Editorial
Organ Interaction
Author Jean-Louis Vincent Editor-in-Chief, ICU Management Head Department of Intensive Care Erasme Hospital / Free University of Brussels. Brussels, Belgium [email protected] Organ interactions in critical illness may occur more often than we realise and physicians’ failure to recognise and react to such scenarios is leading to a multitude of deaths worldwide. Management of bi-directional dysfunction...
Research News
New Drug Reduces Heart Damage, Study Suggests
A single dose of an investigational anti-inflammatory drug called inclacumab significantly reduces damage to heart muscle during angioplasty, a recent international clinical trial has found. The study, which was led by Dr. Jean-Claude Tardif, Director of the Research Centre at the Montreal Heart Institute, affiliated with the University of Montreal, was presented at the American College of Cardiology...
Diabetes Medication May Prevent Patients from Developing Heart Failure
Commonly prescribed to lower blood sugar in diabetic patients, GLP-1 medications appears to also protect these patients from developing heart failure, according to a study at Henry Ford Hospital in Detroit. The retrospective study looked at 4,427 diabetic patients who were taking blood-sugar-lowering medications at Henry Ford Hospital between January 1, 2000 and July 1, 2012. Of these patients,...
Cover Story: Organ Interaction
Polytrauma and Organ Crosstalk
Authors Dieter G. Weber, MBBS, FRACS Department of Traumatology, Division of Surgery John Hunter Hospital and University of Newcastle Newcastle NSW, Australia Zsolt J. Balogh, MD, PhD, FRACS, FACS Department of Traumatology, Division of Surgery John Hunter Hospital and University of Newcastle Newcastle,NSW, Australia [email protected] Trauma is a leading cause of death and disability aroun...
How to Understand Organ-Organ Interactions
A Compartment Syndrome (CS) is Defined as Increased Pressure in a Closedanatomic space which threatens the viability of enclosed and surrounding tissue (Malbrain et al. 2006). Within the body there are four major compartments: the head, the chest, the abdomen and the extremities. Within each compartment, individual organs can be affected by a CS. As such, orbital CS, cardiac CS, hepatic CS, renal CS and pe...
Diagnosis and Management of Critical Limb Ischaemia
Author Samir K. Shah, MD Resident Department of General Surgery Cleveland Clinic, Ohio, US Daniel G. Clair, MD Professor and Chair of Department of Vascular Surgery Clinical & Translational Science Collaborative Cleveland Clinic Heart and Vascular Institute Case Western Reserve University Cleveland Clinic Lerner College of Medicine Ohio,...
Sepsis
Healthcare-Associated Bacterial Infection: Common Sources of Severe Sepsis Among People with HIV
Authors Jared A. Greenberg, MD Section of Pulmonary and Critical Care Medicine Department of Medicine, University of Chicago Chicago, US [email protected] John P. Kress, MD Section of Pulmonary and Critical Care Medicine Department of Medicine, University of Chicago Chicago, US In this Article, We Discuss the Emergence of Healthcare-Associated Bacterial Infections...
Series
The Future of Glucose Control in the ICU
Continuous glucose monitoring systems and therapeutic algorithms adapted to the actual insulin sensitivity are needed to prevent hypoglycaemia, hyperglycaemia and high glucose variability, all associated with poor outcome in intensive care unit (ICU) patients. Introduction A decade after the publication of the landmark Leuven I trial (Van den Berghe et al. 2001),...
Nutritional Failure: An Adaptive Response to Critical Illness?
For decades, intensive care unit (ICU) physicians have been administering artificial nutrition to improve recovery and outcome. This intensified nutritional support has been associated with a better outcome in several large observational studies (Alberda et al. 2009), though unfortunately, it is impossible to distinguish cause and consequence by association. Large randomised controlled trials (RCTs) compa...
Matrix
Racing to Improve Early Warning
The unique challenges in developing early warning for children have led to a patient-specific early warning approach. The methodology, which is based on the altered patterns of physiological derangement, associated with compensation and decompensation in clinical deterioration rather than population normal distributions, is suitable for patients of all ages. A software platform that is used for Formula O...
Management
The Kidney as the Protagonist: An Interview with DR. Sean Bagshaw
Doctor Sean Bagshaw, Clinician Scientist and Associate Professor in the Division of Critical Care Medicine at the University of Alberta, Canada, supported by a Canada Research Chair in Critical Care Nephrology, has played an active and influential role in the research of clinical, epidemiological and translational issues related to acute kidney injury (AKI), and was this year elected as a Scientific Advi...
Country Focus: Italy
Tracheostomy in the Intensive Care Unit: An Italian Snapshot
Optimisation of percutaneous and surgical tracheostomy techniques is one of the challenges of modern intensive care unit (ICU) management. Different percutaneous tracheostomies (PTs) have been developed worldwide over the years. Ciaglia, in North America, described the multiple-step dilational tracheostomy; Griggs, in Australia, defined the guidewire dilating forceps (GWDF) technique; while, in Italy, Fa...
Ensuring Operating Room Safety: The Italian Approach
Policies for the management and control of risks associated with healthcare constitute one of the priorities of the modern health systems. Like most European countries, the Ministry of Health in Italy has recognised the importance of assessing quality and safety on all levels of the system, taking into account patient expectations and enhancing the role and responsibility of health professionals. Thr...