Une application pour téléphones intelligents facilitant l’accueil au début des stages en unité de soins intensifs

Implication Statement The Department of Critical Care at Dalhousie University developed a smartphone app to improve the quality of learner orientation to the intensive care unit (ICU). The app increased satisfaction with orientation and was perceived as useful. It was ranked as the second most valued resource for orientation after other residents. There is potential to improve the experience of learners with this popular technology.Énoncé des implications de la recherche Le département des soins critiques de l'Université Dalhousie a mis au point une application pour téléphones intelligents en vue d'améliorer la qualité de l’accueil des apprenants à l'unité de soins intensifs (USI). L'application a permis d'augmenter la satisfaction par rapport à l’accueil et elle a été jugée utile. Elle a été classée la deuxième ressource d’orientation la plus appréciée après « les autres résidents ». L'expérience des apprenants peut être améliorée à l’aide de cette technologie populaire

Plaque psoriasis in children and adolescents – the role of etanercept

Federica Ricceri, Lara Tripo, Leonardo Pescitelli, Francesca PrignanoDivision of Clinical, Preventive and Oncology Dermatology, Department of Critical Care Medicine and Surgery, University of Florence, Florence, ItalyBackground: Childhood-onset psoriasis affects approximately one-third of the psoriatic population. Among many potential treatments of childhood psoriasis, biological agents are emerging as a valuable option in the management of this disease. In Europe, etanercept has recently been approved for children aged 6 years and over. Data from a well-designed clinical trial indicate that in children, etanercept effectively reduces psoriasis symptoms, with beneficial effects evident as early as 4 weeks after the onset of therapy. The treatment is generally well tolerated; mild injection site reactions are the most common adverse events reported in the literature. Published data of etanercept use in children show promising results, but further clinical studies are necessary to confirm its long-term efficacy and safety.Keywords: pediatric psoriasis, anti-TNF-α, etanercep

A study of the perceived risks, benefits and barriers to the use of SDD in adult critical care units (the SuDDICU study)

Peer reviewedPublisher PD

A pragmatic multi-centre randomised controlled trial of fluid loading and level of dependency in high-risk surgical patients undergoing major elective surgery : trial protocol

Peer reviewedPublisher PD

Clinical stakeholders' opinions on the use of selective decontamination of the digestive tract in critically ill patients in intensive care units : an international Delphi study

Peer reviewedPublisher PD

Diagnosis, evaluation, and management of acute kidney injury : a KDIGO summary (part 1)

Acute kidney injury (AKI) is a common and serious problem affecting millions and causing death and disability for many. In 2012, Kidney Disease: Improving Global Outcomes completed the first ever, international, multidisciplinary, clinical practice guideline for AKI. The guideline is based on evidence review and appraisal, and covers AKI definition, risk assessment, evaluation, prevention, and treatment. In this review we summarize key aspects of the guideline including definition and staging of AKI, as well as evaluation and nondialytic management. Contrast-induced AKI and management of renal replacement therapy will be addressed in a separate review. Treatment recommendations are based on systematic reviews of relevant trials. Appraisal of the quality of the evidence and the strength of recommendations followed the Grading of Recommendations Assessment, Development and Evaluation approach. Limitations of the evidence are discussed and a detailed rationale for each recommendation is provided

Three Cases of Shaken Baby Syndrome without a History of Shaking

Three cases of Shaken Baby Syndrome (SBS) without a history of abusive shaking have been reported.The reason why SBS without intentional shaking as follows;case 1was throwing, case 2 was dropping, case3 was unknown. For all 3 reported cases, attending physicians suspected the SBS from the presence of subduralhematoma and fundus hemorrhage. All 3 cases occurred at home, and the parents had no knowledgeof SBS. After a detailed interview, the diagnosis of SBS without a history of intentional shaking was made.Although the mechanism in detail was unclear in 3 cases, these SBS may happen by the difference betweenacceleration and the deceleration during the throwing and dropping movement;similar to intentional shakingthat causes of common SBS.For subdural hematoma and fundus hemorrhage of unknown cause, it is important to conduct an interviewwith the possibility of unintentional SBS in mind, without the occurrence of abusive shaking. In addition,attention should be paid to both pediatrician and parents about the risk of SBS in the care of infant inthe everyday life

Nomenclature for renal replacement therapy and blood purification techniques in critically ill patients: practical applications

This article reports the conclusions of the second part of a consensus expert conference on the nomenclature of renal replacement therapy (RRT) techniques currently utilized to manage acute kidney injury and other organ dysfunction syndromes in critically ill patients. A multidisciplinary approach was taken to achieve harmonization of definitions, components, techniques, and operations of the extracorporeal therapies. The article describes the RRT techniques in detail with the relevant technology, procedures, and phases of treatment and key aspects of volume management/fluid balance in critically ill patients. In addition, the article describes recent developments in other extracorporeal therapies, including therapeutic plasma exchange, multiple organ support therapy, liver support, lung support, and blood purification in sepsis. This is a consensus report on nomenclature harmonization in extracorporeal blood purification therapies, such as hemofiltration, plasma exchange, multiple organ support therapies, and blood purification in sepsis