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Article: Medical Nutrition Therapy in Critically Ill Patients Treated on Intensive and Intermediate Care Units: A Literature Review.

Kopp Lugli, Andrea / de Watteville, Aude / Hollinger, Alexa / Goetz, Nicole / Heidegger, Claudia

2019 Volume 8, Issue 9

Abstract: Medical nutrition therapy in critically ill patients remains challenging, not only because of the pronounced stress response with a higher risk for complications, but also due to their heterogeneity evolving from different phases of illness. The present ... ...

Abstract	Medical nutrition therapy in critically ill patients remains challenging, not only because of the pronounced stress response with a higher risk for complications, but also due to their heterogeneity evolving from different phases of illness. The present review aims to address current knowledge and guidelines in order to summarize how they can be best implemented into daily clinical practice. Further studies are urgently needed to answer such important questions as best timing, route, dose, and composition of medical nutrition therapy for critically ill patients and to determine how to assess and to adapt to patients' individual needs.
Language	English
Publishing date	2019-09-06
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2662592-1
ISSN	2077-0383
ISSN	2077-0383
DOI	10.3390/jcm8091395
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Correction to: The Role of HbA1c as a Positive Perioperative Predictor of Surgical Site and Other Postoperative Infections: An Explorative Analysis in Patients Undergoing Minor to Major Surgery.

Kopp Lugli, Andrea / Marti, Walter R / Salm, Lilian / Mujagic, Edin / Bundi, Marcel / von Strauss, Marco / Bucheli Laffer, Evelin / Landin, Julia / Fux, Christoph A / Coslovsky, Michael / Weber, Walter Paul / Kindler, Christoph

World journal of surgery

2021 Volume 46, Issue 2, Page(s) 400

Language	English
Publishing date	2021-11-01
Publishing country	United States
Document type	Published Erratum
ZDB-ID	224043-9
ISSN	1432-2323 ; 0364-2313
ISSN (online)	1432-2323
ISSN	0364-2313
DOI	10.1007/s00268-021-06392-x
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: The Role of HbA1c as a Positive Perioperative Predictor of Surgical Site and Other Postoperative Infections: An Explorative Analysis in Patients Undergoing Minor to Major Surgery.

World journal of surgery

2021 Volume 46, Issue 2, Page(s) 391–399

Abstract: Background: Patients with diabetes mellitus type 2 (DM2) inhere impaired peripheral insulin action leading to higher perioperative morbidity and mortality rates, with hospital-acquired infections being one important complication. This post hoc, ... ...

Abstract	Background: Patients with diabetes mellitus type 2 (DM2) inhere impaired peripheral insulin action leading to higher perioperative morbidity and mortality rates, with hospital-acquired infections being one important complication. This post hoc, observational study aimed to analyze the impact of surgical and metabolic stress as defined by the surrogate marker hemoglobin A1c (HbA1c), in relation to self-reported DM2, on perioperative infection rates in a subcohort of the Surgical Site Infection (SSI) Trial population. Methods: All patients of the SSI study were screened for HbA1c levels measured perioperatively for elective or emergency surgery and classified according to the American Diabetes Association HbA1c cutoff values. SSI and nosocomial infections, self-reported state of DM2 and type of surgery (minor, major) were assessed. Results: HbA1c levels were measured in 139 of 5175 patients (2.7%) of the complete SSI study group. Seventy patients (50.4%) self-reported DM2, while 69 (49.6%) self-reported to be non-diabetic. HbA1c levels indicating pre-diabetes were found in 48 patients (34.5%) and diabetic state in 64 patients (46%). Forty-five patients of the group self-reporting no diabetes (65.2%) were previously unaware of their metabolic derangement (35 pre-diabetic and 10 diabetic). Eighteen infections were detected. Most infections (17 of 18 events) were found in patients with HbA1c levels indicating pre-/diabetic state. The odds for an infection was 3.9-fold (95% CI 1.4 to 11.3) higher for patients undergoing major compared to minor interventions. The highest percentage of infections (38.5%) was found in the group of patients with an undiagnosed pre-/diabetic state undergoing major surgery. Conclusions: These results encourage investment in further studies evaluating a more generous and specific use of HbA1c screening in patients without self-reported diabetes undergoing major surgery. Trial registration Clinicaltrials.gov identifier: NCT01790529.
MeSH term(s)	Biomarkers ; Diabetes Mellitus, Type 2/complications ; Elective Surgical Procedures ; Glycated Hemoglobin A/analysis ; Humans ; Surgical Wound Infection/diagnosis ; Surgical Wound Infection/epidemiology
Chemical Substances	Biomarkers ; Glycated Hemoglobin A
Language	English
Publishing date	2021-11-08
Publishing country	United States
Document type	Journal Article ; Observational Study ; Research Support, Non-U.S. Gov't
ZDB-ID	224043-9
ISSN	1432-2323 ; 0364-2313
ISSN (online)	1432-2323
ISSN	0364-2313
DOI	10.1007/s00268-021-06368-x
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Article ; Online: Medical Nutrition Therapy in Critically Ill Patients Treated on Intensive and Intermediate Care Units

