Marlene Wewalka

• University of Vienna

Objective Resting energy expenditure (REE) declines with age in healthy subjects, independent of the age-related decrease in lean body mass. Our study evaluates whether this holds true in critically ill medical patients. Moreover, we assessed how measured REE compares to energy requirements calculated by prediction equations in different age groups...

Zusammenfassung Das Refeeding-Syndrom stellt bei malnutrierten Personen eine potenziell lebensbedrohliche Komplikation einer wiederbegonnenen Nährstoffzufuhr dar. Es ist durch Störungen der Elektrolyt- und Flüssigkeitshomöostase sowie durch Vitaminmangelzustände charakterisiert und kann sowohl durch eine orale, enterale und auch parenterale Energie...

Objectives: New-onset diabetes frequently resolves after pancreaticoduodenectomy (PD). Glucagon-like peptide-1 (GLP-1) conceivably is involved as its release is enhanced by rapid gastric emptying and distal bowel exposure to nutrients. We aimed at studying factors associated with GLP-1 release after PD. Methods: Fifteen PD subjects with distal g...

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Background/Objectives Hyperglycemia is common in critically ill patients and associated with increased mortality. It has been suggested that different nutrition formulas may beneficially influence glucose levels in surgical intensive care patients. In this prospective randomized clinical cohort study we investigated glucose homeostasis in response...

Purpose: To compare effects of Roux-en-Y gastric bypass versus a multi-disciplinary, group-based medical diabetes and weight management program on physical fitness and behaviors. Methods: Physical behavior and fitness was assessed in participants of the study Surgery or Lifestyle With Intensive Medical Management in the Treatment of Type 2 Diabe...

Background: Acute kidney injury (AKI) is a life threatening condition. Despite intensive care treatment the occurrence cannot be predicted as very little indicators exist for direct measurement when tubular epithelial cell injury takes place. We therefore searched for novel peptide indicators expressed at intracellular level at the proximal kidney...

Context: Roux-en-Y gastric bypass (RYGB) leads to high-turnover bone loss, but little is known about skeletal effects of laparoscopic adjustable gastric banding (LAGB) or mechanisms underlying bone loss after bariatric surgery. Objective: To evaluate effects of RYGB and LAGB on fasting and postprandial indices of bone remodeling. Design and set...

Recommendations for surgical compared with lifestyle and pharmacologic based approaches for type 2 diabetes (T2D) management remain controversial. Comparing laparoscopic adjustable gastric band (LAGB) to an intensive diabetes medical and weight management (IMWM) program for T2D. Prospective, randomized clinical trial. Two Harvard Medical School aff...

Mortality on medical intensive care units (ICU) is approximately 25%. It is associated with age, severity of illness, and comorbidities. Preexisting depression is a risk factor for worse outcome in many diseases. The impact of depression on outcome of ICU patients has not been investigated. We assessed a possible association between mortality and p...

Importance Emerging data support bariatric surgery as a therapeutic strategy for management of type 2 diabetes mellitus.Objective To test the feasibility of methods to conduct a larger multisite trial to determine the long-term effect of Roux-en-Y gastric bypass (RYGB) surgery compared with an intensive diabetes medical and weight management (Wei...

Context: Bile acids (BAs) are newly recognized signaling molecules in glucose and energy homeostasis. Differences in BA profiles with type 2 diabetes mellitus (T2D) remain incompletely understood. Objective: The objective of the study was to assess serum BA composition in impaired glucose-tolerant, T2D, and normal glucose-tolerant persons and to...

Background/objectives: Women and men differ in substrate and energy metabolism. Such differences may affect energy requirements during the acute phase of critical illness. Subjects/methods: Data of 155 critically ill medical patients were reviewed for this study. Indirect calorimetry in each patient was performed within the first 72 h following...

Objective: This study aims to investigate the relationship between gastric emptying, postprandial GLP-1 and insulin sensitivity after pancreaticoduodenectomy (PD). Background: Abnormal glucose regulation is highly prevalent in patients with pancreatic neoplasm and resolves in some after PD, the cause of which is unclear. The procedure is carried...

Purpose: Increased arterial ammonia levels are associated with high mortality in patients with acute liver failure (ALF). Data on the prognostic impact of arterial ammonia is lacking in hypoxic hepatitis (HH) and scarce in critically ill patients with cirrhosis. Methods: The patient cohort comprised 72 patients with HH, 43 patients with ALF, 100...

Background: Acute respiratory distress syndrome is characterized by damage to the lung caused by various insults, including ventilation itself, and tidal hyperinflation can lead to ventilator induced lung injury (VILI). We investigated the effects of a low tidal volume (V(T)) strategy (V(T) ≈ 3 ml/kg/predicted body weight [PBW]) using pumpless ext...

Trauma patients who receive fat-based parenteral nutrition (PEN) achieve better glucose control compared with those fed with glucose-based PEN [1,2]. Therefore, we determined whether fat-based enteral nutrition (EN) has the same benefit on glucose control and exogenous insulin demand in medical intensive care patients compared with glucose-based EN...

Increased levels of arterial ammonia in patients with acute liver failure (ALF) are associated with increased mortality. There is a lack of data for prognostic impact of arterial ammonia in patients with acute-on-chronic liver failure (AoCLF) and hypoxic hepatitis (HH). We evaluated arterial ammonia levels and their prognostic relevance in patients...

Critical illness leads to increased endogenous production of carbon monoxide (CO) due to the induction of the stress-response enzyme, heme oxygenase-1 (HO-1). There is evidence for the cytoprotective and anti-inflammatory effects of CO based on animal studies. In critically ill patients after cardiothoracic surgery, low minimum and high maximum car...

Khat is a drug widely used in the Horn of Africa and the Arabian Peninsula. Khat leaves contain, among other substances, the psychoactive alkaloid cathinone, which induce central nervous system stimulation leading to euphoria, hyperactivity, restlessness, and insomnia. However, it also could cause psychological adverse effects such as lethargy, sle...

Hepatic encephalopathy is a potentially reversible complication in patients suffering from liver cirrhosis. Several therapeutic strategies are available. One of the most important aspects is the medical interference of the gut flora by non-absorbable disaccharides and antibiotics such as the oral non-systemic antibiotic rifaximin. Taking into accou...

OBJECTIVE To evaluate the impact of real-time continuous glucose monitoring (CGM) on glycemic control and risk of hypoglycemia in critically ill patients. RESEARCH DESIGN AND METHODS A total 124 patients receiving mechanical ventilation were randomly assigned to the real-time CGM group (n = 63; glucose values given every 5 min) or to the control g...

To compare the success rate of correct jejunal placement of a new self-advancing jejunal tube with the gold standard, the endoscopic guided technique, in a comparative intensive care unit (ICU) patient population. Prospective, randomized study. Two medical ICUs at a university hospital. Forty-two mechanically ventilated patients with persisting int...