Editorial

The COVID-19 pandemic has had a significant impact on ICUs and critical care healthcare providers all across the globe. As of this week, 110 million people have been infected with the virus worldwide, and 2.4 million have died. Many of the infected patients need hospitalisation and admission to the ICU. A high percentage of severely ill patients with COVID-19 require mechanical ventilation. Hence, ICUs have...

Cover Story

2020 has been an unusual year. As we begin 2021, it is important for intensivists to look back over what has happened and see whether lessons can be learned from our combined experiences. The year 2020 has been unusual in so many ways and as we start a new year, it is interesting and important as intensivists to look back and reflect on what has happened. Populations worldwide have experienced lockdowns, c...

In light of harsh criticism regarding physicians’ prioritising scarce resources during the COVID-19 pandemic, the question arises: is prioritising truly a physicians’ problem? The COVID-19 pandemic has led to pronounced discrepancies between the need for medical care and the ability of many health care systems to provide it.Subsequently, treating teams needed and still need to take prioritisation decis...

An overview of the large-scale transition to telemedicine at Mayo Clinic during the COVID-19 pandemic and how it happened in a matter of days and represented one of the most rapid transformations of healthcare in history. The 2019 Coronavirus Disease (COVID-19) pandemic has affected nearly all aspects of society, from family interactions to social activities to workplace structures. Travel restrictions an...

Intensive Care Medicine is generating an amount of data that is hardly analysable by humans. Digitalising and using artificial intelligence has to focus on providing less rather than more data. Whether it's flying robots buzzing around the patient's bed or glowing beams that miraculously heal people in seconds: we are currently a long way from such science fiction scenarios in medicine - Good thing....

Prone position (PP) in awake, non-intubated patients with respiratory failure is a physiology-based ventilatory strategy that improves oxygenation and may decrease the need for intubation and invasive mechanical ventilation (IMV). During the pandemic caused by the SARS-CoV-2 virus, which produces coronavirus disease 2019 (COVID-19), prone positioning (PP) has been proposed for awake, non-intubated patien...

Special Supplement

Moderator Vito Marco Ranieri (Bologna, Italy) Speakers Why Do We Need Sedation in Critically-Ill COVID-19 Patients? Salvatore Maurizio Maggiore (Chieti, Italy) How Should We Manage Sedation in Critically-Ill COVID-19 Patients? Boris Jung (Montpellier, France) The COVID-19 pandemic has wreaked havoc across the globe. Clinicians worldwide have been battling the pandemi...

COVID-19 patients present to the hospital with lung involvement and interstitial pneumonia eventually associated with lung collapse. The clinical picture is dominated by severe hypoxaemia without dyspnoea/tachypneoa and normal respiratory mechanics; this condition has been defined as silent hypoxia. The picture may evolve, and these patients may present with severe refractory hypoxaemia associated with dys...

The Choosing Wisely top five guidelines published a few years ago by the Chest Association of Physicians, the American Thoracic Society, the Society of Critical Care Medicine, and the American Association of Critical Care Nurses state that mechanically ventilated patients should not be deeply sedated without a specific indication and without daily attempts to lighten sedation (Halpern et al. 2014). This...

During the question/answer session, Prof Vito Marco Ranieri discussed some important questions with Prof Salvatore Maurizio Maggiore and Prof Boris Jung regarding sedation regimen, respiratory muscle paralysis, sedation in COVID-19 patients specifically and how it is different from other regular ICU patients. Ranieri: What is your opinion on deep sedation using remifentanil and propofol targeting RASS -4?...

Matrix

Perioperative cardiorespiratory compromise is common and goes largely undetected. Predictive cardiorespiratory indices can help in early detection of harmful deviations and guide preemptive treatment. Using continuous cardiorespiratory monitoring coupled with these tools, we now know which patients are likely to decompensate both within and outside the operating room. There is a tremendous opportunity for...

This paper describes the experiences of the Speech and Language Therapy (SLT) service at Nightingale Hospital, adapting to changing demands, which included upper airway challenges associated with extubation and oral management in patients with COVID-19. The London Nightingale Hospital was set up in response to the COVID-19 pandemic to provide critical care for patients requiring intubation and ventilati...

Point Of View

An overview of the updated guidelines for the diagnosis and management of atrial fibrillation, developed in association with the European Association for Cardio-Thoracic Surgery. The European Society of Cardiology (ESC) provides a range of scientific and educational activities, such as the production and continuous updating of clinical practice guidelines for the diagnosis and treatment of cardiovascul...

During the COVID-19 pandemic, Foch Hospital in Suresnes, France adapted its medical strategy to manage high patient flow, limited resources and staff shortages to ensure efficient patient care. Here is an overview of how the hospital rose up to the challenge. How should we treat patients infected with a virus we know hardly anything about? This was the very first challenge that hospitals in Europe had to...

This article is a summary of a webinar series where three nutritional experts discussed a practical approach on how to feed and how to provide high-quality nutritional therapy to critically ill patients during hospitalisation. Prof Elizabeth De Waele, Dr Arthur Van Zanten and Prof Paul Wischmeyer in the webinar series discuss nutrition support for COVID-19 ICU patients and strategies for the nutrition manag...

The Austrian critical care ventilator TwinStream® ICU was designed with the explicit purpose of saving critically respiratory-distressed patients. In particular those patients with severe lung diseases (e.g. ARDS) who can no longer be supported with conventional ventilation. Its unique p-BLV® mode has become an established value in many Intensive Care Units in Austrian and German hospitals. And when...

Agenda

MARCH 2 ISICEM e-Day - ARDS Virtual meeting https://iii.hm/17cz 19-20 2020 World Critical Care and Anesthesiology Conference Virtual meeting https://iii.hm/17d0 APRIL 8-10 17th Emirates Critical Care Conference 16th World Federation of Critical Care Nurses (WFCCN) World Congress Hybrid meeting https://iii.hm/17d1 13 ISICEM e-DAY – ECMO Virtual Meeting https://iii.hm/17d2 14-16 EURONEURO 2021 Virt...



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