ICU Management & Practice, ICU Volume 8 - Issue 3 - Autumn 2008

Editorial

In critical care, there is no single answer, no magic solution - pharmaceutical or diagnostic that can cure all patients or improve their conditions simultaneously. In ICU Management we are always, however, in search of new diagnostic tools and medications, which we can add to our arsenal of weapons in fighting the deadliest of conditions that our patients face. While an ideal biomarker has not been identi...

Lung Injury Still Too Common in Ventilation, Measures for Protection Insufficient

Ventilator-induced injury in the lungs is responsible for a vast number of deaths in acute respiratory distress syndrome (ARDS). Even healthy surgical patients, who require temporary mechanical ventilation, are at risk of ventilator-induced lung injury. Although such injuries have been reduced tremendously over the last few decades, a new study suggests, they have much further to go. "It is ironic, becaus...

Silver-Coated Endotracheal Tubes appear to Reduce Risk of Pneumonia Associated with Ventilator Use

Among intensive care unit patients who require mechanical ventilation, use of a silvercoated endotracheal tube resulted in reduced incidence of pneumonia associated with ventilators, according to a report in the August 20 issue of JAMA. Ventilator-associated pneumonia is associated with longer hospital stays, increased health care costs and infection with antibiotic-resistant pathogens, according to backg...

biomarkers

The Role of Biomarkers in the Diagnosis of Infection

Author Pedro Póvoa, MD, PhD Coordinator of the Medical Intensive Care, Department of Medicine III São Francisco Xavier Hospital,Centro Hospitalar de Lisboa Ocidenta Professor of Medicine,Faculty of Medical Science New University of Lisbon,Lisboa,Portugal [email protected] Biomarkers, Namely CRP and PCT, can Help Clinicians at the Bedside Since when Used in Combination with the Clinical Examination they...

Biomarkers in the Assessment of Response of Infection to Antibiotic Therapy

Authors Luís Coelho, MD Pulmology Unit,Hospital of the Litoral Alentejano Santiago do Cacém, Portugal [email protected] João Gonçalves Pereira, MD Medical Intensive Care Unit,Department of Medicine III São Francisco Xavier Hospital Centro Hospitalar de Lisboa Ocidental,Lisboa,Portugal Serial Measurements of Biomarkers, Namely CRP and PCT, Used in Combination with the Clinical Examination...

Sepsis Biomarkers in Early Diagnosis and Treatment Planning: An Economic Appraisal

Author Dominique M. Vandijck,MSc,MA Department of Intensive Care Medicine Ghent University Hospital,Interfaculty Centre for Health Economic Research Faculty of Medicine and Health Science Ghent University,Ghent,Belgium [email protected] The approach of using biomarkers for diagnosing and assessing illness severity and treatment response has become a new hype in modern intensive care medicine. P...

The Aging of Our ICUs Part I: A Need for a New Paradigm in Our SICU

Author Robert D. Barraco, MD, MPH, FACS,FCCP Associate Director of Trauma,Chief of Geriatric Trauma Department of Surgery Division of Trauma-Surgical Critical Care Lehigh Valley Hospital,Allentown,Pennsylvania,USA [email protected] The Baby Boom has become the Elder Explosion. According to U.S. Census figures, the population age 85 and over will grow fivefold by the year 2030 (Figure 1). By 2050, up...

education, medical education, training, intensive care, competencies, European Society of Intensive Care Medicine, ESICM, European Diploma of intensive care, EDIC

Education and Training in Intensive Care European Perspective

Education and training have increased its importance the last decades. Twelve years ago European Society of Intensive Care (ESICM) published a paper concerning training in intensive care (Int Care Med 1996) and the society efforts to improve training within intensive care have expanded considerably since that time. Intensive care is an established medical field in all European countries with units found...

Efficient ICU Management: A Framework to Implement Evidence Based Organisation of Care

Authors Rebecca Anas, B.Sc, MBA Project Manager Strategic Decisions, Critical Care Department [email protected] Fabrice Brunet, MD, FRCPC Professor of Medicine,University of Toronto Chief, Critical Care Department Li Ka Shing Knowledge Institute [email protected] David Klein MD FRCP(C) MBA Assistant Professor of Medicine University of Toronto Staff Physician, Critical Care Department klein...

Fever Control in Critically Ill Patients

Author Kees H. Polderman, MD, PhD Associate Professor of Intensive Care Medicine, Dept. of Intensive Care Utrecht University Medical Center,Utrecht,The Netherlands [email protected]@umcutrecht.nl Regional temperature differences exist between various parts of the body under physiological conditions in healthy individuals. Traditionally, a temperature gradient between the “core comparment”...

An Overview of Healthcare in Israel

Hospitals In 2000 Israel had 48 general hospitals, with approximately 14 200 beds, spread throughout the country. The overall general care bed-population ratio is 2.2. Compared to OECD countries Israel is characterised by a low bed-population ratio, an extremely low average length of stay, a mid to high rate of admissions per thousand population and a high occupancy rate. The low bed population ratio is th...

Then and Now: Connctions Between Anaethesisology and Critical Care

Author Gabriel M. Gurman, M.D. Professor Emeritus,Anaesthesiology and Critical Care Ben Gurion University of the Negev,Beer Sheva,Israel [email protected] Most practitioners would agree that there lie inevitable connections between the fields of anaesthesiology and intensive care, as the tasks that define them are almost identical (Table 1). This collusion came to light more vividly while the author was dr...

Intensive Care Nursing Education in Israel

Author Freda DeKeyser Ganz RN, PhD Head Master Program Hadassah-Hebrew University School of Nursing Jerusalem, Israel [email protected] Nursing education in Israel has been undergoing academic upgrading, including a revised post-basic certification course in Intensive Care Nursing allowing nurses increased clinical privileges and responsibilities. Introduction Over 15 years ago the Israeli governmen...

Physical Assessment by Internal Medicine ICU Nurses: Theory into Practice

Authors Rabia Khalaila RN, MPH, PhD Head Nurse,Internal Medicine ICU Hadassah-Ein Kerem Medical Centre Jerusalem, Israel Anwar Kabaha, RN, BSN Yana Tarnovsky, RN, BSN Internal Medicine ICU Hadassah-Ein Kerem Medical Centre Jerusalem, Israel [email protected] Introduction Physical assessment is an important tool in nursing in general and in intensive care in particular. It helps in the identificati...

Evidence Based ICU Nursing

Author Julie Benbenishty, RN BA ICU Chairperson Israeli EBN, Habrew Medical Organisation Hebrew University School of Nursing Jerusalem, Israel [email protected] The population in Israel is a little above 7 million people. At the end of 2007 there were 54,899 registered nurses in the country; 4.4 registered nurses per 1000. There are a total of 12 919 nurses completing post graduate courses of which 52...

SCCM’s 2009 Congress: Live from Nashville

Learning takes center stage in Music City, where SCCM’s Congress never sounded so good. The Society’s annual Congress is the largest multiprofessional critical care event of the year, drawing nearly 6,000 nurses, pharmacists, physicians, respiratory therapists, students, veterinarians, and other providers from around the world. You’ll know you’re into something good when you participate in the valu...

Euroanaesthesia 2008

Author Dr. Iain Moppett Consultant Anaesthetist, Queen’s Medical Centre Nottingham University Hospitals, Nottingham, UK Newsletter Editor European Society of Anaesthesiology The annual scientific of the European Society of Anaesthesiology was held at the Bella Centre in Copenhagen at the end of May this Year. The congress attracted around 5200 delegates over the 4 days in addition...