Cardiac surgical patients in the intensive care unit certainly develop complex nutritional issues. Nutrition support is indicated in these subsets of patients and the same may be customized depending on individual patient characteristics. This review article that aims to examine the American Society for Parenteral and Enteral Nutrition guidelines for the use of parenteral and enteral nutrition in pediatric and adult cardiac surgical patients in cardiac critical care/intensive care unit evaluates the evidence related to the use of nutritional screening and nutritional assessment. The goal of this review is to enrich the discussion contained in the clinical guidelines and simplify the guideline statements to provide a platform for cardiac care providers to implement into their daily practice related to nutrition support in postoperative cardiac surgery patients.

Shewanella spp. is saprophyte bacteria that are part of the marine microflora in warm climates and they are rarely pathogenic. In recent times, the incidence of Shewanella infections is in the rising trend. In humans, it is mostly isolated from cellulitis, abscesses, bacteremia and wound infections and with no literature suggesting its isolation from lactational breast abscess. The case was managed by incision and drainage with proper antibiotic coverage. This case study suggests that Shewanella infection is more widespread and not just limited to coastal areas, with exposure to sea water and marine product ingestion. In addition, the unexpectedly multi-drug resistant isolate raises concern.

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