Effect of Implementing Nursing Guidelines on Nurses' Performance Regarding Complications of Nasogastric Tube among Critically ill Patients

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.

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Pharmacokinetics and absolute bioavailability of ciprofloxacin administered through a nasogastric tube with continuous enteral feeding to critically ill patients

Intensive Care Medicine ◽

10.1007/s001340050714 ◽

1998 ◽

Vol 24 (10) ◽

pp. 1047-1051 ◽

Cited By ~ 49

Author(s):

O. Mimoz ◽

V. Binter ◽

A. Jacolot ◽

A. Edouard ◽

M. Tod ◽

...

Keyword(s):

Critically Ill ◽

Enteral Feeding ◽

Nasogastric Tube ◽

Critically Ill Patients ◽

Absolute Bioavailability

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Effects of synbiotic supplementation on energy and macronutrients homeostasis and muscle wasting of critical care patients: study protocol and a review of previous studies

10.21203/rs.2.16301/v2 ◽

2019 ◽

Author(s):

Najmeh Seifi ◽

Mohammad Safarian ◽

Mohsen Nematy ◽

Reza Rezvani ◽

Majid Khadem-Rezaian ◽

...

Keyword(s):

Critical Care ◽

Gut Microbiota ◽

Critically Ill ◽

Nasogastric Tube ◽

Critically Ill Patients ◽

Muscle Wasting ◽

Control Group ◽

Clinical Prognosis ◽

Synbiotic Supplementation ◽

Critical Care Patients

Abstract Background: Among critically ill patients, regardless of the heterogeneity of disease state, an extreme and persistent dysbiosis occurs. Dysbiosis in critically ill patients may make them prone to hospital-acquired infections, sepsis, multi-organ failure (MOF), energy homeostasis disturbance, muscle wasting, and cachexia. Modulation of gut microbiota through synbiotics can be considered as a potential treatment for muscle wasting and macronutrients homeostasis disturbances. Methods: This is a prospective, single center, double-blind; a parallel randomized controlled trial that aimed to evaluate the effects of synbiotic supplementation on energy and macronutrient ‎homeostasis and muscle wasting in critical care patients.‎ All eligible patients (20 subjects in each group) will receive standard hospital gavage as enteral nutrition through a nasogastric tube (NGT) in the 24-48h after admission. In the intervention group, patients will receive Lactocare (ZistTakhmir) capsules 500 mg every 12h for 14 days. Patients in the control group will receive a placebo capsule which contains only the sterile maize starch and is similar to synbiotic capsules. The synbiotic and placebo capsules will be given through nasogastric tube, separately from gavage, after feeding. Discussion: Gut microbiota modulation through synbiotics is proposed to improve clinical prognosis and reduce infectious complications, ventilator dependency and ICU stay by improving energy and macronutrient homeostasis and reducing muscle protein catabolism. Trials registration: The trial protocol has been approved in Iranian Registry of Clinical Trials at 2019-03-17. The registration reference is IRCT20190227042857N1.

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Secondary bloodstream infection in critically ill patients with COVID-19

Journal of International Medical Research ◽

10.1177/03000605211062783 ◽

2021 ◽

Vol 49 (12) ◽

pp. 030006052110627

Author(s):

Junli Zhang ◽

Peng Lan ◽

Jun Yi ◽

Changming Yang ◽

Xiaoyan Gong ◽

...

Keyword(s):

Risk Factors ◽

Central Venous Catheter ◽

Bloodstream Infection ◽

Critically Ill ◽

Nasogastric Tube ◽

Critically Ill Patients ◽

Secondary Infection ◽

Venous Catheter ◽

Urethral Catheter ◽

Central Venous

Objective Secondary infection, especially bloodstream infection, is an important cause of death in critically ill patients with COVID-19. We aimed to describe secondary bloodstream infection (SBI) in critically ill adults with COVID-19 in the intensive care unit (ICU) and to explore risk factors related to SBI. Methods We reviewed all SBI cases among critically ill patients with COVID-19 from 12 February 2020 to 24 March 2020 in the COVID-19 ICU of Jingmen First People's Hospital. We compared risk factors associated with bloodstream infection in this study. All SBIs were confirmed by blood culture. Results We identified five cases of SBI among the 32 patients: three with Enterococcus faecium, one mixed septicemia ( E. faecium and Candida albicans), and one C. parapsilosis. There were no significant differences between the SBI group and non-SBI group. Significant risk factors for SBI were extracorporeal membrane oxygenation, central venous catheter, indwelling urethral catheter, and nasogastric tube. Conclusions Our findings confirmed that the incidence of secondary infection, particularly SBI, and mortality are high among critically ill patients with COVID-19. We showed that long-term hospitalization and invasive procedures such as tracheotomy, central venous catheter, indwelling urethral catheter, and nasogastric tube are risk factors for SBI and other complications.

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Effect of Implementing Nursing Guidelines on Occurrence of Deep Venous Thrombosis for Critically Ill Patients

Journal of High Institute of Public Health ◽

10.21608/jhiph.2008.20883 ◽

2008 ◽

Vol 38 (1) ◽

pp. 200-228

Author(s):

Naglaa El-Rashedy ◽

Nagwa Reda ◽

Mogedda Mehany

Keyword(s):

Venous Thrombosis ◽

Deep Venous Thrombosis ◽

Critically Ill ◽

Critically Ill Patients ◽

Nursing Guidelines

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Effects of synbiotic supplementation on energy and macronutrients homeostasis and muscle wasting of critical care patients: study protocol and a review of previous studies

10.21203/rs.2.16301/v1 ◽

2019 ◽

Author(s):

Najmeh Seifi ◽

Mohammad Safarian ◽

Mohsen Nematy ◽

Reza Rezvani ◽

Majid Khadem-Rezaian ◽

...

Keyword(s):

Critical Care ◽

Gut Microbiota ◽

Critically Ill ◽

Nasogastric Tube ◽

Critically Ill Patients ◽

Muscle Wasting ◽

Control Group ◽

Clinical Prognosis ◽

Synbiotic Supplementation ◽

Critical Care Patients

Abstract Background Among critically ill patients, regardless of the heterogeneity of disease state, an extreme and persistent dysbiosis occurs. Dysbiosis in critically ill patients may make them prone to hospital-acquired infections, sepsis, multi-organ failure (MOF), energy homeostasis disturbance, muscle wasting, and cachexia. Modulation of gut microbiota through synbiotics can be considered as a potential treatment for muscle wasting and macronutrients homeostasis disturbances.Methods This is a prospective, single center, double-blind; a parallel randomized controlled trial that aimed to evaluate the effects of synbiotic supplementation on energy and macronutrient ‎homeostasis and muscle wasting in critical care patients.‎ All eligible patients (20 subjects in each group) will receive standard hospital gavage as enteral nutrition through a nasogastric tube (NGT) in the 24-48h after admission. In the intervention group, patients will receive Lactocare (ZistTakhmir) capsules 500 mg every 12h for 14 days. Patients in the control group will receive a placebo capsule which contains only the sterile maize starch and is similar to synbiotic capsules. The synbiotic and placebo capsules will be given through nasogastric tube, separately from gavage, after feeding.Discussion Gut microbiota modulation through synbiotics is proposed to improve clinical prognosis and reduce infectious complications, ventilator dependency and ICU stay by improving energy and macronutrient homeostasis and reducing muscle protein catabolism.Trials registration The trial protocol has been approved in Iranian Registry of Clinical Trials at 2019-03-17. The registration reference is IRCT20190227042857N1.

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