The term ‘probiotic’ is derived from the Greek/Latin word “pro” and the Greek word “bios, ” meaning “of life”.The concept of probiotics was first described by Metchnikoff in 1907. The World Health Organization (WHO) and the Food and Agriculture Organization of the United Nations have defined probiotics as “live microorganisms, which, when administered in adequate amounts, confer a health benefit on the host”. These agents are often administered concurrently with substances that promote bacterial colonization and growth (prebiotics); in this instance, they are referred to as synbiotics.

Objectives: To investigate the incidence of hypomagnesemia, hypomagnesemia-associated risk factors, and the effect of hypomagnesemia effect on prognosis among patients followed at pediatric intensive care unit. Methods: This study enrolled patients who were admitted to the Pediatric Intensive Care Unit between January and December 2017. Patients’ admission serum Mg level was measured, and a level below 1. 8 mEq/L was considered hypomagnesemia. Patients with hypomagnesemia were grouped as group 1 and those with normal serum magnesium level as group 2. Results: A total of 59 (39. 9%) of the 148 patients were female and 89 (60. 1%) were male; the mean age was 62. 82  72. 8 (min: 2 – max: 245) months. Compared with the normomagnesemic patients, those with hypomagnesemia had a greater mean age (P: 0. 04), PRISM score (P: 0. 015), duration of intensive care unit stay, (P: 0. 001), mechanical ventilator need (P: 0. 016) and the number of days connected to mechanical ventilator (P: 0. 027), having nasogastric drainage (P: 0. 02), and mortality rate (P: 0. 041). No significant differencewasfound between the groups with respect to diuretic use. Increase risk of hypomagnesemiaby nasogastric drainagewas not significant (P: 0. 082). The rates of hypokalemia, hypocalcemia, hypophosphatemia, and hypoalbuminemia were significantly greater in group 1 (P < 0. 05). Hypokalemia increased the risk of hypomagnesemia by 5. 13 times, hypophosphatemia by 21. 8 times, hypoalbuminemia by 5. 12 times, and nasogastric drainage by 3. 01 times. Conclusions: It should be noted that hypomagnesemia might becommonand associated with mortality among patients admitted to pediatric intensive care units. Therefore, serum magnesium level should be closely monitored.

Moving a critical patient is a dangerous medical intervention; there are risks and benefits. The benefits stIll revolve around providing specialized treatments and diagnostics not available at every facility. Recent literature has shown that time until definitive treatment is an important consideration. Critically Ill patients are at increased risk of morbidity and mortality during transport. Risk can be minimized and outcomes improved with careful planning, the use of appropriately qualified personnel and selection and availability of appropriate equipment. Furthermore, the accompanying personnel and equipment are selected by training to provide for any ongoing or anticipated acute care needs of patient. Pretransport coordination and communication as well as successful communication between the receiving and referring hospitals are essential for successful transport.The tertiary care center that accepts the patient must be accessible and provide recommendations by telephone. The referring hospital must provide adequate information about the patient for appropriate recommendations to be made.Preparing a patient for transport to referring facilities wIll, before transport, be appropriate evaluation and stabilization to the degree possible to ensure patient safety during transport. Accompanying personnel: it is strongly recommended that a minimum of two people accompany a Critically patient. Accompanying Equipment Monitor or standard blood pressure cuff, plus oximeter, and cardiac monitor/defibrIllator should accompany every patient without exception. Equipment for airway management, seized appropriately for each patient, is also transported with each patient. Monitoring During Transport: All Critically Ill patients undergoing transport receive the same level of basic physiologic monitoring during transport as they had in the intensive care unit. This includes at a minimum: continuous ECG monitoring, pulse oximetry, plus rate, and respiratory rate.Conclusion: Each hospital should have a formalized plan for intra- and interhospital transport that addresses: a) Pretransport coordination and communication; b) Transport personnel; c) Transport equipment; d) Monitoring during transport; e) Documentation.

Background: Malnutrition is a prevalent complication among Critically Ill patients. It has very detrimental effects on the patients' clinical course. This study aimed to investigate the impact of nutrition in the intensive care unit (ICU) patients. Methods: In this epidemiologic-analytic study conducted in the surgical ICU of Imam Khomeini hospital, Ahvaz, Iran, 34 patients were selected and divided into two groups. The first group of patients received the appropriate nutrition. The second group received an inappropriate diet, and the nutritional risk was evaluated according to the modified-Nutrition Risk in Critically Ill (m-NUTRIC) score. The energy was calculated by using 25 Kcal/kg, also the two groups were compared in terms of ICU mortality, ICU stays, Acute Physiologic Assessment and Chronic Health Evaluation (APACHE) II Scoring, and the Sequential Organ Failure Assessment (SOFA) Score. Results: Baseline data, such as APACHE II score and mean age, except sex, were not significantly different between the two groups. In this study, results were toward shorter ICU stay, less mortality, and better SOFA score in the group receiving appropriate nutrition compared to the other group. However, due to the low number of patients, no significant differences were observed in the two groups. Conclusion: Our data suggest that nutritional support should be considered as an essential part of the medication during critical Illness.