- Tamas Szakmany added an answer:3Is there any special recommendation between parenteral nutrition and using proton pump inhibitors( PPI) or H2- blocker?
in case of using parenteral nutrition (central or peripheral) is there any contraindication or any recommendation of using proton pump inhibitors( PPI) or H2- blocker in ICU patients??
This is a topic which came under scrutiny recently. The most recent meta-analysis by Alhazzani suggest that there is no real difference between the two classes of drugs in the General ICU population. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0055104
I'm not aware of any specific recommendations for patients on TPN.Following
- G.D. Ceniccola added an answer:4Can anyone suggest good material on nutritional screening for ICU patients?
I Work with trauma patients. If anyone knows specific material for such patients you helps even more. Thanks in advanced.
Hey Sonali Vadi,
thanks for the help!Following
- Markus Wilken added an answer:2What is the prevalence of feeding tube use in countries around the world?
Dear friend and colleagues,
I am looking for the prevalence of feeding tube use in countries all over the world. While we know, that there is a dramatic increase from a french study (Daveluy et al. 20005/2006); I have a feeling there are no confirmed data our nationwide records in most of the countries. If you would have any data; I would be more than delighted to read and cite your papers.
Thank you for your answer and the papers, very interesting material.
- Jeremy Roberts added an answer:3Gastric Residual Volumes, are they reliable and safe?I'm looking at the amounts General ICU's (adult) use for their gastric residual volumes. There are different theories as to the amount we should use to alter or stop the patients feeds. I would suggest the amount of 150mls of gastric residual volumes to determine what should be done with the patient i.e. increase, decrease or stop the feeds. I have seen too many patients have low gastric residual volumes whom then either vomit, aspirate, or have severe swollen abdomens. But Health Care Professionals will follow the figures on the chart in their assumption that the patient is absorbing their feeds. I am asking fellow ICU Professionals and researchers to add their comments to the reduction of the set 200mls Gastric Residual Volumes that seems to be used as a general rule. But are they following on like sheep, and not truely assessing the amount of patients that are vomiting or have other side effects of these feeds with a 200ml maker as an indication that they are absorbing their feeds!!
Thanks for looking at these comments, your help is gratefully recieved.Hi Ronelle, thank you for your response. Your correct in saying that a culture of accepting aspirates upto 400mls is being created. This is acceptable for specific patients, which as you know, need to be assessed as individuals, not as a broad spectrum of the ICU patient population. In saying that, the nurse at the bedside needs to make ongoing clinical assessments with the equipment provided which may not be agreed with by the MDT members. Only in working together will better patient cares be created. Some say that the supply of nutrition to patients is standard, it is anything but standard. What is accepted by one patient, can be completely rejected by another causing reflux and vomiting with a possible outcome of chemically induced pneumonias created by aspirated feeds. I do feel that 200mls is a good marker to start looking for possible signs of rejection of feeds or malabsorption.
I have found from both reading the articles of, and personal communications from Norma Bethany who has studied this issue for many years has been of a great help to me. I hope your work and studies continue to go well. Thank youFollowing