ICU Management & Practice, Volume 22 - Issue 3, 2022 Ten Overlooked Mistakes During Early Mobilisation in the Intensive Care Unit An overview of the most common mistakes in decision making and the practice of early mobilisation in the intensive care unit. Introduction Early mobilisation (EM) is a therapeutic strategy implemented to avoid and overcome impairments developed due to critical illness and ICU stay. Several benefits have been described throu...

EDITORIALFREE PREVIEW Fluid Resuscitation in Acute Pancreatitis — Going over the WATERFALL Timothy B. Gardner N Engl J Med 2022; 387:1038-1039DOI: 10.1056/NEJMe2209132 Acute pancreatitis, responsible for approximately 300,000 hospital admissions in the United States annually, is characterized by intense inflammation of the pancreas that leads to severe disease in approximately one third of affected patients.1 Because no proven pharmacologic therapy for acute p...

Editorial  August 16, 2022 Remote Ischemic Conditioning: Feasible and Potentially Beneficial for Ischemic Stroke David C. Hess, Rolf A. Blauenfeldt, Grethe Andersen JAMA. 2022;328(7):622-624. doi:10.1001/jama.2022.13365 Stroke is the second leading cause of death and disability in the world.1 In 1996, tissue plasminogen activator (tPA) was approved by the US Food and Drug Administration and remains the only approved pharmacologic agent f...

Editorial  August 9, 2022 Therapeutic Strategies for Intracranial Atherosclerosis Craig S. Anderson, Lili Song, Jianmin Liu JAMA. 2022;328(6):529-531. doi:10.1001/jama.2022.11525 Intracranial atherosclerosis (ICAS) is a major cause of stroke worldwide. Although approximately 12% of White patients with a history of acute ischemic stroke or transient ischemic attack (TIA) have some form of ICAS detected on routine screening in predominantly old...

#EA22: Long-Term Exposure to Air Pollution Increases Risk of Severe COVID-19 New research presented at Euroanaesthesia 2022 finds that long-term exposure to air pollution is linked to a greater risk of severe COVID-19. Findings from the study show that people living in counties with higher levels of nitrogen dioxide (NO2) were more likely to need ICU care and mechanical ventilation if they had COVID-19. Long-term exposure to NO2 can have harmful effects on ...

Editorial  September 6, 2022 Clinical Decision Support to Prevent Acute Kidney Injury After Cardiac Catheterization: Moving Beyond Process to Improving Clinical Outcomes Eric R. Gottlieb, Mallika Mendu JAMA. 2022;328(9):831-832. doi:10.1001/jama.2022.14070 Over the past decade, with the advent of meaningful use as part of the 2009 Health Information Technology for Economic and Clinical Health (HITECH) Act, the US health care system has experi...

#EA22: Impact of Fatigue on Doctors and Nurses Consultant Anaesthetist Dr Nancy Redfern of Newcastle Hospitals NHS Foundation Trust, Newcastle, U.K., presented a review at Euroanaesthesia 2022 highlighting the potentially lethal effects of fatigue on doctors and nurses, its impact on the quality of their clinical work and judgement and its subsequent impact on patient safety. According to Dr Redfern, healthcare systems need to have formal risk management systems...

#EA22: Preventing Maternal Deaths In a very relevant session at Eurananesthesia 2022, Dr Nuala Lucas, an Obstetric Anaesthesia Expert from Northwick Park Hospital, London, U.K., presented key messages for anaesthesia practice from U.K.'s Maternal Mortality Reports. These reports are produced annually to provide information about the causes of maternal deaths and promote learning and reduce preventable mortality. The U.K. Maternal Mortality Enquiry programme is led ...

#EA22: Impact of Anaesthesia Handover on Morbidity and Mortality What is the effect of intraoperative handover of anesthesia care on clinical outcomes? This was discussed in a very interesting session at Euroanaesthesia Congress this week. Prof Melanie Meersch-Dini of University Hospital Münster, Germany, reviewed the findings from the HandiCAP trial, published this week in JAMA.  Intraoperative handovers of anaesthesia care are quite common. While handover...

#EA22: Reducing the Carbon Footprint of Anaesthetics Dr Nicolaas Hendrik Sperna Weiland, anaesthesiologist, Amsterdam University Medical Center, The Netherlands, and founder of the centre's Sustainable Healthcare Team discussed the environmental impact of inhaled anaesthetic agents and the need to massively reduce their use at this year's Euroanaesthesia Congress.  Volatile anaesthetics are potent greenhouse gases with a global warming potential (GWP) from ...