Point-of-View

 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...

Dr Herwig Gerlach

Dr Herwig Gerlach

Sepsis and septic shock are the leading causes of death in the ICU. With an estimated mortality rate of 40-60%, septic shock is in the focus of adult critical care medicine. It is broadly accepted that intervention in the very early phase of sepsis before the complex inflammatory host response is initiated should be one major area that clinical research should focus on. Currently, sepsis and septic shock...

COVID-19 affects the myocardium and myocarditis and cardiac injury is a common condition among hospitalised patients. Landiolol, a new ultra-short acting, intravenous most β1 selective blocker, can help reduce inflammation and provide therapeutic benefits. Influenza, bacterial pneumonias, respiratory infections and viruses are well-established factors that cause cardiovascular disease (CVD) and are asso...

An overview of the Surviving Sepsis Guidelines for the vasoactive agent management of COVID-19 patients with septic shock and the use of arginine vasopressin in this patient population. The SARS-CoV-2 has caused a global health crisis. Thousands of people across the globe have been affected by COVID-19. Clinicians are in urgent need of guidance and recommendations to treat patients and improve outcomes....

Dr. Jorge Ibrain Figueira Salluh, MD, PhD

Dr. Jorge Ibrain Figueira Salluh, MD, PhD

In this article, we focus on clinical and practical application of current available cloud-based data analysis to track and benchmark in real-time suspect and confirmed COVID-19 cases, resource use and availability. The COVID-19 pandemic represents an unprecedented challenge to intensive care units (ICU) due to the surge of severe cases of pneumonia posing great stress to hospitals and healthcare system...

Acute Kidney Injury (AKI) develops in over 55% of ICU patients patients (Hoste et al. 2015). As infections and the need for mechanical ventilation are known to be among the high-risk factors for the development of AKI (Bellomo et al. 2017), the incidence may be even higher in the COVID-19 era. For ICU patients with COVID-19 or other complex conditions, essential physiological functions such as cardiac ou...

Dr. Jürgen Fortin

Dr. Jürgen Fortin

The rapid global distribution of COVID-19 is challenging healthcare systems worldwide. In many countries hospitals and ICU departments are overloaded or fear a potential collapse - the optimal allocation of healthcare resources is required. Healthcare professionals are forced to treat severely ill patients with limited access to ventilation equipment, qualified intensive care personnel or protective patien...

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