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Controversies in Intensive Care Medicine

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Ralf Kuhlen(Hg.), Rui P. Moreno(Hg.), Marco Ranieri(Hg.), Andrew Rhodes(Hg.), Controversies in Intensive Care Medicine (2008), Medizinisch Wissenschaftliche Verlagsgesellschaft, Berlin, ISBN: 9783954661916

Getrackt seit 05/2018


Beschreibung / Abstract

In recent years, many clinical interventions in intensive care medicine have been based on clear scientific evidence. However, at least as many clinical interventions still remain the subject of controversy, either due to a lack of rigorous data or due to the existence of conflicting data. In this book, these controversies are discussed by experts of international renown in their respective fields. The goal is twofold: To provide us with a balanced and unbiased presentation of the subject, explaining the different ‘schools of thought’ relevant to the controversy; To summarise the data with a clinically useful and valid recommendation for our practice. Virtually all fields of intensive care medicine are covered in more than 50 chapters dealing with controversies over treatment options in acute illness states, organising and providing care for acutely ill patients, as well as how to answer ethical questions arising in critical care medicine every day.


with contributions from: MG Abate, L Abrahão Hajjar, S Afonso, F Álvarez-Lerma, P Amado, PJD Andrews, D Annane, D De Backer, J Bakker, O Barbosa da Silva, G Bellingan, K Bendjelid, A Biasi Cavalcanti, L Blanch, SI Blot, M Borelli, J Brokmann, C Bruel, C Brun-Buisson, J Carlet, J Chastre, BP Cholley, G Citerio, G Colin, A Combes, RC Costa Filho, C Cozowicz, BH Cuthbertson, D Crippen, J Cruz, R Dembinski, P Devos, J-M Domínguez-Roldán, G Ferreyra, S Finfer, H Flaatten, MJ Garcia Monge, E Gayat, T Geeraerts, FRB Gomes Galas, RD Griffiths, ABJ Groeneveld, O Grottke, O Hamzaoui, GT Henriques Filho, M Hiesmayr, M Imhoff, TC Jansen, AL Jardim, M Jonas, C Jones, JA Kellum, R Kitzberger, E Knobel, M Knobel, L Kramer, K Kranzer, S Kreyer, R Kuhlen, M Leone, A Liolios, T Lisboa, B Lortat Jacob, U Lucangelo, C-E Luyt, MR Macleod, R Maio, C Martin, FO Martins, V Maxime, A Mebazaa, DK Menon, TM Merz, B Misset, I Morales, RP Moreno, T Muders, AP Neves, P Olaechea, G Ospina-Tascon, HM Oudemans-van Straaten, M Palomar, AE Pesaro, F Philippart, J Poelaert, KH Polderman, LF Poli-de-Figueiredo, J-C Preiser, RJ Price, C Putensen, VM Ranieri, J Rello, A Rhodes, JL da Rocha Paranhos, A Rodriguez, J-A Romand, R Rossaint, HU Rothen, D Schmidlin, K Singbartl, JMA Sousa, CL Sprung, M Tavares, JF Teixeira, J-L Trouillet, RJ Trof, V Umbrain, A Valentin, DM Vandijck, J-L Vincent, C Waldmann, J Wernerman, J Woods, H Wrigge


  • Cover
  • Titel
  • Editors
  • Preface
  • Content
  • A. Acute respiratory failure
  • Noninvasive ventilation in hypoxemic respiratory insufficiency
  • Weaning: Protocols vs. clinically driven
  • Pressure-volume curves: Useful in clinical practice
  • Replacing or restricting fluids: Timing, dosing and choosing the type of fluid in patients with or at risk for ALI/ARDS
  • Spontaneous versus mechanical ventilation
  • The role of tracheostomy in ventilatory care
  • B. Acute circulatory failure
  • Controversies in cardiac output monitoring
  • Crystalloids versus colloids versus albumin: Where do we stand?
  • ScvO₂ as a marker for resuscitation in intensive care
  • Calcium sensitisers versus dobutamine in acute heart failure
  • Macro vs. micro targets for haemodynamic support
  • Right heart failure determines outcome
  • Do we really need SPV/PPV to detect low filling status?
  • Vasopressors in the patient with shock
  • Controversies in coronary care
  • C. Acute kidney injury
  • Renal replacement therapies: When, how, and how much?
  • Anticoagulation for renal replacement therapy: Heparin or citrate
  • D. Sepsis and infection
  • Diagnosis of Ventilator-associated Pneumonia
  • Antibiotic combination vs. monotherapy in critically ill patients with pneumonia
  • Do antibiotic protocols impact on resistance?
  • The activated protein C controversy
  • Corticosteroids in septic shock
  • Controversies in goal-directed therapy: Venous saturations and lactate
  • Starting and stopping antibiotic therapy
  • MRSA control
  • E. Neuro-intensive care
  • Does ICP monitoring improve outcome after traumatic brain injury?
  • What care should be provided for poor grade subarachnoid haemorrhage patients?
  • Induced hypothermia to treat neurological injuries
  • Can we increase/lengthen the time window from 3–6 hours for thrombolysis after stroke?
  • Neuroprotective ventilation
  • F. Acute bleeding
  • Monitoring the coagulation
  • Management of refractory bleeding
  • G. Organisational issues
  • Optimisation of patient process and workflow
  • Reducing the number of adverse events in intensive care units
  • Early discharge from the ICU is safe
  • Implementation of surveillance networks
  • Should hospitals have a medical emergency team?
  • E-learning
  • High acuity nurse patient ratio – is it cost-effective?
  • The role of specialist (neurological critical care) units
  • Building and using outcome prediction models: Should we be lumpers or splitters?
  • Specialty of intensive care: Primary specialty vs. supraspecialty
  • H. Surgical intensive care and trauma
  • Fast track after cardiac surgery
  • Fluid: Replace or restrict?
  • Bedside surgery in the ICU
  • I. Adjunctive issues
  • Technology assessment and procurement: ‘Monitoring the monitor’
  • Controversies in intensive care sedation: Continuous infusions in awake patients and end-of-life sedation
  • Tight glucose control: Should we target normoglycemia or an intermediate level?
  • Goals for nutrition support in the ICU
  • Pain and stress in the ICU: All in the mind?
  • Controversies on donation after cardiac death
  • Is there a role for extracorporeal support in hepatic failure?

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