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Gut microbes protect against sepsis
New research published in Cell Host & Microbe suggests that gut bacteria may help in the fight against sepsis. In the study, mice were given particular microbes, which increased blood levels of immunoglobulin A (IgA) antibodies, protecting the mice against polymicrobial sepsis. You might also like : Study: Microbiome Disruption May Have Key Role...
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Glycaemic control in critically ill patients: how tight should it be?
There is still no widespread agreement around optimal targets for glucose control in the ICU: some clinicians maintain that glucose control is unnecessary and harmful, while others claim that blood glucose control is essential to improve prognosis. 1-3 Those who favour liberal glycaemic control assert that hyperglycaemia is simply a beneficial adaptation...
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Dysglycaemia in the critically ill
As has been pointed out, the benefits of tight glycaemic control in the ICU have by no means been clearly established or accepted. In 2010 a meta-analysis of seven prospective randomised studies concluded that intensive insulin therapy in mixed ICU patients was not supported by evidence. 19 Today we understand that hyperglycaemia, hypoglycaemia,...
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The increased recognition of proteins in critical illness
There are many new concepts and old controversies surrounding nutrition in critical care such as: the role of trophic feeding, permissive underfeeding, the use of immune modulating agents, and the optimal timing of nutrient delivery. However, enteral nutrition and protein delivery have consistently been found to be beneficial. Traditionally,...
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Supporting the patient innovator
Their inability to communicate effectively whilst he had a tracheostomy on the intensive care unit (ICU), had such a profound impact on Duncan Buckley and his wife, Lisa-Marie, that they developed a concept for a novel interactive communication device, called ‘ICU CHAT’. Together, they have been embedded within the multidisciplinary ICU research...
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The critical care resuscitation unit
A new paradigm for optimising inter-hospital transfer of patients with non-trauma time sensitive critical conditions The number of clinical conditions which have improved outcomes associated with shorter time to specialised resuscitation and definitive intervention continues to increase. Many of these time-sensitive conditions have improved outcomes...
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Variation in end-of-life care
Do we need yet another standard operating procedure? Variability in end-of-life care would seem to demand a standard operating procedure, but a roadmap towards harmonisation arguably would be easier to implement. Mainly due to enormous pharmacological and technological innovation during the last decades, intensive care medicine can...
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Being an expert witness
Describes the practicalities of being an expert witness and explains what qualities are necessary to succeed in this important role. Our legal system couldn’t function without medical expert witnesses. From personal injury claims to criminal prosecutions, there is a constant demand for experienced doctors with the necessary skills and authority...
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Caring for critically ill immunocompromised patients
We can do better! Élie Azoulay, MD, PhD, is Professor of Medicine in Specialty Pulmonary Medicine and Critical Care at Saint Louis Teaching Hospital and Université Paris Diderot in France. He is the Director of the medical intensive care unit (ICU). He leads the French programme for the care of critically ill immunocompromised patients, and is...
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