Editorial
Cost-Effectiveness
As medical professionals, we are always seeking new, improved ways to save lives and provide a high quality of care. Coupled with the increasing pressure being applied during these increasingly unstable economic times, it comes as no surprise that one of the growing topics is that of addressing and achieving costeffectiveness. How can we create an optimally financially sustainable environment in the critic...
News
Johns Hopkins & Lockheed Martin Collaborate For Next Generation ICU Unit
The Armstrong Institute for Patient Safety and Quality of Johns Hopkins Medicine is collaborating with the Lockheed Martin Corporation, a global security and technology company, to create a safer and more efficient hospital intensive care unit (ICU) model. The two organisations will work to streamline complex and fragmented clinical systems and processes to reduce medical errors and improve the quality of...
Antibiotic Resistance Continues to Rise
The European Centre for Disease Prevention and Control (ECDC) is releasing new European-wide surveillance data showing that the percentage of carbapenem-resistant Klebsiella pneumoniae is increasing within the European Union. Several Member States are now reporting that between 15 and almost 50 percent of K. pneumoniae from bloodstream infections are resistant to carbapenems. Carbapenems are the major last...
Predictors of Poor Hand Hygiene in the Emergency Department
The Society for Healthcare Epidemiology of America shared that a new report studying hand hygiene of healthcare workers in the emergency department found certain care situations, including bed location and type of healthcare worker performing care, resulted in poorer hand hygiene practice. The study was reported in the November issue of Infection Control and Hospital Epidemiology, the journal of the Societ...
Cover Story
Impact of Procalcitonin Measurement on Antibiotic Administration
Author Arzu Topeli Iskit, MDDirector Medical Intensive Care Unit and Division of General Internal MedicineHacettepe University Faculty of MedicineAnkara, Turkey [email protected] Procalcitonin (PCT) is a biomarker which is used extensively, both as a surrogate marker to distinguish bacterial infections from other causes of infection (such as viral infections), and to distinguish sepsis from other...
Therapeutic Temperature Management in Critically Ill Patients
Kees H. Polderman, MD, PhD Department of Critical Care Medicine University of Pittsburgh Medical Center Pittsburgh, U.S. [email protected],[email protected] Therapeutic temperature management is an increasingly important therapeutic intervention in critical care, particularly in patients with neurological injuries. This applies both to induced therapeutic hypothermia and fever management. It has bee...
Management of Delirium in Elderly Patients
Robert D. Barraco, MD, MPH, FACS, FCCP Chief Sections of Geriatric Trauma and Trauma Outreach [email protected] Also Chair Institutional Ethics Committee Lehigh Valley Health Network Allentown, Pennsylvania, USA Delirium was described in the first century AD by Celsus as “mental disorders such as hysteria, depression or mania, during fever or head trauma”. The word delirium comes from the...
Advances in Mechanical Ventilation
Applying Transpulmonary Pressure in the ICU
Tom Piraino, RRT Best Practice Clinical Educator Respiratory Therapy Services St. Joseph's Healthcare, Hamilton, Ontario [email protected] Assistant Clinical Professor (Adjunct) Department of Anaesthesia (Critical Care) Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada Mechanical ventilation in the intensive care unit (ICU) is usually guided by arterial blood gases, and the pa...
Series
Simulation Training
Saïd Hachimi-Idrissi, PhD, MD, FCCM Coordinator Clinical Skills and Simulation Centre; Professor in Critical Care Medicine, Emergency Medicine and Paediatrics; Head PICU, andChairman of the Cerebral Resuscitation Research Group University Hospital of Brussels (UZ Brussels) Brussels, Belgium [email protected] Scharff Editor Editorial and Publications Section European Society of Intensive C...
Pocket-Sized Ultrasonic Stethoscopes
Dr. Bruce J. KimuraMedical Director Cardiovascular Ultrasound Department of Cardiology [email protected] Dr. Stan A. Amundson Director Internal Medicine Residency Dr. David Shaw Director Graduate Medical Education Scripps Mercy Hospital San Diego, CaliforniaAccurate First Impressions Crucial Obtaining an accurate initial diagnostic assessment is the goal of every clinician, but has parti...
Matrix
Data Centre Trends in the Healthcare Sector
Robert Forsyth Bruno Raeymaekers ARCADIS Community of Practice (COP) for Data Centers [email protected] Growing IT applications are taking a central position in the functioning of any healthcare facility. Existing sites are commonly relying on older IT and technical facilities, not able to support the new and demanding requirements of tomorrow’s organisations. Cooperation with other similar h...
Viewpoints
Persistent Organ Failure Before Death in Patients with Severe Sepsis
Intensivists are used to describing the patient’s condition at the time of handover or when speaking to family members as stable, suggesting that nothing new has happened during the last period of clinical treatment or evaluation, usually one day. Families generally receive this information as positive news, thinking that as there has been no further deterioration, that this will give space for future imp...
Technology as a Means of Supporting the Clinical Environment
For this edition of ICU Management, we asked four influential leaders in critical care medicine, "What was the most important or interesting development in intensive care in 2011?" with the aim of pinpointing the hot topics in critical care and emergency medicine during the year just past, and identifying trends for the future. Each contributor provided a different and important viewpoint that identifies k...
Uneven Distribution of Resources in the ICU
For this edition of ICU Management, we asked four influential leaders in critical care medicine, "What was the most important or interesting development in intensive care in 2011?" with the aim of pinpointing the hot topics in critical care and emergency medicine during the year just past, and identifying trends for the future. Each contributor provided a different and important viewpoint that identifies k...
Quality Measurement & Evaluation of ICU
Prof. Dr. Dominique Vandijck Dept. of Public Health and Health Economics Dept. of General Internal Medicine and Infectious Diseases Ghent University Hospital Ghent, Belgium Dept. of Health Economics and Patient Safety Hasselt University Hasselt, Belgium For years, some have tried to deny their value, but today we can no longer ignore the increasing importance of applying measures to monitor and evalu...
Interview
Anaesthesiology and Intensive Care in Bulgaria
Zlatina Alexieva, MD Department of Anaesthesiology and Intensive Care Medicine Military Medical Academy Sofia, Bulgaria Nikolay Petrov, MD Department of Anaesthesiology and Intensive Care Medicine Military Medical Academy Sofia, Bulgaria The accession of Bulgaria as a member of the European Union in 2007, has meant that in recent years, there is an increasing drive to reset Bulgaria’s healthcare sys...
Challenges for Healthcare & ICU Management in Bulgaria
Nikolay Petrov, MD Associate Professor Department of Anaesthesiology and Intensive Care Meicine Military Medical Academy Sofia, Bulgaria [email protected] Also, President of Society of Anaesthesiologists in Bulgaria President of BULSPEN (Bulgarian Society for Parenteral and Enteral Nutrition) Stefan Bakalov, MD Department of Anaesthesiology and Intensive Care Meicine Military Medical Academy Sofia, Bulga...