Nutritional Support

2017 ◽  
Author(s):  
Rindi Uhlich ◽  
Parker Hu ◽  
Patrick L Bosarge
Keyword(s):  
Nutritional Assessment ◽  
Scoring Systems ◽  
Infectious Complications ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Surgical Patient ◽  
The Subject ◽  
New Scoring ◽  
Significant Effort ◽  
Parenteral Protein

Nutritional optimization of the surgical patient remains a cornerstone of perioperative care. Significant effort and scrutiny are routinely directed to the field as it has the potential to improve outcomes, limit infectious complications, and decrease hospital length of stay and mortality. As such, previously identified cornerstones of care have been called into question. The timing, route, and intensity of nutritional supplementation remain the subject of controversy in an ever-evolving field. Previous methods of nutritional assessment, such as albumin and transthyretin, have proved unreliable, and their use is no longer recommended. In their place, new scoring systems are available to risk assess patients for malnutrition. We review the most pressing changes and assess the landscape of the field today. Key words: critical illness, enteral, glutamine, malnutrition, nutrition, outcomes, parenteral, protein

Nutritional Support

2018 ◽  
Author(s):  
Rindi Uhlich ◽  
Parker Hu ◽  
Patrick L Bosarge
Keyword(s):  
Nutritional Assessment ◽  
Scoring Systems ◽  
Infectious Complications ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Surgical Patient ◽  
The Subject ◽  
New Scoring ◽  
Significant Effort ◽  
Parenteral Protein

Nutritional optimization of the surgical patient remains a cornerstone of perioperative care. Significant effort and scrutiny are routinely directed to the field as it has the potential to improve outcomes, limit infectious complications, and decrease hospital length of stay and mortality. As such, previously identified cornerstones of care have been called into question. The timing, route, and intensity of nutritional supplementation remain the subject of controversy in an ever-evolving field. Previous methods of nutritional assessment, such as albumin and transthyretin, have proved unreliable, and their use is no longer recommended. In their place, new scoring systems are available to risk assess patients for malnutrition. We review the most pressing changes and assess the landscape of the field today. Key words: critical illness, enteral, glutamine, malnutrition, nutrition, outcomes, parenteral, protein

Nutritional Support

2017 ◽  
Author(s):  
Rindi Uhlich ◽  
Parker Hu ◽  
Patrick L Bosarge
Keyword(s):  
Nutritional Assessment ◽  
Scoring Systems ◽  
Infectious Complications ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Surgical Patient ◽  
The Subject ◽  
New Scoring ◽  
Significant Effort ◽  
Parenteral Protein

Nutritional optimization of the surgical patient remains a cornerstone of perioperative care. Significant effort and scrutiny are routinely directed to the field as it has the potential to improve outcomes, limit infectious complications, and decrease hospital length of stay and mortality. As such, previously identified cornerstones of care have been called into question. The timing, route, and intensity of nutritional supplementation remain the subject of controversy in an ever-evolving field. Previous methods of nutritional assessment, such as albumin and transthyretin, have proved unreliable, and their use is no longer recommended. In their place, new scoring systems are available to risk assess patients for malnutrition. We review the most pressing changes and assess the landscape of the field today. Key words: critical illness, enteral, glutamine, malnutrition, nutrition, outcomes, parenteral, protein

Nutritional Support

2017 ◽  
Author(s):  
Rindi Uhlich ◽  
Parker Hu ◽  
Patrick L Bosarge
Keyword(s):  
Nutritional Assessment ◽  
Scoring Systems ◽  
Infectious Complications ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Critically Ill Patient ◽  
The Subject ◽  
New Scoring ◽  
Significant Effort ◽  
Parenteral Protein

Nutritional optimization of the critically ill patient remains a cornerstone of perioperative care. Significant effort and scrutiny are routinely directed to the field as it has the potential to improve outcomes, limit infectious complications, and decrease hospital length of stay and mortality. As such, previously identified cornerstones of care have been called into question. The timing, route, and intensity of nutritional supplementation remain the subject of controversy in an ever-evolving field. Previous methods of nutritional assessment, such as albumin and transthyretin, have proved unreliable, and their use is no longer recommended. In their place, new scoring systems are available to risk assess patients for malnutrition. We review the most pressing changes and assess the landscape of the field today. Key words: critical illness, enteral, glutamine, malnutrition, nutrition, outcomes, parenteral, protein

Infections Acquired by Adults Who Receive Extracorporeal Membrane Oxygenation Risk Factors and Outcome

