ICU Management & Practice, ICU Volume 6 - Issue 4 - Winter 2006/2007

Hypothermia in Care

Author Jean-Louis Vincent Head, Department of Intensive Care, Erasme Hospital Free University of Brussels, Belgium Medical professionals have long recognized the therapeutic benefits of regulating body temperature. In recent years, however, therapeutic hypothermia has garnered increased attention for its potential applications in treating several critical medical conditions. Indeed, this co...

Industry

Maquet Critical Care Unveils Neutrally Controlled Ventilation Technology www.maquet.com At the 19th Annual Congress of the European Society of Critical Care Medicine (ESICM) in September, Maquet Critical Care (Maquet) announced the launch of its latest breakthrough in mechanical ventilation, Neurally Adjusted Ventilatory Assist (NAVA). Maquet’s new Servo-i ventilator with NAVA enables the patient’s...

World

Clean Hands Leading to Safer Healthcare for Half the World’s Population http://www.who.int/gpsc/en/ The World Health Organization (WHO) recently announced that a total of 22 countries, representing 55% of the world’s population, have signed on to the Global Patient Safety Challenge, a worldwide movement to address healthcareassociated infections, since it was launched by the WHO Alliance for Patien...

Use of Induced Hypothermia: Acceptance and Implementation Issues

Author Prof. Armand R.J. Girbes Department of Intensive Care, University Hospital VU Medical Center Amsterdam, The Netherlands [email protected] or [email protected] In this article, Professor Girbes discusses the difficulties a manager may face when introducing the practice of therapeutic hypothermia into the intensive care unit (ICU), as well as the best techniques for overcoming these ob...

therapeutic hypothermia, cardiac arrest

Therapeutic Hypothermia After Cardiac Arrest

In this article, Dr. Nolan discusses the benefits of induced hypothermia following cardiac arrest. He further explains the key factors that must be considered when implementing this therapy to optimize patient outcome. Of the patients who sustain an out-of-hospital cardiac arrest caused by cardiac disease, just 7%survive to hospital discharge (Pell 2003). Survival to discharge after in-hospital cardiac arr...

Economic Impact of rFVIIa in Management of Perioperative Bleeds in Burns Patients

Author Pär I. Johansson MD, MPA Medical Director Transfusion Service, HS Blood bank Rigshospitalet/National University Hospita´l Blegdamsvej 9 Dk 2100 Copenhagen, Denmark [email protected] In addition to its more common, approved uses, activated recombinant coagulation factor VII (rFVIIa) can be beneficial to the treatment of burn injuries when excision and skin grafting are perf...

Taking the Next Step in Medical Emergency Team Management

Authors Michael R. Pinsky, MD, Dr hc Michael A. DeVita, MD Department of Critical Care Medicine University of Pittsburgh,Pittsburgh, USA [email protected] Medical emergency teams responding to bedside caregiver-activated calls, triggered by deterioration in defined, continuously measured physiological variables, reduce mortality, morbidity and the cost of healthcare. However, to become unive...

Evidence- Based Management of Acute Lung Injury and Acute Respiratory Distress Syndrome

Authors Ravindranath Tiruvoipati, FRCSEd Christopher Harvey, MRCS Giles J Peek, MD, FRCS (CTh) Department of ECMO and Cardiac Surgery Glenfield Hospital Leicester, United Kingdom . This article reviews the practices that are evidence-based in managing adult patients with acute lung injury and acute respiratory distress syndrome. Introduction Acute lung injury (ALI) and acute respirat...

Challenges of Economic Analysis of Pharmaceuticals in the ICU Setting:Outcomes of Sedatives

Author Joseph F. Dasta, MSc. Professor The Ohio State University, College of Pharmacy Columbus, OH, USA Despite considerable literature on the clinical use of sedatives in the intensive care unit (ICU) population, there is limited information on pharmacoeconomics of these agents and their effects on healthcare resources (Wittbrodt 2001). In fact, most studies are limited to an assessment of d...

Failure to Regain Weight After Critical Illness: A Short Review

Authors Vanessa Helliwell, FRCA, EDICM Royal Devon & Exeter NHS Foundation Trust, Exeter, United Kingdom [email protected] Sheena Hubble Consultant ITU Medicine,Royal Devon and Exeter Hospital Exeter, United Kingdom Robert Fraser Mortality following intensive care (IC) is well reported, but morbidity information is much more meaningful for survivors. Several...

Warming/Cooling Units

ECRI Europe Weltech Centre Ridgeway Welwyn Garden City Herts AL7 2AA, United Kingdom Tel. +44 (0)1707 871511 Fax. +44 (0)1707 393138 [email protected] www.ecri.org.uk ECRI is a totally independent nonprofit research agency designated as a Collaborating Centre of the World Health Organization (WHO). Such organizations are appointed to contribute to WHO’s public health mission by provi...

