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Nutrition
Effect of a nutritional support protocol on enteral nutrition and clinical outcomes of critically ill patients: a retrospective cohort study
Heemoon Park, Sung Yoon Lim, Sebin Kim, Hyung-Sook Kim, Soyeon Kim, Ho Il Yoon, Young-Jae Cho
Acute Crit Care. 2022;37(3):382-390.   Published online July 19, 2022
DOI: https://doi.org/10.4266/acc.2022.00220
  • 3,681 View
  • 254 Download
  • 2 Crossref
AbstractAbstract PDFSupplementary Material
Background
Enteral nutrition (EN) supply within 48 hours after intensive care unit (ICU) admission improves clinical outcomes. The “new ICU evaluation & development of nutritional support protocol (NICE-NST)” was introduced in an ICU of tertiary academic hospital. This study showed that early EN through protocolized nutritional support would supply more nutrition to improve clinical outcomes.
Methods
This study screened 170 patients and 62 patients were finally enrolled; patients who were supplied nutrition without the protocol were classified as the control group (n=40), while those who were supplied according to the protocol were classified as the test group (n=22).
Results
In the test group, EN started significantly earlier (3.7±0.4 days vs. 2.4±0.5 days, P=0.010). EN calorie (4.0±1.0 kcal/kg vs. 6.7±0.9 kcal/kg, P=0.006) and protein (0.17±0.04 g/kg vs. 0.32±0.04 g/kg, P=0.002) supplied were significantly higher in the test group. Although EN was supplied through continuous feeding in the test group, there was no difference in complications such as feeding hold due to excessive gastric residual volume or vomit, and hyper- or hypo-glycemia between the two groups. Hospital mortality was significantly lower in the group that started EN within 1.5 days (42.9% vs. 11.8%, P=0.018). The proportion of patients who started EN within 1.5 days was higher in the test group (40.9% vs. 17.5%, P=0.044).
Conclusions
The NICE-NST may improve EN supply and mortality of critically ill patients without increasing complications.

Citations

Citations to this article as recorded by  
  • Nutritional support for patients with abdominal surgical pathology: the view of a surgeon and an anesthesiologist — opponents or allies?
    Natalya P. Shen, Svetlana Yu. Mukhacheva
    Clinical nutrition and metabolism.2023; 3(4): 181.     CrossRef
  • Provision of Enteral Nutrition in the Surgical Intensive Care Unit: A Multicenter Prospective Observational Study
    Chan-Hee Park, Hak-Jae Lee, Suk-Kyung Hong, Yang-Hee Jun, Jeong-Woo Lee, Nak-Jun Choi, Kyu-Hyouck Kyoung
    Annals of Clinical Nutrition and Metabolism.2022; 14(2): 66.     CrossRef
Pediatrics
Hearing screening outcomes in pediatric critical care survivors: a 1-year report
Pattita Suwannatrai, Chanapai Chaiyakulsil
Acute Crit Care. 2022;37(2):209-216.   Published online March 8, 2022
DOI: https://doi.org/10.4266/acc.2021.00899
  • 3,133 View
  • 159 Download
  • 1 Web of Science
  • 1 Crossref
AbstractAbstract PDF
Background
Hearing loss is a potentially serious complication that can occur after surviving a critical illness. Study on screening for hearing problems in pediatric critical care survivors beyond the neonatal period is lacking. This study aimed to identify the prevalence of abnormal hearing screening outcomes using transitory evoked otoacoustic emission (TEOAE) screening in children who survived critical illness and to find possible associating factors for abnormal hearing screening results.
Methods
This study was a single-center, prospective, observational study. All children underwent otoscopy to exclude external and middle ear abnormalities before undergoing TEOAE screening. The screening was conducted before hospital discharge. Descriptive statistics, chi-square, and logistic regression tests were used for data analysis.
Results
A total of 92 children were enrolled. Abnormal TEOAE responses were identified in 26 participants (28.3%). Children with abnormal responses were significantly younger than those with normal responses with a median age of 10.0 months and 43.5 months, respectively (P<0.001). Positive association with abnormal responses was found in children younger than 12 months of age (adjusted odds ratio [OR], 3.07; 95% confidence interval [CI], 1.06–8.90) and children with underlying genetic conditions (adjusted OR, 6.95; 95% CI, 1.49–32.54).
Conclusions
Our study demonstrates a high prevalence of abnormal TEOAE screening responses in children surviving critical illness, especially in patients younger than 12 months of age. More extensive studies should be performed to identify the prevalence and associated risk factors of hearing problems in critically ill children.

