Publications by authors named "Moran Hellerman-Itzhaki"
Background: There are no clinical or laboratory markers that can diagnose acute mesenteric ischemia (AMI) accurately. This study aimed to find differences in clinical and laboratory markers between arterial occlusive AMI and other acute abdominal diseases where AMI was initially suspected.
Methods: This was a post hoc study of an international prospective multicenter study where data on patients with suspected AMI were collected.
Article Synopsis
- Glycemic control during critical illness is crucial, with recommendations suggesting insulin therapy for glucose levels over 180 mg/dL, and possibly lowering it to 140 mg/dL for non-diabetics; this study explored the relationship between different glucose thresholds and 90-day mortality.
- A retrospective study analyzed data from 1,429 critical patients, revealing that diabetic individuals had higher mean glucose levels and mortality rates compared to non-diabetics.
- The findings indicated that non-diabetic patients with glucose levels exceeding 150 mg/dL were at a greater risk of mortality within 90 days, highlighting the importance of managing hyperglycemia in this group.
Article Synopsis
- Hypophosphatemia is a significant concern in critically ill patients receiving nutritional support, with over 59% of studied patients developing the condition.
- Factors such as age, BMI, pre-existing diabetes, and certain admission conditions were linked to a lower risk of developing hypophosphatemia, while trauma increased the risk.
- Interestingly, hypophosphatemia was found to be associated with a decreased risk of mortality, though factors like age and specific health scores remained critical indicators of ICU mortality.
Article Synopsis
- This study investigates how high flow nasal cannula (HFNC) oxygen therapy affects gastric reflux events and gastric residual volumes (GRV) in patients who were mechanically ventilated and then extubated.
- Using the smART+ Platform, researchers compared reflux events and GRV before and after patients switched to HFNC therapy.
- The results indicated that while GRV increased significantly on HFNC, the frequency of major reflux events showed no significant change between the two patient states.
Purpose Of Review: The use of noninvasive techniques [noninvasive ventilation (NIV) or high flow nasal cannula (HFNC) oxygen therapy] to support oxygenation and/or ventilation in patients with respiratory failure has become widespread, even more so since the coronavirus disease 2019 pandemic. The use of these modalities may impair the patient's ability to eat. "To breath or to eat" may become a dilemma.
View Article and Find Full Text PDFIntroduction: Persistent critical illness (PCI) is a syndrome in which the acute presenting problem has been stabilized, but the patient's clinical state does not allow ICU discharge. The burden associated with PCI is substantial. The most obvious marker of PCI is prolonged ICU length of stay (LOS), usually greater than 10 days.
View Article and Find Full Text PDFObjective: Patients with chronic intestinal failure use home parenteral nutrition infusion support. Non-compliance of home parenteral nutrition treatment is well documented, especially if clinical resources are remote. Objective delivery data from Infusion Pump reports have the potential to support treatment progress and planning.
View Article and Find Full Text PDFBackground: The aim of this multicentre prospective observational study was to identify the incidence, patient characteristics, diagnostic pathway, management and outcome of acute mesenteric ischaemia (AMI).
Methods: All adult patients with clinical suspicion of AMI admitted or transferred to 32 participating hospitals from 06.06.
Purpose: Nutritional therapy is essential to ICU care. Successful early enteral feeding is hindered by lack of protocols, gastrointestinal intolerance and feeding interruptions, leading to impaired nutritional intake. smART+ was developed as a nutrition management feeding platform controlling tube positioning, reflux, gastric pressure, and malnutrition.
View Article and Find Full Text PDFDirect oral anticoagulants (DOACs) have become the treatment of choice in thromboembolism prophylaxis for non-valvular atrial fibrillation, surpassing warfarin. While interruption of DOAC therapy for various reasons is a common eventuality, the body of data from real-world clinical practice on the implications of such interruptions in different clinical settings is still limited. We assessed complication rates from DOAC (apixaban, rivaroxaban, dabigatran) interruption compared with warfarin in hospitalized patients.
View Article and Find Full Text PDFThe use of high flow nasal cannula (HFNC) oxygen therapy is common in patients with respiratory distress to prevent intubation or ensure successful extubation. However, these critical patients also need medical nutritional support and practitioners are often reluctant to prescribe oral or enteral feeding, leading to a decrease in energy and protein intake. Vomiting and aspiration are the major concerns.
View Article and Find Full Text PDFArticle Synopsis
- Parenteral nutrition has greatly improved, with safer and more accessible "all-in-one" admixtures that reduce infection risks.
- Recent studies highlight the advantages of parenteral nutrition over enteral nutrition, supported by advanced safety measures like indirect calorimetry.
- Advances in glycemic control and better formulations of lipids and proteins contribute to parenteral nutrition becoming a safer choice compared to enteral nutrition.