Acute kidney injury (AKI), a rapid decline in renal function, is highly prevalent in critically ill patients, and is associated with an increased risk of short- and long-term complications that extend beyond the acute phase (Pickkers et al. 2017). AKI is defined and classified by an increase in serum creatinine or a decline in urine output, both...
READ MOREThe Surviving Sepsis Campaign (SSC) ( survivingsepsis.org ), has released its 2016 guidelines for the management of sepsis and septic shock. The document, published simultaneously in Critical Care Medicine and Intensive Care Medicine , is an update to the 2012 SSC guidelines. The recommendations in the document cannot replace the clinician’s...
READ MOREThe specialty of intensive care medicine grew out of the realisation that critically ill patients needed more attention and specialised treatment than could be provided on a general ward, and that many of these patients had similar clinical problems and processes, so management would be facilitated if they were grouped together in one place. Since...
READ MOREMultiple failed clinical trials testing immunomodulatory therapies for sepsis argue for a new approach. While precision medicine has been successfully implemented in other fields, testing it in sepsis poses challenges, which this review will discuss, along with potential implementation strategies. Sepsis has an estimated annual incidence of 1.3...
READ MOREWhat is the path forward for treatment of acute respiratory distress syndrome (ARDS)? Is it big trials (favoured by clinical scientists) or further insight into disease physiopathology (favoured by basic scientists)? Or both? Funding resources are limited and the debate is wide open. In the post-genomic era, a new direction is needed. On 20 January 2015,...
READ MOREPeter Pronovost, MD, PhD, FCCM, is Director, Armstrong Institute for Patient Safety and Quality, Senior Vice President, Patient Safety and Quality and Professor of Anesthesiology and Critical Care Medicine at Johns Hopkins Medicine in Baltimore, Maryland, USA. Dr. Pronovost is a leading authority on patient safety and developed a scientifically...
READ MOREThe progress towards, and potential of, personalised/ precision medicine in intensive care is the theme for our cover story. We are making progress in moving away from therapies based on poorly characterised patient populations to more personalised treatment of critically ill patients, although true precision medicine, based on individual genes, environment...
READ MOREMechanical ventilation has become the established standard therapy for acute respiratory failure in modern intensive-care medicine. Although intensive-care ventilation frequently represents the only option to ensure sufficient pulmonary gas exchange and adequate tissue oxygenation, ventilation therapy can also cause further lung damage and lead to ventilation-induced...
READ MOREPatient-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...
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