44 results on '"M, Berger"'
Search Results
2. How to deal with micronutrient product shortage - Editorial
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Francisca Joly, Manpreet Mundi, Rocco Barazzoni, Mette M. Berger, Frederico Bozzetti, Cristina Cuerda, Palle B. Jeppesen, Simon Lal, Georg Lamprecht, Kinga Szczepanek, André Van Gossum, Stéphane Schneider, Alan Shenkin, Geert Wanten, and Loris Pironi
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Nutrition and Dietetics ,All institutes and research themes of the Radboud University Medical Center ,lnfectious Diseases and Global Health Radboud Institute for Health Sciences [Radboudumc 4] ,Critical Care and Intensive Care Medicine - Abstract
Item does not contain fulltext 01 februari 2023
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- 2023
3. Computer customization errors compromised the optimization of trace element repletion dose after major burns
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Céline Jina Dusapin, Olivier Pantet, Pierre Voirol, Mélanie Charrière, Pauline Thomann, and Mette M. Berger
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Selenium ,Zinc ,Nutrition and Dietetics ,Computers ,Humans ,Salts ,Burns ,Critical Care and Intensive Care Medicine ,Copper ,Retrospective Studies ,Trace Elements - Abstract
Major burns develop acute trace element (TE) deficiencies due to exudative losses of copper, selenium, and zinc from the wounds. A repletion strategy has been shown to decrease infectious and surgical complications. The TE doses have been adapted over time and the last adaptation, was not followed by the expected changes. The study aims at identifying the causes of the failure.Retrospective cohort study including critically ill major burns patients admitted to intensive care with burns exceeding 20% of body surface area (BSA). Period A (2011-2015) included patients admitted before the dose change, and Period B patients after (2017-2020). Demographic variables, daily TE delivery, and weekly TE blood levels were extracted from the computerized information system (CIS).Altogether 71 patients completed the inclusion criteria (Periods A and B: 42 and 29 patients respectively). They were aged 38 (32) years and burned 35 (30) % BSA, with no severity differences. Comparing periods A and B, copper (p = 0.046) and selenium (p = 0.031) blood levels were significantly lower in B. The dose value extracted from CIS was as planned. Customization error was found: TE salts' weight had been entered instead of elemental weight in molar units.The lower TE repletion doses administered since 2017 resulted in a significant decrease in blood levels of Cu and Se. A CIS customisation error, confusing salt weight and elemental weight was the source of the error. A systematic quality control is crucial to identify systemic errors, as is the use of the standard international units.
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- 2022
4. Micronutrients: A low blood concentration is not equivalent to deficiency
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Alan Shenkin and Mette M. Berger
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Selenium ,Nutrition and Dietetics ,Humans ,Micronutrients ,Critical Care and Intensive Care Medicine ,Trace Elements - Published
- 2022
5. Comprehensive metabolic amino acid flux analysis in critically ill patients
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R.A. Wierzchowska-Mcnew, Pierre Singer, Itai Bendavid, Marina Verçoza Viana, Mette M. Berger, Mariëlle P.K.J. Engelen, Olivier Pantet, Gabriella A. M. Ten Have, Nicolaas E. P. Deutz, and John J. Thaden
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Male ,0301 basic medicine ,medicine.medical_specialty ,Critical Illness ,030209 endocrinology & metabolism ,Critical Care and Intensive Care Medicine ,Article ,Sepsis ,03 medical and health sciences ,0302 clinical medicine ,Disease severity ,Internal medicine ,Electric Impedance ,medicine ,Humans ,Amino Acids ,Aged ,030109 nutrition & dietetics ,Nutrition and Dietetics ,business.industry ,Critically ill ,Matched control ,Middle Aged ,medicine.disease ,Clinical trial ,Plasma concentration ,Body Composition ,Female ,Registry data ,Basal Metabolism ,business ,Whole body - Abstract
Amino acid (AA) metabolism is severely disturbed in critically ill ICU patients. To be able to make a more scientifically based decision on the type of protein or AA nutrition to deliver in ICU patients, comprehensive AA phenotyping with measurements of plasma concentrations and whole body production (WBP) is needed. Therefore, we studied ICU patients and matched control subjects using a novel pulse isotope method to obtain in-depth metabolic analysis. In 51 critically ill ICU patients (SOFA~6.6) and 49 healthy controls, we measured REE and body composition/phase-angle using BIA. In the postabsorptive state, we collected arterial (ized) blood for CRP and AA. Then, we administered an 8 mL solution containing 18 stable AA tracers as a pulse and calculated WBP. Enrichments: LC-MS/MS and statistics: t-test, ANCOVA. Compared to healthy, critically ill ICU patients had lower phase-angle (p 0.00001), and higher CRP (p 0.0001). Most AA concentrations were lower in ICU patients (p 0.0001), except tau-methylhistidine and phenylalanine. WBP of most AA were significantly (p 0.0001) higher with increases in glutamate (160%), glutamine (46%), and essential AA. Remarkably, net protein breakdown was lower. There were only weak relationships between AA concentrations and WBP. Critically ill ICU patients (SOFA 8-16) had lower values for phase angle (p = 0.0005) and small reductions of most plasma AA concentrations, but higher tau-methylhistidine (p = 0.0223) and hydroxyproline (p = 0.0028). Remarkably, the WBP of glutamate and glutamine were lower (p 0.05), as was their clearance, but WBP of tau-methylhistidine (p = 0.0215) and hydroxyproline (p = 0.0028) were higher. Our study in critically ill ICU patients shows that comprehensive metabolic phenotyping was able to reveal severe disturbances in specific AA pathways, in a disease severity dependent way. This information may guide improving nutritional compositions to improve the health of the critically ill patient. CLINICAL TRIAL REGISTRY: Data are from the baseline measurements of study NCT02770092 (URL: https://clinicaltrials.gov/ct2/show/NCT02770092) and NCT03628365 (URL: https://clinicaltrials.gov/ct2/show/NCT03628365).
