Growing and changing needs in intensive care require innovative and varied solutions. In this issue, we cover some of these solutions, from proposed legislation aimed to encourage trials for paediatric medicines, to the application of industry-based process control techniques to intensive care management. Solutions are increasingly to be found across disciplines and through ICU Management, we aim to commun


Author Helicia Herman Editor European Affairs Correspondence [email protected] The proposal for a regulation on medicinal products intended for paediatric use (http://dg3.eudra.org) adopted by the Commission in September 2004, is designed to increase the availability of medicines tested specifically for children. This article describes the key measures proposed (table 1). In Detai

News and Innovations

Contact Maquet www.maquet.com Roche www.roche-diagnostics.com/npt www.coaguchek.com Nils Rosén, Vice President Marketing and Christian Keller, President, MAQUET Critical Care holding the 2005 Market Leadership Award Maquet Every year, Frost & Sullivan presents a Market Leadership Award to a company that has exhibited market share leadership through the implementation of mar

Author Jean-Louis Vincent Head, Dept of Intensive Care, Erasme Hospital, Free University of Brussels, Belgium ISICEM hosted an exchange of scientific innovations, both historical and futuristic. Predicted physician shortages need innovative solutions; some more traditional and some exploiting the most advanced technology available. This year the International Symposium of Intensive Care a

Cover Story:Outreach

Author Ken Hillman, MBBS, FRCA, FANZCA, FJFICM, Professor of Intensive Care, University of New South Wales Director, The Simpson Centre for Health Services Research Co-Director, Division of Critical Care, Liverpool Health Service, Sydney, Australia. Correspondence [email protected] Ken Hillman describes the evolutions in health care which have led to the development of hospital wid

Author David R Goldhill, MA, MBBS, MD, FRCA, EDIC, Anaesthetic Department, Royal National Orthopaedic Hospital Stanmore, UK [email protected] Hospital wards may contain patients who are, or may become, critically ill. They can usually be identified by abnormal physiological values. Early intervention may be beneficial. The intensive care unit (ICU) is only one place in whic

Authors Nancy Santiano, RN MClinNsg Simpson Centre for Health Services Research New South Wales Australia Jeff Murphy, RN, ICUCert, ICU Campbelltown Hospital NSW, Australia Michelle Cretikos, MBBS, MPH Ken Hillman, FRCA, FANZCA, FJFICM Simpson Centre for Health Services Research New South Wales, Australia University of New South Wales, Sydney NSW, Australia Correspond


Author François Lemaire Service de Réanimation Médicale Hôpital Henri Mondor Créteil, France Correspondance [email protected] Acknolodgement I am indebted to Nicolas Fulli-Lemaire for his editorial assistance After a case of euthanasia attracted attention in France in 2003, the Parliament adopted a legislationlast November, which allows withdrawal of life support in te

Clinically and Economically Justified? Authors Kees H. Polderman Senior Consultant in Intensive Care Medicine Armand R.J. Girbes Professor of Intensive Care Medicine Dept. of Intensive Care, VU, University Medical Centre Amsterdam, The Netherlands Correspondance [email protected] Preventing hyperglycaemia and electrolyte disorders and optimizing ventilator settings can help

Product Comparison

Authors Karel Allegaert Neonatal ICU Gasthuisberg UZ Leuven, Belgium Dept. of Paediatric Surgery Sophia’s Children Hospital Rotterdam, The Netherlands Jan de Hoon Center for Clinical Pharmacology Gasthuisberg UZ Leuven, Belgium Hugo Devlieger Neonatal ICU Gasthuisberg UZ Leuven, Belgium Dick Tibboel Dept. of Paediatric Surgery Sophia’s Children Hospital Rotterdam,

Author Manu Malbrain MD Director of ICU, Ziekenhuis Netwerk Antwerpen Correspondence [email protected] Due to its unique pharmacokinetic profile, remifentanil may lead to improved clinical outcomes and cost-savings in the Intensive Care Unit (ICU). Abstract Unlike other opioids, remifentanil is quickly metabolised to an inactive metabolite by non-specific esterases. It does

