JPEN. Journal of parenteral and enteral nutrition
-
JPEN J Parenter Enteral Nutr · Sep 2017
Nutrition Therapy in Critically Ill Patients Following Cardiac Surgery: Defining and Improving Practice.
Malnutrition is a predictor of poor outcome following cardiac surgery. We define nutrition therapy after cardiac surgery to identify opportunities for improvement. ⋯ Postoperative cardiac surgery patients who stay in the ICU for 3 or more days are at high risk for inadequate nutrition therapy. Further studies are required to determine if targeted nutrition therapy may alter clinical outcomes.
-
JPEN J Parenter Enteral Nutr · Aug 2017
Metabolic Requirement of Septic Shock Patients Before and After Liberation From Mechanical Ventilation.
This study identified the difference in energy expenditure and substrate utilization of patients during and upon liberation from mechanical ventilation. ⋯ Measured energy expenditure was higher during than upon liberation from mechanical ventilation. This could be the increase in work of breathing from the continuous positive pressure support, repeated weaning cycles from mechanical ventilation, and/or the asynchronization between patients' respiration and ventilator support. Future studies should examine whether more appropriately matching energy expenditure with energy intake would promote positive health outcomes.
-
JPEN J Parenter Enteral Nutr · Aug 2017
Comparative StudyApproximation of Resting Energy Expenditure in Intensive Care Unit Patients Using the SenseWear Bracelet: A Comparison With Indirect Calorimetry.
Indirect calorimetry (IC) is the gold standard for determining energy expenditure in patients requiring mechanical ventilation. Metabolic armbands using data derived from dermal measurements have been proposed as an alternative to IC in healthy subjects, but their utility during critical illness is unclear. The aim of this study was to determine the level of agreement between the SenseWear armband and the Deltatrac Metabolic Monitor in mechanically ventilated intensive care unit (ICU) patients. ⋯ The systematic bias and large variability of the SenseWear armband when compared with gas exchange measurements confer limited benefits over the Harris Benedict equation in determining caloric requirements of ICU patients.
-
JPEN J Parenter Enteral Nutr · Jul 2017
Evaluation of an Intravenous Potassium Dosing Algorithm for Hypokalemic Critically Ill Patients.
The intent of this study was to evaluate the safety and efficacy of an intravenous (IV) potassium (K) dosing algorithm for hypokalemic critically ill trauma patients. ⋯ The Nutrition Support Service-guided IV K dosing algorithm was safe for patients with mild and moderate hypokalemia and efficacious for those with moderate hypokalemia. Further study in patients with severe hypokalemia (serum K, <3 mEq/L) is warranted.
-
JPEN J Parenter Enteral Nutr · Jul 2017
Energy Expenditure in Critically Ill Elderly Patients: Indirect Calorimetry vs Predictive Equations.
Predictive equations (PEs) are used for estimating resting energy expenditure (REE) when the measurements obtained from indirect calorimetry (IC) are not available. This study evaluated the degree of agreement and the accuracy between the REE measured by IC (REE-IC) and REE estimated by PE (REE-PE) in mechanically ventilated elderly patients admitted to the intensive care unit (ICU). ⋯ The effectiveness of PEs is limited for estimating REE of critically ill elderly patients. Nonetheless, HB multiplied by a correction factor of 1.2 can be used until a specific PE for this group of patients is developed.