Critical energy deficit and mortality in critically ill patients

Objective: We investigate the influence of caloric and protein deficit on mortality and length of hospital stay of critically ill patients. Methods: A cohort prospective study including 100 consecutive patients in a tertiary intensive care unit (ICU) receiving enteral or parenteral nutrition. The daily caloric and protein deficit were collected each day for a maximum of 30 days. Energy deficits were divided into critical caloric deficit (≥ 480 kcal/day) and non-critical caloric deficit (≤ 480 kcal/day); and in critical protein deficit (≥ 20 g/day) and non-critical protein deficit (≤ 20 g/day). The findings were correlated with hospital stay and mortality. Results: The mortality rate was 33%. Overall, the patients received 65.4% and 67.7% of the caloric and protein needs. Critical caloric deficit was found in 72% of cases and critical protein deficit in 70% of them. There was a significant correlation between length of stay and accumulated caloric deficit (R = 0.37; p < 0.001) and protein deficit (R = 0.28; p < 0.001). The survival analysis showed that mortality was greater in patients with both critical caloric (p < 0.001) and critical protein deficits (p < 0.01). The Cox regression analysis showed that critical protein deficit was associated with higher mortality (HR 0.25, 95% CI 0.07-0.93, p = 0.03). Conclusions: The incidence of caloric and protein deficit in the ICU is high. Both caloric and protein deficits increase the length of hospital stay, and protein deficit greater than 20 g/day is an independent factor for mortality in critical care unit.

Pathological anatomy and self-portraiture

Why should an artist look to anatomical or pathological specimens as a reservoir of images with which to facilitate an articulation of his or her own artistic or personal identity? This is the starting point of a reflection on the disappearance of the artist and its transformation into a passive object. As a result, it is also a reflection into the blurring lines between subject and object. On the grounds of the work elaborated by the artist Lisa Temple-Cox and the critical look and comments made by the observer Harcourt, this paper is a first-hand attempt to understand the configuration of the self and the influence of the artistic intervention in the generation and representation of anatomical knowledge, resulting in an exploration into the intertwined processes that create both historical subjects and historical objects.