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  1. Article: Manual proning of a morbidly obese COVID-19 patient: A case report.

    Salciute-Simene, Erika

    Australian critical care : official journal of the Confederation of Australian Critical Care Nurses

    2021  Volume 35, Issue 1, Page(s) 102–104

    Abstract: Continuously rising numbers of obese critical care patients pose many challenges to the healthcare workers, especially during the COVID-19 pandemic. Among them, proning may be one of the most labour-intensive tasks. Prone positioning is performed ... ...

    Abstract Continuously rising numbers of obese critical care patients pose many challenges to the healthcare workers, especially during the COVID-19 pandemic. Among them, proning may be one of the most labour-intensive tasks. Prone positioning is performed manually in hospitals where mechanical lifting aids are unavailable; however, the exact method of manual proning is not explicitly described in the literature. Here, we present a case of a morbidly obese patient with COVID-19 pneumonitis in the intensive care unit with a step-by-step guide of the manual proning technique. Our approach is simple and feasible, as only readily available tools, such as bed sheets and friction-reducing sheets, are used.
    MeSH term(s) COVID-19 ; Humans ; Obesity, Morbid/complications ; Pandemics ; Patient Positioning ; Prone Position ; SARS-CoV-2
    Language English
    Publishing date 2021-10-22
    Publishing country Australia
    Document type Case Reports ; Journal Article ; Review
    ZDB-ID 1159493-7
    ISSN 1878-1721 ; 1036-7314
    ISSN (online) 1878-1721
    ISSN 1036-7314
    DOI 10.1016/j.aucc.2021.10.002
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Impact of enteral nutrition interruptions on underfeeding in intensive care unit

    Salciute-Simene, Erika / Stasiunaitis, Raimundas / Ambrasas, Eduardas / Tutkus, Jonas / Milkevicius, Ignas / Sostakaite, Gintare / Klimasauskas, Andrius / Kekstas, Gintautas

    Clinical nutrition. 2020 Aug. 15,

    2020  

    Abstract: Malnutrition leads to poor outcomes for critically ill patients; however, underfeeding remains a prevalent issue in the intensive care unit (ICU). One of the reasons for underfeeding is enteral nutrition interruption (ENI). Our aim was to investigate the ...

    Abstract Malnutrition leads to poor outcomes for critically ill patients; however, underfeeding remains a prevalent issue in the intensive care unit (ICU). One of the reasons for underfeeding is enteral nutrition interruption (ENI). Our aim was to investigate the causes, frequency, and duration of ENIs and their association with underfeeding in critical care.This was a prospective observational study conducted at the Vilnius University Hospital Santaros Clinics, Lithuania, between December 2017 and February 2018. It included adult medical and surgical ICU patients who received enteral nutrition (EN). Data on ENIs and caloric, as well as protein intake were collected during the entire ICU stay. Nutritional goals were assessed using indirect calorimetry, where available.In total 73 patients were enrolled in the study. Data from 1023 trial days and 131 ENI episodes were collected; 68% of the patients experienced ENI during the ICU stay, and EN was interrupted during 35% of the trial days. The main reasons for ENIs were haemodynamic instability (20%), high gastric residual volume (GRV) (17%), tracheostomy (16%), or other surgical interventions (16%). The median duration of ENI was 12 [6–24] h, and the longest ENIs were due to patient-related factors (22 [12–42] h). The rate of underfeeding was 54% vs. 15% in the trial days with and without ENI (p < 0.001), respectively. Feeding goal was achieved in 26% of the days with ENI vs. 45% of days without ENI (p < 0.001). The daily average caloric provision was 77 ± 36% vs. 106 ± 29% in the trial days with and without ENI (p < 0.001) and protein provision was 0.96 ± 0.5 vs. 1.3 ± 0.5 g/kg, respectively (p < 0.001).The episodes of ENI in critically ill patients are frequent and prolonged, often leading to underfeeding. Similar observations have been reported by other studies; however, the causes and duration of ENI vary, mainly because of different practices worldwide. Hence, safe and internationally recognised reduced-fasting guidelines and protocols for critically ill patients are needed in order to minimise ENI-related underfeeding and malnutrition.
    Keywords adults ; calorimetry ; clinical nutrition ; duration ; enteral feeding ; frequency ; hemodynamics ; hospitals ; malnutrition ; objectives ; observational studies ; patients ; protein intake ; protocols ; restricted feeding ; volume ; Lithuania
    Language English
    Dates of publication 2020-0815
    Publishing place Elsevier Ltd
    Document type Article
    Note NAL-light ; Pre-press version
    ZDB-ID 604812-2
    ISSN 1532-1983 ; 0261-5614
    ISSN (online) 1532-1983
    ISSN 0261-5614
    DOI 10.1016/j.clnu.2020.08.014
    Database NAL-Catalogue (AGRICOLA)

