Perioperative nutrition management for critically ill patients based on the concept of enhanced recovery after surgery / 医学研究生学报

Nutrition management based on enhanced recovery after surgery(ERAS) programs is a continuously evolving field in perioperative critical illness. Preoperative and post-operative nutritional measurement of ERAS are the core of perioperative nutrition. For critically ill patients, enteral nutrition assessment checklist may be able to improve the quality of enteral nutrition implementation. The management of gastric tube jejunal nutrition tube needs to be personalized according to the patient's condition. Auscultation-assisted bare-handed jejunal tube placement may make it easier for ICU patients to establish jejunal nutrition pathways.This paper will discuss nutrition management based on ERAS.

Normal saline for intravenous fluid therapy in critically ill patients / 中华创伤杂志(英文版)

The efficacy and safety of normal saline (NS) for fluid therapy in critically ill patients remain controversy. In this review, we summarized the evidence of randomized controlled trials (RCTs) which compared NS with other solutions in critically ill patients. The results showed that when compared with 6% hydroxyethyl starch (HES), NS may reduce the onset of acute kidney injury (AKI). However, there is no significant different in mortality and incidence of AKI when compared with 10% HES, albumin and buffered crystalloid solution. Therefore, it is important to prescribe intravenous fluid for patients according to their individual condition.

Effect of Continuous Blood Purification on Multiple Organ Dysfunction Syndrome:33 Cases Report / 中国康复理论与实践

@#ObjectiveTo study the effect of continuous blood purification (CBP) on the multiple organ dysfunction syndrome(MODS). MethodsContinuous blood purification were used in 33 patients with MODS. Results Among 33 patients,24 mended and 8 died. The scores of Acute Physiology And Chronic Health Evaluation (APACHE Ⅱ) and MODS obviously declined(P<0.05), as well as the BUN and blood Cr (P<0.05), but the bilirubin did not (P>0.05). The haemodynamic variables were stabilized during CBP and no obvious side-effect related to CBP was found. ConclusionThe therapy of continuous blood purification can improve the prognosis to the patients with multiple organ dysfunction syndrome. The patients were able to bear at the quality better.

Application of bispectral index during sedation in the patients in ICU / 中国康复理论与实践

@#ObjectiveTo evaluate the value of bispectral index(BIS) monitoring during sedation in the ICU.Methods60 patients in ICU were randomly divided into three groups. By transfusing propofol and midazolam with injecting pump, the BIS of groups Ⅰ,Ⅱ and Ⅲ were controlled within 75～85, 65～75 and 55～65, respectively. ResultsCompared with the pre-sedation, there was no remarkable change in the patients of groups Ⅰ and Ⅱ after sedation(P>0.05)while there was remarkable change in the patients of group Ⅲ(P<0.05).The average score of Ramsay in groups Ⅰ, Ⅱ and Ⅲ were 2.2, 3.4 and 4.6 while the dose of propofol were (9.54±2.43) μg/kg·min, (12.69±3.12) μg/kg·min, (14.18±2.91) μg/kg·min and the dose of midazolam were (0.23±0.09) μg/kg·min, (0.25±0.07) μg/kg·min, (0.28±0.11) μg/kg·min, respectively.ConclusionThe application of BIS can make good judgement in the sedation, which showed different choices to different needs to obtain optimistical sedation effect.