Identifying critically ill patients who benefit the most from nutrition therapy: the development and initial validation of a novel risk assessment tool
TLDR
This scoring algorithm may be helpful in identifying critically ill patients most likely to benefit from aggressive nutrition therapy in the intensive care unit (ICU), and based on the statistical significance in the multivariable model, the final score used all candidate variables except BMI.Abstract:
To develop a scoring method for quantifying nutrition risk in the intensive care unit (ICU). A prospective, observational study of patients expected to stay > 24 hours. We collected data for key variables considered for inclusion in the score which included: age, baseline APACHE II, baseline SOFA score, number of comorbidities, days from hospital admission to ICU admission, Body Mass Index (BMI) < 20, estimated % oral intake in the week prior, weight loss in the last 3 months and serum interleukin-6 (IL-6), procalcitonin (PCT), and C-reactive protein (CRP) levels. Approximate quintiles of each variable were assigned points based on the strength of their association with 28 day mortality. A total of 597 patients were enrolled in this study. Based on the statistical significance in the multivariable model, the final score used all candidate variables except BMI, CRP, PCT, estimated percentage oral intake and weight loss. As the score increased, so did mortality rate and duration of mechanical ventilation. Logistic regression demonstrated that nutritional adequacy modifies the association between the score and 28 day mortality (p = 0.01). This scoring algorithm may be helpful in identifying critically ill patients most likely to benefit from aggressive nutrition therapy.read more
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Erfassung und apparatives Monitoring des Ernährungsstatus von Patient*innen auf der Intensiv- und Intermediate Care Station
Arved Weimann,Wolfgang H. Hartl,Michael Adolph,Matthias Angstwurm,Frank M. Brunkhorst,Andreas Edel,Geraldine de Heer,Thomas W. Felbinger,Christiane Goeters,Aileen Hill,K. Georg Kreymann,Konstantin Mayer,Johann Ockenga,Sirak Petros,Andreas Rümelin,Stefan J. Schaller,Andrea Schneider,Christian Stoppe,Gunnar Elke +18 more
TL;DR: In this paper , the authors present consensus-based recommendations for the assessment and technical monitoring of nutritional status of patients in intensive and intermediate care units, which supplement the current S2k guideline "Clinical Nutrition in Intensive Care Medicine" of the German Society for Nutritional Medicine.
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Main Barriers in Control of Energy-Protein Deficit in Critical Oncologic Patient at Nutritional Risk
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TL;DR: The main barriers in control of energy-protein deficit in critical oncologic patient at nutritional risk on EN and on MV were extubation and hemodynamic instability.
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TL;DR: In this paper , an international, multicenter, pragmatic randomized clinical trial (RCT) evaluating protein dose in ICU patients with circulatory shock was conducted, and the authors found that early enteral nutrition (EEN) was associated with improved clinical outcomes in mechanically ventilated (MV) patients.
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