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- 2021
6. ESPEN guideline on clinical nutrition in the intensive care unit
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Waleed Alhazzani, Michael P Casaer, Michael Hiesmayr, Wojciech Szczeklik, Claude Pichard, J.C. Montejo, Philip C. Calder, Simon Oczkowski, Mette M. Berger, Arthur R. H. van Zanten, Jean-Charles Preiser, Pierre Singer, Stephan C. Bischoff, Annika Reintam Blaser, and Konstantin Mayer
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0301 basic medicine ,Parenteral Nutrition ,medicine.medical_specialty ,ESPEN ,Critical Care ,Critical Illness ,Nutritional Status ,030209 endocrinology & metabolism ,Clinical nutrition ,Guidelines ,Critical Care and Intensive Care Medicine ,Enteral administration ,law.invention ,03 medical and health sciences ,Enteral Nutrition ,0302 clinical medicine ,Parenteral ,law ,Intensive care ,Humans ,Medicine ,Medical nutrition therapy ,Intensive care medicine ,Enteral ,Societies, Medical ,Nutrition ,ddc:616 ,030109 nutrition & dietetics ,Nutrition and Dietetics ,Nutritional Support ,business.industry ,Guideline ,Dysphagia ,Intensive care unit ,Europe ,Intensive Care Units ,medicine.symptom ,business ,Abdominal surgery - Abstract
Following the new ESPEN Standard Operating Procedures, the previous guidelines to provide best medical nutritional therapy to critically ill patients have been updated. These guidelines define who are the patients at risk, how to assess nutritional status of an ICU patient, how to define the amount of energy to provide, the route to choose and how to adapt according to various clinical conditions. When to start and how to progress in the administration of adequate provision of nutrients is also described. The best determination of amount and nature of carbohydrates, fat and protein are suggested. Special attention is given to glutamine and omega-3 fatty acids. Particular conditions frequently observed in intensive care such as patients with dysphagia, frail patients, multiple trauma patients, abdominal surgery, sepsis, and obesity are discussed to guide the practitioner toward the best evidence based therapy. Monitoring of this nutritional therapy is discussed in a separate document.
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- 2019
7. Trace element repletion following severe burn injury: A dose-finding cohort study
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Olivier Pantet, Pierre Voirol, A. Vernay, Patricia Stoecklin, Mette M. Berger, and M. Charrière
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Adult ,Male ,0301 basic medicine ,medicine.medical_treatment ,Nutritional Status ,Reference range ,Critical Care and Intensive Care Medicine ,Cohort Studies ,Selenium ,03 medical and health sciences ,Dose finding ,Intensive care ,Humans ,Medicine ,Severe burn ,Prospective Studies ,Renal replacement therapy ,610 Medicine & health ,Retrospective Studies ,030109 nutrition & dietetics ,Nutrition and Dietetics ,Dose-Response Relationship, Drug ,business.industry ,Malnutrition ,Major burn ,Middle Aged ,Trace Elements ,Zinc ,Anesthesia ,Plasma concentration ,Female ,Burns ,business ,Copper ,Cohort study - Abstract
Summary Background & aims Major burn patients are characterized by large exudative losses of Cu, Se and Zn. Trace element (TE) repletion has been shown to improve clinical outcome. Having increased the TE doses over time, the study aimed at analysing if our repletion protocol corrected TE plasma concentrations and if the necessity for continuous renal replacement therapy (CRRT) might increase the TE needs. Methods Retrospective analysis of prospectively collected data in burn patients requiring intensive care (ICU) between 1999 and 2015. Inclusion criteria: Admission on day 1, full treatment, burned surface area (TBSA) ≥20% and ≥1 TE plasma determination during the stay. Four groups were constituted according to protocol changes. Period 1 (P1): 1999–2000, P2: 2001–2005, P3: 2006–2010, P4: 2011–2015. Changes consisted in increasing TE repletion doses and duration. Demographic data, daily TE intakes and weekly plasma concentrations were retrieved for the first 21 ICU-days. Data as median (IQR). Results 139 patients completed the criteria, aged 37 (28) years, burned on 35 (25) % TBSA. As a result of prescription, Cu, Se and Zn intakes increased significantly between P1 and P4, resulting in normalization of plasma Cu (16 μmol/l) since P3 and Zn (13.5 μmol/l) since P2. Median plasma Se were above reference range (1400 nmol/l) during P3 and P4. CRRT patients required higher doses of Cu for maintenance within normal ranges. Conclusion This dose finding study shows that the latest repletion protocol is safe and normalizes Cu and Zn concentrations. Se doses result in supra-normal Se concentrations, suggesting prescription reduction. CRRT patients are at high risk of Cu depletion and require specific monitoring.
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- 2019
8. Trace element intakes should be revisited in burn nutrition protocols: A cohort study
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Wassim Raffoul, Mette M. Berger, Daniel Haselbach, William Watfa, Lee Ann Applegate, Olivier Pantet, Marc Augsburger, Aurélien Thomas, Paris Jafari, and Murielle Michetti
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Adult ,Male ,0301 basic medicine ,Burn injury ,medicine.medical_specialty ,Nutritional Status ,Reference range ,Critical Care and Intensive Care Medicine ,Cohort Studies ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Animal science ,Humans ,Medicine ,Prospective Studies ,Prospective cohort study ,Inductively coupled plasma mass spectrometry ,Aged ,Aged, 80 and over ,030109 nutrition & dietetics ,Nutrition and Dietetics ,business.industry ,Spectrophotometry, Atomic ,Nutritional Requirements ,Trace element ,030208 emergency & critical care medicine ,Middle Aged ,Micronutrient ,Trace Elements ,Surgery ,Parenteral nutrition ,Dietary Supplements ,Female ,Burns ,business ,Total body surface area - Abstract
Due to inflammatory and hypermetabolic responses and to extensive exudative trace element (TEs) losses, major burn patients have substantially increased nutritional requirements. To date, information is only available for Cu, Se, and Zn. We aimed at analyzing losses of 12 TEs and Mg through burn wound exudation and corresponding plasma concentrations during the first week after burn injury, and to evaluate the impact of current TE repletion protocols.Burn wound exudate was collected under negative pressure in 15 adult patients burned 29 ± 20% of body surface (TBSA) for 8 days after injury. Two samples were collected daily. The TE concentrations were measured by inductively coupled plasma mass spectrometry (ICP-MS). Losses and serum concentrations were compared to intakes.For the majority of 12 TEs, the highest losses were observed on day 1, and declined thereafter. Despite Cu supplementation (4.23 mg/day) serum levels remained below reference values. Se supplements (745 μg/day) normalized and even increased serum levels to upper normal value. Despite large supplements (Zn 67.5 mg/day), serum Zn values remained below reference range. Large exudative losses of B, Br and Mg were found, as well as of Fe and I, with the latter being probably due to contamination.Current nutritional Cu, Se, Zn repletion protocols in major burn patients which were based on measured exudative losses should be revised to include higher Cu and lower Se doses, as well as planned Mg administration. In burns20% TBSA and for the other TEs the recommended parenteral nutrition TE doses appear sufficient.