Citations

Citations to this article as recorded by  
  • Physiological and electrophysiological evaluation of the hearing system in low birth weight neonates treated with cholestin: a cohort study
    Nastaran Khosravi, Malihah Mazaheryazdi, Majid Kalani, Nasrin Khalesi, Zinat Shakeri, Saeedeh Archang, Maryam Archang
    The Egyptian Journal of Otolaryngology.2023;[Epub]     CrossRef
Ethics
Outcomes of critically ill patients according to the perception of intensivists on the appropriateness of intensive care unit admission
Youjin Chang, Kyoung Ran Kim, Jin Won Huh, Sang-Bum Hong, Younsuck Koh, Chae-Man Lim
Acute Crit Care. 2021;36(4):351-360.   Published online November 26, 2021
DOI: https://doi.org/10.4266/acc.2021.00283
  • 5,228 View
  • 144 Download
  • 4 Web of Science
  • 4 Crossref
AbstractAbstract PDFSupplementary Material
Background
It is important for intensivists to determine which patient may benefit from intensive care unit (ICU) admission. We aimed to assess the outcomes of patients perceived as non-beneficially or beneficially admitted to the ICU and evaluate whether their prognosis was consistent with the intensivists’ perception.
Methods
A prospective observational study was conducted on patients admitted to the medical ICU of a tertiary referral center between February and April 2014. The perceptions of four intensivists at admission (day 1) and on day 3 were investigated as non-beneficial admission, beneficial admission, or indeterminate state.
Results
A total of 210 patients were enrolled. On days 1 and 3, 22 (10%) and 23 (11%) patients were judged as having non-beneficial admission; 166 (79%) and 159 (79%), beneficial admission; and 22 (10%) and 21 (10%), indeterminate state, respectively. The ICU mortality rates of each group were 64%, 22%, and 57%, respectively; their 6-month mortality rates were 100%, 46%, and 81%, respectively. The perceptions of non-beneficial admission or indeterminate state were the significant predictors of ICU mortality (day 3, odds ratio [OR], 4.049; 95% confidence interval [CI], 1.892–8.664; P<0.001) and 6-month mortality (day 1: OR, 4.983; 95% CI, 1.260–19.703; P=0.022; day 3: OR, 4.459; 95% CI, 1.162–17.121; P=0.029).
Conclusions
The outcomes of patients perceived as having non-beneficial admission were extremely poor. The intensivists’ perception was important in predicting patients’ outcomes and was more consistent with long-term prognosis than with immediate outcomes. The intensivists’ role can be reflected in limited ICU resource utilization.

Citations

Citations to this article as recorded by  
  • Characteristics of critically ill patients with cancer associated with intensivist's perception of inappropriateness of ICU admission: A retrospective cohort study
    Carla Marchini Dias da Silva, Bruno Adler Maccagnan Pinheiro Besen, Antônio Paulo Nassar Jr
    Journal of Critical Care.2024; 79: 154468.     CrossRef
  • Characteristics, ICU Interventions, and Clinical Outcomes of Patients With Palliative Care Triggers in a Mixed Community-Based Intensive Care Unit
    Michele M. Iguina, Aunie M. Danyalian, Ilko Luque, Umair Shaikh, Sanaz B. Kashan, Dionne Morgan, Daniel Heller, Mauricio Danckers
    Journal of Palliative Care.2023; 38(2): 126.     CrossRef
  • Association of appropriateness for ICU admission with resource use, organ support and long-term survival in critically ill cancer patients
    Carla Marchini Dias Silva, Janaina Naiara Germano, Anna Karolyne de Araujo Costa, Giovanna Alves Gennari, Pedro Caruso, Antonio Paulo Nassar Jr
    Internal and Emergency Medicine.2023; 18(4): 1191.     CrossRef
  • Can the intensivists predict the outcomes of critically ill patients on the appropriateness of intensive care unit admission for limited intensive care unit resources ?
    SeungYong Park
    Acute and Critical Care.2021; 36(4): 388.     CrossRef

ACC : Acute and Critical Care