A simple method to estimate flow restriction for dual ventilation of dissimilar patients: The BathRC model.

Background: With large numbers of COVID-19 patients requiring mechanical ventilation and ventilators possibly being in short supply, in extremis two patients may have to share one ventilator. Careful matching of patient ventilation requirements is necessary. However, good matching is difficult to achieve as lung characteristics can have a wide range and may vary over time.

Therapeutic hypothermia after cardiac arrest in a 66-year-old man.

Hypoxic-ischaemic brain injury is an important cause of morbidity and mortality following both in- and out-of-hospital cardiac arrest. Despite significant advances in critical care the only intervention proven to increase survival rates after cardiac arrest is mild hypothermia. The authors present a case describing the use of therapeutic hypothermia after ventricular fibrillation cardiac arrest, including its indications and contra-indications, and the techniques that can be used to induce it.

How to weigh the current evidence for clinical practice.

This article presents a template for judging trials of tight glucose control in critically ill patients. It reviews threats to both internal validity and generalisability using examples from the current literature. When judging internal validity, it is important to consider factors specific to trials of glucose control (particularly the methods of glucose control, measurement and reporting) in addition to factors common to all randomised controlled trials (such as treatment allocation, losses to follow-up and protocol violations).

Introducing intensive insulin therapy: the nursing perspective.

Intensive insulin therapy (IIT) for the management of high blood glucose can reduce mortality and morbidity in the critically ill. However, there is little published literature on how to implement it successfully. The aim of this study is to chronicle the development and difficulties encountered in implementing an IIT protocol in a critical care unit in a district general hospital.

Does hyperglycaemia precede the clinical onset of myocardial ischaemia?

Stress hyperglycaemia has been observed previously in a large proportion of patients with acute myocardial infarction. We report a patient who presented to our intensive care unit (ICU) on two occasions with acute hyperglycaemia preceding new onset myocardial ischaemia by several hours.

Epidemiology of severe sepsis occurring in the first 24 hrs in intensive care units in England, Wales, and Northern Ireland.

Objective: To investigate the numbers, clinical characteristics, resource use, and outcomes of admissions who met precise clinical and physiologic criteria for severe sepsis (as defined in the PROWESS trial) in the first 24 hrs in the intensive care unit.

Design: Observational cohort study, with retrospective analysis of prospectively collected data.

Setting: Ninety-one adult general intensive care units in England, Wales, and Northern Ireland between 1995 and 2000.