin levels. Randomized controlled large cohort trials are needed to to compare intermittent and continuous enteral nutrition to determine which one is more adaptable to diurnal patterns of secretion metabolic hormones.

scholarly journals Dialyzable Leukocyte Extract (Transferon™) Administration in Sepsis: Experience from a Single Referral Pediatric Intensive Care Unit

2019 ◽  
Vol 2019 ◽  
pp. 1-10 ◽  
Author(s):  
Maria Isabel Castrejón Vázquez ◽  
Aldo Arturo Reséndiz-Albor ◽  
Mario A. Ynga-Durand ◽  
Ivonne Maciel Arciniega Martínez ◽  
Vanessa Ivonne Orellana-Villazon ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Laboratory Data ◽  
Pediatric Intensive Care ◽  
Control Group ◽  
Immunomodulatory Agents ◽  
Reactive Protein ◽  
Significant Difference ◽  
Pediatric Sepsis

Immunomodulatory agents have been proposed as therapeutic candidates to improve outcomes in sepsis. Transferon™, a dialyzable leukocyte extract (DLE), has been supported in Mexico as an immunomodulatory adjuvant in anti-infectious therapy. Here we present a retrospective study describing the experience of a referral pediatric intensive care unit (PICU) with Transferon™ in sepsis. We studied clinical and laboratory data from 123 patients with sepsis (15 in the DLE group and 108 in the control group) that were admitted to PICU during the period between January 2010 and December 2016. Transferon™ DLE use was associated with lower C reactive protein (CRP), increase in total lymphocyte counts (TLC), and decrease in total neutrophil count (TNC) 72 hours after Transferon™ DLE administration. The control group did not present any significant difference in CRP values and had lower TLC after 72 hours of admission. There was no difference in PICU length of stay between control and Transferon™ DLE group. Transferon™ DLE administration was associated with a higher survival rate at the end of PICU stay. This study shows a possible immunomodulatory effect of Transferon™ on pediatric sepsis patients.

Abstract 19663: Failed Delayed Sternal Closure Following Neonatal Cardiac Surgery Predicted by High Mean Airway Pressure and Associated with Increased Post-operative Mortality

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Dashiell Massey ◽  
Kathryn A Williams ◽  
Ravi R Thiagarajan ◽  
Frank Pigula ◽  
Catherine K Allan
Keyword(s):  
Intensive Care Unit ◽  
Cardiac Surgery ◽  
Intensive Care ◽  
Cardiopulmonary Bypass ◽  
Categorical Variables ◽  
Sternal Closure ◽  
Increased Risk ◽  
Significant Difference ◽  
Delayed Sternal Closure ◽  
Neonatal Cardiac Surgery

Background: Myocardial edema, increased lung water, and anasarca are common following neonatal cardiac surgery with cardiopulmonary bypass and amplify the risk of hemodynamic instability and inadequate ventilation following sternal closure. Delayed sternal closure (DSC) in the intensive care unit one or more days following surgery is a common strategy to mitigate this risk, but has been associated with increased risk of infection. In addition, failed DSC has previously been identified as a risk factor for mortality. This study sought to identify predictor variables and determine impact of failed DSC. Methods: Records of all neonates undergoing DSC in the cardiac intensive care unit (CICU) following surgery with cardiopulmonary bypass between January 2008 and May 2013 were reviewed. Pre-operative, intra-operative and post-operative variables were compared for those patients who failed DSC versus those who did not. Continuous variables were compared utilizing Wilcoxon’s test and categorical variables using Fisher’s exact test. Results: Of 256 neonates undergoing DSC in the CICU, 22 failed first attempt at DSC. No significant difference between the two groups was appreciated in age, weight, or bypass (cross clamp, circulatory arrest, and total) times. Comparing DSC failures to successes, significantly more failures: followed Stage I palliation (63% vs. 31%); occurred later (post-operative day 4.7 vs. 2.8, p = 0.009); and were proceeded by higher mean airway pressures (9 vs. 8 cm H2O, p = 0.04), peak inspiratory pressure (27 vs. 24, p = 0.002), and inotrope score (12.1 vs. 9.6, p = 0.06). There was no association with systolic blood pressure or lactate prior to DSC. Failed DSC was associated with increased duration of mechanical ventilation (41.6 vs 7.4 days, p < 0.001), length of ICU stay (44.3 vs 12.0 days, p < 0.001), and mortality (38 vs 3%, p < 0.001). Conclusions: Mortality for patients who fail the first ICU attempt at delayed sternal closure is significantly higher than for those with successful sternal closure. Ventilatory pressures but not hemodynamic variables prior to DSC differed significantly between the two groups. First attempt at DSC was later in those who failed, suggesting that clinicians had a priori identified these patients as higher risk.

