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49 results on '"Heyland, Daren"'

2. The long-term intercorrelation between post-burn pain, anxiety, and depression: a post hoc analysis of the “RE-ENERGIZE” double-blind, randomized, multicenter placebo-controlled trial

Author

Panayi, Adriana C., Heyland, Daren K., Stoppe, Christian, Jeschke, Marc G., Didzun, Oliver, Matar, Dany, Tapking, Christian, Palackic, Alen, Bliesener, Björn, Harhaus, Leila, Knoedler, Samuel, Haug, Valentin, Bigdeli, Amir K., Kneser, Ulrich, Orgill, Dennis P., and Hundeshagen, Gabriel

Published
2024
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6. The impact of higher protein dosing on outcomes in critically ill patients with acute kidney injury: a post hoc analysis of the EFFORT protein trial

Author

Stoppe, Christian, Patel, Jayshil J., Zarbock, Alex, Lee, Zheng-Yii, Rice, Todd W., Mafrici, Bruno, Wehner, Rebecca, Chan, Man Hung Manuel, Lai, Peter Chi Keung, MacEachern, Kristen, Myrianthefs, Pavlos, Tsigou, Evdoxia, Ortiz-Reyes, Luis, Jiang, Xuran, Day, Andrew G., Hasan, M. Shahnaz, Meybohm, Patrick, Ke, Lu, and Heyland, Daren K.

Published
2023
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19. A randomized trial of supplemental parenteral nutrition in underweight and overweight critically ill patients: the TOP-UP pilot trial

Author

Wischmeyer, Paul E., primary, Hasselmann, Michel, additional, Kummerlen, Christine, additional, Kozar, Rosemary, additional, Kutsogiannis, Demetrios James, additional, Karvellas, Constantine J., additional, Besecker, Beth, additional, Evans, David K., additional, Preiser, Jean-Charles, additional, Gramlich, Leah, additional, Jeejeebhoy, Khursheed, additional, Dhaliwal, Rupinder, additional, Jiang, Xuran, additional, Day, Andrew G., additional, and Heyland, Daren K., additional

Published
2017
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20. Role of nutrition support in adult cardiac surgery: a consensus statement from an International Multidisciplinary Expert Group on Nutrition in Cardiac Surgery

Author

Stoppe, Christian, primary, Goetzenich, Andreas, additional, Whitman, Glenn, additional, Ohkuma, Rika, additional, Brown, Trish, additional, Hatzakorzian, Roupen, additional, Kristof, Arnold, additional, Meybohm, Patrick, additional, Mechanick, Jefferey, additional, Evans, Adam, additional, Yeh, Daniel, additional, McDonald, Bernard, additional, Chourdakis, Michael, additional, Jones, Philip, additional, Barton, Richard, additional, Tripathi, Ravi, additional, Elke, Gunnar, additional, Liakopoulos, Oliver, additional, Agarwala, Ravi, additional, Lomivorotov, Vladimir, additional, Nesterova, Ekaterina, additional, Marx, Gernot, additional, Benstoem, Carina, additional, Lemieux, Margot, additional, and Heyland, Daren K., additional

Published
2017
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23. Pro/con clinical debate: The use of a protected specimen brush in the diagnosis of ventilator associated pneumonia

Author

Heyland, Daren, Ewig, Santiago, and Torres, Antoni

Subjects
Male, Intensive Care Units, bronchoscopy, quantitative cultures, Attitude of Health Personnel, Commentary, Equipment Contamination, Humans, Pneumonia, Middle Aged, protected specimen brush, Respiration, Artificial, Anti-Bacterial Agents
Abstract

Although mechanical ventilation is instituted as a life-saving technique, it may lead to complications that can negatively impact on patients' morbidity and/or mortality. Ventilator associated pneumonia (VAP) is one such complication that is a common challenge to intensivists. Although most experts would agree that early 'appropriate' antibiotic use is essential in patients who develop VAP, the best diagnostic test to guide decision-making is far from clear. One diagnostic test that is capable of providing microbiological samples from the lower respiratory tree is invasive bronchoscopy with a protected specimen brush. Such a procedure has long been available to intensivists and is frequently employed in many intensive care units. However, this procedure has associated costs and potential complications, and its utility in VAP has been challenged. In this issue of Critical Care Forum, the two sides of this debate are brought forward with compelling arguments. The authors' arguments should fuel future trials.

