All Articles

ICU Management

Editorial Board Welcomes New Member

2016 30 Nov

Prof. Flavia Machado has recently been welcomed to the Editorial Board of ICU Management & Practice by Editor-in-Chief, Prof. JeanLouis Vincent. Dr. Machado is Professor of Intensive Care and head of the Intensive Care Section of the Anesthesiology, Pain and Intensive Care Department at the Federal University of São Paulo in São Paulo, Brazil. She is one... Read more

ICU Management

Patient Handoff Protocols

2016 30 Nov

Whether they are called handoffs or handovers, it is known from the literature that the transfer of patient information between caregivers at shift changes has the potential for error. Although the U.S. Joint Commission requires healthcare providers to implement a standardised approach to handoff communication as a national patient safety goal, clear... Read more

ICU Management

New Resource for Children

2016 30 Nov

An activity book for children visiting intensive care units (ICUs) has been published by ICUsteps, the UK intensive care patient and relative support charity. The resource comes with an information sheet for parents and carers to help them support the children, and can be downloaded from the ICUsteps website.   Catherine White, Information Manager,... Read more

ICU Management

National ICU Quality Indicators Revisited

2016 30 Nov

The last two decades have seen an accelerated interest in quality management in healthcare in general, and also in intensive care specifically. Often safety has been the main issue, but increasingly a more general approach to quality has emerged, in particular with a focus on quality indicators (QI).   It is now more than 15 years since Pronovost and... Read more

ICU Management

Quality Management: The Role of Intensive Care Registries

2016 30 Nov

To initiate, maintain and advance a quality improvement programme in your intensive care unit consumes large amounts of time and energy. There are many advantages for quality management in joining an intensive care registry; the most important is access to precisely defined data for comparative audit.   Intensive Care Registries   Joint collection of... Read more

ICU Management

Biomarkers in Heart Failure

2016 30 Nov

Cardiac biomarkers, including natriuretic peptides and troponins, have become widely used in the treatment of heart failure and acute coronary syndrome. As we learn more about the function of these markers, their use has begun to expand. We can now track and utilise natriuretic peptides throughout hospital admission to monitor progress of heart failure... Read more

ICU Management

Difficult Intubation in the ICU: Why and How to Prevent and Manage Difficult Intubation?

2016 30 Nov

Severe hypoxaemia and cardiovascular collapse, leading to cardiac arrest, cerebral anoxia and death, are the most frequent complications related to intubation in intensive care units (ICU), associated with difficulty of intubation. To prevent and limit the incidence of difficult intubation, specific risk factors for difficult intubation in the ICU have... Read more

ICU Management

Pain Assessment and Management for Intensive Care Unit Patients: Seeking Best Practices

2016 30 Nov

 This review article focuses on research-based advances in pain assessment practices in intensive care units (ICUs), and stresses clinician consideration of multimodal analgesic techniques for pain management in ICUs.   Over the past 30 years, attention devoted to pain experienced by intensive care unit (ICU) patients has evolved from recognising pain... Read more

ICU Management

Emergency Intraosseous Access: Novel Diagnostic and Therapeutic Possibilities and Limitations

2016 30 Nov

The intraosseous needle is an essential tool in emergency settings when initial vascular access is difficult to achieve. This paper focuses on possible biochemical analyses on blood from emergency intraosseous needles, suggesting principles of use as well as pointing out advantages and shortcomings.   Intraosseous (IO) access has been used since 1922... Read more

ICU Management

What Can Psychologists Do in Intensive Care?

2016 30 Nov

As awareness has grown of the great distress intensive care patients may suffer, units have begun recruiting psychologists to their teams. Intensive care unit psychologists aim to assess and reduce distress for patients, families and staff, to improve outcomes. This paper summarises research on the psychological impact of critical illness, highlights... Read more

ICU Management

Clinical Pharmacist Role in the ICU

2016 30 Nov

We provide an overview of the various facets of pharmacist practice in the intensive care unit (ICU), the current extent to which pharmacists are present in the ICU, along with a discussion on barriers and lessons learned in garnering support for such a role.   Caring for critically ill patients in an intensive care unit (ICU) is considered a standard... Read more

ICU Management

Social Media: Blessing or Curse?

