Citation Strom T, Martinussen T, Toft P: A protocol of no sedation for critically ill patients receiving mechanical ventilation: a randomized trial.

Physiologic alterations in critically ill patients can significantly affect the pharmacokinetics of drugs used in the critically ill patient population. Understanding these pharmacokinetic changes is essential relative to optimizing drug therapy. This article outlines the major differences seen in the absorption, distribution, metabolism, and excretion of drugs in critically ill patients. Impor...

Communication failures are a significant contributor to medical errors that harm patients. Critical care delivery is a complex system of inter-professional work that is distributed across time, space, and multiple disciplines. Because health-care education and delivery remain siloed by profession, we lack a shared framework within which we discuss and subsequently optimize patient care. Further...

This short review will address the potential uses for quantitative analyses of organ function in the critically ill patient. Multiple system failure is common in the critical-care unit, and the ability to measure reserves of organ function may enable earlier detection and treatment of this problem and provide a more accurate prognosis for such patients.

Delirium is a relevant condition in critically ill patients with long-term impacts on mortality, cognitive and functional status and quality of life. Despite the progress in its diagnosis, prevention and management during the last years, its impact persists being relevant, so new preventive and therapeutic strategies need to be explored. Among non-pharmacologic preventive strategies, recent rep...

Nurses caring for patients with acute stroke are likely to administer both music and medication with therapeutic intent. The administration of medication is based on accumulated scientific evidence and tailored to the needs of each patient. However, the therapeutic use of music is generally based on good intentions and anecdotal evidence. This review summarizes and examines the current literatu...

Background: Hand hygiene plays a key role in the prevention of healthcare-associated infection in critical patients. Objective: The current study aimed to evaluate compliance with hand hygiene practices. Methods: An observational and descriptive study was carried out in a 35-bed medical-surgical critical care unit in La Habana (Cuba...

The report by Chase and coworkers in the previous issue of Critical Care describes the implementation into clinical practice of the Specialized Relative Insulin Nutrition Table (SPRINT) for tight glycaemic control in critically ill patients. SPRINT is a simple, wheel-based system that modulates both insulin rate and nutritional inputs. It achieved a better glycaemic control in a severely ill cr...

Some of our colleagues believe that everything should be tested in prospective, randomized clinical trials. Some of our colleagues also believe that so-called pragmatic trials can help improve the care of critically ill patients. The designs of such studies are based on the postulate that patients are all the same and will be globally either improved or harmed by one strategy compared with anot...