Immune Enteral Nutrition Can Improve Outcomes in Medical-Surgical Patients with ARDS: A Prospective Randomized Controlled Trial

Elamin, Elamin M.; Miller, Andrew C.; Ziad, Sophia

doi:10.4172/2161-0509.1000109

Cited by 31 publications

(60 citation statements)

References 41 publications

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“…There were a total of 4 new RCTs of enteral fish oils, borage oils, and antioxidants published since the 2009 CCPGs, 11 , 30 – 32 and with the addition of the data from these, the effect on mortality decreased from relative risk (RR) = 0.67, 95% confidence interval (CI) = 0.51, 0.87, P = .003, heterogeneity I 2 = 0% to RR = 0.84, 95% CI = 0.56, 1.26, P = .39, heterogeneity I 2 = 61% (see Figure 1). There were concerns about the adequacy of the control group in 1 large multicenter study 11 in which patients received significantly more protein.…”

Section: Update Of the Ccpgsmentioning

confidence: 99%

The Canadian Critical Care Nutrition Guidelines in 2013

et al. 2013

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Clinical practice guidelines (CPGs) are systematically developed statements to assist practitioners and patient decisions about appropriate healthcare for specific clinical circumstances, and are designed to minimize practice variation, improve costs, and improve clinical outcomes. The Canadian Critical Care Practice Guidelines (CCPGs) were first published in 2003 and most recently updated in 2013. A total of 68 new randomized controlled trials were identified since the last version in 2009, 50 of them published between 2009 and 2013. The remaining articles were trials published before 2009 but were not identified in previous iterations of the CCPGs. For clinical practice guidelines to be useful to practitioners, they need to be up-to-date and be reflective of the current body of evidence. Herein we describe the process by which the CCPGs were updated. This process resulted in 10 new sections or clinical topics. Of the old clinical topics, 3 recommendations were upgraded, 4 were downgraded, and 27 remained the same. To influence decision making at the bedside, these updated guidelines need to be accompanied by active guideline implementation strategies. Optimal implementation strategies should be guided by local contextual factors including barriers and facilitators to best practice recommendations. Moreover, evaluating and monitoring performance, such as participating in the International Nutrition Survey of practice, should be part of any intensive care unit's performance improvement strategy. The active implementation of the updated CCPGs may lead to better nutrition care and improved patient outcomes in the critical care setting.

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Section: Update Of the Ccpgsmentioning

confidence: 99%

The Canadian Critical Care Nutrition Guidelines in 2013

et al. 2013

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“…Ìè âèä³ëèëè â³ñ³ì äîñë³äaeåíü [233][234][235][236][237][238][239][240], ïðèñâÿ÷åíèõ öüîìó ïèòàííþ; â ÷îòèðüîõ ç íèõ òàêîae çàñòîñîâóâàëèñü àíòèîêñèäàíòè. Ìåòà-àíàë³ç íå âèÿâèâ aeîäíèõ ïåðåâàã (äèâ.…”

Section: êîìåíòàð äî ðåêîìåíäàö³é 30-32unclassified

Методичні Рекомендації ESPEN Щодо Клінічного Харчування У Відділенні Інтенсивної Терапії

Singer¹,

Blaser²,

Berger³

et al. 2019

Pain Anaesth Int Care

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“…1): [38][39][40][41][42][43][44][45] para la síntesis de ATP y 2,3-difosfoglicerato, imprescindibles en la función pulmonar. El riesgo de realimentación es frecuente en estos pacientes que se encuentran en estado carencial por lo que se debe sospechar y tratar (27,28).…”

Section: Soporte Nutricional En El Paciente Epoc (Fig 1)unclassified

“…Pero hasta el momento, los estudios han sido contradictorios en demostrar la eficacia clínica de las dietas con combinaciones de grasas ricas en ácidos eicosapentanoico (EPA), docosahexaenoico (DHA), γ-linolénico (GLA) y antioxidantes en el complejo mundo de la LPA y el SDRA (42)(43)(44)(45)(46)(47)(48)(49)(50)(51). La heterogenicidad de los estudios, la ausencia de información sobre el manejo clíni-co, la utilización de fórmulas con mezclas de farmaconutrientes y la disparidad de resultados hacen que no se pueda recomendar el uso rutinario de estas fórmulas enterales (52).…”