Procalcitonin and C-Reactive Protein Levels According to Blood Culture Results in Intensive Care Unit Patients

2014 ◽  
Vol 22 (5) ◽  
pp. 267-270 ◽  
Author(s):  
Ozgur Aslan ◽  
Ilhan Afsar ◽  
Metin Demir ◽  
Asl Gamze Sener ◽  
Mehmet Koseoglu
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Blood Culture ◽  
C Reactive Protein ◽  
Protein Levels ◽  
Reactive Protein

scholarly journals Vitamin D in acutely ill patients

2018 ◽  
Vol 46 (10) ◽  
pp. 4246-4257 ◽  
Author(s):  
Ifigenia Kostoglou-Athanassiou ◽  
Eleni Pantazi ◽  
Sofoklis Kontogiannis ◽  
Dimitrios Kousouris ◽  
Iordanis Mavropoulos ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Inverse Relationship ◽  
Control Group ◽  
C Reactive Protein ◽  
Protein Levels ◽  
Reactive Protein ◽  
Control Subjects ◽  
Healthy Control ◽  
The Mean

Objective To investigate 25(OH)D3 levels and their relationship to survival in a cohort of acutely ill patients on admission to an intensive care unit. Methods This study enrolled acutely ill patients at admission to an intensive care unit and a group of sex- and age-matched healthy control subjects. The 25(OH)D3 levels were measured using an enzyme immunoassay. C-reactive protein and procalcitonin levels were also measured using immunoassays. Results A total of 50 acutely ill patients and 50 healthy control subjects were enrolled in the study. The mean ± SEM 25(OH)D3 levels were significantly lower in the acutely ill patients compared with the control group (11.74 ± 0.88 ng/ml versus 24.66 ± 1.60 ng/ml, respectively). The 25(OH)D3 levels were not related to survival. An inverse relationship was observed between 25(OH)D3 levels and C-reactive protein levels. A weak inverse relationship was also observed between 25(OH)D3 levels and procalcitonin levels. Conclusions The 25(OH)D3 levels were decreased in acutely ill patients admitted to an intensive care unit compared with healthy control subjects. 25(OH)D3 levels may be inversely related to C-reactive protein and procalcitonin levels.

TNF-α, iNOS Augmentation Due to Macrophages and Neutrophils Activity in Samples from Patients in Intensive Care Unit with COVID-19 Infection

2021 ◽  
Author(s):  
Zivar Zangeneh ◽  
Alireza Andalib ◽  
Gholamreza Khamisipour ◽  
Hamid Saadabadimotlagh ◽  
Sareh Zangeneh ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Lactate Dehydrogenase ◽  
Inflammatory Cytokines ◽  
White Blood Cells ◽  
Cell Activity ◽  
C Reactive Protein ◽  
Therapeutic Goals ◽  
Reactive Protein ◽  
Inflammatory Macrophages

Background and Aims: Cells and secreted molecules by the innate immune system are the essential factors in the pathogenesis and determining the severity of inflammation in COVID-19 patients. Severe inflammation results from increased activity of neutrophils, macrophages, and other cells with their products. Inflammatory cytokines such as tumor necrosis factor-a (TNF-a)  increases the severity and pathogenesis of the disease caused by the virus. Phagocytes are armed with inducible nitric oxide synthase (iNOS), that upon stimulation by proinflammatory cytokines augment an immune response against pathogens. Materials and Methods: Two groups of patients were included with COVID-19 infection from the intensive care unit (ICU, n=52) and (non-ICU-care, n=54). Blood samples were collected to measure cells and serum parameters, including lymphocytes, neutrophils, platelet counts, accompanied with C-reactive protein, lactate dehydrogenase, TNF-a and iNOS levels. Results: In the ICU group, increased white blood cells (p=0.048), decreased lymphocytes (p=0.0007), increased neutrophils (p=0.001), decreased platelets, increase serum levels for lactate dehydrogenase (p =0.0001), c-reactive protein (p=0.003), TNF-a (p=0.018), and iNOS (p=0.008) were statistically obtained. Positive correlations were calculated between TNF-a and iNOS (r=0.65, p=0.0002) and with c-reactive protein (r=0.52, p=0.003) and with lactate dehydrogenase (r=0.68, p=0.0001). Conclusion: Inflammation due to macrophages and neutrophils activity in COVID-19 patients and increased mediators correlate with disease progression. It seems that control of the cell activity and their inflammatory cytokines would be considered for therapeutic goals. Changing the polarization of inflammatory macrophages to anti-inflammatory macrophages with therapeutic applications could prevent the severity of the provocative course of the disease.

