Within any given hospital, the critically ill are among those patients requiring the highest level of specialised care and resources; but as it is increasingly noted, there are growing sub-populations of patients who require even more specialised care, equipment and protocols. In past issues of ICU Management, we have focused on many of these distinctive groups - from the management of obese patients to the expanding number of elderly in our units.
In this edition of ICU Management, we delve into another uniquely spe- cial patient: The Paediatic Patient. As the mindset surrounding this patient group has morphed from the simpli- fied treatment of "small adults" into a more complex physiology of care, so too does the need for more vigor- ous studies and subsequent guidelines covering the management of this pre- cious, yet precarious population.
Beginning with an economic evaluation, Prof. Regier from Seattle, Washington examines the use of therapeutic hypothermia for perinatal hy- poxic ischaemic encephalopathy, while Dr. Mehta teams up with paediatric critical care dietitian Heather Skillman to discuss optimal nutrition therapy in the PICU. Dr. Webb, a Paediatric Cardiologist and her colleague Kaliope Berdusis from Children's Memorial Hospital in Chicago, Illinois describe how they run an optimised telecardiology service in their institution.
Rounding out our cover story and within our new "Advances in Mechanical Ventilation" section we have an overview of haemodynamic monitoring and management in children from Prof. Cannesson, who has a background in paediatrics. We also feature a brief article written by consultant anaesthetists Tim Cook and Nicholas Woodall, which outlines indings relevant to intensive care from NAP4, a UK audit project from the Royal College of Anaesthetists and Difficult Airway Society.
In the features, there is an interesting article on the clinical implications of patterns of CRP-ratio response to antibiotics from Drs. Coelho, Póvoa (Portugal) and Salluh (Brazil), as well as a discussion of the management of abdominal compartment syndrome in medical patients by Drs. Smith and Cheatham (Orlando, US).
Technology is once again our focus in the management section, where we highlight an electronic prescription system that is designed and implemented by ICU clinicians in a bid to utilise IT to reduce medication errors and improve patient safety.
In Viewpoints, Managing Editor Sherry Scharff visits Prof. Saïd Hachimi-Idrissi, Head of the Paediatric Intensive Care Unit at of the University Hospital of Brussels and this issue features an excerpt of their in depth conversation on the staffing the PICU, and other management dilemmas.
We then head to Spain for a look at intensive care in the country as well as a description of how an outbreak of linezolid-resistant staphylococcus aureus was effectively controlled in a Madrid ICU.
As the strains on resources within our units steadily increase, so do the expectations of our patients, and their families - within our growing specialised patient populations. Be it elderly, obese or paediatric patients, we must mobilise our teams to respond to their specific needs and requirements and to continue to share our experiences - both successes and challenges with our colleagues throughout the critical care field.