Latest Articles in icu
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Out with the saline?
Reduced use linked to better outcomes Two companion studies have shown that use of saline as intravenous fluid therapy, compared to crystalloids, was associated with poor survival and increased risk of kidney complications. Matthew Semler, MD, MSc, assistant professor of Medicine at Vanderbilt University School of Medicine, told ICU Management...
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Improving diagnostic stewardship by using new microbiological technologies
Describes an episode of sepsis in a leukaemia patient, whose treatment was early guided by using rapid diagnostics technology to identify the cause of infection. A 4-year-old patient under treatment for acute lymphoblastic leukaemia, diagnosed 6 months before, was admitted to the emergency room (ER) at midnight (00h33) due to a fever episode...
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“Simulate, or not to simulate?”
Evolution in medicine and the anaesthesia context. A brief discussion about the importance and the state of the art of simulation in anaesthesia and intensive care medicine. Training in simulation plays a key role in complex systems such as aviation and the nuclear industry, to investigate predictable errors that lead to adverse outcomes....
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Gut microbes protect against sepsis
New research published in Cell Host & Microbe suggests that gut bacteria may help in the fight against sepsis. In the study, mice were given particular microbes, which increased blood levels of immunoglobulin A (IgA) antibodies, protecting the mice against polymicrobial sepsis. You might also like : Study: Microbiome Disruption May Have Key Role...
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Glycaemic control in critically ill patients: how tight should it be?
There is still no widespread agreement around optimal targets for glucose control in the ICU: some clinicians maintain that glucose control is unnecessary and harmful, while others claim that blood glucose control is essential to improve prognosis. 1-3 Those who favour liberal glycaemic control assert that hyperglycaemia is simply a beneficial adaptation...
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“Vision without action is a daydream. Action without vision is a nightmare.”
The COmpetency-BAsed Training programme in Intensive Care for Europe and other world regions (CoBaTrICE) The COmpetency-BAsedTraining programme in Intensive Care Medicine (CoBaTrICE) has been the European Society of Intensive Care Medicine (ESICM)’s vision to achieve a unified and harmonised model of training doctors caring for critically...
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Is there a ‘weekend effect’ for ICU mortality?
The risk of dying in the intensive care unit (ICU) is higher for patients admitted at the weekend compared to those admitted on a weekday, according to a retrospective study of registry data from Austria published in Critical Care (Zajic et al. 2017). However, the risk of dying in the ICU on a weekend was found to be lower than on a weekday, highlighting...
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Study: AKI alerts associated with lower mortality, LOS
A clinical decision support system (CDSS) that monitors blood creatinine levels in hospitalised patients to alert physicians to potential acute kidney injury (AKI) was associated with a small but significant reduction in mortality and hospital length of stay (LOS), according to research from the University of Pittsburgh and UPMC published in the Journal...
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Improving quality of care in severe traumatic brain injury patients
Process indicator-based plan-do-act-check cycle in a single-centre quality improvement initiative To assess whether intracranial pressure (ICP) management in severe traumatic brain injury patients is being applied according to our institutional protocol we developed a process indicator aimed at improving quality of care. Background...
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Improving sepsis outcomes in Brazil
Flávia Machado is Professor of Intensive Care and Head of the Intensive Care Section of the Anesthesiology, Pain and Intensive Care Department at the Federal University of São Paulo in São Paulo, Brazil. She is one of the founders of the Latin America Sepsis Institute (LASI), which is devoted to quality improvement process in Brazilian hospitals as...
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