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- 2018
9. Indirect calorimetry in nutritional therapy. A position paper by the ICALIC study group
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Claudia Paula Heidegger, Claude Pichard, Michael Hiesmayr, Anne Berit Guttormsen, Pierre Singer, Mette M. Berger, Elisabeth De Waele, Jan Wernerman, Taku Oshima, Faculty of Medicine and Pharmacy, and Supporting clinical sciences
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0301 basic medicine ,Databases, Factual ,Critical Illness ,Rest ,Carbon dioxide production (VCO ) ,Indirect calorimetry ,Critical Care and Intensive Care Medicine ,03 medical and health sciences ,0302 clinical medicine ,Basic knowledge ,Intensive care ,Outpatients ,Humans ,Medicine ,Oxygen consumption (VO ) ,Indirect calorimetry, Energy expenditure (EE), Respiratory, quotient (RQ), Oxygen consumption (VO2), Carbon dioxide production (VCO2), Resting energy expenditure (REE) ,Medical nutrition therapy ,Energy expenditure (EE) ,ddc:616 ,Respiratory quotient (RQ) ,Inpatients ,030109 nutrition & dietetics ,Nutrition and Dietetics ,Nutritional Support ,Critically ill ,business.industry ,Resting energy expenditure (REE) ,Nutritional Requirements ,Calorimetry, Indirect ,030208 emergency & critical care medicine ,Clinical Practice ,Intensive Care Units ,Risk analysis (engineering) ,Energy expenditure ,Position paper ,Current technology ,Energy Metabolism ,business - Abstract
Summary Background & aims This review aims to clarify the use of indirect calorimetry (IC) in nutritional therapy for critically ill and other patient populations. It features a comprehensive overview of the technical concepts, the practical application and current developments of IC. Methods Pubmed-referenced publications were analyzed to generate an overview about the basic knowledge of IC, to describe advantages and disadvantages of the current technology, to clarify technical issues and provide pragmatic solutions for clinical practice and metabolic research. The International Multicentric Study Group for Indirect Calorimetry (ICALIC) has generated this position paper. Results IC can be performed in in- and out-patients, including those in the intensive care unit, to measure energy expenditure (EE). Optimal nutritional therapy, defined as energy prescription based on measured EE by IC has been associated with better clinical outcome. Equations based on simple anthropometric measurements to predict EE are inaccurate when applied to individual patients. An ongoing international academic initiative to develop a new indirect calorimeter aims at providing innovative and affordable technical solutions for many of the current limitations of IC. Conclusion Indirect calorimetry is a tool of paramount importance, necessary to optimize the nutrition therapy of patients with various pathologies and conditions. Recent technical developments allow broader use of IC for in- and out-patients.
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- 2017
10. Impact of decreasing energy intakes in major burn patients: A 15-year retrospective cohort study
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Mette M. Berger, Patricia Stoecklin, Olivier Pantet, and A. Vernay
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Adult ,Male ,medicine.medical_specialty ,Pediatrics ,Adolescent ,Critical Illness ,Nutritional Status ,Critical Care and Intensive Care Medicine ,Nutrition Policy ,Young Adult ,03 medical and health sciences ,Enteral Nutrition ,0302 clinical medicine ,Weight loss ,Intensive care ,Internal medicine ,Weight Loss ,Humans ,Medicine ,030212 general & internal medicine ,Medical nutrition therapy ,Young adult ,Child ,Serum Albumin ,Aged ,Retrospective Studies ,Aged, 80 and over ,Nutrition and Dietetics ,business.industry ,Nutritional Requirements ,Area under the curve ,030208 emergency & critical care medicine ,Retrospective cohort study ,Major burn ,Middle Aged ,Intensive Care Units ,C-Reactive Protein ,Patient Compliance ,Female ,Energy intakes ,Dietary Proteins ,medicine.symptom ,Burns ,Energy Intake ,Energy Metabolism ,business ,Follow-Up Studies - Abstract
Nutritional therapy is particularly important after major burn injury and specific nutritional guidelines have been developed. The study aimed at evaluating the impact of the changes in our nutritional practice, general compliance with the guidelines and potential consequences. Retrospective analysis of prospectively collected data in burn patients requiring intensive care (ICU) between 1999 and 2014. admission on day 1, full treatment and length of ICU stay >7 days. Four periods (P) were defined by protocol changes (P1: 1999-2001, P2: 2002-2005, P3: 2006-2010, P4: 2011-2014). Collected data: demographic and nutritional data, infectious complications, weights, CRP and prealbumin concentrations during the first 21 days. 240 patients were included (median age 43 years, burned area 25%). Measured energy expenditure (MEE) was stable through all periods but the prescribed caloric target decreased significantly, and below MEE (P1: 33 kcal/kg, IQR 7, P4: 28 kcal/kg, IQR 8, p
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- 2017
11. Trace element monitoring in the ICU: Quality and economic impact of a change in sampling practice
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Olivier Boulat, Ghislaine Gagnon, Ludivine Soguel, Mette M. Berger, and Pierre Voirol
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Adult ,Male ,Pediatrics ,medicine.medical_specialty ,Quality Assurance, Health Care ,Critical Illness ,Reminder Systems ,Clinical nutrition ,Critical Care and Intensive Care Medicine ,Antioxidants ,Selenium ,Humans ,Medicine ,Micronutrients ,Economic impact analysis ,Medical prescription ,Aged ,Retrospective Studies ,Nutrition and Dietetics ,Dose-Response Relationship, Drug ,Computers ,business.industry ,Retrospective cohort study ,Middle Aged ,Micronutrient ,Trace Elements ,Intensive Care Units ,Zinc ,Dietary Supplements ,Critical illness ,Cohort ,Emergency medicine ,Female ,business ,Blood Chemical Analysis ,Copper ,Switzerland ,Blood sampling - Abstract
summary Background & aims: Trace elements (TE) are involved in the immune and antioxidant defences which are of particular importance during critical illness. Determining plasma TE levels is costly. The present quality control study aimed at assessing the economic impact of a computer reminded blood sampling versus a risk guided on-demand monitoring of plasma concentrations of selenium, copper, and zinc.. Methods: Retrospective analysis of 2 cohorts of patients admitted during 6 months periods in 2006 and 2009 to the ICU of a University hospital. Inclusion criteria: to receive intravenous micronutrient supplements and/or to have a TE sampling during ICU stay. The TE samplings were triggered by computerized reminder in 2006 versus guided by nutritionists in 2009.methods. Results: During the 2 periods 636 patients met the inclusion criteria out of 2406 consecutive admissions, representing 29.7% and 24.9% respectively of the periods’ admissions. The 2009 patients had higher SAPS2 scores (p ¼ 0.02) and lower BMI compared to 2006 (p ¼ 0.007). The number of laboratory determinations was drastically reduced in 2009, particularly during the first week, despite the higher severity of the cohort, resulting in a 55% cost reduction.. Conclusions: The monitoring of TE concentrations guided by a nutritionist resulted in a reduction of the sampling frequency, and targeting on the sickest high risk patients, requiring a nutritional prescription adaptation. This control leads to cost reduction compared to an automated sampling prescription.. 2014 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism.
