Intensive care units nutrition

The water-soluble salt of vitamin K3 (menadione) should never be used in therapeutics. It is particularly ineffective in the treatment of warfarin overdosage. Vitamin K deficiency frequently occurs in hospitalized patients in intensive care units because of poor diet, parenteral nutrition, recent surgery, multiple antibiotic therapy, and uremia. Severe hepatic failure results in diminished protein synthesis and a hemorrhagic diathesis that is unresponsive to vitamin K. 

Severe cases of tetanus generally require admission to an intensive care unit for 3-5 weeks. Weight loss is universal in tetanus and these patients require enteral nutrition. Other important measures include close control of fluid balance, chest physiotherapy to prevent pneumonia, prophylaxis of thromboembolism and intensive nursing care to prevent pressure sores. 

Pollack MM. Nutritional support of children in the intensive care unit. In Suskind RM, Lewinter-Suskind L, eds. Textbook of Pediatric Nutrition, 2d ed. New York, Raven Press, 1993 207-216. 

Russell MK, Chamey P. Is there a role for specialized enteral nutrition in the intensive care unit Nutr Chn Pract 2002 17 156-168. 

Many patients in intensive care units receive intravenous nutrition, which is a mixture of various amino acids, sorbitol, and ethanol. In a study of 30 patients with normal preoperative folate levels who were operated on for gastrointestinal disease, the serum folate fell within 48 hours by 60-95% in 20 patients receiving intravenous nutrition (W24). Seven patients had a megaloblastic bone marrow. Daily treatment with 0.5 mg of folic acid given intravenously prevented any clinical signs of folate deficiency. These patients received between 100 and 150 g of ethanol daily as part of their parenteral nutrition, and this may have played a significant role in the development of folate deficiency. However, Tennant (T12) examined this possibility and found that acute depression of the serum folate concentration occurred with both alcohol-firee and alcohol-containing preparations used for parenteral nutrition. It was also noted that only one particular brand of... 

All infants, on admission to the neonatal intensive care unit, were established on parenteral fluids within the first hour of day 1 at 80 ml/kg/day with a solution of electrolytes, dextrose 10%, amino acids (Vaminolact, Fresenius Kabi, Cheshire, UK) and a phosphate supplement (Addiphos, Fresenius Kabi, Cheshire, UK). Fluid intakes were thereafter managed on the basis of clinical requirements. On day 2 of life, and thereafter, the solution was further supplemented with water-soluble vitamins (Solvito N, Fresenius Kabi, Cheshire, UK) and trace elements (Peditrace, Fresenius Kabi, Cheshire, UK), to the levels recommended by the manufacmrer. In tandem, a fat emulsion solution (Intralipid 20%, Fresenius Kabi, Cheshire, UK) with added fat-soluble vitamins (Vitfipid, Fresenius Kabi, Cheshire, UK) was infused, initially at 8ml/kg/ day, increasing maximally to 18 ml/kg/day by posma-tal day 5. Enteral feeds were started, when the condition of the infant was stable, as hourly boluses of 0.5—1 ml/h. Thereafter enteral feed volumes were gradually increased as determined by the infants clinical condition, with reciprocal reductions in the volume of parenteral nutrition infused. No infant progressed beyond hourly bolus feeds for the duration of the study. 

Total Parenteral Nutrition in the Newborn Table III. Diagnosis of Infants Receiving TPN in the Neonatal Intensive Care Unit at the Hospital for Sick Children (Toronto) During 6 Mo of 1982 ... 

Lima, L.F., Leite, H.P., and Taddei, J.A., 2011. Low blood thiamine concentrations in children upon admission to the intensive care unit risk factors and prognostic significance. The American Journal of Clinical Nutrition. 93 57-61. 

The susceptibility factors for cholestasis associated with parenteral nutrition have been studied in 62 premature infants in a neonatal intensive care unit, of whom 11 (18%) developed cholestasis [72 ]. There were significant differences in terms of... 

Balegar VKK, Azeem MI, Spence K, Badawi N. Extending total parenteral nutrition hang time in the neonatal intensive care unit is it safe and cost effective J Paediatr Child Health January 2013 49(1) E57-61. 

SINPE Consensus Paper. Glutamitaly 2003. Riv It Nutriz Parenter Enter 2004 22 115-133. Heyland DK, Dhaliwal R, Suchner U, et al. Antioxidant nutrients a systematic review of trace elements and vitamins in the critically ill patient. Intensive Care Med 2005 31 327—237. Mackenzie SL. Implementation of a nutrition support protocol increases the piopmtion of mechanically ventilated patients reaching enteral nutrition targets in the adult Intensive care unit. JPEN J Parenter Enteral Nutr 2005 29 74-80. 

Placement of a nasogastric tube (NGT) is a common procedure in the intensive care unit and operating room for reasons of gastric decompression, nutrition, and drug administration. However, verification of correct NGT... 

---