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4. Nutrition delivery across hospitalisation in critically ill patients with COVID-19: An observational study of the Australian experience

Author

Chapple, Lee-anne S., Ridley, Emma J., Ainscough, Kate, Ballantyne, Lauren, Burrell, Aidan, Campbell, Lewis, Dux, Claire, Ferrie, Suzie, Fetterplace, Kate, Fox, Virginia, Jamei, Matin, King, Victoria, Serpa Neto, Ary, Nichol, Alistair, Osland, Emma, Paul, Eldho, Summers, Matthew J., Marshall, Andrea P., and Udy, Andrew

Published
2024
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14. Study protocol for TARGET protein: The effect of augmented administration of enteral protein to critically ill adults on clinical outcomes: A cluster randomised, cross-sectional, double cross-over, clinical trial

Author

Summers, Matthew J., Chapple, Lee-anne S., Bellomo, Rinaldo, Chapman, Marianne J., Ferrie, Suzie, Finnis, Mark E., French, Craig, Hurford, Sally, Kakho, Nima, Karahalios, Amalia, Maiden, Matthew J., O'Connor, Stephanie N., Peake, Sandra L., Presneill, Jeffrey J., Ridley, Emma J., Tran-Duy, An, Williams, Patricia J., Young, Paul J., Zaloumis, Sophie, and Deane, Adam M.

Published
2023
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20. Characteristics of enteral and oral nutrition support among infants and young children in the pediatric intensive care unit: A descriptive cohort study.

Author

Winderlich, Jacinta, Little, Bridget, Oberender, Felix, Bollard, Tessa, Farrell, Tamara, Jenkins, Samantha, Landorf, Emma, McCall, Andrea, Menzies, Jessica, O'Brien, Katie, Rowe, Carla, Sim, Kirsten, van der Wilk, Melanie, Woodgate, Jemma, Paul, Eldho, Udy, Andrew A., and Ridley, Emma J.

Subjects
PEDIATRIC intensive care, ENTERAL feeding, INTENSIVE care units, NUTRITION, BREAST milk, INFANT formulas, CHILD nutrition
Abstract

Background: Children who are critically ill are often reliant on enteral and oral nutrition support. However, there is limited evidence to guide "what" to prescribe, and current practice is unknown. The primary objective of this study was to describe enteral nutrition prescription in children ≤2 years of age in the pediatric intensive care unit (PICU). The secondary objectives were to describe oral nutrition support practices and factors associated with the use of increased energy and protein density nutrition support. Methods: Children ≤2 years of age admitted to participating PICUs over a 2‐week period in June 2021 were enrolled. Data were collected on PICU admission days 1 to 7, 14, 21, and 28 on the mode of nutrition, enteral and oral nutrition support prescription, and dietitian intervention. Results: Eighty‐four children were included (49 [58%] male; 79 [94%] ≤1 year of age). Enteral nutrition was administered to 79 (94%) children (with expressed breast milk in 45 [57%]). Forty‐three children received formula as enteral nutrition. Increased energy and protein density formulas were provided to 14 (33%) children enterally, with concentrated standard infant formula powder being the most common (5 [12%]). Among children offered oral intake (22; 26%), three (14%) received oral nutrition support. Children who received increased energy and protein density enteral nutrition were more likely to receive dietitian intervention (P = 0.002). Conclusion: In children ≤2 years of age admitted to PICU, expressed breast milk was provided to half of those requiring enteral nutrition and oral nutrition support prescription was infrequent. One third of children receiving formula via enteral nutrition received an increased energy and protein density feed, and this was strongly associated with dietitian intervention. [ABSTRACT FROM AUTHOR]

Published
2024
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26. Nutrition considerations for patients with persistent critical illness: A narrative review.

