Metabolic and Nutrition Support in the Chronic Critical Illness Syndrome

Schulman, Rifka; Mechanick, Jeffrey I.

doi:10.4187/respcare.01620

Cited by 71 publications

(41 citation statements)

References 159 publications

(206 reference statements)

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“…Calculation errors have been reported in the range of 7-55 % [4]. The lack of accurate metabolic rate determination threatens their recovery process, where patients need varying calorific intake dependent on their recovery phase.…”

Section: Breath Analysismentioning

confidence: 99%

A low cost MEMS based NDIR system for the monitoring of carbon dioxide in breath analysis at ppm levels

Vincent

Gardner

2016

Sensors and Actuators B: Chemical

130

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Please cite this article as: T.A.Vincent, J.W.Gardner, A low cost MEMS based NDIR system for the monitoring of carbon dioxide in breath analysis at ppm levels, Sensors and Actuators B: Chemical http://dx.doi.org/10. 1016/j.snb.2016.04.016 This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.A low cost MEMS based NDIR system for the monitoring of carbon dioxide in breath analysis at ppm levels Highlights  MEMS based NDIR system for ppm CO2 detection with lock-in amplifier.  Fast 1.3 s response time for breath-by-breath analysis.  Portable breath analyser designed for measuring metabolic rate of subjects.  Effect of path length on NDIR system investigated with novel sensor housing.  Silicon on insulator IR emitter used for low power, low cost gas detection. AbstractThe molecules in our breath can provide a wealth of information about the health and well-being of a person. The level of carbon dioxide (CO2) is not only a sign of life but also when combined with the level of exhaled oxygen provides valuable health information in the form of our metabolic rate. We report upon the development of a MEMS-based non-dispersive infrared CO2 sensor for inclusion in a hand held portable breath analyser. Our novel sensor system comprises a thermopile detector and low power MEMS silicon on insulator (SOI) wideband infrared (IR) emitter. A lock-in amplifier design permits a CO2 concentration of 50 ppm to be detected on gas bench rig. Different IR path lengths were studied with gases in dry and humid (25 % and 50 % RH) in order to design a sensor suitable for detecting CO2 in breath with concentrations in the range of 4 to 5 %. A breath analyser was constructed from acetal and in part 3D printed with a side-stream sampling mechanism and tested on a range of subjects with two data-sets presented here. The performance of the novel MEMS based sensor was validated using a reference commercial breath-by-breath sensor and produced comparable results and gave a response time of 1.3 s. Further work involves the detection of other compounds on breath for further metabolic analysis and reducing the overall resolution of our MEMS sensor system from ca. 250 ppm to 10 ppm.

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Section: Breath Analysismentioning

confidence: 99%

A low cost MEMS based NDIR system for the monitoring of carbon dioxide in breath analysis at ppm levels

Vincent

Gardner

2016

Sensors and Actuators B: Chemical

130

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“…Trials to treat undernutrition during critical illness with supplemental nutrition have been ineffective and might have actually potentiated muscle atrophy and weakness (15,76,(111)(112)(113)(114), and a trial of growth hormone replacement in acutely critically ill medical and surgical patients doubled the risk of in-hospital death (115). In light of these studies, there is developing interest in targeting nutritional supplementation and hormone replacement therapies after ICU discharge to reverse weight loss and exhaustion in survivors of critical illness (116,117).…”

Section: Frailty As a Therapeutic Target In Pulmonary Disease And Crimentioning

confidence: 99%

Frailty in Pulmonary and Critical Care Medicine

Singer

Lederer²,

Baldwin

2016

Annals ATS

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Conceptualized first in the field of geriatrics, frailty is a syndrome characterized by a generalized vulnerability to stressors resulting from an accumulation of physiologic deficits across multiple interrelated systems. This accumulation of deficits results in poorer functional status and disability. Frailty is a "state of risk" for subsequent disproportionate declines in health status following new exposure to a physiologic stressor. Two predominant models have emerged to operationalize the measurement of frailty. The phenotype model defines frailty as a distinct clinical syndrome that includes conceptual domains such as strength, activity, wasting, and mobility. The cumulative deficit model defines frailty by enumerating the number of age-related things wrong with a person. The biological pathways driving frailty include chronic systemic inflammation, sarcopenia, and neuroendocrine dysregulation, among others. In adults with chronic lung disease, frailty is independently associated with more frequent exacerbations of lung disease, all-cause hospitalization, declines in functional status, and all-cause mortality. In addition, frail adults who become critically ill are more likely develop chronic critical illness or severe disability and have higher in-hospital and long-term mortality rates. The evaluation of frailty appears to provide important prognostic information above and beyond routinely collected measures in adults with chronic lung disease and the critically ill. The study of frailty in these populations, however, requires multipronged efforts aimed at refining clinical assessments, understanding the mechanisms, and developing therapeutic interventions.Keywords: frailty; body composition; disability; health-related quality of life; mortality Correspondence and requests for reprints should be addressed to Jonathan P. Singer, M.D., M.S.,

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“…Najkritičnije su akutna faza (prvih 3 dana) i produžena akutna faza (od 3-10 dana intenzivnog lečenja) 1 . U hroničnoj fazi kritične bolesti (posle 14 dana intenzivnog lečenja), bolesnik je na produženoj mehaničkoj ventilaciji sa traheostomom, kompleksnim fiziološkim poremećajima praćenim hipoalbuminemijom, anasarkom, stresom indukovanom hiperglikemijom, deficitom vitamina D, i izraženom polineuropatijom i miopatijom izazvanom kritičnom bolešću.…”

Section: In the Last Few Decades The Advanced Technology Significantlunclassified

Comparasion between effects of nutritional immunomodulation with glutamine: An integral part of the treatment of critically ill: Trend and perspective (immunonitrition in critically ill patients)

Jović¹

2017

Serb J Anes Inten Therap

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Metabolic and Nutrition Support in the Chronic Critical Illness Syndrome

Cited by 71 publications

References 159 publications

A low cost MEMS based NDIR system for the monitoring of carbon dioxide in breath analysis at ppm levels

A low cost MEMS based NDIR system for the monitoring of carbon dioxide in breath analysis at ppm levels

Frailty in Pulmonary and Critical Care Medicine

Comparasion between effects of nutritional immunomodulation with glutamine: An integral part of the treatment of critically ill: Trend and perspective (immunonitrition in critically ill patients)

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