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CPD

Optimizing Nutrition Support in Critically Ill and Surgical Cancer Patients

  • Authors: Arved Weimann, MD, MA; Kenneth Fearon, MD; Daren Heyland, MD, MSc, FRCPC; Alessandro Laviano, MD; Jean-Charles Preiser, MD, PhD
  • CPD Released: 9/25/2015
  • THIS ACTIVITY HAS EXPIRED FOR CREDIT
  • Valid for credit through: 9/25/2016, 11:59 PM EST
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Target Audience and Goal Statement

This educational activity is intended for an international audience of non-US healthcare professionals, specifically hematologists/oncologists, critical care specialists, emergency care physicians, and nutritionists involved in the management of critically-ill and surgical cancer patients.

The goal of this activity is to improve physicians' understanding of nutrition as an independent risk factor of prognostic value and a therapeutic target in critically ill and surgical cancer patients.

Upon completion of this activity, participants will be able to:

  1. Recognize malnutrition as an independent risk factor of prognostic value and a therapeutic target in critically ill and surgical cancer patients
  2. Review the role of malnutrition in the pathophysiology, metabolic response, and alteration of prognosis in these patients
  3. Describe the latest nutritional guidelines and clinical findings on enteral nutrition in these patients


Disclosures

WebMD Global requires each individual who is in a position to control the content of one of its educational activities to disclose any relevant financial relationships occurring within the past 12 months that could create a conflict of interest.


Moderator

  • Arved Weimann, MD, MA

    Professor and Chief, Department of General and Visceral Surgery, St. Georg Hospital, Affiliated Hospital of the University of Leipzig, Leipzig, Germany

    Disclosures

    Disclosure: Arved Weimann, MD, MA has disclosed the following relevant financial relationships:
    Served as a speaker or a member of a speakers bureau for: Baxter; B. Braun Melsungen AG; Fresenius SE & Co. KGaA; Nestlé; Nutricia
    Received grants for clinical research from: Baxter; Danone

Faculty

  • Kenneth Fearon, MD

    Professor of Surgical Oncology, Department of Clinical and Surgical Sciences, School of Clinical Sciences and Community Health, University of Edinburgh, Royal Infirmary, Edinburgh, Scotland, UK

    Disclosures

    Disclosure: Kenneth Fearon, MD has disclosed the following relevant financial relationships:
    Served as an advisor or consultant for: Helsinn Therapeutics, Inc
    Served as a speaker or a member of a speakers bureau for: Fresenius SE & Co. KGaA; Helsinn Therapeutics, Inc
    Received grants for clinical research from: Novartis Pharmaceuticals Corporation

  • Daren Heyland, MD, MSc, FRCPC

    Professor, Department of Medicine, Director, Clinical Evaluation Research Unit, Kingston General Hospital, Queen's University, Kingston, Ontario, Canada

    Disclosures

    Disclosure: Daren Heyland, MD, MSc, FRCPC has disclosed the following relevant financial relationships:
    Served as an advisor or consultant for: GlaxoSmithKline; Lyric Pharmaceuticals
    Served as a speaker or a member of a speakers bureau for: Abbott Nutrition
    Received grants for clinical research from: Abbott Laboratories; GlaxoSmithKline; Lyric Pharmaceuticals; Nestlé

  • Alessandro Laviano, MD

    Associate professor, Department of Clinical Medicine, Sapienza University, Rome, Italy

    Disclosures

    Disclosure: Alessandro Laviano, MD has disclosed the following relevant financial relationships:
    Served as an advisor or consultant for: SmartFish
    Served as a speaker or a member of a speakers bureau for: Baxter; B. Braun Melsungen AG; Fresenius SE & Co. KGaA; Nestlé Health Science; Nutricia

  • Jean-Charles Preiser, MD, PhD

    Professor, Head of Clinic, Department of Intensive Care, Erasme University Hospital, Université Libre de Bruxelles, Brussels, Belgium

    Disclosures

    Disclosure: Jean-Charles Preiser, MD, PhD has disclosed no relevant financial relationships.

Editor

  • Jamieson Bretz, PhD

    Scientific Director, WebMD Global, LLC

    Disclosures

    Disclosure: Jamieson Bretz, PhD has disclosed no relevant financial relationships.

Content Reviewer

  • Robert Morris, PharmD

    Associate CME Clinical Director

    Disclosures

    Disclosure: Robert Morris, PharmD, has disclosed no relevant financial relationships.


Accreditation Statements

    For Physicians

  • The Faculty of Pharmaceutical Medicine of the Royal Colleges of Physicians of the United Kingdom (FPM) has reviewed and approved the content of this educational activity and allocated it 1.0 continuing professional development credits (CPD).

