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Excellence in Nutrition Therapy
Lessons from the International Nutrition Survey and the Best of the Best Awards Over recent years, nutrition therapy for critically ill patients has gained momentum as an essential part of patient care. Research into this often undervalued intervention has escalated, demonstrating that providing the right amount of...
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Intensive Care Dietitian: An Important Contributor to Quality of Care
Many experts have shown that nutritional therapy improves intensive care unit (ICU) outcomes. In particular, the use of early enteral nutrition (EN), as recommended by ESPEN guidelines (2006), is associated with a reduction in mortality in the sickest patients (Artinian et al. 2006). Paradoxically, enteral feeding is most difficult to perform in the...
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The Future of Non-Invasive Ventilation
Introduction Non-invasive ventilation (NIV) provides safe and effective assistance to patients with acute respiratory failure (ARF) from various causes (Garpestad et al. 2007). The main reason for applying NIV is to avoid the complications of endotracheal intubation, according to Evans et al. (2000). The ventilator setting generally used to apply...
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Decreasing Central Line Associated Bacteraemia in a New Zealand Intensive Care Unit
Putting Evidence into Practice Introduction Central venous catheters are commonly used in intensive care units, with studies suggesting that approximately 50% of ICU patients have such lines inserted. Meanwhile, central line infections are responsible for 40-60% of bloodstream infections in intensive care patients, according to New South Wales...
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An Emerging Consensus for Acute Kidney Injury
Acute kidney injury (AKI) is a hot topic in the medical arena, with prominent research and discussion ongoing, prompting amendments to recommended practice. The Acute Kidney Injury Network (AKIN) and Acute Dialysis Quality Initiative (ADQI) and AKI section of the European Society Intensive Care Medicine (ESICM) continue to work on counsel for clinical...
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Dutch Intensive Care Medicine: Its Start, Professionalism and Future Prospects
The Dutch Society of Intensive Care celebrates its 35th anniversary this year, prompting this overview of developments in intensive care medicine within the Netherlands and the society known as Nederlandse Vereniging voor Intensive Care (NVIC), looking at eras of evolution and innovation, as well as assessing what the future holds. The Emergence...
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The Intensive Care Unit of Tomorrow
The University Medical Center Utrecht (UMC Utrecht) is a 1,042 bed hospital, which admits approximately 30,000 inpatients per year. All academic specialties are present and the hospital provides a core service in heart and lung transplantations, ventricular assist devices, trauma, neurosurgery, oncology, haematology and AIDS patients. In 2004, an independent...
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New Ambulance Concepts to Improve Care in the ICU?
The Helen Hamlyn Centre for Design at the Royal College of Art in London has a focus on people- centred and inclusive design. From its origins, researching and designing for an ageing population, its work has grown over the past 20 years to encompass better healthcare and better workplaces, because many people now live and work longer despite age-related...
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Past and Present Challenges in ICU Management
Introduction Maintaining an intensive care unit (ICU) and providing intensive care for all patients who benefit from it necessitates a high investment in personnel, technology, and material resources within a short time period, and is naturally associated with costs. The complexity of the care processes involved, and the fluctuation in the...
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Improving handovers by learning from Scuderia Ferrari
Introduction It has been nearly a decade since seminal reports and associated research documenting the surprising frequency of accidental injury in healthcare were published in the UK and around the world (Vincent, Neale and Woloshynowych 2001). Around that time, complex and systemic causes of a sequence of probable accidental deaths at the Bristol...
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