Latest Articles in ICU

Shock

Shock is an emergency, and if it is not treated, it will mostly be fatal. Early intervention and admission to the ICU is essential. Our cover story considers several aspects of shock, including pathophysiology and multi-organ dysfunction syndrome, as well as source control, fluids, differentiat

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Pathophysiology of endotoxic shock

Mechanisms of endotoxin-induced multi-organ damage. Endotoxin-induced sepsis remains a leading cause of mortality in intensive care units (ICUs) worldwide. Lipopolysaccharide (LPS) identification by the immune system triggers a cascade of signalling pathways, leading to the release of sev

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Fluids in shock

Fluid management during shock from physiology to bedside. Shock is a common life-threatening, generalised form of acute circulatory failure in critically ill patients, which is usually managed by infusing fluids to increase cardiac output and supply the systemic oxygen request. Internatio

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It is time for improved fluid stewardship

A conceptual framework for developing institutional programmes and guidelines to enhance fluid stewardship (especially in the intensive care unit [ICU] environment), an activity that includes appropriate selection, dosing, duration, de-escalation, and monitoring of fluid therapy. The primar

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Vasoactive medication and RCTs - an impossible marriage

A review and introduction of the concept “enough.” We provide a brief overview of important physiology and the pharmacology of vasoactive drugs that are currently used in the ICU as well as newer agents, along with a concise review of recent publications comparing these agents. We attempt

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Advances in source control in patients with sepsis and septic shock

In the past decades there have been significant advances in the diagnosis and management of patients with sepsis and septic shock, and overall awareness has increased significantly (Angus and van der Poll 2013). Emphasis is currently on the early detection of sepsis and rapid initiation of fl

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Organ cross-talk in shock and critical illness

Organ cross-talk is a popular mechanism invoked to explain the progression of multi-organ dysfunction syndrome; however this term is often ill-defined and may encompass many differing mechanisms of organ interaction. In this article the concept of cross-talk is reviewed and its real meaning t

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POCUS and SHOCK

Point-of-care ultrasound (POCUS) is an invaluable tool to differentiate the various types of shock which may co-exist in the critically unwell patient. It is beyond the remit of this article to teach the skill of POCUS. Rather, it provides an overview of how the various POCUS modules could be

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Xenon limits brain damage following cardiac arrest

Xenon and brain injury. Xenon, a chemically inert but biologically active monatomic gas, has been applied in patients for anaesthesia/sedation, and most recently in the critical care of patients with acute ongoing neurological damage. Following preclinical evidence that xenon

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What’s new in sepsis in children?

The latest in diagnosis and treatment. Sepsis is a life-threatening condition in children. Current paediatric definitions are based on systemic inflammatory response syndrome. Since the publication of the third international consensus definitions for sepsis and septic shock for adults, ef

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