Energy expenditure and nutritional support in intensive care patients

Neðst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn View/OpenSTUDY OBJECTIVES: Nutritional support of ICU patients is usually guided by estimations of their caloric needs. However, recent studies have shown that energy expenditure (EE) of critically ill patients is not as high as previously thought. The goal of this study was to measure EE in ICU patients, compare it with estimated EE and evaluate nutritional support. METHODS: Energy expenditure was measured with indirect calorimetry in a broad group of ICU patients requiring mechanical ventilation >48 hours. In comparison EE was estimated with the Harris-Benedict equation. Nutritional support during ICU stay was registered. RESULTS: Mean measured EE of 56 patients was 1820 +/- 419 kcal/day or 22 kcal/kg/day. The Harris- Benedict equation underestimated EE by 11%, but adding a stress factor resulted in 15% overestimation. Mean nutritional support was 1175 +/- 442 kcal/day or 67% of EE. The energy deficit was greatest during the first week of ICU stay. Mean protein administration was 0,44 g/kg/day. CONCLUSION: Measured EE of ICU patients was less than nutritional support recommended by international guidelines. These results are in accordance with recent studies. Nutritional support was only 67% of measured energy expenditure and protein content less than recommended. Further studies are needed as it has not be shown how this might influence outcome.Tilgangur: Við næringu gjörgæslusjúklinga er oftast stuðst við áætlaða orkuþörf. Rannsóknir benda þó til að orkunotkun sé minni en áður var talið. Markmið þessarar rannsóknar var að mæla raunverulega orkunotkun gjörgæslusjúklinga og bera saman við áætlaða orkunotkun og að kanna magn og samsetningu næringargjafar. Aðferðir: Orkunotkun var mæld með óbeinni efnaskiptamælingu (indirect calorimetry) hjá sjúklingum sem þurftu öndunarvélameðferð >48 klukkustundir. Til samanburðar var orkunotkun áætluð með Harris-Benedict-jöfnu. Skráðar voru upplýsingar um alla næringargjöf sem sjúklingur fékk. Niðurstöður: Meðalorkunotkun hjá 56 sjúklingum reyndist vera 1820 ± 419 kcal/dag. Harris-Bene-dict-jafnan vanmat orkunotkun um 11,3% en með viðbættum streitustuðli var um 15,3% ofmat að ræða. Meðalnæringargjöf var 1175 ± 442 kcal/dag eða um 67% af orkunotkun. Mestur munur var á orkunotkun og næringargjöf í fyrstu viku gjörgæslumeðferðar. Próteingjöf var að meðaltali 0,44 g/kg/dag. Ályktun: Orkunotkun gjörgæslusjúklinga var minni en sú orkugjöf sem mælt er með samkvæmt næringarleiðbeiningum sérgreinafélaga en í samræmi við niðurstöður annarra nýlegra rannsókna. Næringargjöf var einungis 67% af mældri orkunotkun og próteininnihald næringar undir ráðlögðu magni. Ekki hefur verið sýnt fram á að það hafi áhrif á horfur sjúklinga. Þörf er á frekari rannsóknum á þessu sviði