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  3. Article ; Online: Impact of enteral nutrition interruptions on underfeeding in intensive care unit.

    Salciute-Simene, Erika / Stasiunaitis, Raimundas / Ambrasas, Eduardas / Tutkus, Jonas / Milkevicius, Ignas / Sostakaite, Gintare / Klimasauskas, Andrius / Kekstas, Gintautas

    Clinical nutrition (Edinburgh, Scotland)

    2020  Volume 40, Issue 3, Page(s) 1310–1317

    Abstract: Background & aims: Malnutrition leads to poor outcomes for critically ill patients; however, underfeeding remains a prevalent issue in the intensive care unit (ICU). One of the reasons for underfeeding is enteral nutrition interruption (ENI). Our aim ... ...

    Abstract Background & aims: Malnutrition leads to poor outcomes for critically ill patients; however, underfeeding remains a prevalent issue in the intensive care unit (ICU). One of the reasons for underfeeding is enteral nutrition interruption (ENI). Our aim was to investigate the causes, frequency, and duration of ENIs and their association with underfeeding in critical care.
    Methods: This was a prospective observational study conducted at the Vilnius University Hospital Santaros Clinics, Lithuania, between December 2017 and February 2018. It included adult medical and surgical ICU patients who received enteral nutrition (EN). Data on ENIs and caloric, as well as protein intake were collected during the entire ICU stay. Nutritional goals were assessed using indirect calorimetry, where available.
    Results: In total 73 patients were enrolled in the study. Data from 1023 trial days and 131 ENI episodes were collected; 68% of the patients experienced ENI during the ICU stay, and EN was interrupted during 35% of the trial days. The main reasons for ENIs were haemodynamic instability (20%), high gastric residual volume (GRV) (17%), tracheostomy (16%), or other surgical interventions (16%). The median duration of ENI was 12 [6-24] h, and the longest ENIs were due to patient-related factors (22 [12-42] h). The rate of underfeeding was 54% vs. 15% in the trial days with and without ENI (p < 0.001), respectively. Feeding goal was achieved in 26% of the days with ENI vs. 45% of days without ENI (p < 0.001). The daily average caloric provision was 77 ± 36% vs. 106 ± 29% in the trial days with and without ENI (p < 0.001) and protein provision was 0.96 ± 0.5 vs. 1.3 ± 0.5 g/kg, respectively (p < 0.001).
    Conclusions: The episodes of ENI in critically ill patients are frequent and prolonged, often leading to underfeeding. Similar observations have been reported by other studies; however, the causes and duration of ENI vary, mainly because of different practices worldwide. Hence, safe and internationally recognised reduced-fasting guidelines and protocols for critically ill patients are needed in order to minimise ENI-related underfeeding and malnutrition.
    MeSH term(s) Adult ; Aged ; Aged, 80 and over ; Critical Care/methods ; Critical Illness/therapy ; Energy Intake/physiology ; Enteral Nutrition/methods ; Female ; Humans ; Intensive Care Units ; Lithuania ; Male ; Malnutrition/etiology ; Middle Aged ; Nutritional Requirements ; Prospective Studies
    Language English
    Publishing date 2020-08-27
    Publishing country England
    Document type Journal Article ; Observational Study
    ZDB-ID 604812-2
    ISSN 1532-1983 ; 0261-5614
    ISSN (online) 1532-1983
    ISSN 0261-5614
    DOI 10.1016/j.clnu.2020.08.014
    Database MEDical Literature Analysis and Retrieval System OnLINE

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