ICU Management & Practice, Volume 22 - Issue 3, 2022 Pain Management in Paediatric Critical Care An overview of the main treatment options currently available in paediatric critical care setting. Critically ill paediatric patients often suffer from pain secondary to trauma, complex medical procedures, invasive testing monitoring devices and illness-induced discomfort. Although the gold standard for assessing patient comfort is self-report, in paediatrics...

ICU Management & Practice, Volume 22 - Issue 3, 2022 Perioperative Haemodynamic Optimisation of the High-Risk Surgical Patient An overview of evidence supporting perioperative haemodynamic optimisation in high-risk surgery patients and strategies to facilitate its implementation and adoption to improve patient outcomes. A million surgical procedures performed every year worldwide are at risk of complications that can be attributed to the nature of the su...

Editorials Oxygen administration during general anaesthesia for surgery Michele Samaja, Davide Chiumello BMJ 2022; 379 doi: https://doi.org/10.1136/bmj.o2823 (Published 30 November 2022)Cite this as: BMJ 2022;379:o2823 Oxygen can be a double edged sword Oxygen is routinely administered to almost all patients undergoing general anaesthesia,1 to ensure adequate oxygenation from intubation until awakening—the period when complications due to hypoxaemia ar...

ICU Management & Practice, Volume 22 - Issue 3, 2022 Analgesia, Sedation and Neuromuscular Blockade in Critically Ill Patients A Practical Approach for Intensivists A practical approach to analgesia, sedation and neuromuscular blockade of critically ill patients and a discussion on potential benefits, adverse effects and current professional international recommendations. Introduction Patients hospitalised in the Intensive Care Unit (ICU) are natur...

The Influence of COVID-19 on Intensivist Wellbeing The COVID-19 pandemic has been challenging for healthcare systems around the world. In particular, the pandemic has resulted in critical care staffing shortages and has affected the quality of care.  In this review, the researchers examine the emergency response of hospitals to the pandemic and how it influenced the well-being of frontline intensivists. They also discuss potential strategies to improve inte...

Endotypes of Traumatic Brain Injury Traumatic brain injury (TBI) is a heterogeneous disease. It has various injury mechanisms and tissue pathologies. It is a leading cause of mortality and morbidity in young individuals globally. In addition, the incidence of TBI in older patients is an area of concern with an increase in an ageing population that is more likely to be multi-morbid and fall-prone.  Mortality from TBI has decreased over the years. How...

Prehospital Lyophilised Plasma Transfusion for Trauma-Induced Coagulopathy Trauma-induced coagulopathy affects approximately 20 to 50% of patients with severe trauma. Its occurrence increases transfusion requirements, multi-visceral failure, and mortality. Blood transfusion is the primary therapy for trauma-induced coagulopathy. However, optimal modalities for plasma transfusion in a prehospital setting remain undefined. Findings from the COMBAT (Control of...

Feature Christmas 2022: The Scientist On the 12th Day of Christmas, a Statistician Sent to Me . . . Richard D Riley, Tim J Cole, Jon Deeks, et al BMJ 2022; 379 doi: https://doi.org/10.1136/bmj-2022-072883 (Published 20 December 2022)Cite this as: BMJ 2022;379:e072883 The BMJ’s statistical editors relish a quiet Christmas, so make their wish come true and pay attention to the list of common statistical faux pas presented here by Riley and colleagues ...

Venous Thromboembolism in Sepsis Septic patients are often affected by coagulation disorders. Hence, they are at a high risk of thrombotic complications, ranging from widespread microvascular involvement, such as disseminated intravascular coagulation, to venous thromboembolism, arising as deep vein thrombosis or pulmonary embolism. Over the years, knowledge about the interconnected and reciprocal influence of immune and coagulation systems has emerged. This phe...

Capnodynamic Monitoring to Assess PEEP in COVID-19 Optimal positive end-expiratory pressure (PEEP) level during mechanical ventilation for COVID-19 pneumonia remains debated. A third of experts in a recent consensus statement supported a low-level PEEP for COVID-19-related acute respiratory failure (C-ARDS), with half of the panel remaining neutral without agreement on PEEP titration. However, the Surviving Sepsis Campaign guideline recommends using high level of P...