2013 ◽  
Vol 34 (1) ◽  
pp. 24-30 ◽  
Author(s):  
Cecile Aubron ◽  
Allen C. Cheng ◽  
David Pilcher ◽  
Tim Leong ◽  
Geoff Magrin ◽  
...  
Keyword(s):  
Risk Factors ◽  
Length Of Stay ◽  
Extracorporeal Membrane Oxygenation ◽  
Unit Length ◽  
Severity Of Illness ◽  
Infectious Complications ◽  
Hospital Length ◽  
Interquartile Range ◽  
Hospital Length Of Stay ◽  
Membrane Oxygenation

Objectives.To analyze infectious complications that occur in patients who receive extracorporeal membrane oxygenation (ECMO), associated risk factors, and consequences on patient outcome.Design.Retrospective observational survey from 2005 through 2011.Participants and Setting.Patients who required ECMO in an Australian referral center.Methods.Cases of bloodstream infection (BSI), catheter-associated urinary tract infection (CAUTI), and ventilator-associated pneumonia (YAP) that occurred in patients who received ECMO were analyzed.Results.A total of 146 ECMO procedures were performed for more than 48 hours in 139 patients, and 36 patients had a total of 46 infections (30.1 infectious episodes per 1,000 days of ECMO). They included 24 cases of BSI, 6 of them secondary to VAP; 23 cases of VAP; and 5 cases of CAUTI. The most frequent pathogens were Enterobacteriaceae (found in 16 of 46 cases), and Candida was the most common cause of BSI (in 9 of 24 cases). The Sequential Organ Failure Assessment score before ECMO initiation and the number of days of support were independenuy associated with a risk of BSI, with odds ratios of 1.23 (95% confidence interval [CI], 1.03-1.47; P = .019) and 1.08(95% CI, 1.03-1.19]; P = .006), respectively. Infected patients did not have a significantly higher mortality compared with uninfected patients (41.7% vs 32%; P = .315), but intensive care unit length of stay (16 days [interquartile range, 8-26 days] vs 11 days [IQR, 4-19 days]; P = .012) and hospital length of stay (33.5 days [interquartile range, 15.5-55.5] vs 24 days [interquartile range, 9-42 days]; P = .029) were longer.Conclusion.The probability of infection increased with the duration of support and the severity of illness before initiation of ECMO. Infections affected length of stay but did not have an impact on mortality.

scholarly journals The Impact of Selenium Supplementation on Trauma Patients—Systematic Review and Meta-Analysis

Nutrients ◽  
2022 ◽  
Vol 14 (2) ◽  
pp. 342
Author(s):  
Jen-Fu Huang ◽  
Chih-Po Hsu ◽  
Chun-Hsiang Ouyang ◽  
Chi-Tung Cheng ◽  
Chia-Cheng Wang ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Meta Analysis ◽  
Infectious Complications ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Current Evidence ◽  
Trauma Patients ◽  
Positive Effects ◽  
Standard Difference ◽  
The Impact

This study aimed to assess current evidence regarding the effect of selenium (Se) supplementation on the prognosis in patients sustaining trauma. MEDLINE, Embase, and Web of Science databases were searched with the following terms: “trace element”, “selenium”, “copper”, “zinc”, “injury”, and “trauma”. Seven studies were included in the meta-analysis. The pooled results showed that Se supplementation was associated with a lower mortality rate (OR 0.733, 95% CI: 0.586, 0.918, p = 0.007; heterogeneity, I2 = 0%). Regarding the incidence of infectious complications, there was no statistically significant benefit after analyzing the four studies (OR 0.942, 95% CI: 0.695, 1.277, p = 0.702; heterogeneity, I2 = 14.343%). The patients with Se supplementation had a reduced ICU length of stay (standard difference in means (SMD): −0.324, 95% CI: −0.382, −0.265, p < 0.001; heterogeneity, I2 = 0%) and lesser hospital length of stay (SMD: −0.243, 95% CI: −0.474, −0.012, p < 0.001; heterogeneity, I2 = 45.496%). Se supplementation after trauma confers positive effects in decreasing the mortality and length of ICU and hospital stay.

scholarly journals Validation of population-specific Mini-Nutritional Assessment with its long-term mortality-predicting ability: results of a population-based longitudinal 4-year study in Taiwan

2010 ◽  
Vol 104 (1) ◽  
pp. 93-99 ◽  
Author(s):  
Alan C. Tsai ◽  
Shu-Fang Yang ◽  
Jiun-Yi Wang
Keyword(s):  
Life Satisfaction ◽  
Length Of Stay ◽  
Nutritional Status ◽  
Mortality Risk ◽  
Nutritional Assessment ◽  
Mini Nutritional Assessment ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Nutritional Screening ◽  
Screening Assessment

