Current opinion in critical care
-
Curr Opin Crit Care · Dec 2007
ReviewHow safe is my intensive care unit? An overview of error causation and prevention.
To link generic research on patient safety and the reliability of care to the specific context of the critically ill patient and the environment of the intensive care unit. ⋯ Patient safety initiatives, clinical care and medical education need to be better integrated to follow the continuum of the acutely ill patient's journey through the hospital system. Key elements include improving the reliability and standardization of processes of care, reducing unnecessary variation and complexity, and encouraging teamworking.
-
The early detection of acute kidney injury may allow for timely preventive or therapeutic measures. This review discusses the role of traditional and novel biomarkers in early acute kidney injury diagnosis. ⋯ The early detection of acute kidney injury is a clinical and research priority. Traditional measures may contribute to delayed acute kidney injury diagnosis. Recent biomarkers have promise for earlier detection and for research into novel interventions.
-
Curr Opin Crit Care · Oct 2007
ReviewBiomarkers to improve diagnostic and prognostic accuracy in systemic infections.
We review the advantages and drawbacks of biomarkers in the diagnostic and prognostic assessment of systemic infections. ⋯ If used in the proper setting, serial measurements of diagnostic biomarkers may allow treatments to be adjusted at an early stage in patients with severe infections. This may involve either intensifying treatment when infection levels stay high or avoiding unnecessary prolonged courses of antibiotics when levels rapidly decrease, thereby improving the allocation of healthcare resources.
-
Curr Opin Crit Care · Oct 2007
ReviewPatient and caregiver counselling after the intensive care unit: what are the needs and how should they be met?
To examine current research on the psychological needs of both patients and their families following critical illness, and discuss how these may be met in a cost-effective manner. ⋯ Currently, there is an awareness of the psychological sequelae of critical illness for patients and their family caregivers, and with this a responsibility to assess and appropriately help those who are unable to manage their distress. The development and application of specialist psychological services after an episode of critical illness, possibly using a stepped care model, is in its infancy. There are a few centres of excellence that are currently employing these resources, but the vast majority of patients and their families are left to cope on their own. This lack of psychological support has important implications for long-term recovery and quality of life following the episode of critical illness.