All Articles
Cardiac Arrest
2017 28 May
The “chain of survival” metaphor for improving outcomes from sudden cardiac arrest (CA) was first coined in the 1980s. Since adopted by the American Heart Association and the International Liaison Committee on Resuscitation amongst others, it is a useful tool to concentrate efforts on how to optimise every link in the chain to improve survival and neurologically... Read more
Europe: Wide Variation in Severe Critical Events in Paediatric Anaesthesia
2017 28 May
A Europe-wide observational study of anaesthesia practice in children has shown wide variation in severe critical events and a higher incidence than previously understood. The study was run by the European Society of Anaesthesiology and the results are published in Lancet Respiratory Medicine. The Anaesthesia PRactice In Children Observational Trial (APRICOT)... Read more
Sepsis Detection and Management: New KLAS Report
2017 28 May
Healthcare providers are increasingly turning to technology to detect sepsis and report on sepsis management. As most electronic medical record (EMR) providers do not offer easily deployed sepsis modules, healthcare providers report using solutions from infection control and surveillance vendors as well as specialised sepsis solutions. KLAS Research’s... Read more
Denmark: Increased Bystander CPR, Decreased Mortality in Out-of-Hospital Cardiac Arrest
2017 28 May
Aregistry study from Denmark has investigated the 1-year risk of anoxic brain damage or nursing home admission and of mortality among patients who survived to day 30 after an out-of-hospital cardiac arrest. The risks were analysed according to whether bystander CPR or defibrillation was performed. The study is published in the New England Journal of... Read more
Reducing Brain Injury After Cardiac Arrest: American Academy of Neurology Practice Guideline
2017 28 May
Therapeutic hypothermia (TH) (32-34°C for 24 hours) should be mandatory practice for patients who are comatose after being resuscitated from out-of-hospital cardiac arrest, if the initial cardiac rhythm is either pulseless ventricular tachycardia (VT) or ventricular fibrillation (VF), according to the American Academy of Neurology (AAN)’s newly published... Read more
Does Gender Matter in Resuscitation Teams?
2017 28 May
A simulated study of cardiopulmonary resuscitation (CPR) that compared performance by male and female medical students found that the female students performed less efficiently and were less effective resuscitation team leaders. The researchers, from the University of Basel and University Hospital Basel, suggest that gender-specific training may be... Read more
Out-of-Hospital Cardiac Arrest: Bystander CPR Impact on Survival, Cost
2017 28 May
Bystander cardiopulmonary resuscitation (CPR) is crucial to successful resuscitation following out-of-hospital cardiac arrest (OHCA). New research shows that bystander CPR was positively associated with long-term survival and appears cost-effective, with an incremental costeffectiveness ratio of USD48,044 per quality-adjusted life year (QALY).The findings... Read more
Extracorporeal Cardiopulmonary Resuscitation: Who Could Benefit?
2017 28 May
This article summarises the current ratio and scientific evidence on which cardiac arrest patients could benefit from extracorporeal cardiopulmonary resuscitation. Acute cardiac arrest has a dismal prognosis even when advanced cardiac life support is initiated without delay. Extracorporeal cardiopulmonary resuscitation (eCPR) refers to a technique... Read more
Targeted Therapeutic Mild Hypercapnia After Cardiac Arrest
2017 28 May
Cardiac arrest (CA) causes ischaemic brain injury and persistent cerebral hypoperfusion and cerebral hypoxia during the early post-resuscitation period. PaCO2 is the major physiological regulator of cerebral blood flow, is a modifiable component of care and mild hypercapnia may lead to improved neurological outcomes for resuscitated CA survivors. In... Read more
Prognostication Following Out-of-Hospital Cardiac Arrest
2017 28 May
This article reviews the current evidence on prognostication after cardiac arrest. Post-resuscitation care has developed and evolved significantly since 2003, following recommendations by the Advanced Life Support task force of the International Liaison Committee on Resuscitation to implement therapeutic hypothermia (TH) in unconscious survivors following out-ofhospital... Read more
Airway Pressure Release Ventilation: What's Good About It?
2017 28 May
The use of APRV has many proposed benefits for patients with lung injury. However, quality evidence supporting the use of this technique is limited. This article summarises the purported benefits and limitations of routine use of the technique in the management of ARDS, and critically reviews the evidence supporting its use. Airway pressure release... Read more
High Altitude Research and its Relevance to Critical Illness
2017 28 May
Critical illness can be considered as the body’s failure to compensate for severe pathophysiological ‘stress’. The result is a vicious circle of damage that ultimately ends in organ failure, permanent harm and, unfortunately for many, death. Fortunately, the human body is remarkably resilient. It has the ability to tolerate changes to its internal milieu... Read more
How to Run Successful Rounds in the Intensive Care Unit
2017 28 May
Rounds in the intensive care unit (ICU) allow for scheduled discussions in which healthcare providers review clinical information and develop care plans for critically ill patients. Despite this straightforward concept, there is widespread variability in numerous components of rounds. While some of these differences are culturally rooted and, as such,... Read more
From Independent Attorney to Critically Ill Patient
2017 28 May
How Acute Respiratory Distress Syndrome Changed My Life in a Split SecondLife changed forever when Eileen Rubin was hospitalised with ARDS. After a slow recovery it was time to give something back, and Eileen went on to co-found the ARDS Foundation. “I can’t breathe. I think I’m dying.” Those were the words I gasped to my mother less than two days... Read more
Standardised, Hospital-Wide Airway Trolleys
2017 28 May
Inspired by the Difficult Airway Society Guidelines and the Vortex Cognitive ToolOne of the main recommendations of the 4th National Audit Project of the UK Royal College of Anaesthetists and the Difficult Airway Society was that every intensive care unit (ICU) should have access to a difficult airway trolley, which should have the same content and... Read more
Five Reasons Why Value-Based Healthcare is Beneficial
2017 28 May
Patient-centered care is becoming a major topic in healthcare. Many initiatives have begun focusing their care around patients and their medical conditions. This requires focusing on patient value (Porter and Teisberg 2006). When focusing on value for patients, a few challenges may arise. Firstly, the meaning of value for patients varies widely among... Read more
Reaching the Heights of Respiratory Physiology
2017 28 May
Professor John B. West is a renowned respiratory physiologist and researcher. He joined the faculty of the University of California San Diego in 1969, where he is Distinguished Professor of Medicine and Physiology in the School of Medicine, where he still teaches first-year medical students. He is author of Respiratory physiology - the essentials, which... Read more
Evidenced-based ICU Organisation: Interview with Professor Jeremy Kahn
2017 28 May
Jeremy Kahn is Professor of Critical Care, Medicine and Health Policy in the University of Pittsburgh School of Medicine and Graduate School of Public Health. As a core faculty member in the CRISMA Center in the Department of Critical Care Medicine, he directs the CRISMA Program on Critical Care Health Policy & Management. His research focuses on the... Read more
Intensive Care in Tunisia
2017 28 May
According to the World Bank classification, Tunisia is considered a lower middle-income country, corresponding to a country with a Gross National Income (GNI) per capita between USD1,026 and USD4,035 (World Bank 2015). The economic growth of Tunisia has been slowed following the 2011 Arab Spring, which was initiated in this country. Despite economic... Read more