Andrea Kopp Lugli / Aude de Watteville / Alexa Hollinger / Nicole Goetz / Claudia Heidegger

Journal of Clinical Medicine, Vol 8, Iss 9, p

A Literature Review

2019 Volume 1395

Abstract	Medical nutrition therapy in critically ill patients remains challenging, not only because of the pronounced stress response with a higher risk for complications, but also due to their heterogeneity evolving from different phases of illness. The present review aims to address current knowledge and guidelines in order to summarize how they can be best implemented into daily clinical practice. Further studies are urgently needed to answer such important questions as best timing, route, dose, and composition of medical nutrition therapy for critically ill patients and to determine how to assess and to adapt to patients’ individual needs.
Keywords	nutritional support ; medical nutrition therapy ; intensive care unit ; intermediate care unit ; critically ill patients ; Medicine ; R
Language	English
Publishing date	2019-09-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Non-invasive evaluation of new-onset atrial fibrillation after cardiac surgery: a protocol for the BigMap study.

ESC heart failure

2022 Volume 9, Issue 4, Page(s) 2703–2712

Abstract: Aims: New-onset atrial fibrillation (NOAF) is the most common complication after cardiac surgery, occurring in 25-50% of patients. It is associated with post-operative stroke, increased mortality, prolonged hospital length of stay, and higher treatment ... ...

Abstract	Aims: New-onset atrial fibrillation (NOAF) is the most common complication after cardiac surgery, occurring in 25-50% of patients. It is associated with post-operative stroke, increased mortality, prolonged hospital length of stay, and higher treatment costs. Previous small observational studies have identified the left atrium as a source of the electrical rotors and foci maintaining NOAF, but confirmation by a large prospective clinical study is still missing. The aim of the proposed study is to investigate whether the source of NOAF lies in the left atrium. The correct identification of NOAF-maintaining structures in cardiac surgical patients might offer potential therapeutic targets for prophylactic perioperative ablation strategies. Methods and results: This is a prospective single-centre observational study of patients developing NOAF after cardiac surgery. The primary outcome is the description of NOAF-maintaining structures within the atria. Key secondary outcomes include overall mortality, intensive care unit length of stay, hospital-ventilator-free days, and proportion of persistent NOAF. In NOAF patients, the non-invasive electrophysiological mapping will be conducted using a 252-electrode electrocardiogram vest. After mapping, a low-dose computed tomography scan of the chest will be performed to integrate the electrophysiological mapping results into a 3D picture of the heart. The study will include approximately 570 patients, of whom 30% (n = 170) are expected to develop NOAF. Sample size calculation revealed that 157 NOAF patients are necessary to assess the primary outcome. Patients will be tracked for a total of 5 years. Conclusions: This is the largest prospective study to date describing the electrophysiological mechanisms of NOAF using non-invasive mapping.
MeSH term(s)	Atrial Fibrillation/complications ; Atrial Fibrillation/etiology ; Cardiac Surgical Procedures/adverse effects ; Electrocardiography ; Humans ; Observational Studies as Topic ; Prospective Studies ; Risk Factors
Language	English
Publishing date	2022-04-19
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2814355-3
ISSN	2055-5822 ; 2055-5822
ISSN (online)	2055-5822
ISSN	2055-5822
DOI	10.1002/ehf2.13902
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Anaesthetic mechanisms: update on the challenge of unravelling the mystery of anaesthesia.

Kopp Lugli, Andrea / Yost, Charles Spencer / Kindler, Christoph H

European journal of anaesthesiology

2009 Volume 26, Issue 10, Page(s) 807–820

Abstract: General anaesthesia is administered each day to thousands of patients worldwide. Although more than 160 years have passed since the first successful public demonstration of anaesthesia, a detailed understanding of the anaesthetic mechanism of action of ... ...

