ICU Management & Practice, ICU Volume 11 - Issue 2 - Summer 2011

The Paediatric Patient

Within any given hospital, the critically ill are among those patients requiring the highest level of specialised care and resources; but as it is increasingly noted, there are growing sub-populations of patients who require even more specialised care, equipment and protocols. In past issues of ICU Management, we have focused on many of these distinctive groups - from the management of obese patients to th...

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 examiningthe cost effectiveness of therapeutic hypothermia to treat neonatal encephalopathy. Introduction Neonatal encephalopathy is a major cause of death and neurodevelopmental impairment worldwide. New medical interventions are ur...

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 of stay, and loss of muscle tissue in this population (Ba...

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 internationally. The continued suc- cess of this type of...

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, pulse contour analysis, bioimpedance-bioreactance, an...

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, in ICU or in the Emergency Department (ED). Event...

Antiobiotics, ICU

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 rate, blood pressure, white cell count, and tracheo...

Abdominal Compartment Syndrome in the Medical Patient

Authors Chadwick P. Smith, MS, FACC Fellow Department of Surgical Education, Orlando Regional Medical Center Orlando, Florida, USA [email protected] Michael L. Cheatham, MD, FACS, FCCM Director Department of Surgical Education Orlando Regional Medical Center Orlando, Florida, USA Intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) have been well-described in trau...

Reducing Medication Errors and Improving Patient Safety

Authors Katie Went, BSc(Hons), PhD Research Assistant School of Computing University of Dundee Dundee, Scotland [email protected] Ian Ricketts, BSc, PhD, FBCS, FRSA, FRSM, MIT, MIEEE, ACM Chair of Assistive Systems and Healthcare Computing, and Professor School of Computing University of Dundee Dundee, Scotland [email protected] Shaun McLeod MBChB, FRCA, Dip ICM Consultant Depa...

Treating the Patient and Their Families

For this special issue of ICU Management, Professor Saïd Hachimi-Idrissi, Head of the Paediatric Intensive Care Unit at the University Hospital of Brussels (UZ Brussels) took Managing Editor Sherry Scharff on a tour of the unit and sat down to talk about the challenges of managing paediatric patients, maintaining staff levels and avoiding burnout. Could You Take Me Through a Standard Day? I start at 8...

Intensive Care Medicine in Spain

In Spain, the first units for critically ill patients, which appeared during the 1970s, were managed by anaesthetists, internists and, to a lesser extent, by cardiologists and pneumologists. The need for continuous and specific care of these critically ill patients represented the basis and origin of the specialty known as Intensive Care Medicine. The training of medical specialists (Resident Physicians [M...

Control of an Outbreak of Linezolid-Resistant

Staphyococcus Aureus in a Spanish Intensive Care Department Author Miguel Sanchez Garcia, MD, PhD Intensive Care Department Hospital Clínico San Carlos Madrid, Spain [email protected] A 12-patient outbreak with linezolid-resistant Staphylococcus aureus (LRSA) developed in our intensive care department. A combination of interventions, in close collaboration with the microbiolog...

Remove Children's Catheters as Soon as Possible to Prevent Bloodstream Infections

Hospitals can reduce the risk of lifethreatening bloodstream infections in children with peripherally inserted central venous catheters by assessing daily the patient's progress and removing the device as early as possible, according to a new Johns Hopkins Children's Center study published online in the journal Clinical Infectious Diseases. The study, believed to be the largest one to date of its kind in p...

New Procedure to Make Brain Surgery Safer

To increase patient safety in clinical practice and minimise risks and damage that may arise during surgery, computer support and digital medical imaging are key technologies. Before brain operations, neurosurgeons can now evaluate patient-specific surgical risks, achieve increased safety, and avoid unacceptable risks. Brain interventions must be planned so that the neurosurgeon can access and remove th...