Critical care clinics
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Critical care clinics · Jul 2006
ReviewGlobal distribution of infectious diseases requiring intensive care.
This article describes infectious diseases that are of special importance to intensivists. The emphasis on epidemiology notwithstanding, it also addresses clinical, diagnostic, and treatment issues related to each infection described. The discussion avoids terrorism-related aspects of these infections, because they were very well covered in the October 2005 issue of the Critical Care Clinics.
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Critical care clinics · Jul 2006
ReviewA global view of education and training in critical care medicine.
The Educational Committee of the World Federation of Societies of Intensive and Critical Care Medicine (WFSICCM) performed a survey in various countries and reviewed data from the Cobatrice study and from surveys of the Pan-American and Iberic Federation of Societies of Intensive and Critical Care Medicine to characterize current structures and processes in education in intensive care medicine to determine the potential for convergence to a common competency-based training program, and to a common competency certification in most countries around the world, guided by the local scientific societies and the WFSICCM. Training in critical care medicine sponsored by the WFSICCM should provide a competency approach that permits diversity of training methods while creating a common outcome: doctors with a universal set of knowledge, skills, and attitudes essential for a specialist in intensive care medicine.
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The understanding of the pathogenesis of sepsis has substantially changed in past years and continues to improve. New therapeutic options are being developed and incorporated into clinical practice. ⋯ The recognition of severe sepsis should be accompanied without delay by very well defined therapeutic measures. In 2002 the Surviving Sepsis Campaign was introduced with the overall goal of increasing clinicians' awareness and improving outcome in severe sepsis and septic shock.
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This article provides an up-to-date account of intensive care in Australia and New Zealand. Overall, intensive care medicine in Australia and New Zealand is in a healthy state. ⋯ The ICU is recognized as an expensive and limited resource. Overall, intensivists in these two countries have good control of it and have learned to use it wisely.
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Critical care clinics · Jul 2006
ReviewManagement of severe sepsis and septic shock: challenges and recommendations.
Sepsis and related aspects has become an area of active and intense research, leading to important advances for an early diagnosis and appropriate management useful to improve patient outcome. The septic response is an extremely complex cascade of events, including proinflammatory, anti-inflammatory, humoral, cellular, and circulatory involvement. The pathophysiology of this syndrome, its various and changing clinical aspects, and the vast variety of therapeutic options available, not always of well-proved efficacy, make its management a goal difficult to achieve.