Published
2002

27. Systematic review: The relation between nutrition and nosocomial pneumonia: randomized trials in critically ill patients

Author

Cook, Deborah, Jonghe, Bernard De, and Heyland, Daren

Subjects
ventilator-associated pneumonia, prevention, Research, nosocomial pneumonia, enteral nutrition, parenteral nutrition
Abstract

OBJECTIVE: To review the effect of enteral nutrition on nosocomial pneumonia in critically ill patients as summarized in randomized clinical trials. STUDY IDENTIFICATION AND SELECTION: Studies were identified through MEDLINE, SCISEARCH, EMBASE, the Cochrane Library, bibliographies of primary and review articles, and personal files. Through duplicate independent review, we selected randomized trials evaluating approaches to nutrition and their relation to nosocomial pneumonia. DATA ABSTRACTION: In duplicate, independently, we abstracted key data on the design features, population, intervention and outcomes of the studies. RESULTS: We identified four trials of enteral vs total parenteral nutrition, one trial of early enteral nutrition vs delayed enteral nutrition, one trial of gastric vs jejunal tube feeding, one trial of intermittent vs continuous enteral feeding, and three trials evaluating different enteral feeding formulae. Sample sizes were small, pneumonia definitions were variable and blinded outcome assessment was infrequent. Randomized trial evidence is insufficient to draw conclusions about the relation between enteral nutrition and nosocomial pneumonia. CONCLUSIONS: Nutritional interventions in critically ill patients appear to have a modest and inconsistent effect on nosocomial pneumonia. This body of evidence neither supports nor refutes the gastropulmonary route of infection.

Published
1997

34. Nutrition support practices in critically ill head-injured patients: a global perspective.

Author

Chapple, Lee-anne S., Chapman, Marianne J., Lange, Kylie, Deane, Adam M., and Heyland, Daren K.

Abstract

Background: Critical illness following head injury is associated with a hypermetabolic state but there are insufficient epidemiological data describing acute nutrition delivery to this group of patients. Furthermore, there is little information describing relationships between nutrition and clinical outcomes in this population. Methods: We undertook an analysis of observational data, collected prospectively as part of International Nutrition Surveys 2007-2013, and extracted data obtained from critically ill patients with head trauma. Our objective was to describe global nutrition support practices in the first 12 days of hospital admission after head trauma, and to explore relationships between energy and protein intake and clinical outcomes. Data are presented as mean (SD), median (IQR), or percentages. Results: Data for 1045 patients from 341 ICUs were analyzed. The age of patients was 44.5 (19.7) years, 78 % were male, and median ICU length of stay was 13.1 (IQR 7.9-21.6) days. Most patients (94 %) were enterally fed but received only 58 % of estimated energy and 53 % of estimated protein requirements. Patients from an ICU with a feeding protocol had greater energy and protein intakes (p <0.001, 0.002 respectively) and were more likely to survive (OR 0.65; 95 % CI 0.42-0.99; p = 0.043) than those without. Energy or protein intakes were not associated with mortality. However, a greater energy and protein deficit was associated with longer times until discharge alive from both ICU and hospital (all p <0.001). Conclusion: Nutritional deficits are commonplace in critically ill head-injured patients and these deficits are associated with a delay to discharge alive. [ABSTRACT FROM AUTHOR]

Published
2016
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46. Authors' response.

