The Japanese Critical Care Nutrition Guideline 2024

Journal of Intensive Care, Journal Year: 2025, Volume and Issue: 13(1)

Published: March 21, 2025

Abstract Nutrition therapy is important in the management of critically ill patients and continuously evolving as new evidence emerges. The Japanese Critical Care Guideline 2024 (JCCNG 2024) specific to Japan latest set clinical practice guidelines for nutrition critical care that was revised from JCCNG 2016 by Society Intensive Medicine. An English version these created based on contents original version. These were developed help health providers understand provide will improve outcomes children adults admitted intensive units or requiring care, regardless disease. intended users are all healthcare professionals involved including those who not familiar with therapy. consists 37 questions 24 recommendations, covering immunomodulation therapy, special conditions, children. accordance Grading Recommendations, Assessment, Development Evaluation (GRADE) system experts various related and/or care. All GRADE-based good statements (GPS), future research questions, answers background finalized consensus using modified Delphi method. Strong recommendations include early enteral (EN) within 48 h provision pre/synbiotics. Weak use a protocol, EN rather than parenteral nutrition, higher protein doses, post-pyloric EN, continuous omega-3 fatty acid-enriched probiotics, indirect calorimetry use. h, bolus energy/protein-dense formulas. A nutritional assessment recommended GPS both be disseminated through educational activities mainly Committee at scientific meetings seminars. Since studies treatment being reported worldwide, 4 6 years. We hope used research.

Language: Английский

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Challenges in identifying malnutrition in obesity; An overview of the state of the art and directions for future research

Nutrition Research Reviews, Journal Year: 2024, Volume and Issue: unknown, P. 1 - 10

Published: April 5, 2024

(Protein-energy) malnutrition in individuals living with obesity presents complex diagnostic challenges due to the distinctive physiological characteristics of obesity. This narrative review critically examines identification within population obesity, distinguishing from related conditions such as sarcopenic While noting some shared features, highlights key differences between these conditions. The also limitations current screening tools, which are not designed for These tools primarily rely on anthropometric measurements, neglecting (among others) nutrient intake assessment, hinders accurate detection. Additionally, this discusses existing criteria, including Global Leadership Initiative Malnutrition (GLIM) when applied Challenges include appropriate cut-off values phenotypic criteria (unintentional weight loss, low body mass index and muscle mass) aetiological reduced food inflammation Overall, emphasises need modified recognise assess leading improved clinical outcomes overall wellbeing.

Language: Английский

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Obesity as a Risk Factor for Hyperglycemia, Electrolyte Disturbances, and Acute Kidney Injury in the Emergency Department

Biomedicines, Journal Year: 2025, Volume and Issue: 13(2), P. 349 - 349

Published: Feb. 3, 2025

Background/Objectives: Obesity is a global health challenge linked to higher risk of metabolic and cardiovascular complications. This study investigates the role markers in predicting crises obese patients, focusing on prevalence clinical implications these markers. Methods: retrospective cohort included 433 patients presenting with at Emergency Department Timișoara Municipal Hospital between 2019 2024. Patients were classified into (n = 161) non-obese 272) groups, obesity further stratified four grades based body mass index (BMI). Cardiovascular markers, including NT-proBNP, troponin I, CRP, CK-MB, D-dimer, alongside parameters, analyzed. Results: Metabolic significantly more prevalent all emergencies: hyperglycemia (27.9% vs. 11.0%, p < 0.001), electrolyte imbalance (23.6% 9.2%, acute kidney injury (AKI) (12.4% 5.5%, 0.01). NT-proBNP levels independently predicted AKI (adjusted OR: 1.14 per 1000 pg/mL, 95% CI: 1.10–1.19, excellent discriminatory power (AUC: 0.88). Troponin I D-dimer imbalance, respectively, emphasizing cardiac stress pro-thrombotic states. Inflammatory such as CRP associated disturbances, supporting contribution systemic inflammation. Comorbidities, particularly heart failure atrial fibrillation, increased crises. Conclusions: suggest potential utility for early stratification patients. However, studies are needed validate their applicability establish standardized approaches integrating biomarkers routine practice, especially advanced grades.

Language: Английский

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The U-Shaped Curve of Energy Supply in the First 72 Hours of Critical Illness May Apply Only to Patients with Normal Body Mass Index: A Post-Hoc Analysis of a Prospective Observational Multicenter Study

Published: Jan. 1, 2025

Language: Английский

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The U-shaped Curve of Energy Supply in the First 72 Hours of Critical Illness May Apply Only to Patients with Normal Body Mass Index: A Post-hoc Analysis of a Prospective Observational Multicenter Study

Research Square (Research Square), Journal Year: 2025, Volume and Issue: unknown

Published: Feb. 14, 2025

Objective Nutritional support is crucial for critically ill patients. Body mass index (BMI) represents nutritional reserves to some extent, but it unclear whether the U-shaped relationship between caloric delivery during acute phase of critical illness and prognosis applies patients across all BMI categories. Methods This secondary analysis a multicenter prospective observational study, which included who were admitted intensive care unit (ICU) at least 3 days. The divided into two subgroups based on BMI: normal overweight (BMI > 25 kg/m²). We used univariate multivariate Cox regression analyses investigate calorie within first 72 hours ICU admission 28-day mortality, explore non-linear exists two. Results A total 361 in final analysis, including 272 subgroup 89 subgroup. In regression, there was significant (P = 0.003) association 0.002) daily delivered calories mortality. Increasing from 0 18 kcal/kg/day associated with decreasing mortality (hazard ratio (HR) 0.892, 95% CI 0.816–0.975), while increasing (HR 1.116, 1.016–1.227)); subgroup, higher also observed increase 1.124, 1.043–1.211, P 0.003), this disappeared (P 0.466). After adjustment, above results still hold up. Conclusions only those < kg/m², no such curve kg/m². Further research needed validate conclusion.

