Search Tag: ICU
2021 30 Sep
Join our panellists on October 12 at 16:00 CET as they discuss the role of microbiome in critical illness, possible complications and potential microbiome treatment strategies and approaches. Register here ! Moderator JEAN-LOUIS VINCENT Editor-in-Chief ICU Management & Practice Professor Department of Intensive Care Erasme Hospital...Read more
2021 30 Sep
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...Read more
2021 30 Sep
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. Assessing The Transition From Fully Controlled to Assisted Ventilation One of the key issues with mechanical ventilation is the transition...Read more
2021 14 Sep
More than forty randomised trials have evaluated early mobilisation and rehabilitation in ICUs in the last decade. These trials usually aim to reduce the incidence of ICU acquired weakness (ICUAW) which is known to be associated with poor long-term survival, poor physical function and decreased quality of life. Eight international guidelines recommend...Read more
2021 24 Aug
G ender inequity in critical care medicine remains a pressing issue as the representation of women and minorities continues to be lowest in this specialty. Women continue to be underrepresented in leadership roles and senior positions. Whether it is overall compensation, lucrative opportunities, recipients of research funding, lead authors and editors,...Read more
2021 24 Aug
Looking at gender, bias and equality through the lens of the COVID-19 crisis and its potential for broad and lasting effects and addressing how this unprecedented situation can be a chance for interaction, learning and the development of best practices, such as developing work structures that could be continued in our post-pandemic future....Read more
2021 24 Aug
Among 1,841 very old ICU patients with respiratory failure, although women had higher age and frailty, males had higher 30-day mortality assessed one month after ICU admission. Particularly in light of the ongoing pandemic, male patients appear to be at significantly higher risk for worse outcomes than females. Introduction Demographic...Read more
2021 24 Aug
Change content default valueSex interplays with the development of several diseases and syndromes, impacting differently the need for intensive care unit admission between men and women. All in all, men are more prone to develop critical illness than women, which explains their over-representation in the intensive care unit. On the other hand, treatments...Read more
2021 24 Aug
How should you handle a chronic ventilator user admitted to your ICU with acute critical illness? A personal observation and reflection on how to handle a chronic ventilator user and suggestions to smoothen the sojourn of the next chronic ventilator user through an ICU, while ensuring maximal dignity and maintenance of function; minimising...Read more
2021 24 Aug
COVID-19 has drastically changed how end-of-life care is practiced in the intensive care unit. Safety concerns for society limits family visitation but is contrary to patient and family-oriented care. This article provides an ethical analysis of the pros and cons of having family members present at the death of a COVID-19 positive ICU patient and...Read more
2021 23 Aug
Severe COVID-19 in adults is characterised by severe pneumonia followed by systemic inflammation that could result in death. In adults, age, comorbidities and multiple organ failure are associated with increased in-hospital mortality. However, initial reports of COVID-19 in children suggest a milder course of illness compared to adults. Reports from...Read more
2021 19 Jul
Mechanical ventilation is a life-saving strategy for critically ill patients. However, it can promote and/or exacerbate lung injury through several mechanisms, including alveolar overdistension and repetitive opening and closing of the alveoli and small airways. Positive end-expiratory pressure (PEEP) has been employed to prevent end-expiratory alveolar...Read more
2021 06 Jul
Women account for only about 35-45% of patients in the ICU. This is surprising since half of the world’s population are women. This highlights a very pertinent question: do men and women have equitable access to the ICU? There have been several clinical studies that have tried to determine sex differences in illness severity and survival. However,...Read more
2021 06 Jul
Artificial Intelligence (AI) holds great promise in critical care. Vast amounts of data are regularly collected in intensive care units, making ICUs the perfect environment for deploying machine-learning techniques. AI in ICUs can have several applications. For example, when determining the short and long-term outcomes of different interventions,...Read more
2021 06 Jul