Author

Deane, Adam M, Dhaliwal, Rupinder, Day, Andrew, Ridley, Emma J, Davies, Andrew R, and Heyland, Daren K

Published
2014

47. Authors’ response.

Author

Mourtzakis, Marina, Moisey, Lesley, Heyland, Daren, and Kozar, Rosemary

Published
2013

48. Persistent organ dysfunction plus death: a novel, composite outcome measure for critical care trials.

Author

Heyland, Daren K, Muscedere, John, Drover, John, Jiang, Xuran, Day, Andrew G, and Canadian Critical Care Trials Group

Abstract

Introduction: Due to resource limitations, few critical care interventions have been rigorously evaluated with adequately powered randomized clinical trials (RCTs). There is a need to improve the efficiency of RCTs in critical care so that more definitive high quality RCTs can be completed with the available resources. The objective of this study was to validate and demonstrate the utility of a novel composite outcome measure, persistent organ dysfunction (POD) plus death, for clinical trials of critically ill patients.Methods: We performed a secondary analysis of a dataset from a prospective randomized trial involving 38 intensive care units (ICUs) in Canada, Europe, and the United States. We define POD as the persistence of organ dysfunction requiring supportive technologies during the convalescent phase of critical illness and it is present when a patient has an ongoing requirement for vasopressors, dialysis, or mechanical ventilation at the outcome assessments time points. In 600 patients enrolled in a randomized trial of nutrition therapy and followed prospectively for six months, we evaluated the prevalence of POD and its association with outcome.Results: At 28 days, 2.3% of patients had circulatory failure, 13.7% had renal failure, 8.7% had respiratory failure, and 27.2% had died, for an overall prevalence of POD + death = 46.0%. Of survivors at Day 28, those with POD, compared to those without POD, had a higher mortality rate in the six-month follow-up period, had longer ICU and hospital stays, and a reduced quality of life at three months. Given these rates of POD + death and using a two-sided Chi-squared test at alpha = 0.05, we would require 616 patients per arm to detect a 25% relative risk reduction (RRR) in mortality, but only 286 per arm to detect the same RRR in POD + mortality.Conclusions: POD + death may be a valid composite outcome measure and compared to mortality endpoints, may reduce the sample size requirements of clinical trials of critically ill patients. Further validation in larger clinical trials is required. [ABSTRACT FROM AUTHOR]

Published
2011
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49. Reduction of nosocomial pneumonia after major burns by trace element supplementation: aggregation of two randomised trials

Author

Berger, Mette, Eggimann, Philippe, Heyland, Daren, Chioléro, René, Revelly, Jean-Pierre, Day, Andrew, Raffoul, Wassim, and Shenkin, Alan

Abstract

Introduction Nosocomial pneumonia is a major source of morbidity and mortality after severe burns. Burned patients suffer trace element deficiencies and depressed antioxidant and immune defences. This study aimed at determining the effect of trace element supplementation on nosocomial or intensive care unit (ICU)-acquired pneumonia.Methods Two consecutive, randomised, double-blinded, supplementation studies including two homogeneous groups of 41 severely burned patients (20 placebo and 21 intervention) admitted to the burn centre of a university hospital were combined. Intervention consisted of intravenous trace element supplements (copper 2.5 to 3.1 mg/day, selenium 315 to 380 μg/day, and zinc 26.2 to 31.4 mg/day) for 8 to 21 days versus placebo. Endpoints were infections during the first 30 days (predefined criteria for pneumonia, bacteraemia, wound, urine, and other), wound healing, and length of ICU stay. Plasma and skin (study 2) concentrations of selenium and zinc were determined on days 3, 10, and 20.Results The patients, 42 ± 15 years old, were burned on 46% ± 19% of body surface: the combined characteristics of the patients did not differ between the groups. Plasma trace element concentrations and antioxidative capacity were significantly enhanced with normalisation of plasma selenium, zinc, and glutathione peroxidase concentrations in plasma and skin in the trace element-supplemented group. A significant reduction in number of infections was observed in the supplemented patients, which decreased from 3.5 ± 1.2 to 2.0 ± 1.0 episodes per patient in placebo group (p < 0.001). This was related to a reduction of nosocomial pneumonia, which occurred in 16 (80%) patients versus seven (33%) patients, respectively (p < 0.001), and of ventilator-associated pneumonia from 13 to six episodes, respectively (p = 0.023).Conclusion Enhancing trace element status and antioxidant defences by selenium, zinc, and copper supplementation was associated with a decrease of nosocomial pneumonia in critically ill, severely burned patients.

Published
2006
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