Latest Articles in icu
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Goal-Directed Therapy
Goal-directed therapy (GDT) continues to be a subject of controversy in intensive care medicine, especially after the results of recent trials exploring its effectiveness. Our cover story this issue looks at two aspects of GDT. Azriel Perel addresses some of the remaining questions about the practice of perioperative goal-directed therapy. Despite...
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Perioperative Goal-Directed Therapy
Some Remaining Questions What is Perioperative Goal-Directed Therapy? Perioperative mortality of patients undergoing high-risk surgery has been steadily declining over recent years. And yet this reduced mortality rate is still considered to be higher than anticipated (Pearse et al. 2012). Newer approaches aimed at improving perioperative outcome...
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Early Goal-Directed Therapy Following Cardiac Surgery
Early goal-directed therapy (EGDT) is a therapeutic strategy based on haemodynamic monitoring and pre-defined goals. The roots of this approach come from observational studies in non-cardiac surgery that showed that poor post-operative outcomes and higher mortality were associated with decreased oxygen delivery in the perioperative period (Clowes et...
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Conservative Fluid Management In Intensive Care Medicine
Asserting the existence of a state of permanent controversy is a staple during presentations on the topic of resuscitation fluids. Clinical audiences recognise a cliché when they hear it, and may disengage. This is unfortunate, since there has been a steady crescendo in the quality and quantity of clinical fluid science in the last two decades. In...
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Antibiotic Management in the ICU
Antimicrobial management in the intensive care unit (ICU) represents an ongoing challenge for critical care clinicians. The goal of this review is to focus on strategies aimed at optimising antimicrobial use within intensive care units. Antimicrobial management in the intensive care unit (ICU) represents an ongoing challenge for critical care...
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A Critical Age: The Influence of Frailty Measurements
While prognosis of elderly patients in intensive care is often seen as poor, this is largely due to deficits that can be described with the vocabulary of frailty and its measures. Using the Clinical Frailty Scale as a tool to assess patients referred to intensive care might facilitate discussions about treatment aims, and identify patients who are...
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State of Intensive Care in Turkey
The history of intensive care (IC) in Turkey has followed a somewhat similar pattern to other European countries (see Figure 1). The first intensive care unit (ICU) was founded in a state hospital in Istanbul in 1959. The first attempts to institute intensive care in several cities were performed almost exclusively by anaesthesiologists. In 1977 those...
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Hot Topics in Intensive Care in Turkey
In Turkey intensive care was not a separate specialty for years, and was managed mainly as a subspecialty of anaesthesiology. In 2009 a new regulation was announced by the Ministry of Health (MoH) in which intensive care medicine (ICM) was recognised as a supraspecialty. Regarding this regulation, ICM education has a duration of three years after primary...
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ICS UK State Meeting preview
Highlights of the State of the Art Meeting 2014 Would you want to be admitted to hospital on a Sunday? As the NHS implements its drive to a full 7-day service, many in intensive care will say “we’re there already!” On Day 1 of the conference, Professor Julian Bion will outline a project examining (in the light of the higher mortality rate associated...
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Early Warning for Sepsis
Sepsis Care Faster, Reduced Mortality Suggested Harnessing vital signs information in the electronic health record (EHR) to develop an automated early warning and response system for sepsis led to a marked increase in sepsis identification and care, transfer to the ICU, and an indication of fewer deaths due to sepsis. A study assessing the tool,...
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