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Expert Pearls

Sepsis - ascorbic acid, vitamin C - 50917

Ascorbic Acid intravenously (AA) (50 mg/kg/day for 4 days) or high dose AA (200 mg/kg/day for 4 days) was given in 4 divided doses every 6 hours prepared in 50 ml aliquots of D5%W. Once the AA solution was prepared, the aliquots to be administered were kept at 4 degrees centigrade in the dark. The 50 ml aliquots had a light protected hood placed over the bag. When AA was to be infused, the hooded AA aliquot was taken from the ICU refrigerator and infused into the patient in light-protected tubing over 30 minutes. All these measures were taken to prevent AA from spontaneously oxidizing which it will do if these measures are not addressed. No nutrients were added to the AA solution. [J Transl Med. 2014;12:32. 50917 (8/2015)] Interview PubMed

Sepsis - carnitine - 49705

Carnitine (L) 12 grams given in an IV bolus and over 12 hours (normal saline) started within the first 18 hours after the diagnosis of sepsis showed mortality was significantly lower at 28 days in the L-carnitine group (4/16 vs 9/15), with a nonsignificant improved survival at 1 year. Carnitine therapy has very low side effects. [ JPEN J Parenter Enteral Nutr, 2013 July 12; [Epub ahead of print]. 49705 (8/2013)] Summary Interview PubMed

Sepsis - diet - 44455

Diet - enteral nutrition (continuous tube-feeding) mean daily doses were: EPA 4.9 ± 0.14 g/d; GLA 4.60 ± 0.13 g/d; vitamin C 907 ± 27 mg/d; vitamin E 346 ± 10 IU/d. [Crit Care Med., 2006 Jul 17; [Epub ahead of print]. 44455 (9/2006)] Summary Interview PubMed

Sepsis - fish oil - 44774

Fish oil 0.1 – 0.25 g/kg/d . (Commercially available fish oil-based lipid emulsions have about 4 g of n-3 fatty acids per 10 g of lipids supplied. For a patient of 70 kg and at an infused dose of 0.15 g/kg/d this would result in the provision of about 4 g of n-3 fatty acids per day). [Curr Opin Clin Nutr Metab Care, 2006 Mar;9(2):140-8. 44774 (11/2006)] Interview PubMed

Sepsis - fish oil - 47796

Fish oil given parenterally in a 50:40:10 mixture of medium-chain fatty acids, soybean oil and fish oil reduced interleukin-6 in the blood, improved lung function and shortened hospital stay. [Critical Care, Jan 19, 2010;14:R5. 47796 (5/2010)] Summary Interview PubMed

Sepsis - n-acetylcysteine - 46020

N-acetylcysteine 150 mg/kg and then 15 mg/kg/hr from a continuous I.V. infusion inhibited the adverse effects of E. coli endotoxin on renal function. [Crit Care Med, 2007; 35(8):1869-75. 46020 (7/2008)] Summary Interview PubMed

Sepsis - selenium - 23738

Selenium deficiency is a risk factor and should be assessed for, if deficient replaced with 200-1000 mcg/d. [Biological Trace Element Research, 1995;50:149-155. 23738 (1995)] Summary Interview PubMed
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