Volume 20 - Issue 4, 2020

Numerous patients are admitted to the Intensive Care Unit (ICU) every year. Many of these critically ill patients receive multiple interventions to treat and manage acute conditions and prevent further deterioration. However, these treatments can often affect a patient's mind and body. That is why many ICU survivors, as they transition out of the ICU, do not have the same abilities as they did before their...

Intubation and tracheostomy as a result of COVID-19 critical illness may result in laryngeal dysfunction, which can lead to serious consequences. This article provides assessment and rehabilitation recommendations for those working with critically ill COVID-19 patients in the ICU. COVID-19 was declared a worldwide pandemic in March 2020, with the virus SARS-CoV-2 causing severe acute respiratory syndrom...

The use of corticosteroids for respiratory diseases has been a matter of discussion. Here, we present recent evidence of corticosteroids benefits for COVID-19, including improvements in mortality and ventilator-free days. More than six months riding treacherous waves in the COVID-19 storm had passed until a glimpse of a rudimentary old harbour appeared. Corticosteroids. The first drug to decrease mortali...

This article discusses the 2020 innovations in ICU surge capacity, their benefits and challenges and how they may prevent or delay the need to enact triage criteria /decision-making in pandemic and mass casualty situations. Even though governments in many countries have taken unprecedented steps to shut down their economies and impose massive self-isolation, social distancing and masking policies to help...

A historical review of the birth of intensive care medicine and home mechanical ventilation; and an opinion piece on the merits of intensivists participating in home ventilation care teams. The world is currently reeling from the ravages of COVID-19. It is still too early to know how healthcare will be transformed as a result of this epidemic. For now, it appears that COVID-19 will leave behind large num...

The laboratory plays a critical role in ensuring optimal outcomes for ICU patients. Several biomarkers are valuable in this context and can help clinicians achieve improved patient outcomes and decreased expenses for healthcare. Improving both in-ICU and post-ICU clinical outcomes often depends on actions taken much sooner in a patient’s pathway during hospitalisation. Regardless of the underlying diag...

An overview of the clinical application and future perspective of the Seraph® 100 haemoperfusion in critically ill patients with sepsis. Over the last few decades, sepsis has been spreading worldwide to such an extent that it has been declared global health priority by the World Health Organization (Reinhart et al. 2017). Sepsis is an old disease (Cutuli et al. 2017) and many efforts have been exerted b...

Hypotension during septic shock is a strong indicator of patient outcome and mortality. Arginine vasopressin is a naturally produced human hormone with vasoconstriction effect via V1 receptor activation and a short 5-20 minutes half-life and is recommended by the Surviving Sepsis Campaign guidelines to be added as a second-line vasoactive agent when increasing mean arterial pressure with norepinephrine alon...

In this article, we aim to summarise the current management of Post Intensive Care Syndrome (PICS) and Post-Intensive Care Syndrome – Family (PICS-F), understanding the need for continuum assessment and support throughout critical disease. People who have been admitted to an Intensive Care Unit report a reduced quality of life for up to twelve years following critical illness compared to the general po...

Survivors of critical illness and their caregivers frequently face long-term impairments of cognition, mental health, mobility and beyond, which demand for a patient-centred transition management and well-coordinated, outpatient post-ICU care. In recent years, the post-ICU sequelae of survivors of critical illness have become a focus of attention in research and patient care. This is the result of progres...

This article summarises the current nutrition evidence in the phase of recovery that occurs following critical illness. It is plausible that the importance of nutrition may differ across different phases of illness. Reflecting this, the most recently updated clinical nutrition practice guidelines for critical care from the European Society for Clinical Nutrition and Metabolism (ESPEN) recommend tailoring nu...

This article outlines the current understanding, prevalence, risk factors and management of the post-intensive care syndrome in paediatrics. Persistent critical illness acquired morbidities have been well known to affect adults since our attention was drawn to this in the landmark publication by Herridge et al. in 2003. What was first labelled as intensive care unit-acquired weakness, was broadened as w...

