Point-of-View Articles

Point-of-View articles on trending topics, winning practices and cross-collaboration in healthcare.

An overview of a discussion on sepsis and the Pancreatic Stone Protein (PSP) biomarker by Dr João Pereira, Hospital De Vila Franca De Xira, Portugal and how it can be used for early diagnosis of sepsis and facilitate decision-making regarding the administration of antibiotics. The discussion was chaired by Prof Pedro Póvoa, coordinator of the Intensive Care Unit (ICU) at Hospital de Sao Francisco Xavier,...

An overview of nutritional targets and their impact on critically ill patients and the need to use a systematic approach to nutritional support for optimal patient outcomes. Critically ill patients are often hypermetabolic and catabolic and are at a higher risk of underfeeding. Nutritional support for these patients can prevent energy deficits and improve outcomes (Villet et al. 2005). Underfeeding criti...

An overview of vasopressor management, current evidence and when to initiate vasopressor therapy for best possible patient outcome. Vasopressor management is a cornerstone in the haemodynamic management of septic shock for reversing hypotension by increasing systemic vascular resistance and improving organ perfusion. The Surviving Sepsis Campaign (SSC) guidelines 2021 recommend an initial target mean arte...

A summary of data regarding the use of landiolol as a potential immunomodulator in septic patients and its effectiveness and safety in the management of new-onset postoperative atrial fibrillation (POAF). Cardiovascular dysfunction is a common complication of sepsis. Approximately 40 to 50% of patients with prolonged septic shock develop myocardial dysfunction. The changes induced by sepsis in circulating...

An overview of critical care guidelines for enteral nutrition (EN) and the use of gastric residual volume (GRV) management and monitoring as an essential component of EN patient care to help prevent complications. Disease-related malnutrition is a common problem among hospitalised patients. Specifically, in critically ill patients, oral food intake may not provide the required nutritional value. This may...

Prof Nicolas Girerd

Prof Nicolas Girerd

An overview of estimated plasma volume (ePVS), recent evidence supporting the association of ePVS with clinical congestion and whether it can help improve outcomes in patients with heart failure (HF). Plasma volume (PV) is the level of intravascular fluid minus the red blood cells, white blood cells and platelets. PV in heart failure (HF) patients is associated with increases in fluid compartments. For ex...

 Dennis Begos, MD, FACS

Dennis Begos, MD, FACS

The complexity of glucose testing, the limitations of point-of-care blood glucose monitoring systems and the need for accuracy and reliability to ensure optimised patient outcomes. Critically ill patients are not found just in intensive care units, but throughout the hospital: emergency departments, post-anaesthesia care units, operating rooms, and many other environments now care for the critically ill....

In 2020, the ultra-short acting beta-blocker landiolol was first included in the ESC guidelines with a class I recommendation. The recommendations were based on study results demonstrating the rapid response, efficacy, and safety of this drug. At a recent symposium, during 2021 Heart Failure World Congress, cardiologists were invited to present their daily clinical practice of landiolol use. The discover...

 Irene Telias

Irene Telias

Monitoring the strength of the patient´s breathing effort, titrating the sedation, and selecting the correct mode of ventilation is vital when transitioning from controlled to assisted ventilation. One of the key issues with mechanical ventilation is the transition from fully controlled to assisted mechanical ventilation, which must be achieved as soon as possible to improve the patient’s outcomes. Th...

 Jacob C. Jentzer, MD FACC FAHA

Jacob C. Jentzer, MD FACC FAHA

This article summarises the proceedings of an ESICM webinar in which two experts discuss vasopressor therapy and its fundamental role in the treatment of septic shock-induced hypotension. They provide an overview of severe septic shock, the benefits of second-line vasopressors and their use in COVID-19 patients. (Jacob C. Jentzer) Vasopressors are classified as drugs that are designed to increase arter...

