Latest Articles in icu
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Study: Vasopressin vs. Norepinephrine in Septic Shock
A multicentre trial investigating early use of vasopressin compared to norepinephrine to treat septic shock found no reduction in the number of kidney failure-free days. The results of the VAsopressin vs. Noradrenaline as Initial therapy in Septic sHock (VANISH) trial are published in JAMA (Gordon et al. 2016). Patients who had septic...
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New Antibiotics for Abdominal Infections: What Can We Expect?
Recently a number of new antibiotics or combinations for complicated intra-abdominal infections have been introduced. Here we review the currently available data of these new drugs and discuss how they can be used in critically ill patients with complicated intraabdominal infections. Complicated intra-abdominal infections (cIAI) remain...
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Is Enteral Feeding Feasible Early After Abdominal Crisis?
The enteral route is commonly accepted as the first choice for providing nutrition to patients in the ICU with stable haemodynamics and a functional gastrointestinal (GI) tract. However, there is wide uncertainty regarding safe enteral nutrition in patients with critical pathology in the abdomen. In the current review we address different abdominal...
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Evolving Concepts in Acute-on-Chronic Liver Failure
Most patients with liver cirrhosis remain in a compensated stage for more than 10 years, regardless of the aetiology of the liver disease. The progression to decompensated cirrhosis is defined by the occurrence of a major complication such as ascites, variceal bleeding and/or hepatic encephalopathy. From here on most patients will not die because...
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Controversies in Ventilator-Associated Pneumonia Diagnosis
Ventilator-associated pneumonia is a major complication of mechanical ventilation and represents the most common reason for antibiotic prescription in ventilated patients. Incidence ranges from 1.2 to 8.5 cases per 1000 ventilator days or 9 to 27% cases per mechanically ventilated patient; attributable mortality rates vary between 0% and 70%...
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Monitoring Peripheral Circulation
Even though systemic haemodynamic variables may be normalised, there could be regions with inadequate regional oxygenation at the tissue level. The most recent developments of noninvasive monitoring of the peripheral circulation have helped physicians to early identify patients at high risk for tissue hypoperfusion, organ failure and poor outcome....
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Touch Creates a Healing Bond in Healthcare
In contemporary healthcare, touch— contact between a doctor’s hand and a patient—appears to be on its way out. The expanding role of CT and MRI imaging is decreasing reliance on touch as a way of making diagnoses. Pressures to move patients through the system more quickly leave health professionals with fewer opportunities to make contact....
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Redesigning Emergency Ambulatory Care with Point-of-Care Testing: Reduced Costs and Length of Stay
Many patients presenting to the hospital emergency department do not need to stay overnight. Ambulatory emergency care (AEC) may optimise identification and management of such patients by delivering streamlined, efficient patient care within one working day. This may improve clinical outcomes, patient experience and lower costs. At James...
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Critical Care in Brazil
Brazil is the largest country in South America, and ranks fifth in the list of the most populous countries, with a population of approximately 209 million people (84% urban). It is a large country with many challenges that affect the healthcare sector, such as economic inequalities, and the demographic transition with an ageing population (>10%...
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