Intensive care patients with influenza A (H1N1) infection in Iceland 2009

Neðst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn Skoða/Opna(view/open)BACKGROUND: We describe the main characteristics of patients that required intensive care due to the influenza (H1N1) outbrake in 2009. METHODS: Retrospective and prospective analysis of medical records from patients admitted to ICU with positive RT-PCR for (H1N1). RESULTS: During a six week period in the fall of 2009, 16 patients were admitted to intensive care in Iceland with confirmed H1N1 infection. Mean age was 48 years (range 1-81). Most patients were considered quite healthy but the majority had risk factors such as smoking, obesity or hypertension. All but one had fever, cough, dyspnea and bilateral infiltrates on chest x-ray and developed any organ failures (mean SOFA score 7). 12 needed mechanical ventilation and two extra corporeal membrane oxygenation (ECMO). Mean APACHE II score was 20. No patient died in the ICU but one elderly patient with multiple underlying diseases died a few days after being discharged from the ICU. CONCLUSIONS: (1) The incidence of severe influenza A (H1N1) that leads to ICU admission appears to be high in Iceland. (2) Many patients developed acute respiratory distress syndrome in addition to other organ failures, and required additional measures for oxygenation such as prone position, nitric oxide inhalation and ECMO. (3) 28 day mortality was low. (4) This study will aid in future outbreak planning in Iceland. Key words: influenza A, pneumonia, multiple organ failure, death rate, intensive care, ventilator therapy, ECMO.Tilgangur: Að lýsa helstu einkennum og afdrifum þeirra sem lögðust inn á gjörgæsludeildir á Íslandi vegna inflúensusýkingar af A stofni (H1N1) haustið 2009. Aðferðir: Aflað var upplýsinga um sjúklinga sem lögðust inn á gjörgæsludeildir á Íslandi með staðfesta H1N1 2009 sýkingu. Niðurstöður: 16 sjúklingar lögðust inn á gjörgæsludeildir vegna inflúensu A (H1N1) sýkingar, meðalaldur 48 ár (1-81). Flestir töldust vera tiltölulega frískir fyrir, en 13 höfðu þó sögu um reykingar, offitu eða háþrýsting. 15 höfðu hita, hósta, öndunarþyngsli og dreifðar íferðir í báðum lungum á lungnamynd og margir fengu fjöllíffærabilun. Allir fengu veirulyf og 12 voru meðhöndlaðir í öndunarvél, þar af tveir einnig í hjarta- og lungnavél. Enginn sjúklingur lést á gjörgæsludeild, en einn fjölveikur aldraður sjúklingur lést síðar á legudeild. Ályktanir: (1) Tíðni alvarlegra sjúkdómseinkenna af völdum inflúensu A (H1N1) sem leiða til gjörgæslumeðferðar er há á Íslandi. (2) Þessir sjúklingar fá flestir, auk annarra líffæratruflana, mjög alvarlega öndunarbilun sem oft lætur ekki undan hefðbundinni öndunarvélameðferð. (3) Árangur meðferðar á íslenskum gjörgæsludeildum hefur verið góður. (4) Niðurstöður þessarar rannsóknar geta nýst yfirvöldum við mat á meðferðarmöguleikum og fyrirbyggjandi aðgerðum gegn þessum lífshættulega sjúkdómi