2016 30 Nov

Social Media in the “Real” World Social media is all around us, and enables real-time communication with patients, families and with colleagues. There are general social networks (Facebook), professional networks (LinkedIn), blogs (WordPress), microblogs (Tumblr) and media sharing sites for photos, videos and podcasts. The Wall Street fortunes of these... Read more

ICU Management

Renal Replacement Therapy for Acute Kidney Injury: Questions Remain

2016 30 Nov

Eric Hoste is Professor in Medicine and Head of Clinic at Ghent University Hospital, Belgium. Prof. Hoste’s primary clinical area of interest is clinical critical care nephrology, and he has published more than 190 original papers, review articles and book chapters primarily within this field. He is a Senior Clinical Investigator, Research Foundation-Flanders... Read more

ICU Management

Protective Ventilation: When and Why to Individualize

2016 30 Nov

ARDS is Heterogeneous Acute respiratory distress syndrome (ARDS) is a heterogeneous entity. Calfee and colleagues’ analysis of the ARMA and ALVEOLI trials (Calfee et al. 2015) differentiated two ARDS subphenotypes, one of which was categorized by more severe inflammation and worse clinical outcomes. Response to positive end-expiratory pressure (PEEP)... Read more

ICU Management

Indirect Calorimetry to Measure Energy Requirements: From Consensus to Daily Practice

2016 30 Nov

Why Personalize Nutrition Therapy?   The need for personalized nutrition therapy for ICU patients is shown by several observational studies that measured the energy needs of critically ill patients. The 2005 study by Villet and colleagues found that patients with an energy deficit had an increased number of complications, especially infections (Villet... Read more

ICU Management

Optimising Nutrition With an Integrated Nutrition Module: Myth or Reality?

2016 30 Nov

As a neurointensivist with a strong interest in nutritional support, I was delighted to trial a new integrated nutritional module. We know that nutrition really matters to our ICU patients in the context of first indicators. For example, our research group recently published a paper about two patients with viral meningoencephalitis. Invasive neuromonitoring... Read more

ICU Management

Introduction

2016 30 Nov

The intensive care unit (ICU) is a complex environment, due to the surroundings, the heterogeneity of patients, caregiver turnover and the at times lengthy patient stays, which lead to increased complexity. The multiple technologies available add another layer of intricacy. However, with the modern tools available to the intensivist, it is now possible... Read more

ICU Management

Does Dexmedetomidine Reduce Delirium by Improving Sleep?

2016 30 Nov

Delirium is a common complication in intensive care unit (ICU) patients and its occurrence is associated with worse outcome (Inouye et al. 2014; Abelha et al. 2013). Sleep disturbances are considered one of the important risk factors of delirium development (Flink et al. 2012). Recent evidence shows that dexmedetomidine, either at sedative or non-sedative... Read more

ICU Management

Early Mobilisation in ICU: From Concept to Reality - Four Steps to Change Patient Outcomes

2016 30 Nov

For years, 28-day survival was the holy grail of ICU physicians. As ICU survival continues to improve, a high proportion of these ICU survivors experience significant cognitive, psychological, and physically disabling side effects of their ICU stay. These consequences of critical illness, regardless of their admitting diagnosis, have a dramatic impact... Read more

ICU Management

Current State of Glycaemic Control Practice

2016 30 Nov

Elevated blood glucose is a widely recognised response to critical illness, with most non-diabetic patients exhibiting concentrations outside the normoglycaemic range and a substantial proportion having significantly or hugely elevated blood levels (Farrokhi et al. 2011). It has been 15 years since the publication of the Leuven study abruptly changed... Read more


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