#ecuimres transcript

Healthcare Social Media Transcript

From: Fri Dec 07 0:00:00 PST 2012
To: Fri Dec 07 8:00:00 PST 2012

What is #ecuimres? Who were the influencers during this time period? #ecuimres analytics


Healthcare Conference  - Healthcare Tweet Chats  -  Healthcare Analytics

nephondemand
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#ecuimres #grandrounds 12/7: Periop Nutrition Intervention in Gastrointestinal Cancer Surgery by J Ochoa; profile here http://t.co/wKFLuMVw
nephondemand
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#ecuimres #grandrounds 12/7 by J Ochoa: nutrition is a medical therapy essential 4 all surgical pts; it is not a supportive therapy at all
nephondemand
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#ecuimres #grandrounds 12/7 by J Ochoa: colorectal sx outcomes from the SCOAP database is unacceptable http://t.co/5EzJD0bs
nephondemand
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#ecuimres #grandrounds 12/7 by J Ochoa: nutrition isn't intuitive; nutritional intervention should b done throughout the entirety of pt care
nephondemand
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#ecuimres #grandrounds 12/7 by J Ochoa: u can actually harm some pts w/nutritional intervention
nephondemand
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#ecuimres #grandrounds 12/7 by J Ochoa: albumin is the single most important discriminator 4 how pts will do p surgery: JPEN 2003 27:1-9
nephondemand
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#ecuimres #grandrounds 12/7 by J Ochoa: 7 d of TPN periop will reduce post-op complications from 45% to 5% p < 0.03; NEJM 1991 325(8):525
nephondemand
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#ecuimres #grandrounds 12/7 by J Ochoa: but TPN is difficult 2 manage. If TPN used in NON-malnourished pts, infxn rate triples! NEJM 325(8)
ecuimchiefs
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#ecuimres #grandrounds http://t.co/aPmjLsGL
nephondemand
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#ecuimres #grandrounds 12/7 by J Ochoa: in fact enteral nutrition is better than TPN 2 decr post-op complications Ann Surg 1993 Vol 217
nephondemand
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#ecuimres #grandrounds 12/7 by J Ochoa: so we know that malnourished pts absolutely need a nutritional intervention prior 2 surgery
ecuimchiefs
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#ecuimres #grandrounds Dr Ochoa asks "is there nutrition intervention that would benefit non-malnourished patients?"
nephondemand
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#ecuimres #grandrounds 12/7: Ochoa hypothesizes that restoration of nutritional state will improve t-lymphocytes & microcirculation
ecuimchiefs
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#ecuimres #grandrounds Discovery of Myeloid cells expressing arginase: http://t.co/5nkxfbXN
ecuimchiefs
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#ecuimres #grandrounds Nitric oxide levels differ in septic patients (high) vs trauma patients (low). http://t.co/QlmK5qmF
ecuimchiefs
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#ecuimres #grandrounds Dr Ochoa enforces that arginine levels influence T-cell function.
FMCNA
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RT @nephondemand: #ecuimres #grandrounds 12/7 by J Ochoa: so we know that malnourished pts absolutely need a nutritional intervention pr ...
nephondemand
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#ecuimres #grandrounds 12/7 by J Ochoa: shows a variety of mouse studies which indicate myeloid cells req Arginine 2 fxn;
nephondemand
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#ecuimres #grandrounds 12/7 by J Ochoa: in a meta analysis overall use of Arginine decr risk of Infxn: RR 0.6 p < 0.0001; Drover et al JACS
ecuimchiefs
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#ecuimres #grandrounds Arginine + omega fatty acids pre-op and post-op has beneficial effects on pts INDEPENDENT of nutritional status.
nephondemand
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#ecuimres #grandrounds 12/7: Arginine supplementation is best given in PERIop period & is independent of baseline nutritional status
nephondemand
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#ecuimres #grandrounds 12/7 by J Ochoa: Arginine is best administered with omega 3 fatty acid
nephondemand
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#ecuimres #grandrounds 12/7: nutritional bundle=smoking cessation, ensure med compliance, adequate blood sugar control, & take Arginine
ecuimchiefs
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#ecuimres #grandrounds Nutrition Intervention cannot work without full "bundle" ie: blood sugar control, tobacco cessation, med compliance
nephondemand
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#ecuimres #grandrounds 12/7 by J Ochoa: this nutritional bundle should b executed in all pts undergoing elective surgery 5-14 d preop
ecuimchiefs
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#ecuimres #grandrounds http://t.co/it9rHqa0
nephondemand
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#ecuimres #grandrounds 12/7 by J Ochoa: periop nutritional intervention algorithm here Current Opinion in Anesthesiology 2011 24:339-348

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