Language: Английский

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Nutrition Therapy in Critically Ill Patients with Obesity: An Observational Study

Nutrients, Journal Year: 2025, Volume and Issue: 17(4), P. 732 - 732

Published: Feb. 19, 2025

Critically ill patients with obesity (PwO) have anthropometric characteristics that can be associated different nutritional-metabolic requirements than other critically patients. However, recommendations regarding nutrition delivery in PwO are not clearly established among the published clinical practice guidelines (CPGs). Our main aim was to evaluate impact of energy and protein intake PwO. A multicenter (n = 37) prospective observational study performed. Adult requiring medical therapy (MNT) were included, (BMI ≥ 30 Kg·m-2) analyzed. Demographic data, comorbidities, nutritional status, average caloric administered first 14 days, including complications outcomes, recorded a database. Patients classified analyzed based on adequacy according CPG recommendations. 525 whom 150 (28.6%) had obesity. The considered inadequate (<11 Kcal/Kg/d) 30.7% 46) adequate (≥11 69.3% 104) cases. who received greater use parenteral route longer mean hospital stays (28.6 ± 26.1 vs. 39.3 28.1; p 0.01) but lower ICU mortality (32.6% 16.5%; 0.02). Protein (<0.8 g/Kg/d) 63.3% 95), insufficient (0.8-1.2 31.33% 47), (≥1.2 only 5.4% 8) delivery-compared delivery-had higher (25.5% 14.9%; Multivariate analysis revealed (hazard ratio [HR]: 0.398; 95% confidence interval [CI]: 0.180-0.882; 0.023) better survival, while (HR: 0.404; CI 95%: 0.171-0.955; 0.038) survival those delivery. frequently receive from MNT during an stay, which may short-term these It is emerging develop strategies optimize patients, improve their outcomes. NCT Registry: 03634943.

Language: Английский

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O MANEJO DO OBESO CRÍTICO EM UNIDADE DE TERAPIA INTENSIVA: REVISÃO DE LITERATURA

Revista Contemporânea, Journal Year: 2025, Volume and Issue: 5(2), P. e7593 - e7593

Published: Feb. 28, 2025

A obesidade, uma condição clínica em franca ascensão, apresenta desafios significativos no contexto da terapia intensiva, impactando tanto o manejo quanto os desfechos clínicos dos pacientes. Embora haja evidências de um possível "efeito protetor" obesidade alguns estudos, a realidade é caracterizada por série complexidades, como dificuldades na ventilação, suporte nutricional, nos aspectos farmacológicos e acessos vasculares. Isso ressalta necessidade urgente estratégias terapêuticas adaptadas essa população. Este estudo orientações práticas para melhorar atendimento aos pacientes obesos UTIs, com objetivo reduzir riscos otimizar qualidade do cuidado. Através análise abrangente literatura, trabalho propõe conjunto diretrizes baseadas evidências, visando não apenas cuidado, mas também aumentar segurança tratamento. pesquisa contínua se faz essencial avanço das clínicas desenvolvimento protocolos mais eficazes.

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Obesity Class and Severity of Metabolic Emergencies: A Single-Center Retrospective Five-Year Study

Healthcare, Journal Year: 2025, Volume and Issue: 13(6), P. 617 - 617

Published: March 12, 2025

Background/Objectives: This study aims to investigate the impact of obesity severity on prevalence and outcomes acute metabolic emergencies in emergency department (ED) setting, with a specific focus class stratification associated complications. Methods: retrospective, single-center analyzed data from 433 patients admitted ED Timisoara Municipal Emergency Hospital between January 2019 March 2024. Patients were classified according WHO grades (Class I: BMI 30.0–34.9 kg/m2, Class II: 35.0–39.9 III: ≥ 40.0 kg/m2). The emergencies, including hyperglycemic crises, kidney injury (AKI), severe electrolyte imbalances, compared across classes. Results: Obese (37.2%) exhibited significantly higher than non-obese individuals (p < 0.001). Hyperglycemia was present 27.9% obese vs. 11.0% AKI incidence nearly doubled (12.4% 5.5%, p = 0.01). Logistic regression identified III as an independent risk factor for (adjusted OR 3.2, 95% CI: 2.1–4.9, Conclusions: increases increasing class, emphasizing need obesity-specific settings. Routine monitoring markers early intervention strategies should be prioritized high-risk patients.

Language: Английский

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Increased fat accumulation may be associated with severe muscle wasting in critically ill patients: a prospective observational study

Scientific Reports, Journal Year: 2025, Volume and Issue: 15(1)

Published: April 3, 2025

Language: Английский

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The Lifestyle Medicine Eco-System: Deriving an Infrastructure to Defragment Healthcare

Lifestyle Medicine, Journal Year: 2025, Volume and Issue: unknown, P. 731 - 759

Published: Jan. 1, 2025

Language: Английский

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