Introduction ECRI is a totally independent non profit 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 providing specialized knowledge, expertise, and support in the health field to the WHO and its member nations. Established as an Emergency Care Research Institute, ECRI opened i

Authors Andrea Casati MD Staff Anaesthesiologist Marco Baciarello MD Anaesthesia Fellow Augusto Fioro MD Anaesthesia Fellow, University of Parma Dept of Anaesthesia and Pain Therapy Italy Correspondence: [email protected] Dr Casati and colleagues review the potential of regional analgesia in the management of trauma andpost-surgical patients in the ICU. Regional Anaesthesia/


Authors M. Hiesmayr Dept. Cardiac Thoracic Vascular Anaesthesia & Intensive Care, Medical University Vienna, Austria D. Schmidlin Anaesthesia & Intensive Care, Hirslanden Klinik im Park, Zürich Management techniques already proven in commerce and industry are increasingly applied to health care. Professors Hiesmayr and Schmidlin provide an introduction to the application of

Author Jan Wernerman, MD PhD Professor of Intensive Care Medicine, Dept. Of Anaesthesiology and Intensive Care Medicine Karolinska University Hospital Huddinge,Stockholm Sweden Correspondence [email protected] Dr Wernerman reviews the limited current-day evidence to guide nutrition management for ICU patients. Does Good Nutritional Management Make a Difference? Evide

Points of View

Author H. Burchardi Göttingen, Germany Professor Burchardi shares his views on step down wards with ICU Management readers. Step down wards are care units between the level of an intensive care unit and the normal ward. Various types are possible: the intermediate care unit (IMC), post operative monitoring (recovery), but also units for coronary care, non-invasive ventilation, long-term ventilation


Interviewee Professor Marko Noc Head, Centre for Intensive Internal Medicine, University Medical Centre, Ljubljana, Slovenia Correspondence [email protected] As a teacher, researcher and manager in intensive care, Professor Noc promotes international training of his personnel, analyses treatment outcome continuously, promotes evidence based treatments and develops clinical pathwa

Country Focus:Austria

Author Alfons F. Hammerle Dept. of Anaesthesiology and Intensive Care Medicine, Medical University of Vienna Correspondence [email protected] Dr Alfons Hammerle gives an account of statistics profiling the general health care in Austria, and outlines recommendations for reform. Socio-Demographic Factors The population in Austria increased between 1991 and 2001 by

Austrian Society of Anaesthesiology, Resuscitation and Intensive Care Medicine (OEGARI) OEGARI is a non-profit organization to support and develop anaesthesiology, resuscitation, intensive medicine, pain therapy, emergency care and catastrophe medicine, with the objective of providing Austria with the best possible care in these fields. Membership is open to doctors already specialised or in tr

Author P. Krafft, MD, PhD Dept. of Anaesthesiology & Intensive Care Medicine Medical University of Vienna, Austria Vice President, Austrian Society of Anaesthesiology, Resuscitation and Intensive Care Medicine (OEGARI) Correspondence [email protected] Website www.oegari.at This article focuses on the current status of postoperative intensive care medicine i

Congress Previews

Author Gordon Drummond FRCA, Scientific Programme Chairman, ESA University Department of Anaesthesia, Critical Care, and Pain Medicine Edinburgh, UK Correspondence [email protected] Website www.euroanesthesia.org Dr Drummond previews the philosophy, methods, and content of the coming ESA meeting. The European Society of Anaesthesiology is a young organisation, bor

Authors Dr Andrew Rhodes Chair Cardiovascular Section ESICM Dr Rui Moreno Chair Division of Scientific Affairs ESICM Correspondence [email protected] Drs Rhodes and Moreno preview the interaction, learning and dissemination of scientific knowledgeoffered by the ESICM’s annual Congress in September. This year the annual congress of the European Society of Intensiv

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