Enteral nutrition in the critically ill: A prospective survey in an Australian intensive care unit

Publisher's copy made available with the permission of the publisher © Australian Society of AnaesthetistsNutritional support is routine practice in critically ill patients and enteral feeding is preferred to the parenteral route. However this direct delivery of nutrients to the gut is potentially ineffective for a variety of reasons. We performed a prospective audit of 40 consecutive intensive care patients to determine whether enteral feeding met the nutritional requirements of our patients. The ideal requirements for each patient were calculated using the Harris-Benedict equation with an adjustment determined by the patient’s diagnosis. We compared the amount of feed delivered with the daily requirements over a seven-day period. Successful feeding was defined as the achievement of 90% of the ideal calorie requirement for two consecutive days. The mean calculated (±SD) energy requirement was 9566kJ (±2586). Patients received only 51% (SD 38) of their energy requirements throughout the study period. Only 10 patients (25%)were successfully fed for at least any two-day period in the seven days. Feeding was limited mainly by gastrointestinal dysfunction or by the need to fast the patient for medical, surgical and airway procedures. Success of feeding was not related to the use of sedative or paralysing agents and had no correlation with plasma albumin concentration. There was no difference in the volume of feed delivered to patients who survived or died. Prokinetic agents were used in 25 patients and in these patients there was a trend towards improved delivery of feed.I. De Beaux, M. Chapman, R. Fraser, M. Finnis, B. De Keulenaer, D. Liberalli, M. Satanekhttp://www.aaic.net.au/Article.asp?D=200111

Laços familiares e aspectos materiais da dinâmica mercantil na cidade de São Paulo (séculos XVIII e XIX)

Based on the family ties established within the active merchant community of the city of São Paulo through the 18th and 19th centuries, the author sets out to tell the life story of nine merchants involved in matrimonial alliances, with a focus on the transactions carried out, their sociopolitical engagement and the fortunes of their descendants. Having done that, she seeks out connections between the urban development of the city center and the activities of these businessmen by means of analyses centered on the material aspects of their lives, particularly those related to their homes and home furniture