ICU Management & Practice, Volume 22 - Issue 2, 2022 ICU Management of the Very Old: The Evidence Base Anno 2022 This overview explores the publications concerning the very old ICU patients since 2011 and with a focus on publications from the VIP network on elderly COVID-19 patients. Introduction In 2017, an international group of intensivists with a particular interest for geriatric intensive care published a statement paper (Flaatten et al. 2017). T...

Editorials Can vitamin D protect against covid-19? Peter Bergman BMJ 2022; 378 doi: https://doi.org/10.1136/bmj.o1822 (Published 07 September 2022)Cite this as: BMJ 2022;378:o1822 Two new trials find no effect, but aren’t the final word Vitamin D is an important regulator of calcium balance. In addition, it has important effects on the immune system, directly inducing antimicrobial peptides at mucosal surfaces and modulating the function of T cells.12Observ...

#ISICEM22: The Place of Antiplatelet Agents in COVID-19 (REMAP-CAP Trial) Thrombotic events are common in patients hospitalised with COVID-19. Platelet activation has been implicated in the COVID-19 inflammatory response. However, the efficacy of antiplatelet therapy in critically ill patients with COVID-19 is still uncertain.  The Randomized, Embedded, Multifactorial Adaptive Platform Trial for Community-Acquired Pneumonia (REMAP-CAP) trial aimed to answer...

ICU Management & Practice, Volume 22 - Issue 2, 2022 Understanding Carbon Dioxide in Resuscitation Peri-arrest CO2 measurement may serve to assess resuscitation efficacy and guide clinical decisions. This paper reviews current knowledge and future research directions for CO2 measurement and clinical application during CPR. Carbon Dioxide During Normal Heart-Lung Function CO2 is produced by the mitochondria as a major end product of tiss...

ICU Management & Practice, Volume 22 - Issue 2, 2022 The Alphabet Book of Sepsis In this article, the author provides the alphabet review of sepsis and septic shock based on personal clinical experience and choice. Sepsis and septic shock have been defined in 2016 (Singer et al. 2016) and the management of patients is framed by the Surviving Sepsis Campaign guidelines with its renewed version in 2021 (Evans et al. 2021). Using PubMed, around 15,000 hits ...

ICU Management & Practice, Volume 22 - Issue 2, 2022 Symmetrical Peripheral Gangrene In this article, the authors describe the presentation, pathophysiology, and potential treatment options for symmetrical peripheral gangrene. Limitations in the current literature and a possible strategy for future study are highlighted. Introduction Symmetrical peripheral gangrene (SPG) refers to the development of tissue necrosis in an acral distribution without vas...

ICU Management & Practice, Volume 22 - Issue 2, 2022 Sepsis Surveillance (Sepsis Sniffer): Where We Are Now and Where We Are Going Timely recognition of sepsis is the foundation of improved patient survival. This article discusses opportunities to improve this in multiple areas and the use of sepsis screening tools to improve surveillance and treatment of sepsis. Sepsis is a critical healthcare problem, associated with high mortality rates, and considera...

ICU Management & Practice, Volume 22 - Issue 2, 2022 Challenges in the Haemodynamic Management of Septic Shock An overview of the haemodynamic management of patients in septic shock and strategies for detection of haemodynamic changes and appropriate therapeutic action to improve the prognosis of these patients. Introduction Sepsis is one of the main causes of admission to the Intensive Care Unit (ICU). It is defined as a life-threatening organ dysfun...

Invited Commentary  August 10, 2022 Expanding Options for Total Intravenous Anesthesia—The Etomidate vs Propofol for In-Hospital Complications Trial Jason M. Johanning JAMA Surg. Published online August 10, 2022. doi:10.1001/jamasurg.2022.3339 Using a randomized clinical trial design, the authors compared the ability of etomidate to provide total intravenous (IV) anesthesia with propofol.1 Propofol is the most common IV anesthesia medica...

ICU Management & Practice, Volume 22 - Issue 2, 2022 One Sepsis Fits All? Are There Different Phenotypes of Sepsis? Diagnostic Approaches and Therapies This article presents current research results in relation to an advanced sepsis classification and their implications for new treatment options and research strategies. Introduction Through history, the definition and the term sepsis changed. Since Semmelweis and others formulated the thesis that seps...