Intensive Care Med. 2014 Nov 22
Numerous studies have identified attributes that physicians should acquire in order to be regarded as outstanding practitioners. Whereas attaining excellence, as opposed to mere competence, is desirable in all fields, achieving this higher standard assumes particular importance for intensive care medicine (ICM), where the problems confronted are complex, rapidly changing, and crucial to address in a timely fashion. What defines ‘excellence’ for critical care practice currently [...]
Lancet Respir Med. 2014 Dec 15. pii: S2213-2600(14)70205-X
BACKGROUND: Morbidity after major surgery is associated with low oxygen delivery. Haemodynamic therapy aimed at increasing oxygen delivery in an effort to reduce oxygen debt, tissue injury, and morbidity, is controversial. The most appropriate target for this strategy is unclear and might have several off-target effects, including loss of neural (parasympathetic)-mediated cellular protection. We hypothesised that individualised oxygen delivery targeted haemodynamic therapy (goal-directed therapy) [...]
Anesthesiology. 2014 Sep;121(3):563-71
BACKGROUND: Auto-positive end-expiratory pressure (auto-PEEP) may substantially increase the inspiratory effort during assisted mechanical ventilation. Purpose of this study was to assess whether the electrical activity of the diaphragm (EAdi) signal can be reliably used to estimate auto-PEEP in patients undergoing pressure support ventilation and neurally adjusted ventilatory assist (NAVA) and whether NAVA was beneficial in comparison with pressure support ventilation in patients affected by auto-PEEP.