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INTRODUCTION@#To improve the nutritional care and resource allocation of critically ill patients with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), we described their characteristics, treatment modalities and clinical outcomes, and compared their nutrition interventions against the American Society for Parenteral and Enteral Nutrition (ASPEN) recommendations.@*METHODS@#This was a retrospective observational study conducted in 5 tertiary hospitals in Singapore. Characteristics, treatment modalities, clinical outcomes and nutrition interventions of critically ill patients with SARS-CoV-2 who received enteral and parenteral nutrition were collected between January and May 2020.@*RESULTS@#Among the 83 critically ill patients with SARS-CoV-2, 22 (28%) were obese, 45 (54%) had hypertension, and 21 (25%) had diabetes. Neuromuscular blockade, prone therapy and dialysis were applied in 70% (58), 47% (39) and 35% (29) of the patients, respectively. Refeeding hypophosphataemia and hospital mortality occurred respectively in 6% (5) and 18% (15) of the critically ill patients with SARS-CoV-2. Late enteral nutrition and cardiovascular comorbidities were associated with higher hospital mortality (adjusted relative risk 9.00, 95% confidence interval [CI] 2.25-35.99; 6.30, 95% CI 1.15-34.40, respectively). Prone therapy was not associated with a higher incidence of high gastric residual volume (≥250mL). The minimum caloric (15kcal/kg) and protein (1.2g/kg) recommendations of ASPEN were achieved in 54% (39) and 0% of the patients, respectively.@*CONCLUSION@#The high obesity prevalence and frequent usage of neuromuscular blockade, prone therapy, and dialysis had considerable implications for the nutritional care of critically ill patients with SARS-CoV-2. They also did not receive adequate calories and protein. More audits should be conducted to refine nutritional interventions and guidelines for this ever-evolving disease.
Subject(s)
Humans , COVID-19/therapy , Critical Illness/therapy , Nutritional Support , SARS-CoV-2 , Singapore/epidemiology , United StatesABSTRACT
OBJECTIVE：To prepar e Breviscapine gastric adhesive tablets ，to optimize the formulation and to evaluate the quality. METHODS ：HPMC K 100M and carbomer 934P were used as bioadhesives and skeleton materials ，and lactose was used as filler，and magnesium stearate was used as glidant and lubricant to prepare Breviscapine gastric adhesive tablets by direct powder pressing method. The comprehensive scores of scores of accumulative release rate of Breviscapine gastric adhesive tablets in pH 6.8 PBS at 2，6，12 h（Q2 h，Q6 h，Q12 h，with scutellarin meter ，by HPLC method ）and in vitro adhesion force of gastric tissue were evaluated by weighting method. Taking this scores as indexes，L9（34）orthogonal test design was used to optimize the amount of HPMC K 100M，carbomer 934P and lactose in Breviscapine gastric adhesive tablets and validation tests were conducted. The properties，identification，weight difference ，fragility，release and the content of scutellarin of the gastric adhesive tablets were determined. RESULTS ：The optimal prescription of Breviscapine gastric adhesive tablets were 42％ breviscapine，10％ HPMC K100M，3％ carbomer 934P and 45％ lactose. The verification test results show that the Q2 h，Q6 h，Q12 h of 3 batches of Breviscapine gastric adhesive tablets were 20.36％，48.55％，and 87.00％ ；the average in vitro adhesion force of gastric tissue was 31.36 g/cm2；the average comprehensive score was 70.23（RSD＝1.84％，n＝3）. The gastric adhesive tablets were light yellow，tasteless or slightly salty ；the peak time was consistent with that of scutellarin control ；its weight difference were ±6％， the fragility was 0.54％，and the Q12 h was 83.51％（RSD＝2.14％，n＝6）. The content of scutellarin was 288.47 mg/g（RSD＝ 0.70％，n＝3）. CONCLUSIONS ：Breviscapine gastric adhesive tablets is prepared successfully ，and its quality evaluation conforms to the requirements of Chinese Pharmacopoeia （2015 edition）.
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Objective To investigate the clinical effect of combination of ozone ,ozonated water and improved Vacuum Sealing Drainage(VSD) in healing complex wound ,and to observe the expression of fibroblast growth factors(FGF) and interleukin-1(IL-1) in its surface .Methods 40 patients with complex extremity trauma were selected and divided into 4 groups randomly .These 4 groups were Ozone+VSD group and Ozonated Water+ VSD group ,VSD group and Control group ,and received ozone combined VSD treatment ,ozonated water combined VSD treatment ,pure VSD treatment ,and traditional treatment .Each group contained 10 patients .Comparison of clinical effect ,bacteria loads and the expression of FGF and IL-1 in wound surface was made in 4 groups . Results The average cure time ,average replacing frequency and infection rate in Control group were (31 .5 ± 6 .6)days ,(15 .4 ± 3 .9) times and 40% respectively .The average cure time ,twice VSD cases and infection rate in VSD group were (19 .2 ± 2 .3)days , 5 cases and 10% respectively .There were no case of infection or received twice VSD treatment in Ozone + VSD group and Ozonated Water+VSD group .The average cure time were (14 .9 ± 2 .7) days and (14 .1 ± 3 .0) days .The Ozone+ VSD group and Ozonated Water+VSD group had best clinical effect ,and the Ozonated Water+ VSD group had least bacteria loads in wound surface (P<0 .05) .The expression of FGF and IL-1 in 4 group had obvious differences ,and it had statistical significance(P<0 .05) .Conclusion Both ozone or ozonated water combined VSD treatment could decrease IL-1 and increase FGF expression ,accelerate recovery time ,inhibit bacterial infection ,especially ozonated water combined VSD treatment had better effect .