Editorial
Obesity
The World Health Organi sation predicts there will be 2.3 billion overweight adults in the world by 2015 and more than 700 million of them will be obese. Within the critical care field, this changing population is set to trigger a new set of requirements for clinicians – both with regards to equipment and staffing needs and demands as well as for specific management and treatment practices. In our foc...
News
WHO Pandemic Updates
Public Health Significance of Virus Mutation Detected in Norway The Norwegian Institute of Public Health has informed the World Health Organisation (WHO) of a mutation detected in three H1N1 viruses. The viruses were isolated from the first two fatal cases of pandemic influenza in the country and one patient with severe illness. Norwegian scientists have analysed samples from more than 70 patients with cl...
Cover Story
Obese Paediatric Patients Requiring Intensive Care
Childhood obesity is increasing in prevalence worldwide. In the United States, studies estimate that among children aged six to nineteen, 16.5% are overweight (Body Mass Index [BMI] 85th to 94th percentile for age and gender) and 17.1% are obese (BMI ≥ 95th percentile for age and gender) (Ogden et al. 2006). This trend will likely lead to an increase in obese paediatric patients requiring intensive care....
Optimal Positioning of Critically Ill Obese Patients
In endotracheally intubated, mechanically ventilated obese patients, head-up positions seem not to be as effective as in extubated, spontaneously breathing obese ones. Sprung et al. (2003) reported that although initial arterial oxygenation was worse in patients with massive obesity when compared with normal-weight patients, gas exchange remained almost constant regardless of mode of ventilation or body po...
A Physiological Based Approach of Perioperative Management in Obese Patients
The high-risk non-cardiac surgical population represents a major global healthcare challenge. Recent estimates suggest that 234 million major surgical procedures are performed worldwide each year (Weiser et al. 2008). Complications following major surgery are a leading cause of morbidity and mortality (Head et al. 2008; Jencks et al. 2009). Previous sickness before surgery is second only to cardiovascular...
Early Mobilisation of Critically Ill Obese Patients
Obesity is increasing at an alarming rate across many countries throughout the world. As a consequence, we are more frequently challenged with the management of obese patients in our Intensive Care Units (ICUs) (Akinnusi et al. 2008; Hogue, Jr. et al. 2009; Oliveros and Villamor 2008). Obese patients have an increased risk for thromboembolic disease, pressure ulcers, prolonged mechanical ventilation, decon...
Series
Risk Assessment of Patients with Severe Community-Acquired Pneumonia
Severe Community-Acquired Pneumonia is the main single cause of mortality from infectious diseases in developed countries. Risk stratification is essential for patients presenting to the emergency department to allow a precise definition of need of intensive care and the initiation of adjuvant therapies. Numerous scoring systems have been developed to predict mortality. The pneumonia severity index and the...
Early Mobilisation of Critically Ill Patients:
In our previous article, we discussed the rationale for early mobilisation and described general screening guidelines and safety issues when considering this therapy (Korupolu et al. 2009). In this second of three articles, we focus on the feasibility and benefits of early mobility, describing how ICUs use available personnel and equipment to facilitate early rehabilitation. Feasibility of early mobilisa...
Matrix
Prioritising: Is it the Way to Counter Today's Economic Crisis within the Healthcare System?
In response to the current economic constraints within healthcare systems, different action plans and reforms, including tax increases, have been deployed to decrease the se and to increase healthcare's effectiveness. It is, however, the time to realise that these measures are not enough and prioritisation might be the only way to cure this chronic condition. Worldwide, healthcare systems have been stru...
Product Comparison: Intensive Care Ventilators
Intensive Care Ventilators: Purchase Considerations
Contact ECRI Institute Europe Weltech Centre, Ridgeway Welwyn Garden City, Herts AL7 2AA, United Kingdom Tel. +44 (0)1707 871511 Fax. +44 (0)1707 393138 [email protected] Purchase Considerations Included in the accompanying comparison chart are ECRI Institute’s recommendations for minimum performance requirements for intensive care ventilators. The requirements are separated into two cate...
Country Focus: Belgium
Belgian Healthcare: Overview of the Health System and Financing
Authors Dominique Vandijck, PhD Post-Doctoral Research Fellow Department of Public Health, Interfaculty Centre for Health Economic Research Faculty of Medicine and Health Sciences Ghent University [email protected] Lieven Annemans, PhD Professor of Health Economics Department of Public Health, Interfaculty Centre of Health Economic Research Faculty of Medicine and Hea...
Infection Control in the ICU: The Nurse Perspective
Authors Sonia O. Labeau, MNSc Faculty of Healthcare University College Ghent, Faculty of Medicine and Health Sciences Ghent University [email protected] Stijn I. Blot, PhD Faculty of Healthcare, University College Ghent Faculty of Medicine and Health Sciences and General Internal Medicine and Infectious Diseases Ghent University Jordi Rello, PhD Intensive Care Unit J...
Viewpoints
The United States Healthcare System: The Most is Not Necessarily the Best
Author Stephen R. Baker, MD Professor and Chairman of Radiology New Jersey Medical School New York, US [email protected] The United States (US) healthcare agenda is the major domestic debate of President Obama’s presidency. He had made revamping of the US’ pluralistic medical delivery system a cornerstone of his campaign and at his inauguration he prompted both the House of Representat...