The cornerstone of treating patients with shock remains as it has for decades, intravenous fluids. Surprisingly, dosing intravenous fluid during resuscitation of shock remains largely empirical. Recent data suggests that early aggressive resuscitation of critically ill patients may limit and/or reverse tissue hypoxia, progression to organ failure and improve outcome. However, overzealous fluid resuscitation has been associated with increased complications, increased length of intensive care unit (ICU) and hospital stay and increased mortality. This review focuses on methods to assess fluid responsiveness and the application of these methods for goal directed fluid therapy in critically ill and peri-operative patients.
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http://dx.doi.org/10.2174/138161212803832399 | DOI Listing |
Neurology
February 2025
From the Temple University College of Public Health (I.L.H.); Thomas Jefferson University (G.G.); and Department of Neurology (T.D.H.-P.), Lewis Katz School of Medicine at Temple University, Philadelphia, PA.
Background And Objectives: Clinical care for people living with amyotrophic lateral sclerosis (PLWALS) is directed at slowing disease progression and symptom management. The American Academy of Neurology recommends a multidisciplinary approach to providing ALS health care because observational studies show that multidisciplinary clinics (MDCs) extend survival and improve quality of life. However, providing multidisciplinary care is a challenging financial proposition.
View Article and Find Full Text PDFPLoS One
January 2025
School of Health and Social Care, University of Essex, Colchester, United Kingdom.
Background: Non-governmental organisations (NGOs) have the potential to make a significant contribution to improving health system goals through the provision of resources, health services and community participation. Therefore, this paper examines the role of NGOs in achieving health system goals, based on the six building blocks of a health system framework, and identifies strategies to enhance NGO involvement in achieving health system goals.
Methods: A scoping systematic review methodology was used to map and synthesise the existing literature on the topic, following the latest JBI six-stage framework.
BMJ Nutr Prev Health
December 2024
Department of Medicine, University of Alberta, Edmonton, Alberta, Canada.
Background: Health policies promote optimal care, yet policies that address disease-related malnutrition (DRM) are lacking. The purpose of this study was to conduct a scoping review to identify literature on existing and planned policy to address DRM in children or adults and explore the settings, contexts and actors of DRM policy.
Methods: A search strategy comprising DRM and policy keywords was applied to eight databases on 24 February 2023.
Psychol Health
January 2025
Curtin School of Allied Health, Curtin University, Perth, Australia.
Objectives: Previous operationalisations of bedtime procrastination were incongruent with its definition. We addressed this gap in knowledge by testing a new operationalisation that incorporates the three necessary and sufficient conditions of bedtime procrastination. We investigate the motivational antecedents of bedtime procrastination in daily life with this new operationalisation.
View Article and Find Full Text PDFGastroenterol Clin North Am
March 2025
Department of Surgery, Indiana University School of Medicine, Indianapolis, IN, USA.
Necrotizing pancreatitis often demands intervention; contemporary management is directed by the step-up approach. Timing of intervention and specific approach is best directed by a multi-disciplinary team including advanced endosocpists, interventional radiologists, and surgeons with interest and experience managing this complex problem. The intervention is often a combination of percutaneous drainage, transluminal endoscopic approaches, and surgical debridement (minimally invasive or open).
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