التفاصيل البيبلوغرافية
| العنوان: |
Protein and energy delivery in critically ill adult patients and the impact on nutritional and patient-centred outcomes |
| المؤلفون: |
Fetterplace, Kate Emily |
| سنة النشر: |
2020 |
| المجموعة: |
The University of Melbourne: Digital Repository |
| مصطلحات موضوعية: |
Nutrition Support, Enteral Nutrition, Nutrition assessment, Protein, Critically ill, Critical care, Patient Centred Outcomes, Physical Function, Muscle Mass, Muscle Strength |
| الوصف: |
© 2020 Kate Emily Fetterplace ; Adult patients who survive critical illness are known to be at risk of several adverse health consequences, including substantial muscle loss, impaired muscle function and reduced quality of life. While nutrition interventions for critically ill patients may attenuate muscle loss, this therapeutic approach remains unproven. Evidence published by others over the period of this PhD program challenged the existing orthodoxy that greater overall calorie provision during the acute phase of critical illness improves overall patient outcomes. Accordingly, the PhD candidate specifically investigated the relationship between protein provision in critical illness and patient-centred outcomes. This thesis comprises several discrete but aligned studies, including a systematic and narrative review of the literature, three observational studies, and a pilot parallel group randomised clinical trial (RCT). The systematic review and meta-analysis established that current practice guidelines recommending the amount of enteral protein are not based on strong evidence. Moreover, there is a lack of high-quality data about the impact of protein provision on functional outcomes that are important to patients. The narrative review evaluated the methodologies and outcomes used to quantify the effect of nutrition therapy in the critically ill. While patient centred and less direct surrogate clinical outcomes are increasingly being used in the nutrition literature, there remains substantial variation in the tools used and the outcomes selected. In a prospective observational study of patients surviving an intensive care unit (ICU) admission following serious trauma, it was identified that many of the outcomes that would be desirable to measure were not feasible after ICU discharge in this patient cohort. In contrast, it was feasible to implement these methodologies in ICU in a separate cohort of critically ill patients, and cumulative nutrition deficits in the latter study were associated with inferior ... |
| نوع الوثيقة: |
doctoral or postdoctoral thesis |
| اللغة: |
unknown |
| العلاقة: |
http://hdl.handle.net/11343/243115Test |
| الإتاحة: |
http://hdl.handle.net/11343/243115Test |
| حقوق: |
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| رقم الانضمام: |
edsbas.E1E6A19E |
| قاعدة البيانات: |
BASE |
