All Articles
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Protective Ventilation: When and Why to Individualize
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...
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Indirect Calorimetry to Measure Energy Requirements: From Consensus to Daily Practice
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...
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Optimising Nutrition With an Integrated Nutrition Module: Myth or Reality?
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...
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Introduction
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...
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Does Dexmedetomidine Reduce Delirium by Improving Sleep?
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...
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Quality
An emphasis on quality of care has always underpinned healthcare, but in recent years quality measurement has come to the fore, as countries around the world seek to provide the best outcomes for patients while facing ever-increasing healthcare costs. In intensive care, despite the heterogeneity of the patient population, great strides have been made...
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Culture is King: But Only if You Do These Three Things
But Only if You Do These Three Things The phrase “culture is king” is thrown around quite a bit in business circles and yet, if you talk to business leaders, you’ll find that there aren’t many who feel that the culture in their organisations is what they would like it to be. The phrase “culture is king” is thrown around quite a bit in business...
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Patient Identification: Executive Summary
For its fifth Deep Dive analysis of a patient safety topic, ECRI Institute PSO selected patient identification. Safe patient care starts with delivering the intended interventions to the right person. Yet, the risk of wrong-patient errors is ever-present for the multitude of patient encounters occurring daily in healthcare settings. Many patient...
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Automated External Defibrillators
EXECUTIVE SUMMARY Cardiac arrest, or the sudden and abrupt loss of heart function, is a leading cause of death in the United States.According to the American Heart Association (AHA), about 326,200 out-of-hospital cases of sudden cardiac arrests occur annually in the United States; less than 10% of those victims survive (Mozaffarian et al. 2015)....
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Supply Chain Management Challenges in Canada: Focus on Key Interpersonal Skills
Overview Managing a supply chain efficiently and effectively is tremendously challenging in any industry. Time and financial constraints combined with operational dependency on inputs to produce outputs required by buyers is extremely difficult. A publicly-funded supply chain, as in Canada’s healthcare industry, makes it even harder...
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