Author

Viner Smith, Elizabeth, Lambell, Kate, Tatucu‐Babet, Oana A., Ridley, Emma, and Chapple, Lee‐anne

Abstract

Critically ill patients experience high rates of malnutrition and significant muscle loss during their intensive care unit (ICU) admission, impacting recovery. Nutrition is likely to play an important role in mitigating the development and progression of malnutrition and muscle loss observed in ICU, yet definitive clinical trials of nutrition interventions in ICU have failed to show benefit. As improvements in the quality of medical care mean that sicker patients are able to survive the initial insult, combined with an aging and increasingly comorbid population, it is anticipated that ICU length of stay will continue to increase. This review aims to discuss nutrition considerations unique to critically ill patients who have persistent critical illness, defined as an ICU stay of >10 days. A discussion of nutrition concepts relevant to patients with persistent critical illness will include energy and protein metabolism, prescription, and delivery; monitoring of nutrition at the bedside; and the role of the healthcare team in optimizing nutrition support. [ABSTRACT FROM AUTHOR]

Published
2024
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31. The impact of chlortetracycline on Drosophila melanogaster and Aedes aegypti

Author

Ridley, Emma and Douglas, Angela

Subjects
590
Abstract

Microbial symbionts of insects have been demonstrated to play an important role in the nutrition and protection of the host; these include aphids and tsetse. Studies often use antibiotics to eliminate the symbionts but the deleterious impact of using these antibiotics is not commonly addressed. The impact of chlortetracycline treatment on Aedes aegypti and Drosophila melanogaster was investigated by assessing life-span, fecundity, development time, survival, nutrition and metabolism. The impact on microbial numbers and diversity was also determined. With Drosophila, treatment with 50 µg ml-1 and above showed a significant extension in development time and life-span, reduction in fecundity and change in nutritional content. Microbial numbers were significantly reduced at 50 µg ml-1 and above. Culturable techniques and 454 pyrosequencing, demonstrated that the microbial diversity of Drosophila was predominantly Acetobacter. Bacterial elimination through egg dechorionation yielded some similar results to chlortetracycline treatment. However, fecundity and life-span was not significantly affected. Microarray analysis established a significant reduction in the abundance of transcripts associated with immunity, particularly antimicrobial peptides. With Aedes aegypti, treatment significantly reduced the survival and also affected the life-span and nutrition of the insect. Microbial numbers of mosquito larvae were reduced at 30 and 100 µg ml-1. Colonies grew on plates supplemented with 50 µg ml-1 of chlortetracycline, indicating that the larvae bore chlortetracycline-resistant bacteria. 454 pyrosequencing demonstrated a change in diversity of bacteria found in mosquitoes +/- chlortetracycline, switching from Elizabethkingia meningoseptica to Raoultella sp with chlortetracycline. It is concluded that chlortetracycline significantly impacts the performance of the 2 insects through bacterial depletion, changes to bacterial diversity and toxicity. Nevertheless, different responses were observed with Aedes aegypti and Drosophila melanogaster. Moreover, experiments with Drosophila using egg dechorionation, emphasised the toxic impact of using antibiotics to eliminate microbes in the insect host.

Published
2011

33. Personalized nutrition therapy in critical care: 10 expert recommendations

Author

Wischmeyer, Paul E., primary, Bear, Danielle E., additional, Berger, Mette M., additional, De Waele, Elisabeth, additional, Gunst, Jan, additional, McClave, Stephen A., additional, Prado, Carla M., additional, Puthucheary, Zudin, additional, Ridley, Emma J., additional, Van den Berghe, Greet, additional, and van Zanten, Arthur R. H., additional

Published
2023
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39. Personalized nutrition therapy in critical care: 10 expert recommendations

Author

Wischmeyer, Paul E, Bear, Danielle E, Berger, Mette M, De Waele, Elisabeth, Gunst, Jan, McClave, Stephen A, Prado, Carla M, Puthucheary, Zudin, Ridley, Emma J, Van den Berghe, Greet, and van Zanten, Arthur RH

Subjects
Critical Care, Nutritional Support, Protein, Critical Illness, Nutritional Status, Indirect calorimetry, Parenteral nutrition, Body composition, TPN, Intensive Care Units, Enteral Nutrition, ICU, Muscle, Humans, Testosterone, Micronutrients, Critical illness, Enteral nutrition, Nutrition
Abstract

