ICU Volume 12 - Issue 2 - Summer 2012

Amid the challenges of managing the ICU, the elements of the system are forever altering, creating yet more complexity. Changes in an ICU, whether tried and tested or from innovative research that indicates beneficial results, are prone to error if doctors, nurses and other staff are not educated sufficiently. This may involve not just training on modern technology and new procedures, but also stimulating...

A commonly used, inexpensive diagnostic tool, the dipstick proteinuria (DP) urine test, may provide an easier, more effective way to predict Acute Kidney Injury (AKI) in patients with sepsis or severe blood poisoning infections. Led by Dr. Javier Neyra at the Henry Ford Hospital in Detroit, Michigan, researchers have found a new prognostic application for the readily available urine test. Intensivists an...

The US Food and Drug Administration (FDA) will review a new study in which it is indicated that patients taking azithromycin are at a slightly increased risk of sudden cardiac death than patients treated with amoxicillin, ciprofloxacin, or no antibiotic at all. The observational study entitled “Azithromycin and the Risk of Cardiovascular Death”, which was published on May 17, 2012, in the New Englan...

The Competency-Based Training in Intensive Care Medicine in Europe (CoBaTrICE) collaboration was established in 2003 with a grant from the European Union’s Leonardo Programme, and endorsement from the European Society of Intensive Care Medicine and the national training organisations (NTO) of 42 countries, including all those of the EU. The aim was ambitious: to develop an international competency-based...

On 20 July, 1958, delegates of the professional organisations representing medical specialists of the six member countries of the very new European Community (EEC) convened in Brussels and created the European Union of Medical Specialists (UEMS), which later came to define the basic principles involved in training the community’s medical experts. Over the years, amid developments and the expanding EU, re...

European Society of Intensive Care Medicine (ESICM) has for decades engaged in education and training as one of its core activities. Through the Division of Professional development (DPD) it now runs the European Diploma of Intensive Care (EDIC) exam; the distant e-learning tool, PACT; and the Competence Based Training in Intensive Care in Europe (CoBaTrICE) programme. Intensive care training courses are t...

Resource Difficulties in ICU Education Conventional training methods for nurses involve many physical factors that place limits on potential class size (Sorce, Simone, and Madden 2010). Alternate training methods with lower physical requirements may support larger class sizes but, given the tactile quality of nurse training, are most appropriately applied to supplement conventional methods. Where the impor...

Despite the ever-increasing evidence base suggesting that interventions enhance the quality and safety of healthcare, a large gap remains between the existing evidence and the actual implementation of these interventions in day-to-day critical care practice. This gap undoubtedly impacts on patient safety and quality of care. This article provides the most elementary basics for enhancing successful implemen...

Metabolic nutritional support is a cornerstone in the management of seriously ill patients. Election of the route of nutritional administration – parenteral nutrition (PN), enteral nutrition (EN) or mixed – depends on the condition and integrity of the digestive tract as well as the diagnosis and condition of the patient. If the gastrointestinal tract is functional and the haemodynamic status of the...

Introduction Does the caloric intake of critically ill patients make a difference? Ever since initial measurements with indirect calorimetry were made, it has been obvious that predictions from body size end up with some + 30 percent uncertainty with regard to the actual energy expenditure of a patient. Following this realisation, a long line of modified equations has been suggested where, in addition to ag...

Introduction In the US alone, up to 1,000,000 emergent intubations are performed annually in the acute care setting, both in and out of hospital (Weingart et al. 2012; Wang et al. 2011; National Emergency Number Associtation 2011). Meanwhile, multiple studies have demonstrated varying rates of successful endotracheal intubation (ETI). While anesthesiologists and emergency physicians exhibit ETI success rate...

Ultrasonography with a head-to-toe approach has become a comprehensive tool in evaluating critically ill patients from the bedside. In this article, authors propose an innovative approach to critical care ultrasonography, which is simple, fast and transferrable to different anatomical sites. In the past decade many authors have emphasised the role of ultrasonography in daily patient assessment (Beaulieu...

Co-authors Colin Cordemans, MD Intensive Care Unit ZNA Stuivenberg Antwerp, Belgium Niels van Regenmortel, MD Intensive Care Unit ZNA Stuivenberg Antwerp, Belgium Introduction In a previous issue of ICU Management (volume 12, issue 1), we suggested a three hit model of shock and emphasised that both early and late fluid management affect outcome in acute lung injury (ALI), sepsis and trauma (Rivers 200...

A successful research grant application may represent an important step in the career of professionals working in the intensive care medicine field, especially in academic institutions. Grants are needed for launching and keeping research projects, as well as for buying equipment for the laboratory or initiating a clinical trial. Ideally, grant applications should not be driven by ambitions of getting a ch...

Professor Benoit Vallet, Chair for the Department of Anaesthesiology and Intensive Care Medicine at the University Hospital of Lille, France has played a great influence in his fields of professionalism over the years, with his current participating role in the steering committees for the Age of Blood Evaluation (ABLE) randomised controlled trial and European surgical outcomes (EuSOS) study just providing...

Challenges and Changes in Care Provision for the HIV Infected Population The break up of the USSR brought about negative changes in healthcare among other industries, with nepotism in research and corruption from authorities remaining the weak spots of the health system. Although the occupation of a physician has not lost its appeal, more than 50 percent of graduates of Russian medical schools seek jobs el...