“The success of intensive care has not to be measured only by survival statistics, as though each death is a medical failure. It has to be measured by the quality of lives preserved or restored and by the quality of dying of those in whose interest is to die.” This statement of G. R. Dunstan, Prof. of Morals and Social Theology, dating back to 1995, represents a warning to all intensivists. Since then,...

Post-ICU patients are at high-risk of clinical deterioration. Continuous and mobile monitoring on hospital wards is useful to detect clinical deterioration at an early stage. It may help to prevent serious adverse events and ICU readmission. Most patients discharged from ICUs are old and have co-morbidities. Even when they are young and were healthy before ICU admission, the days or weeks spent in the IC...

Critically ill patients can develop a series of complications due to ICU risk factors that may lead to permanent disability. The implementation of strategies to reduce its incidence is essential. Nowadays, the possibilities of survival of critically ill patients have grown due to technological and medical advances. This leads to a series of consequences owing to the critical pathology itself, medical proc...

Out-of-hospital cardiac arrests (OHCA) are associated with very high rates of mortality and poor cognitive outcome. This paper reviews long-term outcomes post OHCA and the pre-hospitalisation factors that predict them. Cardiac arrest is among the most common health emergencies worldwide, suffered by over a half million patients annually in the United States alone. Among these, roughly six in ten (61%) o...

Rehabilitation and recovery following ICU admission aims to improve patient outcomes, optimising function and recovery. Allied health professionals are key members in the multidisciplinary team, positively contributing to the rehabilitation pathway. Survivorship after admission to intensive care (ICU) has moved beyond mortality. Reducing associated morbidity, and improving the quality of physical, cogni...

An overview of the Post-Intensive Care Syndrome (PICS) and the challenges faced by critical care patients post-ICU....

Hospital Sant Joan de Déu (HSJD) is a paediatric and maternity hospital located in Barcelona. In 2018 the new 24-bed Pediatric Intensive Care Unit (PICU) was inaugurated, featuring modern facilities and the latest technology. We moved from an area with open spaces to a unit structured into individual rooms, in order to facilitate 24-hour access for parents. This represented a major challenge in terms of sp...

Is the gender gap a concern for intensive care medicine (ICM)? ICM is not gender friendly by design and this could have a major impact on the discipline given the increase in the number of female doctors. What are the main barriers to career progression for women in ICM? Members of the iWIN Foundation present their views. Several authors and organisations have reflected on the future of Intensive and Cr...

JANUARY 11 NEUROINTENSIVE CARE: Update 2021 – 4th edition Online course https://iii.hm/161x FEBRUARY 31-12 SCCM – 50th Critical Care Congress Virtual conference https://iii.hm/161y MARCH 19-20 2020 World Critical Care and Anesthesiology Conference Bangkok, Thailand https://iii.hm/161z 29-31 9th EuroELSO Congress 2021 London, UK https://iii.hm/1620 APRIL 14-16 Euro Neuro Paris 2021 Paris, France htt...

Issues/Pages Volume 20, Issue 1 1-98 https://iii.hm/137h Volume 20, Issue 2 99-153 https://iii.hm/14eo Volume 20, Issue 3 154-237 https://iii.hm/14ud Volume 20, Issue 4 238-327 https://iii.hm/1653 Subject index Ageing Flaatten H, Guidet B, deLange D. Lessons From the “Very Old Intensive Care Patients” (VIP) P...

Aeyels D 20 https://iii.hm/137p Aleksandrova N 20 https://iii.hm/137p Algethamy H 305https://iii.hm/164t Allan C 313https://iii.hm/164x Alves Cunha AL 66 https://iii.hm/138a Amomed Pharma 16 https://iii.hm/137n, 106 https://iii.hm/14cm, 265https://iii.hm/164a Amrein K 214 https://iii.hm/14tp Antonelli 257https://iii.hm/164d Azevedo L 253https://iii.hm/1644 Azoulay E 121 https://iii.hm/1...