Our cover story this issue is Imaging. The radiology armamentarium is vast, with many imaging modalities available to aid diagnosis and monitoring of therapy in critically ill patients—both at the bedside (x-ray, ultrasound) and in the radiology department (MRI, CT and PET). Research is underway to image even deeper, such as the PROTEUS collaboration in the UK, which is investigating molecular imaging t


ICU Management & Practice is delighted to announce that Dr. Theodoros Kyprianou, MD, PhD, EDIC, has joined the Editorial Board. Dr. Kyprianou will be Section Editor for the new Informatics & Technology section in the journal, starting in 2019. Dr. Kyprianou is a consultant physician in Respiratory & Intensive Care Medicine, practising in Cyprus and the UK. He holds the post of Associate Profe

Cover Story

An evolving partnership A major evolution is underway involving critical care and imaging. The intensive care patient population is changing. Increasingly intensive care units (ICUs) are treating older patients, with more comorbidities, and variable prognosis, at a time when family expectations are different and often with higher expectations of recovery. Life support technology is increasingly sophist

Bedside ultrasound of the whole bodyWhole-body ultrasound can be used in the evaluation of many critical conditions including encephalopathy where brain and ocular ultrasound combined with transcranial Doppler can identify elevated intracranial pressure. Hypoxaemia is mostly related to pulmonary disease and lung ultrasound can rapidly identify the aetiology. Cardiac, lung and abdominal ultrasound will be us

In this article we focus on the evidence of whole-body ultrasonography used for hypotension or shock. We first highlight individual ultrasound components in association to hypotension and shock. Second, we provide an outline of current literature on whole-body ultrasonography, its effect on outcome, and try to integrate the previous observations. Critical care ultrasonography (CCUS) is increasingly advo

Diaphragm ultrasound is a valuable tool to diagnose and prevent ventilator induced diaphragm dysfunction. This review focuses on the use of ultrasound to assess diaphragm structure and function in ventilated patients. The diaphragm is the primary muscle of inspiration. It is a thin dome-shaped muscle that inserts into the lower ribs, xiphoid process, and lumbar vertebrae. It runs parallel to the rib cage

Advice from a radiologist For the Imaging issue, ICU Management & Practice spoke to radiologist Dr. Marcelo Sanchez about radiology-ICU collaboration. How can communication between radiology and ICU be optimised as both specialities become ever more complex? The collaboration must be maintained by establishing protocols and consensus on image indications for the clinical processes analysed in the

The secrets of the abdomen Overview of abdominal point-of-care ultrasound use in the ICU, potential diagnoses and findings common to the critical care patient population. The use of point-of-care ultrasound (POCUS) in critical care as a diagnostic and monitoring tool is rapidly expanding. While its role in cardiovascular and respiratory assessment is well established (within critical care), abdominal ultr

Secondary complications Reports on secondary complications arising from insertion of a multimodal monitoring sensor using a dual lumen introducer kit in patients with subarachnoid haemorrhage, head injury or intracranial haemorrhage. Maintenance of sufficient cerebral oxygen supply to meet metabolic demand is a key goal in managing patients with acute brain injury and in perioperative settings. A discr

Executive summaryMinimum requirements, preferred features, and other advantageous features are identified for ultrasound systems for common exam types. Ultrasound is used for a wide variety of clinical applications, each requiring a somewhat different set of sonographic capabilities. A scanner's array of available features is a key factor in determining its appropriateness for a given application. Liste


Report of a symposium presented at LIVES 2018: 31st congress of the European Society of Intensive Care Medicine, Paris, France Chairs: Michael Sander, Germany & Jean-Daniel Chiche, France Knowledge and practice in sedation and analgesia in the ICU have advanced greatly in recent years. The risks of delirium and of over-sedation and effect on outcomes are well-known

A critical care pharmacist’s perspective and advice on medication safety around sedative and analgesic therapy in the ICU. Medication errors occur at every stage of the drug therapy process. A recent report on medicines processes in English hospitals identified notably high error rates in prescribing (8.8%) and preparation and administration (78.6%) (Elliott et al. 2018). Medication errors in ICU I

Asking why the patient needs to be sedated is as important as the choice of drug for sedation. Why use sedation? Intensivists should ask why they use sedation every time they order it. Sedation is used to reduce the burden and stress of critical illness. Sedative agents mixed with analgesic agents reduce pain and keep the patient calm, especially at night. Intensivists need to look for the cause of agitat

From massive sedation in the past, through current sedation practice relying on cooperation between patients and care providers, the future may further improve sedation in the ICU. The concepts for good sedation include defining the range of sedation, the need for agents with rapid response that can be easily and rapidly varied in restless and confused patients, various modes of ventilation, continuous su

Series: Gases

Reviews the potential uses and pitfalls of capnography in critically ill patients, especially for haemodynamic and respiratory monitoring. Expired CO2 can be easily monitored in the intensive care unit (ICU), especially in patients under invasive mechanical ventilation, using infrared measurement by sampling mainstream expiratory flow using an in-line chamber, or sidestream expiratory flow (by continuous


A review of diagnosis and treatment of dengue, a mosquito-borne febrile illness caused by flavivirus with a clinical spectrum ranging from self-limited fever to dengue haemorrhagic fever with shock. Dengue is a febrile illness, caused by one of the serotypes of Flavivirus (DENV1-4), transmitted by Aedes aegypti and Aedes albopictus mosquitoes during a blood meal (Simmons et al. 2012; Guzman et al. 2015;

Best practice in managing fungal infections Invasive candidiasis: Every milligram of antifungal counts! Think Aspergillus! Invasive fungal infections (IFIs) are a major cause of morbidity and mortality in critically ill patients. Almost 80% of IFIs are due to Candida spp., which are the third most common isolated microorganisms in the intensive care unit (ICU) (Kett et al. 2011; Bassetti et al. 2017). Al


Panacea or illusion?Reflections on key research insights into interprofessional teamwork in the ICU with a critical yet optimistic view for its future. Over the years, interprofessional teamwork in the intensive care unit (ICU) has been viewed as a panacea to most ills and indeed described as a core value of critical care practice (Parker 2016; Donovan et al. 2018; Lyons 2018). However, my recent conver


JANUARY 7-11 Blood Diseases in the ICU: Advanced Training Paris, France 13-18 9th Annual Winter Symposium in Intensive Care, Anaesthesia and Emergency Medicine Vail, USA 30-31 CRITICARE 2019: 25th Annual Conference of Indian Society of Critical Care Medicine Mumbai, India FEBRUARY 1-3 Milan Critical Care Datathon and ESICM's Big Datatalk Milan, Italy 4-7 Canadian Critical Care Conference 2019 W

Subject Index for Volume 18, issues 1-4, 2018. Issue Pages Short URL 1 1-80 https://iii.hm/r8z 2 81-144 https://iii.hm/r90 3 145-224 https://iii.hm/r91 4 225-288 https://iii.hm/r92 A-B C D E F G H I-K L M N-O P-Q R S T U V-Z See Also: Author Index 2018 Acute respiratory distress syndromeKelleher E. ARDS cartoon. 18(2):143. https://iii.hm/kdz Study: air

A B C D E F G H I J K L M N O P-Q R S T-U V W X-Y Z A Author Page Short URL Abrams D 8, 16 https://iii.hm/hwy, https://iii.hm/hww Aissaoui N 20 https://iii.hm/hwv Al Rahma H 136 https://iii.hm/kdp Amir A 244 https://iii.hm/qp2 Andersen B 56 https://iii.hm/hwi Arnal JM 20 https://iii.hm/hwu Artigas A

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