Volume 19 - Issue 4, Winter 2019/2020

Critical Care Medicine has existed for many years, but was only recognised as a specialty in the last 40 years or so. However, during this time, there has been a tremendous amount of change. Over the years, our understanding of different critical illnesses has improved, and our treatment strategies have become more effective. Technology has also played a key role in improving patient care, and adopting a hu...

When envisioning the future of haemodynamic monitoring, we cannot limit the discussion to new sensors and computer innovations. We also need to consider the accessibility to scientific and technological progress, particularly in resource-limited countries where a large number of patients deserve more rational haemodynamic management. The growing number of publications regarding new biomaterials, non-invasi...

Clinical decision support systems (CDSS) are today, a reality. More complex, useful systems will be developed in the near future, forging CDSS an essential part of ICU monitoring. However, we need to understand the algorithms embedded in CDSS and to assess them correctly. They will need to first prove their worthiness before becoming indispensable. Healthcare professionals working in the ICU environment...

Critical Care Ultrasound (CCUS) has progressed by leaps and bounds, and will continue to push boundaries, with techniques being modified to suit evolving clinical needs and new applications. With roots traceable to sonar technology developed for underwater listening and submarine detection, the era of medical ultrasound began during the Second World War; the first research paper on brain ultrasonic tra...

Future ICU designs must feature high visibility to ensure safety. The ability for critical care nurses, physician intensivists, and other caregivers to visualise their patients has always been a high priority as it plays a major role in patient and staff safety. Architects and designers have responded with configurations for intensive care units (ICUs) to support the ability for staff to see their patien...

Seasonal influenza remains a significant health burden and places tremendous and predictable strain on personnel and resources within a health system, specifically within critical care. Despite this, many institutions do not have a comprehensive influenza management plan. Effective and comprehensive critical care management of influenza requires centralised oversight and coordination, a robust electronic he...

An AI-enabled ICU is coming in the not-too-distant future, but it requires strong partnerships between clinicians and engineers. Spoiler alert. The short answer to this question is yes! Artificial Intelligence in Medicine” has been taking place biannually for the past 28 years (Patel et al. 2009). What is new, however, is the cross-industry exponential growth in awareness of, and interest in, AI o...

From massive sedation in the past, through current patient-centred sedation protocols, the future may further improve sedation in the ICU. The concepts for an optimal sedation in the intensive care unit (ICU) should include: Definition of the optimal depth of sedation;The need for agents with on/off effects;The need for agents with dedicated effects on hypnosis, pain, and confusion;Continuous supervi...

Critical care telemedicine is likely to be a key feature of the future ICU, but its success will hinge on the development of a sophisticated and robust implementation roadmap. The future ICU will shape the future of the modern hospital, and the future of healthcare in the wider sense. This responsibility cannot be taken lightly. In this paper, we draw from our experience in London and the international...

Over the next 50 years, critical care will evolve from a system that reacts to patient deterioration into a system that predicts and prevents these events. The application of real-time analytics to large-scale integrated ICU patient data will facilitate creation of learning healthcare systems and delivery of personalised and even predictive critical care medicine. Over the next 50 years, critical care wi...

Integration of care, research and education in the intelligent intensive care unit. Patients admitted to the intensive care unit suffer from a variety of symptoms, pathologies, and comorbidities and are at risk of many adverse outcomes. Healthcare and technology for this vulnerable, heterogeneous patient group have immensely developed over the past decades, but even though mortality rates have fallen, th...

What will the future ICU look like?...

A go-anywhere checklist format to improve emergency tracheal intubation. Tracheal intubation outside the operating room is fraught with danger. According to the landmark NAP4 study, intubation in the ICU may be associated with 50 times greater risk of procedure-related death and brain injury compared to general anaesthetic practice (Cook et al. 2011). The primary risk factors included lack of planning,...

Improving early recognition of sepsis in the Neonatal Intensive Care Unit using machine learning models and electronic health record data. Despite advances in knowledge and medical care, sepsis remains a major cause of morbidity and mortality in infants worldwide, claiming the lives of one million newborn infants each year according to the World Health Organization (Liu et al. 2015;Vogel 2017). By defi...

This article provides an overview of transoesophageal echocardiography training, programme development, feasibility and impact on the diagnosis and treatment of critically ill patients. Recently clinicians at our centre managed one of the most critical patient emergencies. An elderly woman (Patient A) presented to our emergency department (ED) by ambulance with cardiac arrest of unknown aetiology. Informa...

An overview of Human Factors Engineering (HFE), a multidisciplinary science in which human behaviour, capacities, and engineering principles are used to explore why errors occur, and how the likelihood of preventable harm could be reduced. Adverse events and errors are frequent in technology-rich critical care environments, such as Intensive Care Units (ICUs). In such a clinical setting, patients are mo...

Professor Rui P. Moreno works at the Intensive Care Unit of the Hospital de São José (Centro Hospitalar Universitário de Lisboa Central E.P.E) as the coordinator of the Neurocritical and Trauma ICU. Prof. Moreno has been a member of the European Society of Intensive Care Medicine (ESICM) since 1995 and became President of the Society in 2008. He was also co-chair of the Surviving Sepsis Campaign from 20...

Visit https://healthmanagement.org/c/icu/list/blog or contact [email protected] Jeremy M. Kahn Professor of Critical Care Medicine and Health Policy & Management - University of Pittsburgh School of Medicine and Graduate School of Public Health, USA What’s the Future of Intensive Care Medicine? “I envision a future in which there are not more, but fewer ICU beds. These will care...

For a full listing of events visit https://iii.hm/swz JANUARY 27-30 Arab Health 2020 Dubai, UAE https://iii.hm/10q3 31-2 FEB Milan Critical Care Datathon and ESICM's Big Datatalk 2020 Milan, Italy https://iii.hm/10q4 FEBRUARY 6-8...

Subject Index for Volume 19, issues 1-4, 2019. Issue PagesLinkIssue 1 1-64 https://iii.hm/10cv Issue 2 65-128 https://iii.hm/10cw Issue 3 129-192 https://iii.hm/10cxIssue 4 193-256 https://iii.hm/10cy Acute Respiratory Distress SyndromeUse of sedation and controlled paralysis in ICU patients with ARDS. 19(2):70. https://iii.hm/10ex Acute Stroke New recommendations for stroke systems of care - Am...

Abella A 15 https://iii.hm/10d8 Abrams MP 122 https://iii.hm/10fe Amrein K 114 https://iii.hm/10fc Antonelli M 190 https://iii.hm/10fs Artigas A 100 https://iii.hm/10fa Azoulay É 188 https://iii.hm/10fr Bakshi V 56 https://iii.hm/10dj Barach P 182 https://iii.hm/10fq Beaucote V 180 https://iii.hm/10fp Bellomo R 10 https://iii.hm/10d7 Bjertnaes L 46 https://iii.hm/10df Brown S 63 https://iii.h...