All Articles
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The Abdomen
Managing the abdomen and its complications in the intensive care unit is the subject of our Cover Story. First, Jan de Waele considers the data on new antibiotics for complicated intra-abdominal infections. While these, singly and in combination, show promise, he cautions that recent studies have certain shortcomings from a critical care perspective,...
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New Antibiotics for Abdominal Infections: What Can We Expect?
Recently a number of new antibiotics or combinations for complicated intra-abdominal infections have been introduced. Here we review the currently available data of these new drugs and discuss how they can be used in critically ill patients with complicated intraabdominal infections. Complicated intra-abdominal infections (cIAI) remain...
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Evolving Concepts in Acute-on-Chronic Liver Failure
Most patients with liver cirrhosis remain in a compensated stage for more than 10 years, regardless of the aetiology of the liver disease. The progression to decompensated cirrhosis is defined by the occurrence of a major complication such as ascites, variceal bleeding and/or hepatic encephalopathy. From here on most patients will not die because...
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Update on Intra-Abdominal Hypertension
Knowledge of intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) is crucial for successful treatment of critically ill patients, whether medical or surgical, young or old (Kirkpatrick et al. 2013). Today we understand that IAH and ACS are frequent causes of increased morbidity and mortality (De Waele et al. 2016). More importantly,...
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Monitoring Peripheral Circulation
Even though systemic haemodynamic variables may be normalised, there could be regions with inadequate regional oxygenation at the tissue level. The most recent developments of noninvasive monitoring of the peripheral circulation have helped physicians to early identify patients at high risk for tissue hypoperfusion, organ failure and poor outcome....
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Touch Creates a Healing Bond in Healthcare
In contemporary healthcare, touch— contact between a doctor’s hand and a patient—appears to be on its way out. The expanding role of CT and MRI imaging is decreasing reliance on touch as a way of making diagnoses. Pressures to move patients through the system more quickly leave health professionals with fewer opportunities to make contact....
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Redesigning Emergency Ambulatory Care with Point-of-Care Testing: Reduced Costs and Length of Stay
Many patients presenting to the hospital emergency department do not need to stay overnight. Ambulatory emergency care (AEC) may optimise identification and management of such patients by delivering streamlined, efficient patient care within one working day. This may improve clinical outcomes, patient experience and lower costs. At James...
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The Burden Caused by Administrators and Managers: a Euro-American Jumble
We argue that a jumble of rules, protocols, checklists has emerged, which jeopardises not only the pivotal relationship between doctor and patient, but also the quality and costs of care, and the quality of future healthcare workers. It must be emphasised that the introduction of protocols and checklists in clinical medicine has improved care...
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Telemedicine is the Future
Professor Gernot Marx is Director of the Department of Intensive Care Medicine and Intermediate Care, University Hospital Aachen, and Professor of Anaesthesiology and Operative Intensive Care Medicine at RWTH Aachen University, Aachen, Germany. Dr. Marx is a member of the Intensive Care Medicine Scientific Subcommittee of the European Society...
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