PROGNOSTIC VALUE OF INTERLEUKIN 6, PROCALCITONIN, AND C-REACTIVE PROTEIN LEVELS IN INTENSIVE CARE UNIT PATIENTS DURING FIRST INCREASE OF FEVER

Shock ◽  
2006 ◽  
Vol 26 (1) ◽  
pp. 10-12 ◽  
Author(s):  
Peter Fraunberger ◽  
Ying Wang ◽  
Ernst Holler ◽  
Klaus G. Parhofer ◽  
Dorothea Nagel ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Interleukin 6 ◽  
Prognostic Value ◽  
C Reactive Protein ◽  
Protein Levels ◽  
Reactive Protein

scholarly journals Use of CytoSorb therapy to treat critically ill coronavirus disease 2019 patients: a case series

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Yatin Mehta ◽  
Chitra Mehta ◽  
Saurabh Nanda ◽  
Gaurav Kochar ◽  
Joby V. George ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Average Duration ◽  
Case Series ◽  
Asian Ethnicity ◽  
Duration Of Stay ◽  
Protein Levels ◽  
Reactive Protein ◽  
Interleukin 6 Receptor ◽  
Novel Coronavirus

Abstract Background Acute respiratory distress syndrome is an important clinical presentation of respiratory complications caused by severe acute respiratory syndrome coronavirus 2, a novel coronavirus responsible for the ongoing pandemic. The disease is poorly understood, and immunopathogenesis is constantly evolving. Cytokine release syndrome remains central to pathology of coronavirus disease 2019. Antivirals, anticytokine treatment, and other pharmacological approaches have failed to treat it. CytoSorb, an extracorporeal cytokine adsorber that reduces the cytokine storm and other inflammatory mediators in the blood, seems promising in treating severely ill patients with coronavirus disease 2019. Case presentation This article presents three cases of Asian ethnicity of severely ill adult patients with coronavirus disease 2019 admitted to intensive care unit who were treated with CytoSorb therapy. All patients used single CytoSorb device. During their clinical course, all patients were prescribed tocilizumab (an interleukin-6 receptor blocker), antivirals, hydroxychloroquine, azithromycin, and other antibiotics and general antipyretic drugs. No vasopressor treatment was required. The patients’ average duration of stay in intensive care unit was 30 days; the average duration of stay in hospital was 31 days. All three patients showed significant improvement in biochemical parameters and clinical outcomes post CytoSorb therapy. C-reactive protein levels decreased by 91.5%, 97.4%, and 55.75 %, and mean arterial pressure improved by 18%, 23%, and 17 % in patient 1, 2, and 3, respectively, on day 7 post-therapy. Conclusions All three patients improved clinically and survived.

scholarly journals Markers of inflammation as risk predictors of lethal outcome in patients diagnosed with delirium

2016 ◽  
Vol 73 (9) ◽  
pp. 838-843 ◽  
Author(s):  
Ivana Stasevic-Karlicic ◽  
Milena Stasevic ◽  
Slobodan Jankovic ◽  
Slavica Djukic-Dejanovic ◽  
Srdjan Milovanovic
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
White Blood Cells ◽  
Adverse Outcomes ◽  
Control Group ◽  
Case Group ◽  
Lethal Outcome ◽  
Reactive Protein ◽  
Markers Of Inflammation ◽  
Risk Predictors

Background/Aim. Delirium is an acute or subacute, and most frequently reversible syndrome of higher cortical functions disturbances that is manifested as generalized disorder. If not prevented, it is associated with various adverse outcomes. The aim of this study was to determine the connection between the markers of inflammation and lethal outcome in patients diagnosed with delirium, hospitalized in the psychiatric intensive care unit. Methods. This retrospective study included 120 patients hospitalized in the psychiatric intensive care unit in whom examination of differences in inflammation markers was done. The examinees have been divided into two groups: the case group of 40 patients who died during the hospitalization, and the control group of 80 examinees who were discharged with the diagnosis Post delirium status. The following variables were taken into account: age, gender, clinical diagnosis of infection (pneumonia and urinary tract infection), laboratory parameters (total of white blood cells, granulocytes, monocytes, C-reactive protein ? CRP) and type of delirium (withdrawal or organic). Results. The average age of patients was 50.3 ? 13.1 years. The patients who survived delirium, were on the average 10.5 years younger than the deceased (p < 0.001). More than half (57.5%) of the deceased had pneumonia. There was a statistically significant correlation between pneumonia and lethal outcome in the patients with delirium (p < 0.001). The examinees with lethal outcome had significantly higher median CRP levels than the group of examinees who survived (75.6% ? 54.0 vs 30.3 ? 42.5 ng/L, p < 0.001). Conclusion. Aiming to better and more precise diagnostics of this complicated and still unclear neuropsychiatric syndrome it would be useful to consider introduction of more precise diagnostic algorithms in every unit of intensive care. That would significantly reduce the number of delirium diagnosis overlook, decrease complication of clinical features and would also reduce the unfavorable outcome rate, therefore the total cost of treatment.

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