The purpose of nutritional support in the critically ill is to blunt the effects of the stress response, to preserve musculature and organ function, and to promote hepatic protein synthesis, tissue regeneration, and wound healing. Adequate nutritional support is vital to the patient with acute wounds. This article addresses the body's response to physiologic stress and reviews means of supporting nutritional status and the substrates used to maximize nutritional therapy. The critical care nurse will have a better appreciation for how and when to implement nutritional therapy, appropriate nutrients, and methods for monitoring nutritional status.
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J Gastrointest Cancer
January 2025
Surgical Oncology Department, Oncology Center Mansoura University (OCMU), Mansoura, Egypt.
Purpose: Acute kidney injury is a sentinel event affecting colorectal cancer patients either as a consequence of surgery or systemic chemotherapy. It is highly correlated with both short and long-term adverse outcomes. This work aimed to study the prevalence, risk factors, and impact on survival of postoperative (PO-AKI) and post-chemotherapy (PC-AKI) after colorectal cancer (CRC) surgery in Egyptian patients.
View Article and Find Full Text PDFJ Burn Care Res
January 2025
US Army Institute of Surgical Research, JBSA Ft Sam Houston, TX, US.
Two randomized controlled trials conducted in acutely burned patients found clinical benefits with higher carbohydrate (60-65% of total energy), lower fat (12-15%) nutrition, to include faster wound healing, fewer wound infections, decreased hospital stay, and less pneumonia. The primary purpose of this study was to assess whether our change in practice to a higher proportion of carbohydrates (60%) with 25% of energy from protein, and 15% of energy from fat was associated with improved wound healing rates. Secondary outcomes evaluated included invasive fungal wound infections, ischemic bowel, sepsis, and mortality.
View Article and Find Full Text PDFEur J Trauma Emerg Surg
January 2025
Physiotherapy, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Purpose: Thoracic trauma causes pain and hospitalisation. Middle- and high-income countries have different trauma contexts and populations. To report patients' clinical presentation (pain and shortness of breath) and its influence on hospital length of stay (LOS), acute care management, and discharge destinations in South Africa (SA) and Sweden.
View Article and Find Full Text PDFSurg Endosc
January 2025
Department of General Surgery, Fiona Stanley Hospital, 11 Robin Warren Dr, Murdoch, WA, Australia.
Background: Laparoscopic cholecystectomy is the preferred treatment for symptomatic cholelithiasis and acute cholecystitis, with increasing applications even in severe cases. However, the possibility of postoperative endoscopic retrograde cholangiopancreatography (ERCP) to manage choledocholithiasis or biliary injuries poses significant clinical challenges. This study aimed to develop a predictive model for ERCP incidence following emergency laparoscopic cholecystectomy using advanced machine learning techniques.
View Article and Find Full Text PDFJBJS Case Connect
January 2025
Department of Orthopedic Surgery and Rehabilitation Medicine, University of Chicago Medicine, Chicago, Illinois.
Case: A 34-year-old man, amateur weight lifter presented with acute worsening of right shoulder pain after 5 months of prodromal, progressive, atraumatic pain. Imaging showed a short oblique proximal third humeral shaft fracture without evidence of other osseous abnormalities. He was treated operatively with open reduction and internal fixation, healed uneventfully, and returned to weight lifting within 3 months.
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