ICU Without Borders Critical illness is characterised by various phases and outcomes, including deterioration, organ dysfunction, and recovery or death. Patient care is often fragmented, with different groups of healthcare providers managing different aspects of the patient's journey. Communication and collaboration gaps between these groups can lead to breakdowns in care and potentially impact patient outcomes. A study reported that delays in transferring patients...

Editorials Surgeon volume and patient outcomes in shoulder replacement surgery Marta Karbowiak, Nashat Siddiqui BMJ 2023; 381 doi: https://doi.org/10.1136/bmj.p1334 (Published 21 June 2023)Cite this as: BMJ 2023;381:p1334 Higher volumes are associated with lower risks for patients The association between the volume of procedures performed by surgeons and patient outcomes has been well documented, notably in the context of hip and knee joint replacement surg...

ICU Management & Practice, Volume 23 - Issue 2, 2023 Detecting Euglycaemic Diabetic Ketoacidosis Associated With SGLT2 Inhibitors SGLT2 inhibitor associated EDKA is becoming more prevalent due to the increasing use of SGLT2 inhibitors in cardiovascular medicine and type 2 diabetes. Physician awareness and knowledge about the disease and diagnostic tools need to improve for better management. Point of care blood testing for ketones can allow for rapid and ac...

ICU Management & Practice, Volume 23 - Issue 3, 2023 Current Airway Management During Anaesthesia - The STARGATE Study An overview of the International obServational sTudy on AiRway manaGement in operAting room and non-operaTing room anaEsthesia (STARGATE study) that will collect information on peri-intubation adverse events and airway management procedures in adult patients undergoing general anaesthesia to receive surgery or other diagnostic/therapeutic p...

To Mobilise or Not to Mobilise Patients who receive prolonged ventilation are at significant risk of muscle atrophy, severe weakness, long-term disability, and increased mortality. Early mobilisation has been advocated in multiple international guidelines, with widespread support from healthcare professionals. Early mobilisation is believed to have potential benefits, such as reducing the duration of mechanical ventilation, decreasing the occurrence of delirium,...

ICU Management & Practice, Volume 23 - Issue 3, 2023 The Green Intensive Care: From Environmental Hotspot to Action Together we must reduce the impact of the healthcare sector and shift towards a circular economy. This paper describes the shift of three ICU environmental hotspots: gloves, gowns, and CRRT bags. Introduction The healthcare sector is one of the most carbon-intensive sectors, contributing to 4.4% of global net greenhouse gas emissions and...

Perioperative Management of Patients With Diabetes Mellitus Diabetes mellitus (DM) is a chronic disease that is becoming increasingly common in the general population. An estimated 537 million people worldwide have DM. Its prevalence is expected to increase to 700 million by 2045. Approximately 1 in 11 adults in Europe have DM, roughly 61 million individuals. Patients with diabetes account for 15% of all surgical procedures, which burdens healthcare systems sign...

Role of Nurse-to-Nurse Familiarity on Mortality Nursing teams play an important role in providing safe and adequate care to critically ill patients in the ICU. The patient-to-nurse ratio significantly impacts patient outcomes, and teamwork is also crucial. A recent study emphasises the need for effective communication, collaboration, and a shared sense of responsibility among the nursing team to ensure optimal patient care. The authors suggest that investing in ...

Critical Care in Conflict Zones Conflict zones often involve gunfights, bomb blasts, and mass casualty incidents. However, patients in conflict zones may also present with everyday medical problems unrelated to trauma. Despite the challenges of working in a conflict zone, healthcare professionals strive to provide care for all patients, including those with chronic medical conditions. In 2021, MSF, a medical humanitarian organisation, provided medical care to 7,...

EDITORIAL Reinforcing the Checkpoint in Rheumatoid Arthritis Ellen M. Gravallese, Ranjeny Thomas N Engl J Med 2023; 388:1905-1907DOI: 10.1056/NEJMe2300734 Programmed cell death protein 1 (PD-1) is a critical inhibitory receptor in lymphocyte activation, acting as an immune checkpoint to prevent the continued activation of T cells after an immune response and to maintain peripheral immune tolerance. PD-1 is a marker of antigen-experienced T cells. With sustaine...