Publications by authors named "Julia L M Bels"
Missing data and long-term outcomes from nutrition research in the critically ill.
Curr Opin Clin Nutr Metab Care
December 2024
Article Synopsis
- The review highlights the growing importance of using functional outcomes in critical care nutrition research, emphasizing the challenges posed by missing data.
- It points out that ignoring missing data can lead to biased results and suggests proactively estimating the extent and reasons for this missingness.
- The adoption of modern statistical techniques, like multiple imputation and mixed regression models, can enhance the reliability and applicability of research findings in clinical settings.
Objectives: Recent multicenter trials suggest that higher protein delivery may result in worse outcomes in critically ill patients, but uncertainty remains. An updated Bayesian meta-analysis of recent evidence was conducted to estimate the probabilities of beneficial and harmful treatment effects.
Data Sources: An updated systematic search was performed in three databases until September 4, 2024.
Article Synopsis
- Older adults (ages 73 on average) tried heat therapy by using an infrared sauna for 8 weeks to see if it helps their muscles stay strong and healthy.
- The study found that this heat treatment increased the number of tiny blood vessels in their muscles, which is good, but it didn’t make their muscles grow bigger or stronger.
- Overall, while the heat treatment helped the muscles' blood supply, it didn’t improve muscle strength or growth in the older adults.
Article Synopsis
- The PRECISe trial aimed to determine if providing critically ill patients on mechanical ventilation with higher protein intake (2.0 g/kg per day) would enhance their quality of life and functional recovery compared to standard protein intake (1.3 g/kg per day).
- This double-blinded, multicentre trial included patients from 10 hospitals across the Netherlands and Belgium, focusing on those expected to need invasive ventilation for at least three days.
- Key aspects of the study included random assignment to either the standard or high-protein group, with blinding of all involved personnel, and tracking the primary outcome through health utility scores at specified intervals (30, 90, and 180 days post-randomization).
Article Synopsis
- The PRECISe trial is a randomized controlled study that investigates whether higher enteral protein intake improves recovery in critically ill adults on mechanical ventilation, focusing on primary and secondary health outcomes using a Bayesian analysis approach.
- The primary outcome evaluates quality of life through the EQ-5D-5L score, along with various secondary outcomes, including walking test performance, handgrip strength, and mortality rates, assessed throughout the study period.
- The study aims to provide insights into the effects of high protein diets in critically ill patients by applying both weakly informative and more specific priors in its analysis, ensuring robust evaluation of the results.
Background: During Intensive Care Unit (ICU) admission, patients demonstrate up to 15% muscle loss per week, contributing to neuromuscular weakness, complicating recovery and delaying return to daily life. Biomarkers for muscle loss could aid in early detection of patients at risk and help guide resources to mitigate muscle loss, e.g.
View Article and Find Full Text PDFPurpose Of Review: Gastrointestinal (GI) dysfunction is common among critically ill patients and is associated with poor outcomes. In particular, nutrient delivery can be impaired in patients with GI dysfunction and pose a significant challenge to clinicians in daily clinical practice. This review aims to summarize the impact of GI dysfunction on nutrition therapy during critical illness and provide an update on recent advances in nutritional strategies during gastrointestinal dysfunction.
View Article and Find Full Text PDFBackground: Critically ill patients are subject to severe skeletal muscle wasting during intensive care unit (ICU) stay, resulting in impaired short- and long-term functional outcomes and health-related quality of life. Increased protein provision may improve functional outcomes in ICU patients by attenuating skeletal muscle breakdown. Supporting evidence is limited however and results in great variety in recommended protein targets.
View Article and Find Full Text PDFProtein supplementation in critical illness: why, when and how?
Curr Opin Clin Nutr Metab Care
March 2023
Purpose Of Review: In critically ill patients, optimal protein provision remains a challenge given the wide range in recommended protein delivery in international guidelines and the lack of robust, high quality evidence. As patients are confronted with poor functional outcomes after admission, often attributed to muscle wasting and persisting for multiple years, there is a pressing need for optimal nutritional strategies in the ICU, particularly including protein. This review will discuss the recent literature with regard to purpose, timing and mode of protein delivery.
View Article and Find Full Text PDFBackground: The majority of patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection are admitted to the Intensive Care Unit (ICU) for mechanical ventilation. The role of multi-organ failure during ICU admission as driver for outcome remains to be investigated yet.
Design And Setting: Prospective cohort of mechanically ventilated critically ill with SARS-CoV-2 infection.
Introduction: The course of the disease in SARS-CoV-2 infection in mechanically ventilated patients is unknown. To unravel the clinical heterogeneity of the SARS-CoV-2 infection in these patients, we designed the prospective observational Maastricht Intensive Care COVID cohort (MaastrICCht). We incorporated serial measurements that harbour aetiological, diagnostic and predictive information.
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