Section: Soporte Nutricional En El Paciente Con Lpa Y Sdra (Fig 1)unclassified

“…Este efecto puede ser de utilidad en el destete del respirador, pero puede contribuir al agotamiento de los pacientes con escasa reserva NUESTROS GRANDES OLVIDADOS, LOS ENFERMOS RESPIRATORIOS CRÓNICOS [Nutr Hosp 2017;34(Supl. 1): [38][39][40][41][42][43][44][45] alveolar. No disponemos de estudios para establecer recomendaciones sobre el empleo glutamina, aminoácidos ramificados, vitaminas o antioxidantes en este grupo de pacientes, aunque la utilización de antioxidantes en forma de suplementos vitamínicos parece lógica y razonablemente segura (39,57).…”

Section: Soporte Nutricional En El Paciente Con Lpa Y Sdra (Fig 1)unclassified

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Nuestros grandes olvidados, los enfermos respiratorios crónicos

Laguna

2017

Nutr Hosp

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Lung's own properties make that nutritional support, besides covering the requirements can modulate its infl ammatory response. Lung tissue has a low glucose stock. Fatty acids are the main energy producer of type II pneumocytes, which use them in order to form phospholipids, essential for surfactant whose creation and release decrease in acute lung injury (ALI). Glutamine is a good substratum for endocrine cells and type II pneumocytes. Due to high nutritional risk, it is important its assessments in disorders as COPD and acute respiratory distress syndrome (ADRS). Indirect calorimetry values the effect of ventilation and nutritional support, avoiding overfeeding. Hypophosphatemia and refeeding syndrome are frequent and need to be avoided because of their morbidity. In critically ill patients, malnutrition can lead to respiratory failure and increasing mechanical ventilation time. To avoid hypercapnia in weaning, glucose levels should be controlled. High lipids/carbohydrates ratio do not show usefulness in COPD neither mechanical ventilation removal. ALI patients benefi ciate from an early start and the volume administered. Enteral nutrition with high fatty acids ratio (EPA, DHA and γ-linolenic acid) and antioxidants do not show any superiority. Omega-3 fatty acid in parenteral nutrition could modulate infl ammation and immunosuppression in a positive manner. The use of glutamine, vitamins or antioxidants in these patients could be justifi ed. Nuestros grandes olvidados, los enfermos respiratorios crónicos ResumenLas peculiaridades del pulmón hacen que el soporte nutricional, además de cubrir los requerimientos, pueda modular su respuesta infl amatoria. El pulmón tiene mínima capacidad de almacenar glucosa. Los lípidos son el sustrato energético de elección de los neumocitos tipo II que los utilizan para formar fosfolípidos, componentes esenciales del surfactante. Su síntesis y liberación disminuyen en la lesión pulmonar aguda (LPA). La glutamina es un buen sustrato para las células endoteliales y los neumocitos tipo II. La valoración nutricional de los pacientes con EPOC y SDRA es fundamental dado su alto riesgo nutricional. La calorimetría indirecta evalúa la respuesta del soporte nutricional y ventilatorio, evitando la sobrenutrición. La hipofosfatemia del síndrome de realimentación es frecuente y debe evitarse por la morbilidad que conlleva. En críticos, la desnutrición puede mantener la insufi ciencia respiratoria y prolongar el tiempo de ventilación mecánica (VM). En fase de weaning se deberían controlar los aportes de glucosa para evitar la retención de CO 2 . Fórmulas con un alto cociente grasas/hidratos de carbono no han demostrado una clara utilidad en el paciente EPOC ni en la retirada de la VM. Los pacientes con LPA se benefi cian del soporte nutricional precoz y del control del aporte de volumen. Las dietas enterales con alto contenido en grasas (EPA, DHA y γ-linolénico) y antioxidantes no han demostrado superioridad. En nutrición parenteral, las emulsiones con mayor contenido de ácidos gr...

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Immune Enteral Nutrition Can Improve Outcomes in Medical-Surgical Patients with ARDS: A Prospective Randomized Controlled Trial

Cited by 31 publications

References 41 publications

The Canadian Critical Care Nutrition Guidelines in 2013

The Canadian Critical Care Nutrition Guidelines in 2013

Методичні Рекомендації ESPEN Щодо Клінічного Харчування У Відділенні Інтенсивної Терапії

Nuestros grandes olvidados, los enfermos respiratorios crónicos

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