Crowding of Emergency Departments: An Assessment of the NEDOCS In ICU Mon, 21 Oct 2024 Emergency department (ED) crowding is a global issue with a significant impact on patient outcomes, including increased medical errors, higher inpatient mortality, and poorer quality of care. It also leads to inefficiencies, such as longer waiting times and more patients leaving without being seen. The primary causes of crowding are staff shortages, sudden surges in ...

Effect of PEEP on PVR in Patients With Acute Respiratory Distress Syndrome In ICU Mon, 21 Oct 2024 In mechanically ventilated patients with acute respiratory distress syndrome (ARDS), the use of positive end-expiratory pressure (PEEP) presents a therapeutic dilemma. PEEP can improve gas exchange and lung mechanics but may impair haemodynamics. Its effects primarily impact right ventricular (RV) preload and afterload, while left ventricular (LV) functio...

Current Controversies in Early Mobilisation in the ICU In ICU Tue, 1 Oct 2024 ICU Management & Practice, Volume 24 - Issue 4, 2024 This article will address current and controversial topics regarding early mobilisation and respiratory therapy in critically ill patients in the Intensive Care Unit (ICU). We will explore the implications, challenges, and potential benefits related to these interventions, highlighting the need for ongoing research ...

Early Mobilisation: Just a Fad?  In ICU Tue, 1 Oct 2024 ICU Management & Practice, Volume 24 - Issue 4, 2024 A review of recent evidence on early mobilisation and rehabilitation and what remains to be defined. Introduction Critical illnesses encompass a broad spectrum of pathologies that require support for different organs. This often leads to prolonged bed rest and secondary immobilisation, which ultimately fosters the development ...

Editorials Immunotherapies for sepsis and the impact of study design John H Powers III, Charles Natanson BMJ 2025; 388 doi: https://doi.org/10.1136/bmj.r48 (Published 15 January 2025)Cite this as: BMJ 2025;388:r48 Enrolling the right number and type of patient is crucial Sepsis is a life threatening syndrome initiated by microorganisms.1 Severe and often lethal injuries (eg, shock, multiorgan failure, and metabolic derangements) are the manifestation o...

Early Mobilisation, Delirium Prevention and Long-Term Cognitive Function In ICU Tue, 1 Oct 2024 ICU Management & Practice, Volume 24 - Issue 4, 2024 Early mobilisation showed promising positive effects in preventing and shortening delirium and improving long-term cognitive function. Further research is required to confirm its benefits and to identify the best protocol. Introduction In recent years, an increasing demand for critical care s...

Antimicrobial Dosing in Critically Ill Patients on ECMO In ICU Mon, 14 Oct 2024 Extracorporeal membrane oxygenation (ECMO) is used to support critically ill patients, but its impact on antimicrobial pharmacokinetics (PK) and pharmacodynamics (PD) presents significant challenges. ECMO circuits can affect drug delivery, leading to the sequestration of drugs, changes in the volume of distribution (Vd), decreased clearance, and longer elimination half-life...

Leg Cycle Ergometry in Critically Ill Patients In ICU Mon, 14 Oct 2024 Physical rehabilitation interventions initiated in the ICU represent a proactive approach to reducing post-ICU impairments. While many clinical guidelines recommend starting rehabilitation during ICU care, there is no consensus on the optimal timing or specific type of intervention. The types of rehabilitation studied are diverse, leading to varying results across studies. Some rand...

Editorial  November 11, 2024 Intratracheal Budesonide Combined With Surfactant in Extremely Preterm Infants Erik A. Jensen JAMA. Published online November 11, 2024. doi:10.1001/jama.2024.19641 Infants born extremely premature (those with gestational ages of less than 28 weeks at delivery) are at risk of both acute and subsequent chronic respiratory insufficiency due in part to absent or inadequate production of pulmonary surfactant. More than...

Restrictive vs Liberal Transfusion Strategy in Acute Brain Injury In ICU Mon, 14 Oct 2024 The indications for red blood cell transfusions in critically ill patients without life-threatening bleeding are debated, particularly due to the balance between risks and benefits. While anaemia is linked to increased morbidity and mortality, blood transfusions can also lead to complications such as infection or lung injury. Several randomised clinical trials in ...