Complement-mediated hemolytic uremic syndrome associated with postpartum hemorrhage: case series and systematic review of individual participant data.

Background: Postpartum hemorrhage is considered a risk factor for pregnancy-associated complement-mediated hemolytic uremic syndrome (CM-HUS; previously known as atypical hemolytic uremic syndrome) but has not been systematically studied.

Objectives: To systematically examine the role of postpartum hemorrhage in precipitating CM-HUS and to describe the characteristics of postpartum hemorrhage-associated CM-HUS, its prognosis and recommended management.

Methods: A systematic review of individual participant data from case series and reports in addition to a case series from our institution.

Substrate utilization of carbohydrates, fat, and protein in the late acute phase of critically ill surgical patients: A retrospective longitudinal study.

Background And Aims: Tailoring nutrition to measured energy expenditure (EE) and provision of adequate protein amounts, is considered gold standard for critically ill patients. There are currently no recommendations to measure specific substrate utilization or to adapt nutrition accordingly.

Methods: In this retrospective longitudinal study, we analyzed results of 316 simultaneous measurements of indirect calorimetry (IC) and urinary urea nitrogen (UUN) in 191 mechanically ventilated, critically ill patients, admitted to the surgical intensive care unit (SICU) in a tertiary medical center.

The post ICU trajectory: Post acute and post ICU nutritional care.

ICU survivors are growing but a persistent physical and mental disability may occur. The patients discharged from ICU are frequently malnourished and their medical nutritional support is impaired by oral intake limitation due to respiratory support such as non invasive ventilation or high flow nasal cannula oxygen therapy, dysphagia and difficulties to determine energy and protein targets. ICU acquired weakness must be recognized and could be minimized by better energy intake determined by indirect calorimetry, optimal protein intake and physical activity.

How to interpret and apply the results of indirect calorimetry studies: A case-based tutorial.

Evidence is growing that the individual adjustment of energy targets guided by indirect calorimetry (IC) can improve outcome. With the development of a new generation of devices that are easier to use and rapid, it appears important to share knowledge and expertise that may be used to individualize nutrition care. Despite the focus of this tutorial being on one contemporary device, the principles of IC apply across existing devices and can assist tailoring the nutrition prescription and in assessing response to nutrition therapy.

Nutrition therapy in non-intubated patients with acute respiratory failure: a narrative review.

Objectives: Non-invasive ventilation use is increasing in patients from acute respiratory failure. However, nutritional assessment and medical nutritional therapy are often missed and patients may be frequently underfed. This review evaluates the tools for nutritional screening and assessment, assesses the use of medical nutritional therapy in various techniques of non invasive ventilation and suggested tools to improve this therapy.

Presentation, management, and outcomes of older compared to younger adults with hospital-acquired bloodstream infections in the intensive care unit: a multicenter cohort study.

Purpose: Older adults admitted to the intensive care unit (ICU) usually have fair baseline functional capacity, yet their age and frailty may compromise their management. We compared the characteristics and management of older (≥ 75 years) versus younger adults hospitalized in ICU with hospital-acquired bloodstream infection (HA-BSI).

Methods: Nested cohort study within the EUROBACT-2 database, a multinational prospective cohort study including adults (≥ 18 years) hospitalized in the ICU during 2019-2021.

Nutrition during noninvasive respiratory support.

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.

Urea to creatinine ratio as a predictor of persistent critical illness.

Introduction: 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.

A historical cohort study on predictors for successful weaning from prolonged mechanical ventilation and up to 3-year survival follow-up in a rehabilitation center.

Background: We followed prolonged mechanically ventilated (PMV) patients for weaning attempts and explored factors associated with successful weaning and long-term survival.

Methods: This historical cohort study included all adult PMV patients admitted to a single rehabilitation hospital during 2015-2018 and followed for survival according to weaning success up to 3 years or the end of 2021.

Results: The study included 223 PMV patients.

Global availability of parenteral nutrition: Pre- and post-COVID-19 pandemic surveys.

Objective: Parenteral nutrition represents a therapeutic option for patients with type 3 intestinal failure. If used exclusively, parenteral nutrition has to be complete to provide all essential nutrients. The aim was to assess the availability of parenteral nutrition in all parts of the world, to better comprehend the global situation, and to prepare an action plan to increase access to parenteral nutrition.

Insights from home parenteral nutrition infusion data.

Objective: 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.

Predicting invasive mechanical ventilation in COVID 19 patients: A validation study.

Introduction: The decision to intubate and ventilate a patient is mainly clinical. Both delaying intubation (when needed) and unnecessarily invasively ventilating (when it can be avoided) are harmful. We recently developed an algorithm predicting respiratory failure and invasive mechanical ventilation in COVID-19 patients.

Implementation of the ESPEN guideline on clinical nutrition in the intensive care unit (ICU): It is time to move forward!: A position paper from the 'nutrition in the ICU' ESPEN special interest group.

Nutritional assessment and provision of nutritional therapy are a core part of intensive care unit (ICU) patient treatment. The ESPEN guideline on clinical nutrition in the ICU was published in 2019. However, uncertainty and difficulties remain regarding its full implementation in daily practice.

The future of artificial intelligence in clinical nutrition.

Purpose Of Review: Artificial intelligence has reached the clinical nutrition field. To perform personalized medicine, numerous tools can be used. In this review, we describe how the physician can utilize the growing healthcare databases to develop deep learning and machine learning algorithms, thus helping to improve screening, assessment, prediction of clinical events and outcomes related to clinical nutrition.