Latest News articles in icu
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Introduction to multiple organ support
There is a renewed interest in novel extracorporeal technologies as a means of supporting individual organ failures. An emphasis should be placed on characterising the spectrum of extracorporeal devices for various organs and understanding how devices intended for support of one organ can have an indirect or direct impact on other organs, which is particularly...
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From multiple organ support therapy to extracorporeal organ support in critically ill patients
The complex nature of the multiple organ dysfunction syndrome (MODS) requires an integrated supportive therapy. Native organs have a continuous crosstalk and have in common in most cases an altered composition of the blood circulating and perfusing them. In this article we describe the concept of extracorporeal organ support (ECOS) for the treatment...
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Hypothermia in neurocritical care patients other than cardiac arrest
Hypothermia (HT) is a cornerstone of neuroprotective strategies and has been used in critical care for acutely brain injured adult patients for many years. This review aims to discuss the clinical evidence supporting the use of HT in neurocritical care patients beyond care after cardiac arrest (CA), such as traumatic brain injury (TBI), acute ischaemic...
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Intracranial pressure monitoring devices
Intracranial pressure (ICP) monitoring is the cornerstone for treatment and management of patients, especially following traumatic brain injury (TBI) but also other clinical conditions such as non-traumatic bleeds, hydrocephalus, space-occupying lesions and cerebral oedema. The key target to monitor and treat ICP is to optimise the cerebral perfusion...
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Establishing a relationship of trust and care
The chaplain is a resource of ethically competent support and a compassionate caring presence for patients, families and ICU staff. An admission to the intensive care unit (ICU) is often a traumatic experience for both patients and families. Although members of the critical care team are specially trained to provide care and treatment requiring...
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Being an expert witness
Describes the practicalities of being an expert witness and explains what qualities are necessary to succeed in this important role. Our legal system couldn’t function without medical expert witnesses. From personal injury claims to criminal prosecutions, there is a constant demand for experienced doctors with the necessary skills and authority...
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Developing new approaches to patient safety
International Society for Rapid Response Systems joins with the Patient Safety Congress in 2018 The International Society for Rapid Response Systems joins with the Patient Safety Congress in July 2018 to develop new approaches to managing patients at risk of deterioration. Identification and treatment of deteriorating hospital patients is a major...
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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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Dysglycaemia in the critically ill
As has been pointed out, the benefits of tight glycaemic control in the ICU have by no means been clearly established or accepted. In 2010 a meta-analysis of seven prospective randomised studies concluded that intensive insulin therapy in mixed ICU patients was not supported by evidence. 19 Today we understand that hyperglycaemia, hypoglycaemia,...
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Facilitated glucose control in the ICU through nutrition
As recently as 2010, the view of metabolic requirements for patients admitted to ICU was that all patients had the same metabolic needs and could therefore be managed with the same nutritional product. In general, critically ill patients were fed along the same lines as healthy people in the ratio of around 50% carbohydrates, 35% lipids and 15% protein....
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