ICU Management & Practice, Volume 23 - Issue 5, 2023 Administering Care to Critically Ill Patients with FAST HUGS IN BED PLEASE - Revisited Mnemonic In the ICU, providing better care with less is the holy grail. This mnemonic tries to resume a list of the key interventions for human, evidence-based and patient-centred care. Background In 2005, Prof Jean-Louis Vincent introduced the mnemonic "FAST HUG," advocating for a comprehensive approach to patien...

Cardiovascular Management in Septic Shock: Optimising Vascular and Cardiac Function An overview of vasopressor management, current evidence on its use, when to initiate vasopressor therapy for best possible patient outcome and a discussion regarding the use of landiolol in septic patients with persistent tachycardia.   Optimising Vasopressin Initiation in Septic Shock Patients with septic shock, and especially those with high vasopressor needs, are at r...

Medical News & Perspectives  Quick Uptakes February 14, 2024 When It Comes to SARS-CoV-2 Clearance, People Who are Immunocompromised Are Not All Alike Rita Rubin JAMA. Published online February 14, 2024. doi:10.1001/jama.2024.1014 For people who are immunocompromised, the COVID-19 pandemic is not over. In general, their immune system’s response to COVID-19 vaccines and to SARS-CoV-2 infection is blunted compared with individuals who...

VENT-AVOID Trial: ECCO2R to Avoid IMV During Exacerbation of COPD In patients experiencing exacerbation of chronic obstructive pulmonary disease (ECOPD), invasive mechanical ventilation (IMV) is linked with increased morbidity and mortality. Extracorporeal CO2removal (ECCO2R) has been used to prevent intubation in those at risk of NIV failure and to aid early extubation from IMV. However, current evidence supporting the efficacy of ECCO2R devices in reducing or avo...

Exploring Post-ICU Impairment With the increasing survival rates in the ICU, there is more focus on improving the quality of survival. Post-intensive care syndrome (PICS), characterised by cognitive, psychological, and physical impairments affecting up to 80% of ICU survivors, remains a significant challenge despite extensive research. Identifying the risk factors and understanding how they affect recovery is crucial for developing effective prevention and treatmen...

COMMENT|ONLINE FIRST Improved precision in defining the need for thromboprophylaxis during lower limb immobilisation Beverley J Hunt, Xavier L Griffin Lancet Published: February 15, 2024 DOI:https://doi.org/10.1016/S0140-6736(23)02613-2 Hospital-associated venous thromboembolism is defined as venous thromboembolism occurring during hospital admission and up to 90 days after discharge. It is the major cause of venous thromboembolism, accounting for over 50% ...

Temporal Trends in Mortality of Patients with Sepsis Sepsis, characterised by severe organ dysfunction, is a major cause of hospitalisation and mortality globally. The WHO recognises sepsis as a significant global health concern, urging efforts to enhance outcomes for affected individuals.  Despite no new targeted therapies emerging for sepsis in recent decades, advancements in ICU management, shifts in patient demographics, and improved supportive care pra...

Evidence-Based Medicine and the Practice of Personalised Medicine In ICU Fri, 22 Mar 2024 Sharon Einav-Bromiker from Tel Aviv, Israel, delivered a thought-provoking session @ISICEM, exploring the conflict between evidence-based medicine and personalised medicine. She acknowledged the complexity of the topic and aimed to challenge conventional perspectives.  While evidence-based medicine provides a sense of certainty, it may not be as reliable a...

Editorial  January 17, 2023 TRANSFORM-HF—Can We Close the Loop on Diuretics in Heart Failure? Michelle M. Kittleson JAMA. 2023;329(3):211-213. doi:10.1001/jama.2022.21692 Fluid overload is the cardinal manifestation of heart failure, and prior to the 20th century, treatment options were limited to purgatives, bloodletting, leeching, or lancing. It was not until 1920 that the concept of a diuretic was first appreciated, when physicians observe...

Sex - A Biological Variable in the ICU In ICU Thu, 21 Mar 2024 Dr Marlies Ostermann from Guy’s and St Thomas’ NHS Foundation Trust in London presented a tutorial at ISICEM 2024, highlighting the historical disparities and inequalities faced by different sexes in the ICU. These challenges encompass lower ICU admission rates, variations in medical care provision, inadequate personalisation, limited representation in clinical trials, and biases.  ...