Energy, Protein, Carbohydrate, and Lipid Intakes and Their Effects on Morbidity and Mortality in Critically Ill Adult Patients: A Systematic Review

Patková, Anna; Joskova, Vera; Havel, Eduard; Kovařík, Miroslav; Kuchařová, Monika; Zadák, Z; Hronek, Miloslav

doi:10.3945/an.117.015172

Cited by 43 publications

(62 citation statements)

References 100 publications

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“…Effective implementation of programs for infection control, nutritional build-up, physical therapy, and adherence to outpatient consults are suggested measures for faster recovery and prevent unfavorable outcomes in these young patients. 4,5,[22][23][24][25]…”

Section: Discussionmentioning

confidence: 99%

Outcomes of Seizures in Patients with Systemic Lupus Erythematosus in a Tertiary Government Hospital in the Philippines

Cortez

Osio-Salido

2022

Acta Med Philipp

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Background. Seizures in patients with systemic lupus erythematosus (SLE) are uncommon but life-threatening; mortality rate is 25-29%. Seizure in a person with lupus may be due to lupus itself or other conditions. There are no published studies describing the causes and outcomes of seizures in Filipino patients with lupus. Objective. To describe the causes and outcomes of seizure in a cohort of patients with lupus seen at Philippine General Hospital. Methodology. We reviewed the medical records of patients with SLE) with a documented seizure and admitted between January 2016 and April 2019. History, physical examination and laboratory findings, and clinical course were obtained. Results. We included 29 patients with 31 seizure events. They were all women, mostly single, of low socio-economic status, and had poor functional capacity. Lupus was active in 77.4% (24/31), commonly with mucocutaneous or hematologic manifestations. Seizures were generalized in 87 % (27/31). Prior to seizure, one-third had headache, fever, and vomiting. There were no neurologic localizing signs. Twenty-four seizure events (77%) occurred among patients with active lupus; 16 (67%) was attributed to neuropsychiatric systemic lupus erythematosus (NPSLE) and eight (33%) to other causes: infection (tuberculous meningitis and septic encephalopathy), posterior reversible encephalopathy syndrome (PRES), uremia, arrhythmia, and eclampsia. Seven seizures in inactive lupus were not SLE-related. Mortality rate was 28%; infection was the most common cause. Seizure resolved in 97%. Mean duration of hospitalization was 26.7 days. Patients were discharged improved from 19 seizure events (18 patients); 14 had follow-up consultations, three were readmitted. There was no seizure recurrence within 30 days of discharge. There was improvement in functional capacity. Conclusion. The most common cause of seizure was NPSLE, followed by infection. Despite high rates of complete seizure resolution, poor outcomes were noted in almost half of the patients. Prolonged hospitalization was common. A high rate of mortality was observed. Infection was the most common cause of mortality.

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Section: Discussionmentioning

confidence: 99%

Outcomes of Seizures in Patients with Systemic Lupus Erythematosus in a Tertiary Government Hospital in the Philippines

Cortez

Osio-Salido

2022

Acta Med Philipp

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“…The supplementation of calories was 20–25 kcal/kg/day during the acute phase (48 h after ICU admission), and 30 kcal/kg/day during the post-acute phase (>4 days after ICU admission) [ 28 ]. If EN could not be established within 72–96 h after admission, the use of PN was considered [ 8 , 9 ].…”

Section: Methodsmentioning

confidence: 99%

Lipid-Free Parenteral Nutrition Is Associated with an Increased Risk of Hepatic Dysfunction in Surgical Critically Ill Patients: A Retrospective Observational Study

