ICU

Invitation to participate in the ICU Hypotension Survey

Ecccp@scribe Critical care , ,

Invitation to participate in the ICU Hypotension Survey

Hello member society

The WFICC Council recently approved a request for in-principle support for an ICU Hypotension Survey. This is an International Survey conducted among Physicians and Nurses regarding Used Definitions, Incidence, Current Treatment Strategies and Perceived Outcome of Hypotension in Intensive Care Patients.

The lack of consensus regarding an universal definition of hypotension for ICU patients and the need of being proactive rather than reactive towards hypotensive episodes formed a trigger to develop an international survey to map used definitions, treatment and outcome of hypotensive episodes in the ICU among physicians and non-physicians. The aim of this survey is to form a baseline on these topics. Besides, the results of the survey are expected to improve future guidelines, patient care and guide new topics for research. This survey is endorsed by the Executive Committee and the Cardiovascular Dynamics Section of the European Society of Intensive Care Medicine and is supported by the World Federation of Intensive and Critical care.

Please encourage your members to participate

If you are an ICU based physician or non-physician, the WFICC is supporting  a request for your participation. This anonymized survey will take 10 to 15 minutes to complete. Please respond from the perspective of standard practice in your ICU.

Complete the survey here: https://nl.surveymonkey.com/r/3CJCJV9

If you have any questions about the survey, please contact: w.h.vanderven@amsterdamumc.nl

On behalf of the WFICC Council, thank you very much for assisting with the dissemination of the survey and for encouraging the contribution of your members.

Kind regards and best wishes,

Phil Taylor

Chief Executive Officer – WFICC

Web: www.wficc.com

Extracorporeal liver support devices in the ICU.

Ecccp@scribe Critical care, Newsletter , ,

Key points in Critical Care Medicine

Extracorporeal liver support devices in the ICU.

 “Adapted from Oxford Textbook of Critical Care”

  • There is an unmet need for a liver support system because of the increasing shortage of organs for transplantation and the complications associated with the procedure.
  • In theory, acute liver failure and acute decompensation of chronic liver disease secondary to a precipitating event are potentially reversible. In this context, an extracorporeal liver support can temporarily substitute liver functionality to allow natural recovery through regeneration of hepatocytes and elimination of the precipitating event.
  • Goals of liver support system are to provide all functions of the liver, including synthetic and metabolic functions, and to remove as well as reduce the production of pro-inflammatory mediators to attenuate the inflammatory process.
  • Currently existing devices are either purely mechanical and/or cell-based. Detoxification is provided by both systems, but biological activities are limited only to the cell- based systems. Albumin dialysis is the major component of mechanical devices because albumin is irreversibly destroyed in liver failure.
  • Cell-based or bio-artificial systems are essentially ‘mini-livers’, but their success is limited by the lack of a continuous and abundant supply of high-quality hepatocytes.

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Managing ICU Staff Welfare, Morale, and Burnout

Ecccp@scribe Critical care, Newsletter ,

Key points in Critical Care Medicine:

Managing ICU staff Welfare, Morale, and Burnout

 “Adapted from Oxford Textbook of Critical Care-Oxford University Press 2016”

  • The intensive care unit (ICU) environment exposes staff to stressful and emotionally-demanding situations, which places them at high risk for burnout.
  • Risk factors for Burnout can be found at both individual and organization levels.
  • Consequences of low morale and burnout include personal distress for clinicians, poor quality of care for patients, and highly health care costs for organizations and society.
  • Staff engagement is emerging as the antithesis of burnout.
  • We need to promote a wider recognition among ICU staff regrading risks of burnout and the consequences for both them and the patients in their care.

Potential phases of Burnout

  • The need to prove oneself: often occurring in highly motivated and ambitious individuals.
  • Working harder: high personal expectations emerge as further work commitments are undertaken.
  • Neglecting personal needs: no time or energy is reserved for activities or relationships outside the workplace.
  • Displacement of conflict: The individual is unable to identify the cause for their difficulties.
  • Revision of values: isolation from family and friends with a solely job- related value system.
  • Denial: cynicism, aggression, and intolerance of others emerge, leading to isolation.
  • Behavioral changes become more apparent to others: e.g conflict.
  • Depersonalization: loss of appreciation for self and self- worth. Cannot appreciate further success.
  • Inner emptiness: may seek an activity to full the void such as eating, drugs, etc.
  • Depression: typical affective, cognitive and somatic features are present.

Burnout ensues: complete physical and emotional collapse.

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