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- 2015
12. The 2013 Arvid Wretlind lecture: Evolving concepts in parenteral nutrition
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Mette M. Berger
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Parenteral Nutrition ,medicine.medical_specialty ,Pediatrics ,Exacerbation ,Glucose control ,Critical Illness ,Critical Care and Intensive Care Medicine ,Enteral administration ,medicine ,Humans ,Micronutrients ,Medical prescription ,Intensive care medicine ,Randomized Controlled Trials as Topic ,Parenteral Nutrition Solutions ,Nutrition and Dietetics ,business.industry ,Critically ill ,Nutritional Requirements ,medicine.disease ,Hospitalization ,Malnutrition ,Parenteral nutrition ,Dietary Proteins ,Energy Intake ,business ,Weight based dosing - Abstract
Fifty years after the clinical introduction of total parenteral nutrition (TPN) the Arvid Wretlind lecture is an opportunity to critically analyse the evolution and changes that have marked its development and clinical use. The standard crystalline amino acid solutions, while devoid of side effects, remain incomplete regarding their composition (e.g. glutamine). Lipid emulsions have evolved tremendously and are now included in bi- and tri-compartmental feeding bags enabling a true "total" PN provided daily micronutrients are prescribed. The question of exact individual energy, macro- and micro-nutrient requirements is still unsolved. Many complications attributed to TPN are in fact the consequence of under- or over-feeding: the historical hyperalimentation concept is the main cause, along with the use of fixed weight based predictive equations (incorrect in 70% of the critically ill patients). In the late 80's many complications (hyperglycemia, sepsis, fatty liver, exacerbation of inflammation, mortality) were attributed to TPN leading to its near abandon in favour of enteral nutrition (EN). Enteral feeding, although desirable for many reasons, is difficult causing a worldwide recurrence of malnutrition by insufficient feed delivery. TPN indications have evolved towards its use either alone or in combination with EN: several controversial trials published 2011-13 have investigated TPN timing, an issue which is not yet resolved. The initiation time varies according to the country between admission (Australia and Israel), day 4 (Swiss) and day 7 (Belgium, USA). The most important issue may prove to be and individualized and time dependent prescription of feeding route, energy and substrates.
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- 2014
13. SUN-PO274: Validation Process of a New Calorimeter: Importance of a Mixing Chamber
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G. Bagnoud, M. Charrière, Olivier Pantet, D. Favre, Claude Pichard, and Mette M. Berger
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Nutrition and Dietetics ,Calorimeter (particle physics) ,business.industry ,Scientific method ,Nuclear engineering ,Medicine ,Critical Care and Intensive Care Medicine ,business ,Mixing chamber - Published
- 2019
14. MON-PO615: Determinant of Dysglycemia and Glucose Variability in ICU Long-Stayer Patients
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Mette M. Berger, G. Bagnoud, Marina Verçoza Viana, Philippe Eckert, A. Martinez, and Olivier Pantet
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medicine.medical_specialty ,Nutrition and Dietetics ,business.industry ,Internal medicine ,medicine ,Critical Care and Intensive Care Medicine ,business - Published
- 2019
15. SUN-PO023: Long-Stayer Patients in the ICU: Were they Special From Start?
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G. Bagnoud, Mette M. Berger, Olivier Pantet, Marina Verçoza Viana, A. Martinez, and Philippe Eckert
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medicine.medical_specialty ,Nutrition and Dietetics ,business.industry ,medicine ,Critical Care and Intensive Care Medicine ,Intensive care medicine ,business - Published
- 2019
16. ESPEN endorsed recommendations: Nutritional therapy in major burns
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Carole Ichai, Marie Reine Losser, Mette M. Berger, and Anne-Françoise Rousseau
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Adult ,Blood Glucose ,medicine.medical_specialty ,Burn injury ,Evidence-based practice ,Critical Care ,Resuscitation ,medicine.medical_treatment ,Guidelines as Topic ,Critical Care and Intensive Care Medicine ,Enteral administration ,Enteral Nutrition ,Dietary Carbohydrates ,Humans ,Medicine ,Micronutrients ,Medical nutrition therapy ,Amino Acids ,Child ,Intensive care medicine ,Evidence-Based Medicine ,Nutrition and Dietetics ,Rehabilitation ,business.industry ,Nutritional Requirements ,Calorimetry, Indirect ,Evidence-based medicine ,Dietary Fats ,Clinical trial ,Intensive Care Units ,Practice Guidelines as Topic ,Hypermetabolism ,Dietary Proteins ,Burns ,Energy Intake ,business - Abstract
Summary Background & aims Nutrition therapy is a cornerstone of burn care from the early resuscitation phase until the end of rehabilitation. While several aspects of nutrition therapy are similar in major burns and other critical care conditions, the patho-physiology of burn injury with its major endocrine, inflammatory, metabolic and immune alterations requires some specific nutritional interventions. The present text developed by the French speaking societies, is updated to provide evidenced-based recommendations for clinical practice. Methods A group of burn specialists used the GRADE methodology (Grade of Recommendation, Assessment, Development and Evaluation) to evaluate human burn clinical trials between 1979 and 2011. The resulting recommendations, strong suggestions or suggestions were then rated by the non-burn specialized experts according to their agreement (strong, moderate or weak). Results Eight major recommendations were made. Strong recommendations were made regarding, 1) early enteral feeding, 2) the elevated protein requirements (1.5–2 g/kg in adults, 3 g/kg in children), 3) the limitation of glucose delivery to a maximum of 55% of energy and 5 mg/kg/h associated with moderate blood glucose (target ≤ 8 mmol/l) control by means of continuous infusion, 4) to associated trace element and vitamin substitution early on, and 5) to use non-nutritional strategies to attenuate hypermetabolism by pharmacological (propranolol, oxandrolone) and physical tools (early surgery and thermo-neutral room) during the first weeks after injury. Suggestion were made in absence of indirect calorimetry, to use of the Toronto equation (Schoffield in children) for energy requirement determination (risk of overfeeding), and to maintain fat administration ≤ 30% of total energy delivery. Conclusion The nutritional therapy in major burns has evidence-based specificities that contribute to improve clinical outcome.
