Latest News articles in icu
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Benchmarking: Lessons Learnt
Benchmarking —comparing your own results with those of others—has the potential to reveal areas in which your unit could improve. However, there are pitfalls you should be aware of. When he was the CEO of Xerox Corporation, David T. Kearns stated, “Quality improvement can’t be measured in a meaningful way against standards of your own internal...
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Nutrition Monitoring
Most important when monitoring nutrition is to decide upon the nutritional goal for the individual patient. Technically nutrition balance, indirect calorimetry and blood chemistry are the cornerstones. To monitor nutrition is not complicated or difficult. What is more problematic is to monitor nutritional risk and to define the purpose...
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Fluid Resuscitation in Burns
What Is New? Following a severe burn injury, an overwhelming systemic inflammatory response with capillary leak syndrome is initiated, resulting in a combined hypovolaemic and septic shock (Malbrain et al. 2014a). Numerous articles regarding burn resuscitation have been published over the last decades; however, there is no universal consensus on...
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Critically Ill Diabetic Patients
The Case for Liberal Glycaemic Management Background Several large randomised controlled trials (RCTs) have helped provide evidence to guide clinicians’ decisions about blood glucose management in critically ill patients. In two landmark single centre studies, investigators from Leuven reported a reduction in mortality or morbidity with tight...
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Heart-Lung Interactions from the Lung's Perspective
In this article we describe the characteristics of the interaction between lung protective ventilation and pulmonary and right ventricular function in ARDS. We highlight and discuss the concept that protective ventilation should be directed towards all components of the functional unit, and discuss how mechanical ventilation can modulate the interaction...
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ICU-Related Dysphagia
Epidemiology, Pathophysiology, Diagnostics and Treatment Due to malnutrition and aspiration dysphagia in critically ill patients on the ICU is an extremely important symptom with crucial impact on outcome and mortality. A broad variety of pathogenetic factors can lead to severe dysphagia in non-intubated and intubated patients followed by...
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Cognitive Impairment After Critical Illness: Prevention and Treatment
Why did you decide to investigate NTF-prep? Long-term cognitive impairment after critical illness (CIACI) was first described in 1999 (Hopkins 1999). In 1992 we noticed that in cardiac surgery with extracorporeal circulation patients there was a correlation between jugular bulb lactic acid and cognitive decline. We concluded that CIACI was a real...
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Clinical Benefits of Rapid Pathogen Testing with PCR/ESI-MS
Dr. Mark Wilks, Clinical Scientist, Microbiology at Barts Health NHS Trust in London, UK, talks about their experiences of using PCR/ESI-MS technology over a period of 18 months. During its use for the RADICAL study, the department also ran clinical samples of interest through the technology. Which patient groups could potentially benefit...
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Book Review: The Organization of Critical Care
There are not many good books on this topic, and the present one includes contributions from North American and Australian experts in the field. The book has three main sections: organisation, improvement and integration, and a shorter fourth section on global and future perspectives. The list of topics is quite comprehensive, from ICU practitioners...
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