    Contact WebMD Global

For questions regarding the content of this activity, contact the accredited provider for this CME/CE activity noted above. For technical assistance, contact [email protected]


Instructions for Participation and Credit

There are no fees for participating in or receiving credit for this online educational activity. For information about your eligibility to claim credit, please consult your professional licensing board.

This activity is designed to be completed within the time designated on the title page; physicians should claim only those credits that reflect the time actually spent participating in the activity. To successfully earn credit, participants must complete the activity online during the credit eligibility period that is noted on the title page.

Follow these steps to claim a credit certificate for completing this activity:

  1. Read the information provided on the title page regarding the target audience, learning objectives, and author disclosures, read and study the activity content and then complete the post-test questions. If you earn a passing score on the post-test and we have determined based on your registration profile that you may be eligible to claim CPD credit for completing this activity, we will issue you a CPD credit certificate.
  2. Once your CPD credit certificate has been issued, you may view and print the certificate from your CME/CE Tracker. CPD credits will be tallied in your CME/CE Tracker and archived for 6 years; at any point within this time period you can print out the tally as well as the certificates by accessing "Edit Your Profile" at the top of the Medscape Education homepage.

We encourage you to complete an Activity Evaluation to provide feedback for future programming.

You may now view or print the certificate from your CME/CE Tracker. You may print the certificate but you cannot alter it. Credits will be tallied in your CME/CE Tracker and archived for 6 years; at any point within this time period you can print out the tally as well as the certificates by accessing "Edit Your Profile" at the top of your Medscape homepage.

*The credit that you receive is based on your user profile.

CPD

Optimizing Nutrition Support in Critically Ill and Surgical Cancer Patients

Authors: Arved Weimann, MD, MA; Kenneth Fearon, MD; Daren Heyland, MD, MSc, FRCPC; Alessandro Laviano, MD; Jean-Charles Preiser, MD, PhDFaculty and Disclosures
THIS ACTIVITY HAS EXPIRED FOR CREDIT

CPD Released: 9/25/2015

Valid for credit through: 9/25/2016, 11:59 PM EST

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Abbreviations

ACP = American College of Physicians
APACHE II = Acute Physiology and Chronic Health Evaluation II
APPR = acute-phase protein response
ARDsNET = Acute Respiratory Distress Syndrome Network
AUC = area under the curve
BIA = bioelectrical impedance analysis
BMI = body mass index
CAP = community-acquired pneumonia
CDC SSI = Centers for Disease Control surgical site infections
CHO = carbohydrate
CI = confidence interval
COPD = chronic obstructive pulmonary disease
CPG = clinical practice guidelines
CRP = C-reactive protein
CT = computed tomography
DHA = docosahexaenoic acid
EarlyPN (trial) = Early Parenteral Nutrition
EDEN (trial) = Early Versus Delayed Enteral Feeding to Treat People With Acute Lung Injury or Acute Respiratory Distress Syndrome
EE = energy expenditure
EN = enteral nutrition
ERAS = enhanced recovery after surgery
ESPEN = European Society for Clinical Nutrition and Metabolism
EPA = eicosapentaenoic acid
EPaNIC (trial) = Early versus late parenteral nutrition in critically ill adults
FFM = fat-free mass
FFMI = fat-free mass index
GPS = Glasgow Prognostic Score
HP = high-protein nutrition
HR = hazard ratio
ICC = intra-class correlation coefficient
ICU = intensive care unit
IL = interleukin
IMAT = intermuscular adipose tissue
IMDs = immune modulating diets
IMHP = immune-modulating nutrients
IR = interquartile range
IV = intravenous
LCP = long-chain polyunsaturated (fatty acids)
LOS = length of stay
LRA = logical regression analysis
MNA = mini-nutritional assessment
MUST = malnutrition universal screening tool
NG = nasogastric
NRS = nutritional risk screening
NS = not significant
NSAID = nonsteroidal anti-inflammatory
NUTRIC = Nutrition Risk in Critically Ill
ONS = oral nutritional supplement
OR = odds ratio
ORIF = open reduction, internal fixation
OS = overall survival
PANDORA = Patient- And Nutrition-Derived Outcome Risk Assessment Score
PCT = procalcitonin
PermiT (trial) = Permissive Underfeeding vs Target Enteral Feeding in Adult Critically Ill Patients
PN = parenteral nutrition
RCT = randomized control trials
RE = random effects
REDOXS (trial) = A randomized trial of glutamine and antioxidants in critically ill patients
SD = standard deviation
SNAQ = Simplified Nutritional Appetite Questionnaire
SOFA = Sequential Organ Failure Assessment
SPN (trial) = Supplemental Parenteral Nutrition
SSI = surgical site infection
TLC = total lymphocyte count

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