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- 2013
17. Supplemental parenteral nutrition does not alter carbohydrate and protein metabolism and improves immunity: The SPN2 randomized trial
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Mette M. Berger, Nathalie Jacquelin-Ravel, Sabine Schmidt, Fabio Becce, François Spertini, Olivier Pantet, Régine Audran, Luc Tappy, Claude Pichard, and M. Charrière
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0301 basic medicine ,030109 nutrition & dietetics ,Nutrition and Dietetics ,business.industry ,Protein metabolism ,Carbohydrate ,Pharmacology ,Critical Care and Intensive Care Medicine ,law.invention ,03 medical and health sciences ,chemistry.chemical_compound ,Parenteral nutrition ,chemistry ,Randomized controlled trial ,Immunity ,law ,Medicine ,business - Published
- 2018
18. ESPEN Guidelines on Parenteral Nutrition: Intensive care
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Pierre, Singer, Mette M, Berger, Greet, Van den Berghe, Gianni, Biolo, Philip, Calder, Alastair, Forbes, Richard, Griffiths, Georg, Kreyman, Xavier, Leverve, Claude, Pichard, ESPEN, Singer, P, Berger, Mm, VAN DEN BERGHE, G, Biolo, Gianni, Calder, P, Forbes, A, Griffiths, R, Kreyman, G, Leverve, X, Pichard, C, Espen, Hamant, Sarah, General Intensive Care Department and Institute for Nutrition Research, Rabin Medical Center-Beilinson Hospital, Department of Intensive Care Medicine, CHUV, Lausanne, Department of Intensive care Medicine, Catholic University of Leuven - Katholieke Universiteit Leuven (KU Leuven), Department of Clinical Morphological and Technological Sciences, Università degli studi di Trieste = University of Trieste, Institute of Human Nutrition, University of Southampton, Division of Medicine, University College of London [London] (UCL), School of Clinical Sciences, University of Liverpool, Department of Intensive Care, Universitaetsklinikum Hamburg-Eppendorf = University Medical Center Hamburg-Eppendorf [Hamburg] (UKE), Clinique de réanimation médicale, Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-Hôpital Michallon, Laboratoire de bioénergétique fondamentale et appliquée (LBFA), Université Joseph Fourier - Grenoble 1 (UJF)-Institut National de la Santé et de la Recherche Médicale (INSERM), Department of Clinical Nutrition, Geneva University Hospital (HUG), and University of Trieste
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Parenteral Nutrition ,030309 nutrition & dietetics ,Intensive Care/standards ,Guideline ,Critical Care and Intensive Care Medicine ,Enteral administration ,MESH: Parenteral nutrition ,Guidelines ,parenteral nutrition ,intensive care ,0302 clinical medicine ,030212 general & internal medicine ,media_common ,ddc:616 ,0303 health sciences ,MESH: Guidelines ,Evidence-Based Medicine ,Nutrition and Dietetics ,MESH: Amino acids ,Middle Aged ,3. Good health ,Treatment Outcome ,Adult ,medicine.medical_specialty ,Evidence-based practice ,Critical Care ,media_common.quotation_subject ,Nutritional Status ,Young Adult ,03 medical and health sciences ,Malnutrition/*therapy ,MESH: Enteral nutrition ,Enteral Nutrition ,Parenteral Nutrition/adverse effects/standards ,Intensive care ,[SDV.BBM] Life Sciences [q-bio]/Biochemistry, Molecular Biology ,medicine ,Humans ,[SDV.BBM]Life Sciences [q-bio]/Biochemistry, Molecular Biology ,Quality (business) ,Intensive care medicine ,MESH: Micronutrients ,MESH: Glutamine ,business.industry ,Contraindications ,MESH: Omega 3 fatty acids ,Malnutrition ,Evidence-based medicine ,MESH: Lipid emulsions ,medicine.disease ,MESH: Evidence-based ,Parenteral nutrition ,business ,Enteral Nutrition/contraindications - Abstract
International audience; Nutritional support in the intensive care setting represents a challenge but it is fortunate that its delivery and monitoring can be followed closely. Enteral feeding guidelines have shown the evidence in favor of early delivery and the efficacy of use of the gastrointestinal tract. Parenteral nutrition (PN) represents an alternative or additional approach when other routes are not succeeding (not necessarily having failed completely) or when it is not possible or would be unsafe to use other routes. The main goal of PN is to deliver a nutrient mixture closely related to requirements safely and to avoid complications. This nutritional approach has been a subject of debate over the past decades. PN carries the considerable risk of overfeeding which can be as deleterious as underfeeding. Therefore the authors will present not only the evidence available regarding the indications for PN, its implementation, the energy required, its possible complementary use with enteral nutrition, but also the relative importance of the macro- and micronutrients in the formula proposed for the critically ill patient. Data on long-term survival (expressed as 6 month survival) will also be considered a relevant outcome measure. Since there is a wide range of interpretations regarding the content of PN and great diversity in its practice, our guidance will necessarily reflect these different views. The papers available are very heterogeneous in quality and methodology (amount of calories, nutrients, proportion of nutrients, patients, etc.) and the different meta-analyses have not always taken this into account. Use of exclusive PN or complementary PN can lead to confusion, calorie targets are rarely achieved, and different nutrients continue to be used in different proportions. The present guidelines are the result of the analysis of the available literature, and acknowledging these limitations, our recommendations are intentionally largely expressed as expert opinions.
