Critical Care Series

Levosimendan use in critical care - a case series

Introduction Levosimendan is a calcium sensitiser that enhances myocardial contractility without increasing myocardial oxygen consumption or adversely affecting diastolic function. Whilst theoretically attractive, lack of outcome data in critically ill patients means that it is not yet established in intensive care practice. We have been using levosimendan on our Intensive Care Unit (ICU) for m...

Critical Care Neurology and Neuro Critical Care

CRITICAL CARE/RESPIRATORY CARE Corticosteroid Replacement in Critical Illness

Intensivists routinely administer glucocorticoids, which are potent anti-inflammatory, immune, metabolic, and adrenergic modulating compounds at physiologic and pharmacologic doses. Recent investigations report increasing recognition of relative or absolute adrenal insufficiency in critically ill patients and the impact of cortisol responsiveness as a predictor of outcome for the critically ill...

Clinical review: Critical care transport and austere critical care

The development of modern intensive care units (ICUs) has allowed the survival of patients with advanced illness and injury, although at a cost of substantial infrastructure. Natural disasters and military operations are two common situations that can create critically ill patients in an environment that is austere or has been rendered austere. This has driven the development of two related str...

The pulmonary physician in critical care: towards comprehensive critical care?

This overview of intensive care medicine in Europe and the United States is an introduction to the review series on "The pulmonary physician in critical care" which starts in this issue of Thorax.