 Dennis Begos, MD, FACS

Dennis Begos, MD, FACS

An overview of the importance of getting magnesium levels right in critically ill patients and the role ionised magnesium plays. Like all electrolytes, magnesium exists in the bloodstream in “bound” states, and in “free” or “ionised” states, which is the portion that is physiologically active. This ionised component (iMg) represents approximately 55-70% of the total Mg (tMg). Magnesium’s rol...

Dr. Jürgen Fortin

Dr. Jürgen Fortin

Patients and their families often fear surgical interventions due to possible complications during the procedure and falsely assume to have survived the most dangerous part when reaching post-anesthetic care units.1 However, postoperative hypotension more often occurs in the wards, causing myocardial infarction and death,3,4 as it largely remains undetected.5 47% of postsurgical hypotensive events are miss...

An overview of the updated guidelines for the diagnosis and management of atrial fibrillation, developed in association with the European Association for Cardio-Thoracic Surgery. The European Society of Cardiology (ESC) provides a range of scientific and educational activities, such as the production and continuous updating of clinical practice guidelines for the diagnosis and treatment of cardiovascul...

 Charles Cerf

Charles Cerf

During the COVID-19 pandemic, Foch Hospital in Suresnes, France adapted its medical strategy to manage high patient flow, limited resources and staff shortages to ensure efficient patient care. Here is an overview of how the hospital rose up to the challenge. How should we treat patients infected with a virus we know hardly anything about? This was the very first challenge that hospitals in Europe had to...

Prof. Elisabeth De Waele

Prof. Elisabeth De Waele

This article is a summary of a webinar series where three nutritional experts discussed a practical approach on how to feed and how to provide high-quality nutritional therapy to critically ill patients during hospitalisation. Prof Elizabeth De Waele, Dr Arthur Van Zanten and Prof Paul Wischmeyer in the webinar series discuss nutrition support for COVID-19 ICU patients and strategies for the nutrition manag...

Prof. Dr. Thomas Uhlig

Prof. Dr. Thomas Uhlig

The Austrian critical care ventilator TwinStream® ICU was designed with the explicit purpose of saving critically respiratory-distressed patients. In particular those patients with severe lung diseases (e.g. ARDS) who can no longer be supported with conventional ventilation. Its unique p-BLV® mode has become an established value in many Intensive Care Units in Austrian and German hospitals. And when...

Hypotension during septic shock is a strong indicator of patient outcome and mortality. Arginine vasopressin is a naturally produced human hormone with vasoconstriction effect via V1 receptor activation and a short 5-20 minutes half-life and is recommended by the Surviving Sepsis Campaign guidelines to be added as a second-line vasoactive agent when increasing mean arterial pressure with norepinephrine alon...

Dr Fernando Chaves

Dr Fernando Chaves

The laboratory plays a critical role in ensuring optimal outcomes for ICU patients. Several biomarkers are valuable in this context and can help clinicians achieve improved patient outcomes and decreased expenses for healthcare. Improving both in-ICU and post-ICU clinical outcomes often depends on actions taken much sooner in a patient’s pathway during hospitalisation. Regardless of the underlying diag...

 Salvatore Lucio Cutuli

Salvatore Lucio Cutuli

An overview of the clinical application and future perspective of the Seraph® 100 haemoperfusion in critically ill patients with sepsis. Over the last few decades, sepsis has been spreading worldwide to such an extent that it has been declared global health priority by the World Health Organization (Reinhart et al. 2017). Sepsis is an old disease (Cutuli et al. 2017) and many efforts have been exerted b...

Prof. Michael Mansour, MD, PhD, FIDSA, FECMM

Prof. Michael Mansour, MD, PhD, FIDSA, FECMM

Professor Michael Mansour is a physician-scientist with a research concentration in immune responses against invading pathogens. He attends on the Clinical Transplant Infectious Diseases and Immunocompromised Host Service at the Massachusetts General Hospital - Division of Infectious Diseases, where he cares for solid and stem cell transplant recipients and individuals with weakened immunity. He also direc...

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