Publications by authors named "R W BURSLEM"

Hypovitaminosis C is prevalent in critically ill patients. Continuous renal replacement therapy (CRRT) clears vitamin C, increasing the risk for vitamin C deficiency. However, recommendations for vitamin C supplementation in critically ill patients receiving CRRT vary widely, from 250 mg/day to 12 g/day.

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Article Synopsis
  • Early reports indicate that predictive equations often underestimate the energy needs of critically ill COVID-19 patients, which raises concerns about underfeeding and malnutrition.
  • Indirect calorimetry (IC) is the most accurate way to measure energy expenditure, but it's not available in many hospitals.
  • The review of five studies shows that critically ill COVID-19 patients often have higher energy demands than predicted, especially in nonobese individuals, while the metabolic response in obese patients is uncertain.
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Patients discharged from an intensive care unit (ICU) are frequently malnourished and experience ongoing inadequate nutrition intake because of a variety of barriers, which may lead to further declines in nutrition status. The coronavirus disease 2019 (COVID-19) pandemic has drawn increased awareness to this vulnerable patient population and the importance of nutrition rehabilitation to promote optimal recovery from acute illness. Despite this, there are no formal guidelines addressing medical nutrition therapy during the post-ICU recovery phase.

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Hyperglycemia is associated with increased morbidity and mortality. Low-carbohydrate, high-fat (LCHF) enteral formulas are marketed to improve glycemic control; however, given the multifactorial mechanisms contributing to hyperglycemia in patients who are critically ill, the effect that LCHF formulas may have on improving glycemic control in this patient population is unclear. Current guidelines for the use of LCHF formulas among patients who are critically ill are limited by a lack of evidence.

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