Chen

Tsai

et al. 2021

Healthcare

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To evaluate the effects of lipid-free parenteral nutrition (PN) and various intravenous fat emulsions (IVFEs) on hepatic function in surgical critically ill trauma/acute care surgery patients. We retrospectively reviewed trauma/acute care surgery patients without admission hepatic disorder that received PN. The PN groups include lipid-free, soybean oil/medium-chain triglyceride, olive oil-based, and fish-oil contained PN. We excluded patients with (1) age <18 years, (2) without surgery, (3) preexisting liver injury/diseases, (4) hyperbilirubinemia at admission, (5) received more than one type of PN, and (6) repeated ICU episodes in the same hospitalization. Hepatic dysfunction was considered as serum total–bilirubin >6.0 mg/dL. The demographics, severity score, comorbidities, blood stream infection, and mortality were collected for analyses. The major outcome is hepatic function. We also performed analyses stratified by separated lipid doses (g/kg/day). A total of 249 patients were enrolled. There were no demographic differences among groups. The lipid-free PN group had a higher incidence of hepatic dysfunction and mortality. Compared to the lipid-free group, the other three IVFEs had significantly lower risks of hepatic dysfunction, while the olive oil-based group had a significantly lower risk of 30 and 90-day mortality. After being stratified by separating lipid doses, the soybean oils showed a decreasing trend of hepatic dysfunction and mortality with increased dosage. Fish oil >0.05 g/kg/day was associated with lower hepatic dysfunction incidences. Our findings suggest that, when compared to IVFEs, surgical critically ill patients with trauma/acute care surgery that received lipid-free PN are associated with an increased risk of hepatic dysfunction. In addition, the olive oil-based group had a significantly lower risk of mortality, while fish oil >0.05 g/kg/day was associated with lower incidences of hepatic dysfunction; however, further studies are warranted.

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“…The goal of calorie supplementation was ≤25 kcal/kg (actual BW)/day during the acute phase (48 h after ICU admission), followed by 30 kcal/kg (actual BW)/day during the post-acute phase (>4 days postadmission). 13 If EN could not be established within 72–96 h after admission, we considered the use of PN. 4 , 5 In patients with identified preoperative malnutrition (eg, BMI < 18.5 kg/m 2 ) and who were intolerant to enteral feeding, we started PN within 24 h after ICU admission.…”

Section: Methodsmentioning

confidence: 99%

Lipid-Free PN is Associated with an Increased Risk of Hyperbilirubinemia in Surgical Critically Ill Patients with Admission Hepatic Disorder: A Retrospective Observational Study

Wu¹,

Chen²,

Cheng³

et al. 2021

TCRM

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Background To evaluate the effect of different PN types on surgical critically ill trauma/acute care surgery patients with hepatic disorders at admission. Methods This is a retrospective study. The PN types included lipid-free, soybean oil/medium-chain triglyceride, olive oil-based, and fish oil-containing PNs. Patients admitted with liver injury or liver surgery, elevated serum AST/ALT level, and elevated serum total bilirubin level were included. The exclusion criteria are as follows: 1) age <18 years, 2) severe liver disease/cirrhosis, 3) received more than one type of PN and 4) serum total bilirubin >4.9 mg/dl at admission. Demographics, severity, comorbidities, blood stream infection, hyperbilirubinemia (total bilirubin > 6.0 mg/dl), and mortality were collected for analysis. We also performed analysis stratified by separated lipid doses (g/kg/day). Results A total of 156 patients were enrolled. There were no demographic differences among groups. The lipid-free group was associated with the highest mortality rate and incidence of hyperbilirubinemia. Compared to the lipid-free group, the olive oil-based group had the lowest risk of hyperbilirubinemia. After being stratified by separated lipid doses, the incidence of hyperbilirubinemia decreased when the lipid dosage increased. Regarding different types of lipids, patients who received more than the median dosage of lipids showed a significantly lower risk of hyperbilirubinemia, except in the fish oil-containing group. Conclusion Our result suggested that lipid-free PN is associated with an increased risk of hyperbilirubinemia in surgical critically ill patients with admission hepatic disorder. Further studies are warranted.

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Energy, Protein, Carbohydrate, and Lipid Intakes and Their Effects on Morbidity and Mortality in Critically Ill Adult Patients: A Systematic Review

Cited by 43 publications

References 100 publications

Outcomes of Seizures in Patients with Systemic Lupus Erythematosus in a Tertiary Government Hospital in the Philippines

Outcomes of Seizures in Patients with Systemic Lupus Erythematosus in a Tertiary Government Hospital in the Philippines

Lipid-Free Parenteral Nutrition Is Associated with an Increased Risk of Hepatic Dysfunction in Surgical Critically Ill Patients: A Retrospective Observational Study

Lipid-Free PN is Associated with an Increased Risk of Hyperbilirubinemia in Surgical Critically Ill Patients with Admission Hepatic Disorder: A Retrospective Observational Study

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