All Articles
Highlights from the I-I-I Blog
2019 30 May
(I expert, I question, I answer) A selection from the ICU Management & Practice I-I-I blog. Have you got something to say? Visit https://healthmanagement.org/c/icu/list/blog or contact [email protected] Peter Pronovost Chief Clinical Transformation Officer - University Hospitals Cleveland, USA @PeterPronovost ... Read more
Paediatrics
2019 30 May
It is never easy when children are in the hospital. And it is even more stressful when they're in the Paediatric Intensive Care Unit (PICU). When a child is admitted to the PICU, it means that they require the highest level of medical care. Children in the PICU present with different symptoms and conditions - from serious infections to heart conditions;... Read more
Quality improvement in the PICU – a primer for intensivists
2019 30 May
Quality improvement provides tools that help the transformation of an intensive care unit into a highly reliable and safe environment, that nurtures continuous learning and delivery of high-quality care that improves patient experience and outcomes. Despite advances in healthcare and dramatic improvements in survival across the spectrum of... Read more
Can Goal-Directed Therapy solve the economic burden of postsurgical complications?
2019 30 May
How effective are less invasive or even noninvasive methods? The clinical and economic burden of post-surgical complications and the economic impact of Goal-Directed Fluid Therapy (GDFT) implementation. Improving the quality of care by reducing post-surgical complications, decreasing mortality, and decreasing hospital... Read more
PICU Up! A multicomponent early mobility intervention for critically ill children
2019 30 May
An overview of the 'PICU Up!' mobility programme at Johns Hopkins Children's Center, which integrates sleep promotion, delirium prevention, and sedation optimisation to increase mobilisation in critically ill children. What is the PICU Up! Programme? Paediatric intensive units traditionally have had a culture where critically ill children... Read more
PICU-acquired complications: the new marker of the quality of care
2019 30 May
This article describes the rise in PICU-acquired morbidities and its impact on patient outcomes. It discusses early rehabilitation strategies to improve patient outcomes in PICU. Introduction Critical care has traditionally been focused on early recognition of life-threatening conditions, resuscitation, and stabilisation of organ... Read more
Caring for children in the PICU
2019 30 May
From novel technology to family-centred care: new challenges for old needs Challenges and opportunities to improve care and practice in the PICU. “Martin, 2 years old. Sepsis and pneumoniae. High monitoring systems and modern therapies. A nurse is talking to his parents. A smile and a kind gesture help them in this overwhelming... Read more
Virtual reality experience in the PICU
2019 30 May
A pilot study at the Ann & Robert H. Lurie Children's Hospital of Chicago An overview of the virtual reality programme at the Ann & Robert H. Lurie Children’s Hospital of Chicago and its potential benefits on patient outcomes. Ann & Robert H. Lurie Children's Hospital of Chicago has introduced virtual reality into their paediatric intensive... Read more
Seven steps to design, procure, implement and maintain a Clinical Information System for your ICU
2019 30 May
How to design, procure, test, parameterise, implement and maintain a Clinical Information System for an intensive care unit. Introduction e-Health applications, in our case Clinical Information Systems (CIS) or Patient Data Management Systems (PDMS), are taking medicine by storm, and intensive care is not an exception. Ensuring delivery... Read more
Respiratory physiotherapy in critically ill patients
2019 30 May
Respiratory pathologies are among the most common causes of admission to critical care. Respiratory physiotherapy represents a fundamental part of the standard practice in ICU. The following review provides a practical and feasible description of the main physiotherapeutic tools and strategies that can be applied to critically ill patients.... Read more
A structural approach for diagnosing weaning failure
2019 30 May
A case from a specialised weaning centre Using a case of a former patient we describe the structured approach of analysis of the cause of weaning failure with corresponding specific therapies used in our Centre for Expertise. Previously, we suggested a structural approach for diagnosing the cause of weaning failure (Heunks and van... Read more
Vitamin D deficiency in ICU patients
2019 30 May
A review on the role of vitamin D in a well-defined setting of critically ill patients: patients undergoing cardiac surgery and organ transplantation, and the potential benefit of vitamin D supplementation. Vitamin D research has experienced a true hype in all fields of medicine in the last decades. In critical illness, this increased... Read more
Noise in the intensive care unit: where does it come from and what can you do about it?
2019 30 May
Practical measures and interventions to reduce noise levels in the ICU and to improve the patient experience. The intensive care unit (ICU) is known to be noisy and is getting louder (Busch-Vishniac et al. 2007). Despite several trials, no interventions have been able to reduce noise levels by a meaningful amount (Li et al. 2011; Boyko... Read more
Keeping the Person in Personalised Medicine
2019 30 May
As Personalised Medicine endeavours to discover more specific aetiologies and treatments of disease based on genetics and basic science research, it is crucial to maintain a focus on the patient-doctor relationship in order to more fully optimise patient care. In a world where the cutting edge is a crowded place, and people’s lives are at... Read more
European guidelines on the management of traumatic induced bleeding
2019 30 May
Interview with Rolf Rossaint, Prof. of Anaesthesiology, RWTH University Aachen, Germany. Rolf Rossaint is a Professor and Chairman of the Department of Anaesthesiology of the University Hospital at the RWTH University Aachen, Germany. Prof. Rossaint has published several high-quality studies dealing with the treatment of severe acute respiratory... Read more
Use of sedation and controlled paralysis in ICU patients with ARDS
2019 30 May
According to a National Institutes of Health sponsored clinical trial that was conducted at several North American hospitals and was led by clinician-scientists at the University of Pittsburgh and University of Colorado schools of medicine, reversibly paralysing and sedating hospitalised patients with severe breathing problems does not prove improve... Read more
New recommendations for stroke systems of care - American Stroke Association policy statement
2019 30 May
Approximately 7.2 million Americans 20 years or older have had a stroke. Nearly 800,000 people in the U.S. have a new or recurrent stroke each year. A stroke occurs every 40 seconds in the U.S., and someone dies of a stroke every four minutes. According to a policy statement published by the American Stroke Association, and published in the journal... Read more
Cocoon bed aims to lower ICU delirium
2019 30 May
The intensive care unit environment can be extremely stressful, even if they provide some of the best care in the world. It is believed that a patient in the ICU has their sleep interrupted approximately every three minutes either through noise, lights, or medical intervention. Up to 80% of patients in the ICU suffer from some form of delirium, and... Read more
Big Data and hidden subtypes of sepsis
2019 30 May
Results of a study conducted by the University of Pittsburgh School of Medicine suggests that sepsis is not one condition, but many conditions that could benefit from different treatments. The findings are published in JAMA and were presented at the American Thoracic Society's Annual Meeting. Sepsis is the number one killer of hospitalised patients... Read more