Quality Management System in the ICU

Author Dr. Ulrich Bothner, MD, MSc Certified Quality Manager and Medical Informatics Specialist Assistant Professor Anesthesiology University of Ulm, Ulm, Germany [email protected] Quality Initiatives and Concepts Established quality and confirmed quality improvement in healthcare are not givens but the result of meticulous efforts. Many healthcare professionals have worked toward...

The Use of Simulation as a Tool for Improving Teamskills

Authors Torben Wisborg, M.D., D.E.A.A. The BEST Foundation: Better & Systematic Trauma Care (www.bestnet. no) Department of Anesthesia and Intensive Care Hammerfest Hospital,Hammerfest, Norway [email protected] Guttorm Brattebø ,MD Department of Anaesthesia and Intensive Care Haukeland University Hospital Bergen, Norway Teamwork in time-critical and high stake settings...

ICU Design of the Future: Focus on flexibility

Authors Jeannie Wurz, BA Dept. of Intensive Care Medicine, University Hospital Bern, Switzerland Jukka Takala, MD, PhD Dept. of Intensive Care Medicine, University Hospital Bern, Switzerland [email protected] Introduction Designing an intensive care unit (ICU) to handle the needs of critically ill patients in the future requires both an ability to predict which of today’s...

Enhancing Ventilation Monitoring: An Interview with Professor Ola Stenqvist

Professor Ola Stenqvist is a Consultant Anaesthesiologist in the Department of Anaesthesia at Sahlgrenska University Hospital in Gothenburg, Sweden, and a professor in the Department of Anaesthesiology and Intensive Care at Gothenburg University. Professor Stenqvest recently developed two new ventilation monitoring technologies now produced by GE Healthcare, SpiroDynamics and FRC INview. What Research...

Do We Need Doctors to Go Out in Emergencies?

Author Guttorm Brattebø, MD Dept. of Anesthesia & Intensive Care, Haukeland University Hospital Bergen, Norway [email protected] Some national emergency systems regularly send specially trained doctors (often anesthetists) out of the hospital in emergencies (e.g. Germany and France), while other systems mainly are managed without this option (e.g. the U.S.). If one is i...

Committee of the Regions

Author Ilze Raath Editor European Affairs The Committee of the Regions (COR or Committee) was created by the Maastricht Treaty in 1992 and provides a forum for local and regional authorities on issues affecting them. It is an advisory body that ensures public authorities are consulted on European Union (EU) proposals of direct interest to them, especially as they are often responsible for impleme...

Healthcare Scenario in India

Author Dr. S. K. Jawahar, MHA (AIIMS), DNB (Health Admin) Administrative Medical Officer, Sree Chitra Tirunal Institute for Medical Sciences and Technology Thiruvananthapuram, Kerala, India [email protected] www.sctimst.ac.in India, a country with a centuries-old heritage of medical science, first became familiar with the modern systems of medicine in the 17th century. India became an ind...

Critical Care in India

Authors Shailesh Bihari, MD Nikhilesh Jain Dr. N.Ramakrishnan, AB (Int Med), AB (Crit Care), MMM, FACP, FCCP Director of Critical Care Services Senior Consultant in Critical Care & Sleep Medicine, Apollo Hospitals Chennai, India Honorary Professor Sri Ramachandra Medical College & Research Institute,Nithra Institute of Sleep Sciences [email protected] The specialty of cri...

ISCCM Certificate Course and Critical Care Education in India

Author Dr. Shivakumar Iyer, MD, DNB European Diploma in Intensive Care ISCCM Course Coordinator, In-Charge ICU, Jehangir Hospital Pune, India [email protected] [email protected] Introduction Critical care is still a fledgling specialty in India, despite the fact that intensive care units (ICUs) have been in existence here for more than thirty years. Traditionally, critical care has bee...

Antimicrobial Resistance in Indian ICUs

Authors Sheila Nainan Myatra, MD Assistant Professor J.V. Divatia, MD Professor, In-Charge, Critical Care Department of Anaesthesia, Critical Care and Pain Tata Memorial Hospital, Mumbai, India [email protected] [email protected] Infections with resistant organisms have reached alarming proportions in Indian intensive care units (ICUs). Changes in the healthcare system are necessar...

ICU Versus ITU: Comparison of Critical Care Services in India and the UK

Auhors JR Raja, MD.EDIC Manchester Royal Infirmary, Manchester, UK [email protected] N Ramakrishnan AB (Med), AB (Crit.care), FCCP, FCCM, MMM Department of Critical Care Medicine, Apollo Hospitals, Chennai, India Dr. Raja and colleague analyze the key differences in organization and delivery of critical care services in India and the United Kingdom. Introduction It has be...

27th International Symposium of Intensive Care and Emergency Medicine

Author Jean-Louis Vincent Head, Department of Intensive Care, Erasme Hospital, Free University of Brussels, Belgium The 27th International Symposiumof Intensive Care and Emergency Medicine (ISICEM) will be held at the Congress Center in Brussels from March 27 to 30, 2007, and we are looking forward to another exciting week of lectures, debate and discussion. The ISICEM is now the largest annua...