المؤلفون: Otto, Madeleine, Burrell, Aidan J. C., Neto, Ary S., Alliegro, Patricia V., Trapani, Tony, Cheng, Allen, Udy, Andrew A.

المصدر: Internal Medicine Journal; Mar2023, Vol. 53 Issue 3, p330-338, 9p

مصطلحات موضوعية: EVALUATION of medical care, INTENSIVE care units, LENGTH of stay in hospitals, COVID-19, IMMUNIZATION, CRITICALLY ill, COVID-19 vaccines, PATIENTS, TREATMENT duration, HOSPITAL mortality, ARTIFICIAL respiration, VACCINATION status, COVID-19 pandemic, LONGITUDINAL method

مصطلحات جغرافية: AUSTRALIA

مستخلص: Background: Vaccination has been shown to be highly effective in preventing death and severe disease from severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infection. Currently, few studies have directly compared vaccinated and unvaccinated patients with severe COVID‐19 in the intensive care unit (ICU). Aims: To compare the clinical characteristics and outcomes of vaccine recipients and unvaccinated patients with SARS‐CoV‐2 infection admitted to the ICU in a nationwide setting. Methods: Data were extracted from the Short PeRiod IncideNce sTudy of Severe Acute Respiratory Infection Australia, in 57 ICU during Delta and Omicron predominant periods of the COVID‐19 pandemic. The primary outcome was inhospital mortality. Secondary outcomes included duration of mechanical ventilation, ICU length of stay, hospital length of stay and ICU mortality. Results: There were 2970 patients admitted to ICU across participating sites from 26 June 2021 to 8 February 2022; 1134 (38.2%) patients were vaccine recipients, and 1836 (61.8%) patients were unvaccinated. Vaccine recipients were older, more comorbid and less likely to require organ support. Unadjusted inhospital mortality was greater in the vaccinated cohort. After adjusting for age, gender and comorbid status, no statistically significant association between inhospital or ICU mortality, and vaccination status, was apparent. Conclusion: We found COVID‐19 infection can cause severe disease and death in vaccine recipients, though comorbid status and older age were significant contributors to mortality. Organ support requirements and the number of deaths were highest in the unvaccinated cohort. [ABSTRACT FROM AUTHOR]

: Copyright of Internal Medicine Journal is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

المؤلفون: Fetterplace, Kate, Holt, Darcy, Udy, Andrew, Ridley, Emma

المصدر: Internal Medicine Journal; Apr2020, Vol. 50 Issue 4, p403-411, 9p, 5 Charts

مصطلحات موضوعية: MALNUTRITION, AMINO acids, ATTITUDE (Psychology), CARBOHYDRATES, DIET therapy, ELECTROLYTES, LIPIDS, MEDICAL personnel, PARENTERAL feeding, MICRONUTRIENTS, ACUTE diseases, DISEASE complications, ADULTS

مستخلص: Parenteral nutrition (PN) is the administration of a nutritional formula by means other than the gastrointestinal (GI) tract. The formula may include carbohydrates, amino acids, lipids, electrolytes and/or micronutrients. The primary indications for PN are intestinal failure (IF) due to an underlying disease or treatment, or if the GI tract is not accessible. The goals of PN should be to ensure adequate nutrition provision to meet patient needs while minimising the risk of complications. PN should be commenced in <48 h in patients who are malnourished or otherwise within 7 days if oral or enteral nutrition is not possible or insufficient. There has been evolution in PN techniques and technology, and the risks associated with PN administration have been reduced. Monitoring clinical, laboratory and metabolic parameters in acute IF is essential to provision of safe nutritional support. When provided to appropriate patients with IF in a timely and considered manner, PN has been shown to be safe, improve nutritional parameters and reduce complications associated with malnutrition. This review aims to provide clinicians a practical guide for the management of PN in adult patients within the acute setting. [ABSTRACT FROM AUTHOR]

: Copyright of Internal Medicine Journal is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)