Abstract	General anaesthesia is administered each day to thousands of patients worldwide. Although more than 160 years have passed since the first successful public demonstration of anaesthesia, a detailed understanding of the anaesthetic mechanism of action of these drugs is still lacking. An important early observation was the Meyer-Overton correlation, which associated the potency of an anaesthetic with its lipid solubility. This work focuses attention on the lipid membrane as a likely location for anaesthetic action. With the advent of cellular electrophysiology and molecular biology techniques, tools to dissect the components of the lipid membrane have led, in recent years, to the widespread acceptance of proteins, namely receptors and ion channels, as more likely targets for the anaesthetic effect. Yet these accumulated data have not produced a comprehensive explanation for how these drugs produce central nervous system depression. In this review, we follow the story of anaesthesia mechanisms research from its historical roots to the intensely neurophysiological research regarding it today. We will also describe recent findings that identify specific neuroanatomical locations mediating the actions of some anaesthetic agents.
MeSH term(s)	Anesthesia, General/history ; Anesthesia, General/methods ; Anesthetics, General/chemistry ; Anesthetics, General/history ; Anesthetics, General/pharmacology ; Animals ; Central Nervous System/drug effects ; Central Nervous System/metabolism ; Drug Delivery Systems ; Electrophysiology ; History, 18th Century ; History, 19th Century ; History, 20th Century ; Humans ; Solubility
Chemical Substances	Anesthetics, General
Language	English
Publishing date	2009-05-12
Publishing country	England
Document type	Historical Article ; Journal Article ; Research Support, N.I.H., Extramural ; Review
ZDB-ID	605770-6
ISSN	1365-2346 ; 0265-0215
ISSN (online)	1365-2346
ISSN	0265-0215
DOI	10.1097/EJA.0b013e32832d6b0f
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Zs.A 1955: Show issues

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Article ; Online: Strategies for perioperative nutrition support in obese, diabetic and geriatric patients.

Lugli, Andrea Kopp / Wykes, Linda / Carli, Franco

Clinical nutrition (Edinburgh, Scotland)

2008 Volume 27, Issue 1, Page(s) 16–24

Abstract: Malnutrition in surgical patients is associated with higher rates of morbidity and mortality. Nutrition support for perioperative and critically ill patients is still considered as a challenge and remains a controversial topic. In the high-risk ... ...

Abstract	Malnutrition in surgical patients is associated with higher rates of morbidity and mortality. Nutrition support for perioperative and critically ill patients is still considered as a challenge and remains a controversial topic. In the high-risk populations of obese, diabetic and geriatric patients these concerns are even more emphasized. To adapt to their special needs, the management of nutrition support must carefully integrate data from current trials and guidelines. Clinical expertise not only in nutrition support but also in the illness or injury treated and the patient's profile is paramount. This review article discusses current strategies of perioperative nutrition support with special regard to obese, diabetic and geriatric patients.
MeSH term(s)	Adult ; Aged ; Aging ; Diabetes Mellitus/surgery ; Diabetes Mellitus/therapy ; Female ; Humans ; Male ; Nutritional Requirements ; Nutritional Support ; Obesity/complications ; Obesity/surgery ; Obesity/therapy ; Perioperative Care/methods ; Perioperative Care/standards ; Postoperative Complications/prevention & control ; Practice Guidelines as Topic
Language	English
Publishing date	2008-02
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Review
ZDB-ID	604812-2
ISSN	1532-1983 ; 0261-5614
ISSN (online)	1532-1983
ISSN	0261-5614
DOI	10.1016/j.clnu.2007.10.002
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Napoleon Bonaparte's gastric cancer: a clinicopathologic approach to staging, pathogenesis, and etiology.

Lugli, Alessandro / Zlobec, Inti / Singer, Gad / Kopp Lugli, Andrea / Terracciano, Luigi M / Genta, Robert M

Nature clinical practice. Gastroenterology & hepatology

2007 Volume 4, Issue 1, Page(s) 52–57

Abstract: Background: Numerous hypotheses on the cause of Napoleon Bonaparte's death have been proposed, including hereditary gastric cancer, arsenic poisoning, and inappropriate medical treatment. We aimed to determine the etiology and pathogenesis of Napoleon's ...

Abstract	Background: Numerous hypotheses on the cause of Napoleon Bonaparte's death have been proposed, including hereditary gastric cancer, arsenic poisoning, and inappropriate medical treatment. We aimed to determine the etiology and pathogenesis of Napoleon's illness by a comparison of historical information with current clinicopathologic knowledge. Investigations: Evaluation of Napoleon's clinical history, original autopsy reports, and of historical documents. The clinicopathologic data from 135 gastric cancer patients were used for comparison with the data available on Napoleon. Diagnosis: At least T3N1M0 (stage IIIA) gastric cancer. Napoleon's tumor extended from the cardia to the pylorus (>10 cm) without infiltration of adjacent structures, which provides strong evidence for at least stage T3. The N1 stage was determined by the presence of several enlarged and hardened regional (perigastric) lymph nodes, and the M0 stage by the absence of distant metastasis. Analysis of the available historical documents indicates that Napoleon's main risk factor might have been Helicobacter pylori infection rather than a familial predisposition. Conclusions: Our analysis suggests that Napoleon's illness was a sporadic gastric carcinoma of advanced stage. Patients with such tumors have a notoriously poor prognosis.
MeSH term(s)	Famous Persons ; France ; History, 19th Century ; Humans ; Neoplasm Staging ; Stomach Neoplasms/etiology ; Stomach Neoplasms/history ; Stomach Neoplasms/pathology
Language	English
Publishing date	2007-01
Publishing country	England
Document type	Biography ; Historical Article ; Journal Article
ZDB-ID	2177806-1
ISSN	1743-4386 ; 1743-4378
ISSN (online)	1743-4386
ISSN	1743-4378
DOI	10.1038/ncpgasthep0684
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Article: The importance of nutrition status assessment: the case of severe acute pancreatitis.