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- 2009
19. Can oxidative damage be treated nutritionally?
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Mette M. Berger
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Vitamin ,medicine.medical_specialty ,Antioxidant ,Free Radicals ,Critical Illness ,medicine.medical_treatment ,Population ,Critical Care and Intensive Care Medicine ,medicine.disease_cause ,Antioxidants ,Lipid peroxidation ,Therapeutic approach ,chemistry.chemical_compound ,medicine ,Animals ,Humans ,Intensive care medicine ,education ,education.field_of_study ,Evidence-Based Medicine ,Nutrition and Dietetics ,business.industry ,Vitamins ,Evidence-based medicine ,Micronutrient ,Trace Elements ,Surgery ,Disease Models, Animal ,Oxidative Stress ,Treatment Outcome ,chemistry ,Dietary Supplements ,business ,Oxidation-Reduction ,Oxidative stress - Abstract
Summary Background & aims : Nutrition and dietary patterns have been shown to have direct impact on health of the population and of selected patient groups. The beneficial effects have been attributed to the reduction of oxidative damage caused by the normal or excessive free radical production. The papers aims at collecting evidence of successful supplementation strategies Methods : Review of the literature reporting on antioxidant supplementation trials in the general population and critically ill patients. Results : Antioxidant vitamin and trace element intakes have been shown to be particularly important in the prevention of cancer, cardiovascular diseases, age related ocular diseases and in aging. In animal models, targeted interventions have been associated with reduction of tissue destruction is brain and myocardium ischemia-reperfusion models. In the critically ill antioxidant supplements have resulted in reduction of organ failure and of infectious complications. Conclusions : Antioxidant micronutrients have beneficial effects in defined models and pathologies, in the general population and in critical illness: ongoing research encourages this supportive therapeutic approach. Further research is required to determined the optimal micronutrient combinations and the doses required according to timing of intervention.
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- 2005
20. Enteral nutrition in critically ill patients with severe hemodynamic failure after cardiopulmonary bypass
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Jean-Pierre Revelly, René Chioléro, Marie-Christine Cayeux, and Mette M. Berger
- Subjects
Male ,medicine.medical_specialty ,Critical Care ,Critical Illness ,Critical Care and Intensive Care Medicine ,Severity of Illness Index ,Enteral administration ,law.invention ,Enteral Nutrition ,law ,Cardiopulmonary bypass ,Humans ,Medicine ,Prospective Studies ,Simplified Acute Physiology Score ,Aged ,Cardiopulmonary Bypass ,Nutrition and Dietetics ,business.industry ,Extracorporeal circulation ,Hemodynamics ,Nutritional Requirements ,Length of Stay ,Middle Aged ,Intensive care unit ,Surgery ,Cardiac surgery ,Intensive Care Units ,Treatment Outcome ,Parenteral nutrition ,SAPS II ,Anesthesia ,Female ,Energy Intake ,Energy Metabolism ,business - Abstract
Summary Background & aims: The study was designed to investigate and quantify nutritional support, and particularly enteral nutrition (EN), in critically ill patients with severe hemodynamic failure. Methods: Prospective, descriptive study in a surgical intensive care unit (ICU) in a university teaching hospital: patients aged 67±13 yrs (mean±SD) admitted after cardiac surgery with extracorporeal circulation, staying ⩾5 days in the ICU with acute cardiovascular failure. Severity of disease was assessed with SAPS II, and SOFA scores. Variables were energy delivery and balance, nutrition route, vasopressor doses, and infectious complications. Artificial feeding delivered according to ICU protocol. EN was considered from day 2–3. Energy target was set 25 kcal/kg/day to be reached stepwise over 5 days. Results: Seventy out of 1114 consecutive patients were studied, aged 67±17 years, and staying 10±7 days in the ICU. Median SAPS II was 43. Nine patients died (13%). All patients had circulatory failure: 18 patients required intra-aortic balloon-pump support (IABP). Norepinephrine was required in 58 patients (83%). Forty patients required artificial nutrition. Energy delivery was very variable. There was no abdominal complication related to EN. As a mean, 1360±620 kcal/kg/day could be delivered enterally during the first 2 weeks, corresponding to 70±35% of energy target. Enteral nutrient delivery was negatively influenced by increasing dopamine and norepinephrine doses, but not by the use of IABP. Conclusion: EN is possible in the majority of patients with severe hemodynamic failure, but usually results in hypocaloric feeding. EN should be considered in patients with careful abdominal and energy monitoring.
