ICU Management & Practice, Volume 21 - Issue 5, 2021 The Intestinal Microbiome in Critical Illness Critical illness alters the intestinal microbiome, resulting in a loss of microbial diversity and induction of a pathobiome. Manipulating the intestinal microbiome offers a potential treatment approach in ICU patients. The intestinal microbiome is comprised of diverse, robust microbial communities within the intestine, modified by the host’s interaction wit...

ICU Management & Practice, Volume 21 - Issue 5, 2021 Safer Intubation Practices in Critically Ill Patients What We Learned During the COVID-19 Pandemic That Should Not Be Forgotten An overview of the available evidence on safe intubation practices in critically ill patients in light of new discoveries due to the coronavirus pandemic. Introduction Orotracheal intubation is a life-saving procedure in critically ill patients with acute respiratory fai...

ICU Management & Practice, Volume 21 - Issue 5, 2021 Methylene Blue for Vasoplegic Syndrome Post Cardiac Surgery Post-operative cardiac surgical patients are encountered commonly in the intensive care unit. Methylene blue might be a useful treatment for patients with vasopressor-refractory vasoplegia but high quality evidence is lacking. Cardiac surgery is one of the most frequently performed major surgical procedures, with more than 1 million operations...

Transgastric Abdominal Ultrasonography in Anaesthesia and Critical Care Transoesophageal echocardiography (TEE) is a test that provides clinicians with pictures of the heart. It uses ultrasound to produce detailed pictures of the heart and the arteries. TEE differs from a standard echocardiogram. The echo transducer that produces the sound waves is attached to a tube that passes through the patient’s mouth, down their throat and into the oesophagus. The test can pr...

EDITORIAL Booster Doses and Prioritizing Lives Saved Minal K. Patel N Engl J Med 2021; 385:2476-2477DOI: 10.1056/NEJMe2117592 Globally, more than 5 million people have died from Covid-19 since the start of the pandemic.1 This is certainly a grim number, but we are starting to see the lifesaving effect of vaccines.2 From the global public health perspective, the initial primary objective of Covid-19 vaccination is to decrease the severe consequences o...

ICU Management & Practice, Volume 21 - Issue 5, 2021 Microbiome in Sepsis and COVID-19 Bacteria play a fundamental role in human life. Given the many roles of gut microbiota in critical illness and other pathological conditions, it is important to target therapeutical interventions to restore, preserve and enrich its composition. Introduction Bacteria play, for better or worse, a fundamental role in human life. As multidrug resistant bacterial infecti...

Carbapenem Antibiotics for Nosocomial Pneumonia Evidence from previous studies suggests that the treatment of hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP) with empiric carbapenems is associated with lower mortality rates. However, it has also been reported that the use of carbapenems results in higher rates of clinical failure for pseudomonal pneumonia. This meta-analysis is an updated report with sensitivity analyses and meta-regr...

EDITORIAL Molnupiravir — A Step toward Orally Bioavailable Therapies for Covid-19 Richard Whitley N Engl J Med December 16, 2021DOI: 10.1056/NEJMe2117814 The Covid-19 pandemic has resulted in substantial global morbidity and mortality as well as disruption of the economies of virtually every country.1 Some of this tragedy could have been averted with the development of deliverable, orally bioavailable, direct-acting antiviral therapeutics. Molnupiravir, t...

Haemodynamic Monitoring and Management in Critical Care Over the last fifty years, haemodynamic monitoring techniques have progressed quite significantly, moving from bulky sphygmographs to invasive catheters to noninvasive digital monitors that provide continuous values of multiple haemodynamic variables. Haemodynamic monitoring concepts have also changed and have progressed from global macrohaemodynamic monitoring towards a more regional, microcirculatory perfusi...

Perioperative Dexmedetomidine and Postoperative Delirium Delirium is very common in patients who undergo major cardiac and non-cardiac surgery. Delirium is associated with postoperative mortality, postoperative cognitive dysfunction, increased length of stay in the hospital and postoperative complications and morbidity. A study was conducted to investigate the effect of perioperative administration of dexmedetomidine on the incidence of postoperative delirium in...