• Persistent Organ Failure Before Death in Patients with Severe Sepsis

    Intensivists are used to describing the patient’s condition at the time of handover or when speaking to family members as stable, suggesting that nothing new has happened during the last period of clinical treatment or evaluation, usually one day. Families generally receive this information as positive news, thinking that as there has been no further...

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  • Economic Evaluations of Therapeutic Hypothermia Perinatal Hypoxic Ischaemic Encephalopathy

    Therapeutic hypothermia reduces the risk of death and neurological impairment in children  with hypoxic ischaemic encephalopathy. The article reviews the published literature examining the cost effectiveness of therapeutic hypothermia to treat neonatal encephalopathy. Introduction Neonatal encephalopathy is a major cause of death...

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  • Optimal Nutrition Therapy in the Paediatric Intensive Care Unit

    A significant proportion of infants and children admitted to the paediatric intensive care unit (PICU) are malnourished, and further deterioration of nutrition status has been observed dur- ing the course of critical illness. The prevalence of obesity is also rising in the PICU, and is as- sociated with higher rates of complications, increased length...

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  • Guidelines for Running an Optimised Telecardiology Service

    For paediatric cardiologists, telecardiology has become a valuable tool in diagnosing and triaging newborns with suspected congenital heart disease at remote hospital nurseries. The tele-echocardiography programme developed over 15 years ago at Children's Memorial Hospital, Chicago, IL, has spawned similar programmes both in the United States and...

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  • Haemodynamic Monitoring and Management in Children

    During the past 20 years, intensivists and anaesthesiologists have faced tremendous changes in the way haemodynamic monitoring and management is performed in adult patients. The use of the pulmonary artery catheter has dramatically decreased, leaving a strong reliance on less or non-invasive technologies that mainly rely on transpulmonary thermodilution,...

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  • The 4th National Audit Project of the Royal College of Anaesthetists and Difficult Airway Society

    It is increasingly recognised that major airway events, including those with poor outcome, may occur on Intensive Care Units (ICUs). NAP4 (the 4th National audit project of the Royal College of Anaesthetists and Difficult Airway Society) examined major complications of airway management in NHS hospitals in the UK for a period of one year, during anaesthesia,...

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  • Patterns of CRP-Ratio Response to Antibiotics - Clinical Implications

    Patterns of CRP-Ratio Response to Antibiotics – An Innovative Concept After prescription of antibiotics, the evaluation of the patient clinical response as well as the assessment of resolution of the infection relies on the monitoring of the same criteria used for clinical diagnosis. Therefore, following datasuch as temperature, heart rate, respiratory...

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  • How Should We Control Blood Glucose in 2011?

    Many studies, some already published a long time ago, have reported that hyperglycaemia (Dungan et al. 2009), or “dysglycaemia” (Smith et al. 2010) as some prefer, is an independent prognostic marker in acutely ill patients. For example, after cardiac surgery, glycaemia above 180 mg/dl, implying poor glucose control, was consistently and independently...

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  • Education and Training in Intensive Care European Perspective

    Education and training have increased its importance the last decades. Twelve years ago European Society of Intensive Care (ESICM) published a paper concerning training in intensive care (Int Care Med 1996) and the society efforts to improve training within intensive care have expanded considerably since that time. Intensive care is an established...

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  • Are there Compelling Data that Sepsis Bundles can Improve Patient Outcomes

    Michael S. Niederman, MD Professor and Vice-Chairman, Department of Medicine SUNY at Stony Brook Chairman, Department of Medicine Winthrop University Hospital Mineola, New York [email protected] Sepsis bundles are a prescriptive approach to patient management that include a number of superfluous elements, and yet omit...

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