- Published
- 2005
21. What are the clinical risks related to the nutritional support of obese patients?
- Author
-
Mette M. Berger and René Chioléro
- Subjects
medicine.medical_specialty ,Nutrition and Dietetics ,business.industry ,Medicine ,Critical Care and Intensive Care Medicine ,business ,Intensive care medicine - Published
- 2002
22. PT10.1: Adapting Burn Trace Element Repletion: A New Burn Wound Exudate Collection Method Confirms Important CU Losses
- Author
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Paris Jafari, Wassim Raffoul, Marc Augsburger, Aurélien Thomas, Lee Ann Applegate, Olivier Pantet, and Mette M. Berger
- Subjects
Exudate ,medicine.medical_specialty ,Nutrition and Dietetics ,Burn wound ,business.industry ,Trace element ,Medicine ,medicine.symptom ,Critical Care and Intensive Care Medicine ,business ,Collection methods ,Surgery - Published
- 2017
23. MON-P011: Trace Element Repletion Following Severe Burn Injury: A 16-Year Retrospective Cohort Study
- Author
-
A. Vernay, Patricia Stoecklin, M. Charrière, Olivier Pantet, and Mette M. Berger
- Subjects
medicine.medical_specialty ,Pediatrics ,Nutrition and Dietetics ,business.industry ,Trace element ,Medicine ,Severe burn ,Retrospective cohort study ,Critical Care and Intensive Care Medicine ,business ,Surgery - Published
- 2017
24. MON-P009: Impact of Decreasing Energy Intakes in Major Burn Patients: A 15-Year Cohort Study
- Author
-
S. Patricia, Mette M. Berger, A. Vernay, and Olivier Pantet
- Subjects
medicine.medical_specialty ,Nutrition and Dietetics ,business.industry ,Emergency medicine ,medicine ,Energy intakes ,Major burn ,Critical Care and Intensive Care Medicine ,Intensive care medicine ,business ,Cohort study - Published
- 2016
25. SUN-LB259: Cost-Effectiveness of the Swiss Supplemental Parenteral Nutrition (SPN) Intervention
- Author
-
Lorenzo Pradelli, A. Ehm, Claude Pichard, E. Fries-Schaffner, S. Graf, and Mette M. Berger
- Subjects
medicine.medical_specialty ,Nutrition and Dietetics ,Parenteral nutrition ,business.industry ,Cost effectiveness ,Intervention (counseling) ,Medicine ,Critical Care and Intensive Care Medicine ,business ,Intensive care medicine - Published
- 2016
26. Selenium losses in 10 burned patients
- Author
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I. Bartholdi, H. Dirren, C. Cavadini, A. Blondel, S. Krupp, Mette M. Berger, J. Freeman, A. Bart, A. Vandervale, and René Chioléro
- Subjects
medicine.medical_specialty ,Measurement method ,Nutrition and Dietetics ,business.industry ,Urinary system ,chemistry.chemical_element ,Urine ,Glutathione ,Critical Care and Intensive Care Medicine ,Deficiency state ,Excretion ,chemistry.chemical_compound ,Endocrinology ,Animal science ,chemistry ,Internal medicine ,medicine ,business ,Total body surface area ,Selenium - Abstract
To determine the selenium (Se) losses and balances, 10 patients with burns of 32 +/- 9% (mean +/- SD) of total body surface and aged 36 +/- 9 years were studied from D1 (first post-injury) unitl D7. Cutaneous losses were extracted from the textiles surrounding the patients. Serum and urine were collected until D20. Exudative losses of nitrogen decreased progressively (mean 8.7 +/- 3.8 g/24H). Se was detectable in wound seepage only during excision-grafting: mean operative loss was 342 +/- 191 mug. Mean urinary Se excretion was 41 +/- 13 mug/24H. Operative cutaneous losses led to some negative balances. Serum Se and glutathione peroxydase (GSHPx) were depressed until D20. Serum Se was related to N intake (p0.001). The decreased Se and GSHPx levels reflect a deficiency state, which measured losses did not explain, but limitations of the measurement methods prevented detection of Se cutaneous losses 100 mug/24H.
- Published
- 1992
27. PP002-MON: Do Protein or Energy Intakes Matter in Major Burns – Preliminary Results
- Author
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M. Charrière, Mette M. Berger, Y.-A. Que, Olivier Pantet, and A. Vernay
- Subjects
medicine.medical_specialty ,Nutrition and Dietetics ,business.industry ,Environmental health ,Medicine ,Energy intakes ,Critical Care and Intensive Care Medicine ,business ,Surgery - Published
- 2014
28. PP001-MON: Contribution of Propofol Sedation to Energy and Lipid Intake in Critically Ill Patients in 2 University Hospitals
- Author
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Jennifer Hastings, Emma J. Ridley, M. Charrière, Carlos Scheinkestel, Oliver Bianchet, and Mette M. Berger
- Subjects
medicine.medical_specialty ,Nutrition and Dietetics ,Critically ill ,Research centre ,business.industry ,Intensive care ,Medicine ,Clinical nutrition ,Critical Care and Intensive Care Medicine ,business ,Intensive care medicine ,University hospital ,Propofol sedation - Abstract
PP001-MON CONTRIBUTION OF PROPOFOL SEDATION TO ENERGY AND LIPID INTAKE IN CRITICALLY ILL PATIENTS IN 2 UNIVERSITY HOSPITALS M. Charriere1, E. Ridley2, J. Hastings3, O. Bianchet3, C. Scheinkestel3, M.M. Berger4. 1Adult ICU/Clinical nutrition, CHUV, Lausanne, Switzerland; 2ANZIC Research Centre, Monash University, 3ICU, Alfred Hospital, Melbourne, Australia; 4Adult Intensive Care, CHUV, Lausanne, Switzerland
- Published
- 2014
29. Corrigendum to 'ESPEN endorsed recommendation: Nutritional therapy in major burns' [Clin Nutr 32 (4) (2013) 497–502]
- Author
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Mette M. Berger, Carole Ichai, Marie-Reine Losser, and Anne-Françoise Rousseau
- Subjects
medicine.medical_specialty ,Nutrition and Dietetics ,business.industry ,Nice ,Surgical intensive care unit ,Critical Care and Intensive Care Medicine ,University hospital ,Family medicine ,Intensive care ,medicine ,Medical nutrition therapy ,Intensive care medicine ,business ,computer ,computer.programming_language - Abstract
Corrigendum to “ESPEN endorsed recommendation: Nutritional therapy in major burns” [Clin Nutr 32 (4) (2013) 497e502] Anne-Francoise Rousseau , Marie-Reine Losser , Carole Ichai , Mette M. Berger d,*,e Burn Centre and General Intensive Care Department, University Hospital, Liege, Belgium b Intensive Care Department, University Hospital, Nancy, France Medical and Surgical Intensive Care Unit, Saint-Roch Hospital, University of Medicine of Nice, Nice, France d Service of Adult Intensive Care Medicine and Burns Centre, University Hospital (CHUV), Lausanne, Switzerland
- Published
- 2013
30. PP002-MON IMPACT OF THE DIETITIAN'S ABSENCE ON THE ICU'S NUTRITIONAL PERFORMANCE
- Author
