Continuous renal replacement therapy (CRRT) is commonly used to provide in the intensive care unit. Limited published data suggest that CRRT may lead depletion of water-soluble vitamins and trace elements. The goal this study was identify incidence element vitamin deficiencies critically ill patients during CRRT.This based on a retrospective chart review who were referred Emory University Hospital's nutrition support services had at least 1 serum micronutrient level measured (thiamin,...

Despite major advances in the medical management of Crohn's disease (CD), a significant proportion patients will require surgery within 5 years diagnosis. Malnutrition is an independent risk factor for adverse post-operative outcomes following gastrointestinal surgery. Data on value pre-operative total parenteral nutrition (TPN) CD are mixed and there paucity data biologic era. We aimed to define role TPN this population. This was retrospective cohort study conducted at tertiary referral...

Micronutrient deficiencies associated with malnutrition in patients inflammatory bowel disease (IBD) can lead to complications including anemia, coagulopathy, poor wound healing, and colorectal cancer. This study aimed investigate micronutrient (copper, vitamins A, B 9 , E, K) IBD highlight symptoms aid the recognition of deficiencies.

Malnutrition in hospitalized patients is a major cause for hospital re-admission, pressure ulcers and increased costs. Methods to improve the administration documentation of nutritional supplements are needed patient care, outcomes resource utilization. Staff at medium-sized academic health science center southeastern United States noted that ordered high risk malnutrition were not offered or administered standardized manner and/or documented clearly electronic record as per prescription....

Abstract Background Limited evidence is available to describe the prevalence, causes, and consequences of zinc vitamin B 6 deficiencies in those with acutely exacerbated inflammatory bowel disease (IBD). Zinc important for immune function wound healing, needed metabolic neurological function. Patients IBD are at risk micronutrient deficiencies, particularly during flares. Presentations The cases 2 patients exacerbations were reviewed which both identified. Conclusions These highlight need...

Abstract Background Prevalence of malnutrition has been reported in 60% hospitalized and up to 78% patients admitted intensive care units. Malnutrition associated with complications, such as infection, increased hospital length stay, morbidity, mortality. Nutritional support shown reduce avoidable readmissions, pressure ulcers, malpractice claims, costs. Creating a new electronic nutrition administration record (ENAR) linked tab within the health (EHR) would promote enhanced patient outcomes...

We present a 29-year-old male with Crohn's disease who developed chronic inflammatory demyelinating polyneuropathy (CIDP) related to infliximab therapy. He lower extremity weakness and dysesthesia 3 weeks after fourth dose. Laboratory examination revealed an elevated cerebrospinal fluid protein without pleocytosis. The patient initially responded plasmapheresis therapy marked symptomatic improvement, but relapsed was refractory subsequent treatments plasmaphereisis, intravenous...

The American and European guidelines recommend measuring resting energy expenditure (REE) using indirect calorimetry (IC). Predictive equations (PEs) are used to estimate REE, but there is limited evidence for their use in critically ill patients. aim of this study evaluate the degree agreement accuracy between IC-measured REE (REE-IC) 10 different PEs mechanically ventilated patients with surgical trauma who met estimated requirement.REE-IC was retrospectively compared REE-PE by PEs. REE-IC...

Background: After inpatient management of upper gastrointestinal bleeding (GIB) due to peptic ulcer disease (PUD), oral proton pump inhibitor (PPI) therapy is recommended at discharge decrease rebleeding risk and improve healing. Our aim determine whether once-daily PPI dosing hospital associated with inferior 30-day outcomes as compared twice-daily dosing. Methods: We retrospectively identified 233 patients admitted signs symptoms GIB found be PUD on endoscopy. management, discharged were...

Hepatorenal syndrome (HRS) remains a serious complication of cirrhosis with high mortality rate. There is little information on the effect standardizing albumin, midodrine and octreotide combination treatment response in patients HRS.The aim study was to determine impact standardized HRS regimen renal function recovery. The primary outcome full Secondary outcomes included partial no rates, 30-day all-cause mortality, ICU length stay (LOS), hospital LOS, liver transplantation total dose...

Abstract Background It has been reported that many hospitals in the United States have fragmented and ineffective ordering, administration, documentation, evaluation/monitoring of nutrition therapies. This paper reports on a project to investigate if perceived hospital staff awareness documentation support therapies (NSTs) improves by including them as part medication administration record (MAR). Methods Surveys were conducted with nursing staff, physicians, dietitians before after adding...

We present the unique case of adult hyperinsulinism hyperammonemia syndrome (HI/HA). This condition is rarely seen in children and even more infrequently adults. A 27-year-old female with HI/HA, generalized tonic-clonic seizures, staring spells, gastroesophageal reflux disease presented diffuse abdominal pain, hypoglycemia, confusion, sweating. She reported a history significant nausea, vomiting, diarrhea, which had been intermittently over past year. On examination, she was found to have...

Micronutrient deficiencies may develop as a long-term complication of bariatric surgery due to alteration gut anatomy and disruption normal absorption. Inadequate repletion essential vitamin mineral can lead multisystem dysfunction. We present case woman in her 50s, with history Roux-en-Y gastric bypass over 10 years ago, who presented generalised weakness diffuse desquamating rash. A punch biopsy performed was compatible nutritional deficiency. Labs revealed low levels micronutrients A, B 1...

Abstract Background The American Society for Parenteral and Enteral Nutrition (ASPEN)/ of Critical Care Medicine the European Clinical Metabolism guidelines recognize that critically ill patients receiving stable, low doses vasopressors have experienced advantages early initiation enteral nutrition (EN). However, clinical questions remained unanswered including vasopressor combinations associated with complications, advent other therapies during hypotensive states, as well volume content EN...

Although the effects of biologic agents on postoperative outcomes in Crohn's disease patients have been extensively studied, intraoperative outcomes, including blood loss, operative time, and length small bowel resection, remain to be determined. This was a retrospective cohort study at single tertiary referral center. (CD) who underwent major abdominal surgery were identified. Patients receiving preoperative compared with controls. We compare between groups. A total 144 University Florida...

Purpose of review Recent changes in guidelines recommendation during early phase critical illness and use indirect calorimetry. The aim this is to discuss methods determining energy requirements the critically ill highlight factors impacting resting expenditure. finding An appraisal recent literature discussing calorimetry guided-nutrition potential benefits or pitfalls. attempts devise strategy pilot patients requiring continuous renal replacement therapy extracorporeal membrane oxygenation...

INTRODUCTION: Crohn's disease and ulcerative colitis are characterized by chronic inflammation of the gastrointestinal tract. Mucosal healing (MH) is a therapeutic goal in patients with inflammatory bowel (IBD). Current data suggest that Black may experience worse clinical outcomes than White IBD. This study assessed MH between METHODS: Retrospective analysis was performed on adults IBD who were hospitalized for an active flare. The presence at 6–18 months after hospitalization. treatments...