Nutrition is a key element in geriatric health, and nutritional screening/assessment is a key component of comprehensive geriatric evaluation. The study aimed to validate the Mini Nutritional Assessment Taiwan version-1 (MNA-T1) which adopted population-specific anthropometric cut-points, and version-2 (MNA-T2) which replaced BMI with mid-arm and calf circumferences in the scale for predicting the nutritional status of elderly Taiwanese. Using data of a population-representative longitudinal study of 2802 Taiwanese aged 65 years or older, the study graded the nutritional status of each subject with the original and both modified versions at baseline, analysed their hospital length of stay, the Activities of Daily Living (ADL), the Center for Epidemiologic Studies Depression Scale (CES-D) and life-satisfaction scores at baseline and end of 4 years, and tracked their survival during the period. Results showed that both modified versions had superior predictive abilities compared with the original MNA, and their graded scores correlated better with hospital length of stay, and ADL, CES-D and life-satisfaction scores. Both modified versions were effective in predicting follow-up mortality risk. The relative mortality risk was about 7 times for those rated malnourished and 2·5 times for those rated at risk of malnutrition compared with those who were rated normal at baseline by the two modified versions. These results suggest that both of the modified versions are effective in predicting the nutrition and health statuses of Taiwanese elderly and would serve to validate the predictive ability of the two modified versions. The MNA-T2, which requires no BMI, can make routine nutritional screening/assessment an easier task.

Fast-Track Recovery

2019 ◽  
pp. 120-126
Author(s):  
Arturo G. Torres ◽  
Edward McGough
Keyword(s):  
Intensive Care Unit ◽  
Postoperative Care ◽  
Fast Track ◽  
Prolonged Mechanical Ventilation ◽  
Preoperative Assessment ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Surgical Patient ◽  
High Dose ◽  
Fast Track Recovery

Fast-track cardiac care (FTCC) encompasses the entire spectrum of perioperative care for the cardiothoracic surgical patient. From the preoperative assessment to postoperative care, the main goal is to expedite recovery while minimizing the inherent risks associated with cardiac surgery. The practice of prolonged mechanical ventilation due to high-dose narcotic anesthesia has evolved to early protocolized extubation pathways facilitated by multimodal anesthesia. The goal of the postoperative care phase is focused on reducing or completely bypassing the intensive care unit and ultimately decreasing hospital length of stay. Yet, here is where FTCC seems unable to achieve its goals due to multifactorial barriers. An integral part of successful FTCC is constant reevaluation of the patient through each of the perioperative phases (pre-, intra-, and postoperatively).

scholarly journals LAPAROSCOPIC LIVER RESECTION (literature review)

2014 ◽  
Vol 5 (2) ◽  
pp. 54-60 ◽  
Author(s):  
G B Aleksanyan
Keyword(s):  
Liver Resection ◽  
Postoperative Pain ◽  
Open Surgery ◽  
Postoperative Morbidity ◽  
Vascular Reconstruction ◽  
Infectious Complications ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Surgical Trauma ◽  
Recovery Times

Laparoscopic in comparison to open surgery reduces surgical trauma, the inflammatory response and infectious complications and minimizes immunosuppression. Large sizes of tumors, biliary or vascular reconstruction are the only obstacles to the widespread use of laparoscopic liver resections. Numerous clinical studies have demonstrated a significant reduction in postoperative pain, hospital length of stay, postoperative morbidity and recovery times.

scholarly journals Wireless microcurrent-generating antimicrobial wound dressing in primary total knee arthroplasty: a single-center experience

2016 ◽  
Vol 8 (2) ◽  
Author(s):  
James Chow
Keyword(s):  
Financial Burden ◽  
Joint Infection ◽  
Primary Total Knee Arthroplasty ◽  
Score Function ◽  
Infectious Complications ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Wound Management ◽  
Resistant Bacteria ◽  
Total Knee

The spread of multidrug-resistant bacteria and financial burden of periprosthetic joint infection (PJI) further the need for treatments to address pathogenic contamination and expedite healing. This retrospective study was a chart review of a series of 92 patients who underwent 100 total knee arthroplasties performed by the same surgeon and treated with a novel microcurrent-generating antimicrobial dressing (MCD). Mean hospital length of stay was 2.3±0.9 days, while the mean length of treatment with MCD was 8.3±1.2 days. No major complications, PJI or major infectious complications were reported, with two readmissions (2%) within 30 days of surgery. Knee Society Score function showed statistically significant improvements post-operatively, with a mean six-month score of 75.0±20.3 and mean change from baseline of 36.3±21.1 (P&lt;0.0001). These results support previous findings that use of the MCD may result in improved outcomes as an element in postoperative wound management.

Sign in / Sign up

Export Citation Format

Share Document