Search Tag: ICU

ICU Management

ICU telemedicine - why qualitative research matters

2018 27 Nov

ICU telemedicine traces its beginnings to the 1970s, when an intensivist at a university hospital connected to a single small ICU using audio-visual technology to remotely conduct daily patient rounds and weekly teaching rounds with the local staff. This technology-based strategy is intended to improve patient care and outcomes, by extending the reach... Read more

ICU Management

Inequities in access to ICU care

2018 07 Nov

ICU care is an expensive healthcare resource as it offers specialised physical space, advanced equipment and the expertise of well-trained healthcare professionals. Due to the type of services offered by an ICU, the department has to operate on limited resources only dedicated for patients who require life-sustaining interventions.  Over the... Read more

ICU Management

Shock

2018 16 Oct

Shock is an emergency, and if it is not treated, it will mostly be fatal. Early intervention and admission to the ICU is essential. Our cover story considers several aspects of shock, including pathophysiology and multi-organ dysfunction syndrome, as well as source control, fluids, differentiation using point-of-care ultrasound and vasoactive medication.... Read more

ICU Management

It is time for improved fluid stewardship

2018 16 Oct

A conceptual framework for developing institutional programmes and guidelines to enhance fluid stewardship (especially in the intensive care unit [ICU] environment), an activity that includes appropriate selection, dosing, duration, de-escalation, and monitoring of fluid therapy. The primary goal of fluid stewardship is to optimise clinical... Read more

ICU Management

Vasoactive medication and RCTs - an impossible marriage

2018 16 Oct

A review and introduction of the concept “enough.” We provide a brief overview of important physiology and the pharmacology of vasoactive drugs that are currently used in the ICU as well as newer agents, along with a concise review of recent publications comparing these agents. We attempt to answer the question what drug dose should be administered... Read more

ICU Management

Optimising sleep in the ICU

2018 16 Oct

Disordered sleep is common in ICU patients. While many of the reasons for this are impossible to modify, and others rely on improvement in the underlying condition, many directly depend on the actions of the treating team: for example, exposure to noise, timing of therapeutic procedures, tapering of sedating drug doses, and daytime mobilisation.... Read more

ICU Management

Cancer patients in the intensive care unit

2018 16 Oct

Recent advances and new challenges. It has been thought for years that cancer patients have not benefitted from intensive care unit (ICU) admission when they suffer from severe and potentially reversible acute illnesses. Fortunately, numerous studies have shown that this is not the case. Today, the number of cancer patients in ICUs around the... Read more

ICU Management

What should we stop doing in the ICU?

2018 16 Oct

In this article, I highlight that the most important thing intensive care physicians should stop doing is ignoring that they are prone to several cognitive biases. I will first support my statement by looking for conceptual caveats and cognitive bias in routine intensive care unit (ICU) care, and then move to specific patient and structural problems.... Read more

ICU Management

Caring for very old patients in the ICU

2018 16 Oct

Describes the epidemiology and outcomes for very old patients as known in 2018, along with a short introduction to the most relevant “geriatric syndromes” important also for intensivists, and discusses where we should increase our body of knowledge to make a more precise triage in this patient group. The very old ICU patient is a term often... Read more

ICU Management

Humanizing the ICU experience with enhanced communication

2018 16 Oct

Avicenne ICU’s initiative. Decisions to limit therapy (DTLT) are routine for ICU physicians. Although breaking bad news is one of the most difficult tasks clinicians face, ongoing communication is even more crucial as families (not necessary following a legal or genetic definition) of critically ill patients have heightened communication... Read more