Personalization of ICU nutrition is essential to future of critical care. Recommendations from American/European guidelines and practice suggestions incorporating recent literature are presented. Low-dose enteral nutrition (EN) or parenteral nutrition (PN) can be started within 48 h of admission. While EN is preferred route of delivery, new data highlight PN can be given safely without increased risk; thus, when early EN is not feasible, provision of isocaloric PN is effective and results in similar outcomes. Indirect calorimetry (IC) measurement of energy expenditure (EE) is recommended by both European/American guidelines after stabilization post-ICU admission. Below-measured EE (~ 70%) targets should be used during early phase and increased to match EE later in stay. Low-dose protein delivery can be used early (~ D1-2) (

Published
2023

41. Dietitian and nutrition-related practices and resources in Australian and New Zealand PICUs: A clinician survey

Author

Winderlich, Jacinta, primary, Little, Bridget, additional, Oberender, Felix, additional, Farrell, Tamara, additional, Jenkins, Samantha, additional, Landorf, Emma, additional, Menzies, Jessica, additional, O'Brien, Katie, additional, Rowe, Carla, additional, Sim, Kirsten, additional, van der Wilk, Melanie, additional, Woodgate, Jemma, additional, Udy, Andrew A., additional, and Ridley, Emma J., additional

Published
2023
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44. Personalized nutrition therapy in critical care : 10 expert recommendations

Author

Wischmeyer, Paul E., Bear, Danielle E., Berger, Mette M., De Waele, Elisabeth, Gunst, Jan, McClave, Stephen A., Prado, Carla M., Puthucheary, Zudin, Ridley, Emma J., Van den Berghe, Greet, van Zanten, Arthur R.H., Wischmeyer, Paul E., Bear, Danielle E., Berger, Mette M., De Waele, Elisabeth, Gunst, Jan, McClave, Stephen A., Prado, Carla M., Puthucheary, Zudin, Ridley, Emma J., Van den Berghe, Greet, and van Zanten, Arthur R.H.

Abstract

Personalization of ICU nutrition is essential to future of critical care. Recommendations from American/European guidelines and practice suggestions incorporating recent literature are presented. Low-dose enteral nutrition (EN) or parenteral nutrition (PN) can be started within 48 h of admission. While EN is preferred route of delivery, new data highlight PN can be given safely without increased risk; thus, when early EN is not feasible, provision of isocaloric PN is effective and results in similar outcomes. Indirect calorimetry (IC) measurement of energy expenditure (EE) is recommended by both European/American guidelines after stabilization post-ICU admission. Below-measured EE (~ 70%) targets should be used during early phase and increased to match EE later in stay. Low-dose protein delivery can be used early (~ D1-2) (< 0.8 g/kg/d) and progressed to ≥ 1.2 g/kg/d as patients stabilize, with consideration of avoiding higher protein in unstable patients and in acute kidney injury not on CRRT. Intermittent-feeding schedules hold promise for further research. Clinicians must be aware of delivered energy/protein and what percentage of targets delivered nutrition represents. Computerized nutrition monitoring systems/platforms have become widely available. In patients at risk of micronutrient/vitamin losses (i.e., CRRT), evaluation of micronutrient levels should be considered post-ICU days 5–7 with repletion of deficiencies where indicated. In future, we hope use of muscle monitors such as ultrasound, CT scan, and/or BIA will be utilized to assess nutrition risk and monitor response to nutrition. Use of specialized anabolic nutrients such as HMB, creatine, and leucine to improve strength/muscle mass is promising in other populations and deserves future study. In post-ICU setting, continued use of IC measurement and other muscle measures should be considered to guide nutrition. Research on using rehabilitation interventions such as cardiopulmonary exercise testing (CPET

Published
2023

48. COVID‐19: Nutrition Perspectives

Author

Ridley, Emma J., primary, Chapple, Lee‐anne S., additional, Burrell, Aidan, additional, Fetterplace, Kate, additional, Freeman‐Sanderson, Amy, additional, Marshall, Andrea P., additional, and Neto, Ary Serpa, additional

Published
2022
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