Respiratory Support in Critical Care

Dr. Ilkka Kalli, MD, PhD, MBA Editor-in-chief, Clinical Window Web Journal See the editor-in-chief working and his Curriculum Vitae

Clinical Window Web Journal – a new topic and a new visual image

After three successful years and 12 published issues, I feel privileged to invite you come and see our renovated appearance, which is a practical example of Clinical Window’s future vision. The new style, newspaper-like if you wish, reflects our timely approach to developments in healthcare technology. We will keep our principal focus on clinical education and technology, thanks to the positive feedback we have received. In addition, we will continue our proactive search for interesting topics. We also plan on continuing to increase our visual content (pictures, slide presentations, multimedia) in future publications.

In this issue, we start a new human-interest series to illustrate historical milestones in medicine. Our first stepping stones are 3000-year-old pictures with short legends, suggesting how pharmacology had its early start. More such pictures will be added to forthcoming issues, and we will gradually be moving towards more modern times.

Our current clinical topic is Respiratory Support in Critical Care. I am sure that it touches most critical care patients and caregivers in some way or another. Incidentally, all four of our authors have a clinical education background. Please note that there is a new area in the upper right corner of the web journal: Podium presentations. Three of our authors were in Brussels in March 2003, giving their Clinical Window presentation at the 23rd ISICEM Congress. With their kind permission, we have ppt presentation slides available for our readers.

In his comprehensive review, Dr. Matthias Leist (University Hospital Göttingen, Germany) suggests a practical approach to Indications of non-invasive ventilation in intensive care. The intensivist often may have an invasive orientation in daily work. Hence, it is good to remember that non-invasive ventilation can be a treatment of choice for selected patients. That technique may facilitate weaning, or it may help to avoid intubating a COPD patient.

In the next paper, we continue with a similar subject. Chris Harris (London Health Sciences Centre, Ontario, Canada) slightly moves the clinical viewpoint, writing about Weaning with indirect calorimetry from the respiratory therapy perspective. The patient’s metabolic balance may surely affect weaning from the ventilator. This paper introduces us to metabolic monitoring, from the traditional Harris-Benedict Equation to the modern application of indirect calorimetry.

When we strive to balance respiration and metabolism of a critically ill patient, we are optimizing oxygen delivery to meet oxygen demand. Jan Headley’s (Datex-Ohmeda, Tewksbury, USA) article New Trends in Oxygen Delivery, Consumption and Debt Assessment: Global and Regional Indices, is made available with permission from the AACN continuing education test center. In Clinical Window, we publish the introductory part of the article together with a link to the full article at the AACN site for those who want to study it in detail.

One never knows what may happen in the oxygen-demanding hearth of a critically ill patient. Professor Kathy Booker (Millikin University, USA) reviews the pathophysiology of demand myocardial ischemia and the application of continuous 12 lead ECG monitoring. Remember to take a look at her presentation slides, particularly at the clinical case examples of ECG recordings.

YOUR COMMENTS ARE WELCOME!
We have synchronized appearance of this issue with the 23rd ISICEM Congress (March 2003) in Brussels. In composing this issue, we had in mind both congress participants and our international readers. I hope that you find this injection of critical care information useful. Our next issue will have anesthesiology topics, and I expect it to appear a little before the May Glasgow anesthesiology meeting.

Ilkka S. Kalli MD, PhD, MBA
Anesthesiologist, Editor-in-Chief
Clinical Window Web Journal

Contact form

Last updated: 1 March 2003Created
Legal notice	© GE Healthcare 2008 ISSN 1795-6269 (Web) ISSN 1795-6277 (CD)	Webmaster