scholarly journals Relationship between Nutrition Intake and 28-Day Mortality Using Modified NUTRIC Score in Patients with Sepsis

Nutrients ◽  
2019 ◽  
Vol 11 (8) ◽  
pp. 1906 ◽  
Author(s):  
Dae Hyun Jeong ◽  
Sang-Bum Hong ◽  
Chae-Man Lim ◽  
Younsuck Koh ◽  
Jarim Seo ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Critically Ill ◽  
Retrospective Cohort ◽  
Nutritional Support ◽  
Medical Intensive Care Unit ◽  
Nutritional Risk ◽  
Nutrition Risk ◽  
Nutrition Intake ◽  
Medical Intensive Care ◽  
The Relationship

In critically ill patients, malnutrition is known to increase morbidity and mortality. We investigated the relationship between nutritional support and 28-day mortality using the modified NUTrition RIsk in the Critically ill (NUTRIC) score in patients with sepsis. This retrospective cohort study included patients with sepsis admitted to the medical intensive care unit (ICU) between January 2011 and June 2017. Nutritional support for energy and protein intakes at day 7 of ICU admission were categorized into <20, 20 to <25, and ≥25 kcal/kg and <1.0, 1.0 to <1.2, and ≥1.2 g/kg, respectively. NUTRIC scores ≥4 were considered to indicate high nutritional risk. Among patients with low nutritional risk, higher intakes of energy (≥25 kcal/kg) and protein (≥1.2 g/kg) were not significantly associated with lower 28-day mortality. In patients with high nutritional risk, higher energy intakes of ≥25 kcal/kg were significantly associated with lower 28-day mortality compared to intakes of <20 kcal/kg (adjusted hazard ratio (aHR): 0.569, 95% confidence interval (CI): 0.339–0.962, p = 0.035). Higher protein intakes of ≥1.2 g/kg were also significantly associated with lower 28-day mortality compared to intakes of <1.0 g/kg (aHR: 0.502, 95% CI: 0.280–0.900, p = 0.021). Appropriate energy (≥25 kcal/kg) and protein (≥1.2 g/kg) intakes during the first week may improve outcomes in patients with sepsis having high nutritional risk.

scholarly journals Serum potassium levels and outcomes in critically ill patients in the medical intensive care unit

2018 ◽  
Vol 46 (3) ◽  
pp. 1254-1262 ◽  
Author(s):  
Surat Tongyoo ◽  
Tanuwong Viarasilpa ◽  
Chairat Permpikul
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Critically Ill ◽  
Serum Potassium ◽  
Critically Ill Patients ◽  
Medical Intensive Care Unit ◽  
Apache Ii ◽  
Apache Ii Score ◽  
Icu Mortality ◽  
Medical Intensive Care

Objective To compare the outcomes of patients with and without a mean serum potassium (K+) level within the recommended range (3.5–4.5 mEq/L). Methods This prospective cohort study involved patients admitted to the medical intensive care unit (ICU) of Siriraj Hospital from May 2012 to February 2013. The patients’ baseline characteristics, Acute Physiology and Chronic Health Evaluation II (APACHE II) score, serum K+ level, and hospital outcomes were recorded. Patients with a mean K+ level of 3.5 to 4.5 mEq/L and with all individual K+ values of 3.0 to 5.0 mEq/L were allocated to the normal K+ group. The remaining patients were allocated to the abnormal K+ group. Results In total, 160 patients were included. Their mean age was 59.3±18.3 years, and their mean APACHE II score was 21.8±14.0. The normal K+ group comprised 74 (46.3%) patients. The abnormal K+ group had a significantly higher mean APACHE II score, proportion of coronary artery disease, and rate of vasopressor treatment. An abnormal serum K+ level was associated with significantly higher ICU mortality and incidence of ventricular fibrillation. Conclusion Critically ill patients with abnormal K+ levels had a higher incidence of ventricular arrhythmia and ICU mortality than patients with normal K+ levels.

Critically Ill Surgical Patients Followed in a Medical Intensive Care Unit

2010 ◽  
Vol 1 (3) ◽  
pp. 60-62
Author(s):  
Mine Durusu Tanriover ◽  
Bilgin Sait ◽  
Begum Ergan Arsava ◽  
Kaya Yorganci ◽  
Arzu Topeli Iskit
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Critically Ill ◽  
Medical Intensive Care Unit ◽  
Surgical Patients ◽  
Medical Intensive Care ◽  
Critically Ill Surgical Patients

scholarly journals 1099. The Correlation Between Antimicrobial Utilization and Resistance in a Medical Intensive Care Unit

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S390-S391
Author(s):  
John W Ahern ◽  
Lindsay Smith ◽  
W Kemper Alston
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Medical Intensive Care Unit ◽  
Resistance Index ◽  
Antibiotic Use ◽  
Multidrug Resistant ◽  
Antimicrobial Utilization ◽  
Multidrug Resistant Organisms ◽  
Medical Intensive Care ◽  
The Relationship

Abstract Background The relationship between antimicrobial utilization and the incidence of antimicrobial-resistant pathogens can be obscured by a lack of longitudinal data. We used 9 years of antimicrobial utilization data combined with a unique metric of antimicrobial resistance to examine this relationship. Methods The medical intensive care unit (MICU) at UVMMC has 22 beds. The unit’s size and location did not change during the study. Since 2010, defined daily doses (DDD) in the MICU for ceftazidime, ceftriaxone, cefepime, ciprofloxacin, levofloxacin, piperacillin–tazobactam, meropenem, and vancomycin were measured. Concurrently, a database of positive cultures acquired in MICU, whether colonization or infection, was built for 6 selected organisms: Clostridioides difficile, methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci, ceftazidime-resistant Gram-negative bacilli, fluoroquinolone-resistant Pseudomonas aeruginosa (QRPA), and Stenotrophomonas maltophilia. The occurrence of these 6 organisms/1,000 patient-days is termed “resistance index.” Data for both metrics were collected in the same way, by the same person, throughout. The relationship between these 2 measures was analyzed with simple linear regression. Results From 2010 to 2018, the use of 8 broad-spectrum antibiotics fell in a linear fashion from 12.11 to 4.39 DDD/100,000 patient-days. The resistance index for the 6 multidrug-resistant organisms in MICU also fell in parallel from 6.5 to 1.5/1,000 patient-days (figure, r = 0.9, P = 0.001). For the 2 quinolones specifically, use fell from 2.26 to 0.18 DDD/100,000 patient-days, while the occurrence of QRPA fell from 1.5 to 0/1,000 patient-days (figure, r = 0.84, P = 0.004). Conclusion These longitudinal data, collected consistently over 9 years, clearly demonstrate a significant correlation between broad-spectrum antibiotic use and the occurrence of multidrug-resistant organisms in a MICU. A steep, linear decline in antibiotic use was correlated with a parallel fall in these 6 organisms. These data demonstrate that sustained, meaningful reductions in antimicrobial utilization in a MICU can result in significant reductions in the incidence of antimicrobial-resistant pathogens. Disclosures All authors: No reported disclosures.

Association of care by a non-medical intensive care unit provider team with outcomes of medically critically ill patients

2022 ◽  
Vol 68 ◽  
pp. 129-135
Author(s):  
Pavel Sinyagovskiy ◽  
Prem R. Warde ◽  
Bhavarth Shukla ◽  
Dipen J. Parekh ◽  
Tanira Ferreira ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Medical Intensive Care Unit ◽  
Medical Intensive Care
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