ICU Management & Practice, Volume 23 - Issue 2, 2023
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Editorial
Organ Support
When patients are critically ill, one or more organs may not function optimally or even fail, so organ support is an important component of ICU management. However, organ support can be associated with complications such as infections, bleeding, and damage to surrounding tissue or organs. These complications can alter the patient's condition, leading to additional interventions or treatments. Critica...
Organ Support
Combined Extracorporeal Lung and Kidney Support in Fluid Overload
During artificial organ support, kidney injury is multifactorial and related to the high severity of patients treated with extracorporeal membrane oxygenation (ECMO). The successful delivery of continuous renal replacement therapy (CRRT) during ECMO requires a clear prescription of the target solute clearance and fluid removal rate based on the cumulative fluid balance and physiological variables. The role...
Which Vasopressors and Inotropes to Use in the Intensive Care Unit
Vasopressors and inotropes are frequently used in intensive care units. With a special focus on recent studies, this article summarises the key messages in the management of patients requiring inotropes and vasopressors. Cardiac output (CO) is a key determinant of oxygen delivery. Low cardiac output syndrome (LCOS) causes organ dysfunction, prolonged hospital stay, and reduces survival in periopera...
A Very Old Patient in the ICU: Much More Than an Acute Organ Dysfunction
Treating an elderly patient in intensive therapy requires the integration of many components. The purpose of this paper is to promote a comprehensive assessment of the critically ill patient aged 80 or more years. Ageing of the population combined with a shortage of intensive care unit (ICU) beds results in a demand for intensive care continuously outstripping supply of resources even in highly dev...
POINT-OF-VIEW
Biomarkers as Prognostic Predictors and Guide in Critically Ill Patients
An overview of promising biomarkers in critical care, characteristics a biomarker should have and how to ensure their usefulness in clinical practice. Precision medicine is a medical approach that tailors treatments based on individual patient characteristics and their unique response to therapies for a particular disease. The goal of precision medicine is to achieve accuracy in both diagnosis...
Kidney Replacement Therapy in the Intensive Care Unit
Kidney Replacement Therapy is a commonly used therapeutic strategy in the intensive care unit for patients who develop Acute Kidney Injury or who already have a diagnosis of chronic kidney disease. ICU staff should know when to use it and which type is most suitable for the circumstances. Acute kidney injury (AKI) is a common complication in critically ill patients. Up to 20-70% of patients will de...
POINT-OF-VIEW
Detecting Euglycaemic Diabetic Ketoacidosis Associated With SGLT2 Inhibitors
SGLT2 inhibitor associated EDKA is becoming more prevalent due to the increasing use of SGLT2 inhibitors in cardiovascular medicine and type 2 diabetes. Physician awareness and knowledge about the disease and diagnostic tools need to improve for better management. Point of care blood testing for ketones can allow for rapid and accurate diagnosis. Euglycaemic diabetic ketoacidosis (EDKA) is an uncom...
Sustainability and Extracorporeal Organ Support
Extracorporeal organ support (ECOS) involves an extensive use of healthcare resources and clinical problem-solving challenges. The feasibility of applying known ecological analysis and sustainability strategies in healthcare need to be started in this setting. As with any other species, human activity modifies the environment at multiple levels and may or may not alter the ecological balance. As fr...
Predictive Analytics for Kidney Support in the ICU
The timing and application of dialysis in the ICU is highly variable contributing to poor outcomes. A clinical decision support system (CDSS) incorporating a dynamic predictive algorithm for organ support could improve outcomes. Multiorgan failure (MOF) and acute kidney injury (AKI) are frequently encountered in critically ill patients and often require acute dialysis for support to facilitate reco...
Early Mobilisation in Patients Undergoing Extracorporeal Membrane Oxygenation
Extracorporeal membrane oxygenation is a resource that is accessible in hospitals and intensive care units all over the world. In serious situations, ECMO therapy is intended to provide haemodynamic and/or ventilatory support. Because of this, many people refer to the ECMO patient as "the most critical patient." As a result, there is a very high likelihood that a critical disease will result in physical di...
Other Feature Articles
Heparin-Induced Thrombocytopaenia
Heparin-induced thrombocytopaenia (HIT) is an immune complication of heparin therapy. This review discusses the pathophysiology, incidence, clinical manifestations, diagnostic approach, and management of patients with HIT. HIT is an immune complication of heparin therapy caused by IgG antibodies to complexes of platelet factor 4 (PF4) and heparin. These antibodies bind to the Fc receptor of the platel...
DigiConf
Organ Support
Organ support is a life-saving measure and crucial in many critically ill patients. However, organ support can be associated with complications. Join our panellists as they discuss progress in the management of multiorgan failure and different forms of organ support and treatment strategies for acute kidney injury, respiratory failure, cardiac failure and liver failure. Register here! Moderator Jea...
Agenda
Upcoming events/courses/congresses
26-28 Emergency Medicine Workshop (EuSEM) Budapest, Hungary https://iii.hm/1k5s 26-29 11th EuroELSO Lisbon, Portugal https://iii.hm/1k5t 27-28 19th Annual Critical Care Symposium Manchester, United Kingdom https://iii.hm/1k5u 27-28 12th Ultrasound in Acute Care Manchester, United Kingdom https://iii.hm/1k5v 4-6 18th Annual Conference German Society for...