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Ludivine Soguel, M. Charrière, Marie-Denise Schaller, François P. Pralong, and Mette M. Berger
- Subjects
medicine.medical_specialty ,Nutrition and Dietetics ,business.industry ,medicine ,Critical Care and Intensive Care Medicine ,Intensive care medicine ,business - Published
- 2013
31. PP006-MON INDIRECT CALORIMETRY IN THE ICU: INDICATIONS, FEASIBILITY, IMPACT AND COMPLIANCE
- Author
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M. Charrière, Mette M. Berger, and F. Delodder
- Subjects
Compliance (physiology) ,medicine.medical_specialty ,Nutrition and Dietetics ,business.industry ,Medicine ,Critical Care and Intensive Care Medicine ,business ,Intensive care medicine - Published
- 2013
32. Splanchnic metabolism of enterally infused sodium 13C acetate
- Author
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Luc Tappy, R. Chiole´ro, Valentine Rey, M. Bollman, Mette M. Berger, C. Cayeux, P. Schneiter, and Jean-Pierre Revelly
- Subjects
Nutrition and Dietetics ,chemistry ,business.industry ,Sodium ,Medicine ,chemistry.chemical_element ,Metabolism ,Pharmacology ,Critical Care and Intensive Care Medicine ,Splanchnic ,business - Published
- 2003
33. Effects of fish oil on the neuro-endocrine responses to an endotoxin challenge in healthy volunteers
- Author
-
Michaeli, Burkhard, primary, M. Berger, Mette, additional, Revelly, Jean-Pierre, additional, Tappy, Luc, additional, and Chioléro, René, additional
- Published
- 2007
- Full Text
- View/download PDF
34. Copper, selenium, and zinc balances in critically ill during continuous venovenous hemodiafiltration (CVVHDF)
- Author
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Alan Shenkin, E. Roberts, Marie-Christine Cayeux, Jean-Pierre Revelly, Mette M. Berger, Marc D. Bollmann, and René Chioléro
- Subjects
medicine.medical_specialty ,Nutrition and Dietetics ,business.industry ,Critically ill ,chemistry.chemical_element ,Continuous venovenous hemodiafiltration ,Zinc ,Critical Care and Intensive Care Medicine ,Copper ,chemistry ,Medicine ,business ,Intensive care medicine ,Selenium - Published
- 2003
35. Metabolic effects of parenteral nutrition with or without N-3 fatty acids
- Author
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Marie-Christine Cayeux, Jean-Marc Schwarz, Jean-Pierre Revelly, Mette M. Berger, Luc Tappy, René Chioléro, and Marc D. Bollmann
- Subjects
Nutrition and Dietetics ,Parenteral nutrition ,business.industry ,Metabolic effects ,Medicine ,N-3 fatty acids ,Pharmacology ,Critical Care and Intensive Care Medicine ,business - Published
- 2003
36. Effects of N-3 pufas on metabolic, inflammatory and systemic responses to single LPS-injection in healthy volunteers
- Author
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Marie-Christine Cayeux, Luc Tappy, Jean-Pierre Revelly, Burkhard Michaeli, R. Chiole´ro, and Mette M. Berger
- Subjects
Nutrition and Dietetics ,business.industry ,Healthy volunteers ,Medicine ,Pharmacology ,Critical Care and Intensive Care Medicine ,business ,N 3 pufa - Published
- 2003
37. P.65 Gastrointestinal function after cardiac surgery
- Author
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L. Berger, P. Wiesel, René Chioléro, Pierre Voirol, Mette M. Berger, C. Cayeux, and M. Hurni
- Subjects
medicine.medical_specialty ,Nutrition and Dietetics ,business.industry ,Internal medicine ,medicine ,Cardiology ,Critical Care and Intensive Care Medicine ,business ,Gastrointestinal function ,Cardiac surgery - Published
- 1997
38. O.6 Trace element supplements have pharmacological effects and reduce infectious complications in burns — a randomized trial
- Author
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Alan Shenkin, L. Wiesner, François Spertini, C. Schindler, Malcolm Baines, Mette M. Berger, and René Chioléro
- Subjects
medicine.medical_specialty ,Nutrition and Dietetics ,Randomized controlled trial ,business.industry ,law ,Internal medicine ,medicine ,Trace element ,Critical Care and Intensive Care Medicine ,business ,law.invention - Published
- 1997
39. [Untitled]
- Author
-
Mette M. Berger
- Subjects
Human health ,Nutrition and Dietetics ,business.industry ,Medicine ,Disease ,Theology ,Critical Care and Intensive Care Medicine ,business - Published
- 1997
40. P.74 Markers of oxidative protection in major trauma patients following trace element supplementation
- Author
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C.A. Wardle, René Chioléro, A. Pannatierer, Mette M. Berger, Alan Shenkin, and Malcolm Baines
- Subjects
Nutrition and Dietetics ,Trace element supplementation ,business.industry ,Major trauma ,medicine ,Physiology ,Oxidative phosphorylation ,Critical Care and Intensive Care Medicine ,medicine.disease ,business - Published
- 1996
41. Is lipid peroxidation in burns modulated by the trace element intakes?
- Author
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A. Rytz, C. Cavadini, René Chioléro, M. Guichardant, and Mette M. Berger
- Subjects
Lipid peroxidation ,chemistry.chemical_compound ,Nutrition and Dietetics ,chemistry ,Biochemistry ,business.industry ,Trace element ,Medicine ,Food science ,Critical Care and Intensive Care Medicine ,business - Published
- 1994
42. Redistribution of selenium: cause of the ‘low T3 syndrome’ in trauma?
- Author
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Mette M. Berger, T. Lemarchand-Beraud, René Chioléro, C. Cavadini, and C. Nielsen
- Subjects
medicine.medical_specialty ,Nutrition and Dietetics ,Endocrinology ,chemistry ,business.industry ,Internal medicine ,medicine ,chemistry.chemical_element ,Low T3 Syndrome ,Redistribution (chemistry) ,Critical Care and Intensive Care Medicine ,business ,Selenium - Published
- 1994
43. Effect of increased Cu, Zn and Se on leucocytes in burns
- Author
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H. Dirren, S. Guinchard, Mette M. Berger, S. Krupp, and C. Cavadini
- Subjects
Nutrition and Dietetics ,business.industry ,Medicine ,Critical Care and Intensive Care Medicine ,business ,Nuclear chemistry - Published
- 1992
44. Copper in burns: cutaneous and urinary losses
- Author
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S. Krupp, R. Mansourian, J. Freeman, H. Dirren, C. Cavadini, A. Vandervale, René Chioléro, A. Bart, and Mette M. Berger
- Subjects
medicine.medical_specialty ,Nutrition and Dietetics ,chemistry ,business.industry ,Urinary system ,medicine ,chemistry.chemical_element ,Critical Care and Intensive Care Medicine ,business ,Dermatology ,Copper - Published
- 1991
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