Lugli, Andrea Kopp / Carli, Franco / Wykes, Linda

Nutrition reviews

2007 Volume 65, Issue 7, Page(s) 329–334

Abstract: Severe acute pancreatitis is associated with high mortality. Adequate nutrition support improves clinical outcome. Nevertheless, several recent trials have focused primarily on the route of nutrition support and neglected the role of nutrition status ... ...

Abstract	Severe acute pancreatitis is associated with high mortality. Adequate nutrition support improves clinical outcome. Nevertheless, several recent trials have focused primarily on the route of nutrition support and neglected the role of nutrition status assessment in tailoring nutrition support to individual needs.
MeSH term(s)	Acute Disease ; Humans ; Nutrition Assessment ; Nutritional Requirements ; Nutritional Status ; Nutritional Support/methods ; Pancreatitis/therapy ; Pancreatitis, Acute Necrotizing/therapy ; Treatment Outcome
Language	English
Publishing date	2007-01-29
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Review
ZDB-ID	82067-2
ISSN	1753-4887 ; 0029-6643
ISSN (online)	1753-4887
ISSN	0029-6643
DOI	10.1111/j.1753-4887.2007.tb00310.x
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Article: Parenteral amino acids v. dextrose infusion: an anabolic strategy to minimise the catabolic response to surgery while maintaining normoglycaemia in diabetes mellitus type 2 patients

Lugli, Andrea Kopp / Donatelli, Francesco / Schricker, Thomas / Kindler, Christoph H / Wykes, Linda / Carli, Franco

British journal of nutrition. 2012 Feb. 28, v. 107, no. 4

2012

Abstract: Loss of body protein and hyperglycaemia represent typical features of the stress response to surgery and anaesthesia. This appears to be particularly pronounced in patients with diabetes mellitus type 2. The aim of the present study was to highlight the ... ...

Abstract	Loss of body protein and hyperglycaemia represent typical features of the stress response to surgery and anaesthesia. This appears to be particularly pronounced in patients with diabetes mellitus type 2. The aim of the present study was to highlight the greater benefit of amino acids (AA) as represented by positive protein balance and maintenance of blood glucose homoeostasis compared with dextrose (DEX) in diabetic patients after colorectal surgery. A total of thirteen patients underwent a 5 h stable isotope infusion study (2 h fasted, 3 h fed with an infusion of AA (n 6) or DEX (n 7)) on the second post-operative day. Glucose and protein kinetics were assessed by using the stable isotopes l-[1-13C]leucine and [6,6-2H2]glucose. The transition from fasted to fed state decreased endogenous glucose production (P < 0·001) in both groups, with a more profound effect in the DEX group (P = 0·031). In contrast, total glucose production was increased by the provision of DEX while being lowered by AA (P = 0·021). Feeding decreased protein oxidation (P = 0·009) and protein synthesis in the AA group, whereas DEX infusion did not affect oxidation and even decreased protein synthesis. Therefore, only AA shifted protein balance to a positive value, while patients in the DEX group remained in a catabolic state (P < 0·001). Parenteral nutritional support with AA rather than with DEX is an effective strategy to achieve a positive protein balance while maintaining normoglycaemia in diabetic patients after colorectal surgery.
Keywords	anesthesia ; blood glucose ; glucose ; hyperglycemia ; leucine ; noninsulin-dependent diabetes mellitus ; nutritional support ; oxidation ; patients ; protein bodies ; protein synthesis ; stable isotopes ; stress response ; surgery
Language	English
Dates of publication	2012-0228
Size	p. 573-580.
Publishing place	Cambridge University Press
Document type	Article
ZDB-ID	280396-3
ISSN	1475-2662 ; 0007-1145
ISSN (online)	1475-2662
ISSN	0007-1145
DOI	10.1017/S0007114511003126
Database	NAL-Catalogue (AGRICOLA)

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