Sepsis is a leading cause of death worldwide and is also associated with a high burden of patient mortality. This burden is expected to increase as populations age. Patients with sepsis typically require high-cost interventions in ICUs. Even with urgent treatment, the probability of death still remains high. However, ICUs that have more experience...Read more
2021 28 Jun
Human connection has suffered quite significantly during the COVID-19 pandemic. While physical distancing is necessary for our wellbeing, restricting family presence in the ICU has been challenging. There is recent data that show the negative consequences of these policies and restrictions. Moral distress has been reported due to restrictive family...Read more
2021 24 Jun
An overview of current recommendations for oxygen administration in different patient populations and a discussion on optimal oxygen target values. O xygen is the most commonly used substance in hospitals today. After its discovery around 1771 by the German-Swedish pharmacist Carl Wilhelm Scheele and the English chemist Joseph Priestley, oxygen...Read more
2021 24 Jun
An overview of the principles and current applications of diaphragm ultrasound and innovative ultrasound-based techniques. Introduction In the intensive care unit (ICU), ultrasound imaging has become increasingly popular for the diagnosis and to guide treatment in critically ill patients (Volpicelli et al. 2020). The use of ultrasound to...Read more
2021 22 Jun
Critical care admissions continue to increase year after year. There is also increasing evidence that demonstrates discharge from critical care as the start of a challenging process for both patients and caregivers, with many survivors going through physical, social, cognitive, and emotional problems in the years following discharge. It is clinically...Read more
2021 18 May
The intensive care unit is one of the most challenging areas in the hospital and demands the very highest performance from doctors and nurses. In many hospitals, the situation has been further exacerbated by the corona pandemic. Any lightening of the load is welcome – and modern hospital beds, in particular, can contribute a great deal here. During...Read more
2021 18 May
The effects of critical illness on patients and their families last long after the illness episode. While the patient may be suffering from a serious condition, family members also suffer the consequences and may experience symptoms like depression and traumatic stress. To provide improved support to families, it is important to incorporate the...Read more
2021 04 May
COVID-19 is associated with a high incidence of thrombotic complications. The burden of thrombin complications, in particular, pulmonary embolism, remains high in patients with COVID-19, especially those requiring admission to the ICU. Data suggest an incidence of thromboembolic events between 27 to 57% in COVID-19 patients despite standard thromboprophylaxis....Read more
2021 19 Apr
An overview of strategies and measures that can be implemented to improve wellbeing of staff and patients in the ICU. 1. Make the patient the centre of our preoccupations This is the first principle of wellbeing in the ICU and should be written in large letters when one enters an ICU. Wellbeing must concern first and foremost the patient....Read more
2021 19 Apr
Sepsis incidence in very old patients is high and related mortality and morbidity are a major health concern. Frailty and severity of illness, not just age or sepsis diagnosis, are the determinant factors in outcome. Early identification and treatment are decisive in their survival. N owadays, we are facing some important facts: there has...Read more
2021 19 Apr
After a year of this pandemic, this article explores what we currently understand about the psychological impact experienced by ICU teams and provides practical guidance to help build personal and team resilience as the journey with COVID-19 continues with no end in sight. Introduction When COVID-19 emerged as a new pathogen, the pictures...Read more
2021 19 Apr
This article highlights the key points that fall under the meaning of humanisation as part of the ICU Liberation bundle. Introduction How would a patient describe their stay inside an Intensive Care Unit (ICU)? Would it be cold, lonely, a place full of uncertainty? Painful, uncomfortable or scary? The length of stay (LOS) in the ICU may be...Read more
2021 19 Apr
The importance of creating a psychologically safe workplace and the need for a fundamental shift in workforce culture to foster compassionate leadership and collaborative approaches to delivering safe, supported care. I write this almost one year to the day after the UK announced its first coronavirus pandemic lockdown. The next few...Read more
2021 19 Apr
Importance and Objectives To observe the impact and main contributing factors of stress, anxiety and depression among frontline staff in the intensive care units during the COVID-19 pandemic, and to determine if wellness resources are useful. Design Mixed method observational cohort study. Setting and Participants...Read more