Intensive and Critical Care Medicine: Reflections, Recommendations and Perspectives

241 Pages·2005·2.211 MB·English

by  M. Fisher (auth.), Antonino Gullo, Philip D. Lumb (eds.)

A.Gullo • P.D.Lumb (Eds.)
Intensive and Critical Care Medicine
Reflections,Recommendations and Perspectives
A.Gullo • P.D.Lumb (Eds.)
Intensive and Critical
Care Medicine
Reflections,Recommendations
and Perspectives
1 3
ANTONINOGULLO PHILIPD.LUMB
Department ofPerioperative Medicine Department ofAnaesthesiology
Intensive Care and Emergency Keck School ofMedicine at USC
Trieste University School ofMedicine Los Angeles,CA
Trieste,Italy U.S.A.
Library ofCongress Control Number:2005928163
ISBN 88-470-0349-0 Springer Milan Berlin Heidelberg New York
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Ten Steps to the Top
After the Sydney meeting held in 2001,the World Federation of Societies of
Intensive and Critical Care Medicine (WFSICCM) reinforced its multidiscipli-
nary and multi-professional identity.
WFSICCM President Philip D.Lumb from the Keck School of Medicine of the
University of Southern California in Los Angeles has, together with the
Federation Council,envisaged a new strategy to obtain a more-visible target for
its mission.
In the last four years,several goals have been accomplished and the WFSICCM is
now well-positioned to succeed in its global mission.
– First,the functions of the Secretariat and Headquarters have been relocated to
the United Kingdom.Ms Liz Taylor has been appointed the Council’s Executive
Assistant,which represents a significant step towards ensuring the organisation’s
administrative integrity.Clearly,this is a winning decision;
– Second,the WF web-site has improved global communications and become a
useful tool for effective online decision-making;
– Third,Pathfinder UK has helped to develop a strong marketing plan and to cre-
ate a more-visible and proactive presence in the international Critical Care com-
munity;
– Fourth,the President has reached all corners of the world,communicating
enthusiasm and revealing leadership excellence;
– Fifth,the Pan American and Iberian Federation of Societies of Intensive and
Critical Care Medicine has reinforced its relationship with the World Federation;
the memorable 2003 congress held in Cancun,Mexico,has represented a key-
stone in the growing process ofthe WF;
– Sixth, Trieste, Italy, has for three times hosted the WF during APICE, the
International Congress endorsed by the WF;
– Seventh,Durban,South Africa,has represented an important phase in the
expansion process of the WF; an important debate for understanding possible
assistance for countries with limited resources has taken place there;
– Eighth,the Council has encouraged new contacts;the dream ofestablishing the
Mediterranean School of Intensive and Critical Care Medicine is coming true.
VI Ten Steps to the Top
Furthermore,Russia and China represent a new target for the WF Council,with
scientific contacts and expectations becoming increasingly promising;
– Ninth,last April,in Santos,the WF Council considered the future scenario of
the WF after the forthcoming 9thWorld Congress to be held in Buenos Aires;in
the meantime,the capital of tango and the South American atmosphere will be
an ideal environment for continuing our dreams;
– Tenth,Education and Standards of Care are the pillars of the WFSICCM; the
present book is a celebration of the WF Council’s quadrennial activity and sets
out the reflections and perspectives that are necessary for offering care to the
highest standards to critically ill patients.We hope we all agree to think about
this.
Buenos Aires Antonino Gullo
August 27,2005 Philip D.Lumb
Table of Contents
Introduction:World Federation 1993-1997
M.Fisher . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Consent and Intensive Care:Is It Possible?
L.Berggren . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Hepatorenal Syndrome
J.Besso,C.Pru,J.Padron,J.Plaz . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
HIV/AIDS in Developing Countries
S.Bhagwanjee . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27
Do Not Attempt Resuscitation Order
F.J.de Latorre . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35
Molecular Biology in Critical Care:Is It More Than a Look Only?
G.Domínguez-Cherit,J.Gutiérrez,E.Rivero . . . . . . . . . . . . . . . . . . . . . . . . . . 45
Resource Management and Audits in Intensive Care Medicine
