Clinical nutrition : official journal of the European Society of Parenteral and Enteral Nutrition
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Enhanced recovery after surgery (ERAS) pathways have significantly reduced complications and length of hospital stay after colorectal procedures. This multimodal concept could probably be partially applied to major urological surgery. ⋯ ERAS has not yet been widely implemented in urology and evidence for individual interventions is limited or unavailable. The experience in other surgical disciplines encourages the development of an ERAS protocol for cystectomy.
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Preventing severe hyperglycemia with insulin reduced the neuropathological alterations in frontal cortex during critical illness. We investigated the impact of increasing glucose load under normoglycemia on neurons and glial cells. ⋯ During prolonged critical illness, increasing intravenous glucose infusion while strictly maintaining normoglycemia appeared safe for neuronal integrity and did not substantially affect glial cells in frontal cortex.
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Chemotherapy induced peripheral neuropathy [CIPN] is a common significant and debilitating side effect resulting from the administration of neurotoxic chemotherapeutic agents. These pharmaco-chemotherapeutics can include taxanes, vinca alkaloids and others. Moderate to severe CIPN significantly decreases the quality of life and physical abilities of cancer patients and current pharmacotherapy for CIPN e.g. ⋯ Currently no agent has shown solid beneficial evidence to be recommended for the treatment or prophylaxis of CIPN. The standard of care for CIPN includes dose reduction and/or discontinuation of chemotherapy treatment. The management of CIPN remains an important challenge and future studies are warranted before recommendations for the use of supplements can be made.
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To evaluate the impact of a multifaceted nutritional educational intervention on the quality of nutritional therapy and clinical outcomes in critically ill patients. ⋯ Implementing a multifaceted nutritional educational intervention could improve the quality of nutritional therapy and may decrease intensive care unit length of stay in critically ill patients.
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A variety of indirect calorimetry (IC) devices are used for gas exchange measurement and calculation of resting energy expenditure (REE) in the pediatric intensive care unit. The aim of this investigation was to compare oxygen consumption (VO2), carbon dioxide elimination (VCO2), REE and respiratory quotient (RQ) in mechanically ventilated children, obtained by 2 devices using distinct gas sampling methods. ⋯ Despite strong correlations and small mean biases for VO2, VCO2 and REE obtained by the Vmax(®) and E-COVX(®), the limits of agreement were beyond the clinically acceptable range. These devices should not be used interchangeably for gas exchange measurements in mechanically ventilated children.