ICU Management & Practice, Volume 22 - Issue 3, 2022 Pain Management Specificities in Critically Ill Patients With Obesity In patients with obesity, standard, non-weight-based dosing, or weight-based dosing using either ideal body weight or adjusted body weight, is appropriate to limit the risk of overdosing. The prevalence of obesity is increasing worldwide (Schetz et al. 2019). This trend is confirmed in the Intensive Care Unit (ICU) where patients wit...

ICU Management & Practice, Volume 22 - Issue 3, 2022 Delirium: How Can We Protect Our Patients? Detection and Treatment Strategies In this article, the authors aim to summarise the current management of delirium, emphasising new publications and possible new studies that will shed light on delirium management strategy. Introduction According to an updated nomenclature of delirium after an interdisciplinary panel of experts from ten medical societies (...

ICU Management & Practice, Volume 22 - Issue 3, 2022 Practical Implementation of the Pancreatic Stone Protein Sepsis Test An overview of a discussion on sepsis and the Pancreatic Stone Protein (PSP) biomarker by Dr João Pereira, Hospital De Vila Franca De Xira, Portugal and how it can be used for early diagnosis of sepsis and facilitate decision-making regarding the administration of antibiotics. The discussion was chaired by Prof Pedro Póvoa, coordinator o...

ICU Management & Practice, Volume 22 - Issue 3, 2022 Sedation, Analgesia and Respiratory Drive in Mechanically Ventilated Adults An overview of the cardiovascular and respiratory effects of sedative agents commonly used in the ICU, emerging concepts of mechanical ventilation induced injury to the respiratory muscles and evolving concepts for sedation monitoring and sedation minimisation to achieve the goal of expeditious liberation from mechanical ventilati...

ICU Management & Practice, Volume 22 - Issue 3, 2022 Nutrition Monitoring and Patient Data Management Systems An overview of nutritional targets and their impact on critically ill patients and the need to use a systematic approach to nutritional support for optimal patient outcomes. Critically ill patients are often hypermetabolic and catabolic and are at a higher risk of underfeeding. Nutritional support for these patients can prevent energy deficits an...

ICU Management & Practice, Volume 22 - Issue 3, 2022 Pain Assessment in Critical Illness This narrative paper reports the practical assessment of pain in critically ill (ICU) patients, based on current evidence and guidelines. Introduction Pain is one of the top stressful symptoms experienced by critically ill patients hospitalised in intensive care units (ICU) (Chanques et al. 2015). This is because critical pathologies are often severely painful (i....

Clinical, Organisational Factors and COVID-19 Mortality Coronavirus disease 2019 (COVID-19) is one of the most significant challenges faced by critical care workers worldwide. During the COVID-19 pandemic, an unprecedented number of patients with COVID-19 associated pneumonia were admitted to the ICU. As a result, most healthcare facilities faced capacity issues and had to designate clinical areas to accommodate these patients and provide them with the necessary cr...

Nurse Staffing and Mortality Risk of Sepsis Sepsis is one of the most challenging complications in the ICU. It is a physiologic response to infection that could lead to multiorgan failure and death if not managed and treated properly. Sepsis is a major health issue in the U.S., with more than 1.7 million cases diagnosed annually. Sepsis is also a leading cause of death and one of the most expensive conditions treated by hospitals.  The treatment of sepsis h...

Editorials Politics and mortality in the United States Steven Woolf BMJ 2022; 377 doi: https://doi.org/10.1136/bmj.o1308 (Published 07 June 2022)Cite this as: BMJ 2022;377:o1308 Mounting evidence suggests a link between republican politics and higher death rates For decades, people in the US have experienced lower life expectancy and poorer health outcomes than populations in other high income countries, and the problem has worsened over time.1 This pe...

ICU Management & Practice, Volume 22 - Issue 1, 2022 Diagnostic and Prognostic Value of Estimated Plasma Volume Status An overview of estimated plasma volume (ePVS), recent evidence supporting the association of ePVS with clinical congestion and whether it can help improve outcomes in patients with heart failure (HF). Plasma volume (PV) is the level of intravascular fluid minus the red blood cells, white blood cells and platelets. PV in heart failure (HF...