Energy expenditure and nutritional support in intensive care patients

Neðst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn View/OpenSTUDY OBJECTIVES: Nutritional support of ICU patients is usually guided by estimations of their caloric needs. However, recent studies have shown that energy expenditure (EE) of critically ill patients is not as high as previously thought. The goal of this study was to measure EE in ICU patients, compare it with estimated EE and evaluate nutritional support. METHODS: Energy expenditure was measured with indirect calorimetry in a broad group of ICU patients requiring mechanical ventilation >48 hours. In comparison EE was estimated with the Harris-Benedict equation. Nutritional support during ICU stay was registered. RESULTS: Mean measured EE of 56 patients was 1820 +/- 419 kcal/day or 22 kcal/kg/day. The Harris- Benedict equation underestimated EE by 11%, but adding a stress factor resulted in 15% overestimation. Mean nutritional support was 1175 +/- 442 kcal/day or 67% of EE. The energy deficit was greatest during the first week of ICU stay. Mean protein administration was 0,44 g/kg/day. CONCLUSION: Measured EE of ICU patients was less than nutritional support recommended by international guidelines. These results are in accordance with recent studies. Nutritional support was only 67% of measured energy expenditure and protein content less than recommended. Further studies are needed as it has not be shown how this might influence outcome.Tilgangur: Við næringu gjörgæslusjúklinga er oftast stuðst við áætlaða orkuþörf. Rannsóknir benda þó til að orkunotkun sé minni en áður var talið. Markmið þessarar rannsóknar var að mæla raunverulega orkunotkun gjörgæslusjúklinga og bera saman við áætlaða orkunotkun og að kanna magn og samsetningu næringargjafar. Aðferðir: Orkunotkun var mæld með óbeinni efnaskiptamælingu (indirect calorimetry) hjá sjúklingum sem þurftu öndunarvélameðferð >48 klukkustundir. Til samanburðar var orkunotkun áætluð með Harris-Benedict-jöfnu. Skráðar voru upplýsingar um alla næringargjöf sem sjúklingur fékk. Niðurstöður: Meðalorkunotkun hjá 56 sjúklingum reyndist vera 1820 ± 419 kcal/dag. Harris-Bene-dict-jafnan vanmat orkunotkun um 11,3% en með viðbættum streitustuðli var um 15,3% ofmat að ræða. Meðalnæringargjöf var 1175 ± 442 kcal/dag eða um 67% af orkunotkun. Mestur munur var á orkunotkun og næringargjöf í fyrstu viku gjörgæslumeðferðar. Próteingjöf var að meðaltali 0,44 g/kg/dag. Ályktun: Orkunotkun gjörgæslusjúklinga var minni en sú orkugjöf sem mælt er með samkvæmt næringarleiðbeiningum sérgreinafélaga en í samræmi við niðurstöður annarra nýlegra rannsókna. Næringargjöf var einungis 67% af mældri orkunotkun og próteininnihald næringar undir ráðlögðu magni. Ekki hefur verið sýnt fram á að það hafi áhrif á horfur sjúklinga. Þörf er á frekari rannsóknum á þessu sviði

DAX of Things

Lokaverkefni hóps DAX of Things. Unnið fyrir Advania. Snjalltækjamiðuð veflausn fyrir gæðapantanir í Dynamics AX og tenging við IoT tæki

Nationwide Incidence and Outcomes of Patients With Coronavirus Disease 2019 Requiring Intensive Care in Iceland.

To access publisher's full text version of this article click on the hyperlink belowObjectives: To determine the nationwide demographics and hospital mortality of patients with severe acute respiratory syndrome coronavirus 2 infection requiring admission to the ICU for coronavirus disease 2019 in Iceland. Design: Prospective observational study. Setting: All ICUs in Iceland (Landspitali University Hospital and Akureyri Regional Hospital). Patients: All patients admitted to the ICU for management of coronavirus disease 2019 between March 14, 2020, and April 13, 2020, with follow-up through May 5, 2020. Interventions: None. Measurements and main results: A total of 27 patients were admitted to the ICU for coronavirus disease 2019 out of 1,788 severe acute respiratory syndrome coronavirus 2 positive cases, rendering an overall admission ratio of 1.5% (95% CI, 1.0-2.2%). The population rate of ICU admission for coronavirus disease 2019 was 7.4 (95% CI, 4.9-10.8) admissions per 100,000 individuals. The hospital mortality of patients admitted to the ICU was 15% (95% CI, 4-34%), and the mortality of patients receiving mechanical ventilation was 19% (95% CI, 4-46%). Conclusions: We report a lower overall ratio of ICU admissions for coronavirus disease 2019 among severe acute respiratory syndrome coronavirus 2 positive patients and a lower hospital mortality for patients treated in the ICU for coronavirus disease 2019 compared with initial reports from Italy and China. Our results could be explained by the early adoption of widespread testing and a successful national response to the pandemic

