Latest Articles in icu
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Editorial Board Welcomes New Member
Prof. Flavia Machado has recently been welcomed to the Editorial Board of ICU Management & Practice by Editor-in-Chief, Prof. JeanLouis Vincent. Dr. 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...
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Patient Handoff Protocols
Whether they are called handoffs or handovers, it is known from the literature that the transfer of patient information between caregivers at shift changes has the potential for error. Although the U.S. Joint Commission requires healthcare providers to implement a standardised approach to handoff communication as a national patient safety goal, clear...
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Difficult Intubation in the ICU: Why and How to Prevent and Manage Difficult Intubation?
Severe hypoxaemia and cardiovascular collapse, leading to cardiac arrest, cerebral anoxia and death, are the most frequent complications related to intubation in intensive care units (ICU), associated with difficulty of intubation. To prevent and limit the incidence of difficult intubation, specific risk factors for difficult intubation in the ICU...
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Pain Assessment and Management for Intensive Care Unit Patients: Seeking Best Practices
This review article focuses on research-based advances in pain assessment practices in intensive care units (ICUs), and stresses clinician consideration of multimodal analgesic techniques for pain management in ICUs. Over the past 30 years, attention devoted to pain experienced by intensive care unit (ICU) patients has evolved from recognising...
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Emergency Intraosseous Access: Novel Diagnostic and Therapeutic Possibilities and Limitations
The intraosseous needle is an essential tool in emergency settings when initial vascular access is difficult to achieve. This paper focuses on possible biochemical analyses on blood from emergency intraosseous needles, suggesting principles of use as well as pointing out advantages and shortcomings. Intraosseous (IO) access has been used...
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Brexit's Brutal Blow to the NHS
“I’m sorry. I’m just so sorry.” It’s 8am. Two junior doctors, one English, the other Italian, embrace in tears on the steps outside their hospital. We’ve saved lives together, lost patients together, run cardiac arrests, sought to comfort grieving families, seen patients make miraculous recoveries, witnessed death at its most unforgiving and ugly...
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Protective Ventilation: When and Why to Individualize
ARDS is Heterogeneous Acute respiratory distress syndrome (ARDS) is a heterogeneous entity. Calfee and colleagues’ analysis of the ARMA and ALVEOLI trials (Calfee et al. 2015) differentiated two ARDS subphenotypes, one of which was categorized by more severe inflammation and worse clinical outcomes. Response to positive end-expiratory pressure...
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Early Mobilisation in ICU: From Concept to Reality - Four Steps to Change Patient Outcomes
For years, 28-day survival was the holy grail of ICU physicians. As ICU survival continues to improve, a high proportion of these ICU survivors experience significant cognitive, psychological, and physically disabling side effects of their ICU stay. These consequences of critical illness, regardless of their admitting diagnosis, have a dramatic impact...
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Current State of Glycaemic Control Practice
Elevated blood glucose is a widely recognised response to critical illness, with most non-diabetic patients exhibiting concentrations outside the normoglycaemic range and a substantial proportion having significantly or hugely elevated blood levels (Farrokhi et al. 2011). It has been 15 years since the publication of the Leuven study abruptly changed...
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