A.O.Gallesio . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55
Sepsis and Organ(s) Dysfunction – Key Points,Reflections,and Perspectives
A.Gullo,F.Iscra,F.Rubulotta . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 71
How to Evaluate Performance of Adult Intensive Care Units:A 30Year Experience
J.R.Le Gall,E.Azoulay . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 97
Research Ethics in Critical Care Medicine
P.D.Lumb . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 105
Scoring System and Outcome
R.Moreno,P.Metnitz . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 117
VIII Table of Contents
Clinical Decision Making for Non-Invasive Ventilation
S.Prayag,A.Jahagirdar . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 137
Control of Infections in Intensive Care Units
J.Takezawa . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 157
Diagnosis of Pulmonary Embolism
R.G.G.Terzi,M.Mello Moreira . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 167
Critical Care Nursing,a WorldWide Perspective
G.Williams . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 183
Cost of Care in Critical Illness
T.A.Williams,G.J.Dobbs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 193
Gallery 2002 – 2005 (After Affiliation of APICE to WFSICCM) . . . . . . . . . . . . . . . . . . . . . 215
Subject Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 229
List of Contributors
Azoulay E. Dominguez-Cherit G.
Intensive Care Unit, Department ofCritical Care Medicine,
Hôpital Saint Louis, National Institute ofMedical Sciences
Paris (France) and Nutrition ‘Salvador Zubiran’,
Mexico City (Mexico)
Berggren L.
Department ofAnaesthesiology, Fisher M.
Örebro Medical Centre Hospital, Intensive Care Unit,Royal North Shore
Örebro (Sweden) Hospital,St.Leonards (Australia)
Besso J. Gallesio A.O.
Department ofIntensive Care, Unidad de Terapia Intensiva Adulta,
Hospital Centro Medico de Caracas Hospital Italiano,Buenos Aires
(Venezuela) (Argentina)
Bhagwanjee S. Gullo A.
Department ofAnaesthesiology, Department ofPerioperative
University ofWithwatersrand, Medicine,Intensive Care and
Johannesburg Hospital,Johannesburg Emergency,School ofAnaesthesia and
(South Africa) Intensive Care,Trieste University
Medical School,Trieste (Italy)
de Latorre F.J.
Servei de Medicina Intensiva,Hospital Gutierrez J.
Universitari Vall d’Hebron,Barcelona Department ofCritical Care Medicine,
(Spain) National Institute ofMedical Sciences
and Nutrition ‘Salvador Zubiran’,
Dobb G.J. Mexico City (Mexico)
Intensive Care Unit,Royal Perth
Hospital and School ofMedicine and Iscra F.
Pharmacology,University ofWestern Department ofPerioperative
Australia,Perth (Australia) Medicine,Intensive Care and
Emergency,School ofAnaesthesia and
X List of Contributors
Intensive Care,Trieste University Prayag S.
Medical School,Trieste (Italy) Shree Medical Foundation,Prayag
Hospital,Pune (India)
Jahagirdar A.
Shree Medical Foundation,Prayag Pru C.
Hospital,Pune (India) Department ofIntensive Care,Hospital
Centro Medico de Caracas (Venezuela)
Le Gall J.R.
Intensive Care Unit,Hôpital Saint Rivero E.
Louis,Paris (France) Department ofCritical Care Medicine,
National Institute ofMedical Sciences
Lumb P.D. and Nutrition ‘Salvador Zubiran’,
Department ofAnaesthesiology,Keck Mexico City (Mexico)
School ofMedicine,University of
Southern California,Los Angeles Rubulotta F.
(USA) Department ofIntensive Care,
University Hospital,Leuven (Belgium)
Mello Moreira M.
Department ofSurgery,Faculdade de Takezawa J.
Ciências Médicas,Universidade Department ofEmergency and
Estadual de Campinas UNICAMP, Intensive Care Medicine,Nagoya
Campinas,São Paulo (Brazil) University School ofMedicine,Nagoya
(Japan)
Metnitz P.
Department ofAnaesthesiology and Terzi R.
Intensive Care Medicine,Medical Department ofSurgery,Faculdade de
University ofVienna,Vienna (Austria) Ciências Médicas,Universidade
Estadual de Campinas UNICAMP,
Moreno R. Campinas,São Paulo (Brazil)
Unidade de Cuidados Intensivos
Polivalente,Hospital de Santo António Williams G.
dos Capuchos,Centro Hospitalar de Direction ofNursing,Maroondah
Lisboa,Lisbon (Portugal) Hospital,Victoria (Australia)
Padron J. Williams T.A.
Department ofIntensive Care,Hospital Intensive Care Unit,Royal Perth
Centro Medico de Caracas (Venezuela) Hospital and School ofMedicine and
Pharmacology,University ofWestern
Plaz J. Australia,Perth (Australia)
Department ofIntensive Care,Hospital
Centro Medico de Caracas (Venezuela)