Intensive care patients with influenza A (H1N1) infection in Iceland 2009

Neðst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn Skoða/Opna(view/open)BACKGROUND: We describe the main characteristics of patients that required intensive care due to the influenza (H1N1) outbrake in 2009. METHODS: Retrospective and prospective analysis of medical records from patients admitted to ICU with positive RT-PCR for (H1N1). RESULTS: During a six week period in the fall of 2009, 16 patients were admitted to intensive care in Iceland with confirmed H1N1 infection. Mean age was 48 years (range 1-81). Most patients were considered quite healthy but the majority had risk factors such as smoking, obesity or hypertension. All but one had fever, cough, dyspnea and bilateral infiltrates on chest x-ray and developed any organ failures (mean SOFA score 7). 12 needed mechanical ventilation and two extra corporeal membrane oxygenation (ECMO). Mean APACHE II score was 20. No patient died in the ICU but one elderly patient with multiple underlying diseases died a few days after being discharged from the ICU. CONCLUSIONS: (1) The incidence of severe influenza A (H1N1) that leads to ICU admission appears to be high in Iceland. (2) Many patients developed acute respiratory distress syndrome in addition to other organ failures, and required additional measures for oxygenation such as prone position, nitric oxide inhalation and ECMO. (3) 28 day mortality was low. (4) This study will aid in future outbreak planning in Iceland. Key words: influenza A, pneumonia, multiple organ failure, death rate, intensive care, ventilator therapy, ECMO.Tilgangur: Að lýsa helstu einkennum og afdrifum þeirra sem lögðust inn á gjörgæsludeildir á Íslandi vegna inflúensusýkingar af A stofni (H1N1) haustið 2009. Aðferðir: Aflað var upplýsinga um sjúklinga sem lögðust inn á gjörgæsludeildir á Íslandi með staðfesta H1N1 2009 sýkingu. Niðurstöður: 16 sjúklingar lögðust inn á gjörgæsludeildir vegna inflúensu A (H1N1) sýkingar, meðalaldur 48 ár (1-81). Flestir töldust vera tiltölulega frískir fyrir, en 13 höfðu þó sögu um reykingar, offitu eða háþrýsting. 15 höfðu hita, hósta, öndunarþyngsli og dreifðar íferðir í báðum lungum á lungnamynd og margir fengu fjöllíffærabilun. Allir fengu veirulyf og 12 voru meðhöndlaðir í öndunarvél, þar af tveir einnig í hjarta- og lungnavél. Enginn sjúklingur lést á gjörgæsludeild, en einn fjölveikur aldraður sjúklingur lést síðar á legudeild. Ályktanir: (1) Tíðni alvarlegra sjúkdómseinkenna af völdum inflúensu A (H1N1) sem leiða til gjörgæslumeðferðar er há á Íslandi. (2) Þessir sjúklingar fá flestir, auk annarra líffæratruflana, mjög alvarlega öndunarbilun sem oft lætur ekki undan hefðbundinni öndunarvélameðferð. (3) Árangur meðferðar á íslenskum gjörgæsludeildum hefur verið góður. (4) Niðurstöður þessarar rannsóknar geta nýst yfirvöldum við mat á meðferðarmöguleikum og fyrirbyggjandi aðgerðum gegn þessum lífshættulega sjúkdómi

The Icelandic Cancer Project--a population-wide approach to studying cancer.

Cancer initiation and progression require a complex interaction of genetic, environmental and clinical factors. Most research, however, has been focused on only a narrow aspect of the disease process. Data generated by the Human Genome Project, as well as large-scale molecular analysis of tumours, have indicated that a more systematic approach, in which the biological information is integrated with clinical features, is warranted. There are many aspects of the Icelandic population that make it well suited for such a broad-based approach. The Icelandic Cancer Project was therefore initiated to build a population-based clinical genomics database and biobank that can be used to study cancer - from genetic predisposition to clinical outcome

Future Opportunities for Bioeconomy : Focus on the West Nordic Region

This final report provides an overview of bioresources in the West Nordic region focusing on Iceland, the Faroe Islands and Greenland, their utilisation and future opportunities based on green growth. The report provides good basis for strategic identification of beneficial projects in the region. Based on the results, a specific action plan has been formed consisting of four main actions; 1. Create a West Nordic Bioeconomy panel, 2. Establish an interdisciplinary Centre of Excellence (CoE) for the West Nordic region, 3. Arctic bioeconomy II – Project focusing on opportunities in biotechnology and 4. Program focusing on “The Blue Bioeconomy”