It is a pleasure to announce the 2nd Innsbruck Hypothermia Symposium. We are very happy that Crit... more It is a pleasure to announce the 2nd Innsbruck Hypothermia Symposium. We are very happy that Critical Care has agreed to publish extended abstracts submitted by invited renowned scientists from all over the world; that is, Europe, the Americas, Asia. Neuroprotection-potentially achieved by targeted temperature management (that is, therapeutic hypothermia or prophylactic controlled normothermia)-is essential in emergency and acute care management of various severe neurologic and cardiologic diseases. Beyond neuroprotection-for this aim, therapeutic hypothermia has been established after resuscitation of patients with cardiac arrest due to a shockable arrhythmia and in neonatal asphyxic encephalopathytherapeutic hypothermia and prophylactic controlled normothermia have been published in single case reports, retrospective, open, but also in prospective randomised controlled trials in many other emergency disciplines in which both neuroprotection and protection of other organs and tissues are the target of our therapeutic endeavours. The Medical University Innsbruck, Austria, is happy to organise this conference on temperature management, therapeutic hypothermia and prophylactic normothermia respectively, to be held in Portoroz, Slovenia. In accordance with the first Meeting on Hypothermia, which was held in Miami, Florida, USA (CHilling At the Beach), we are proud to suggest the acronym CHAB standing for take Care for Heart And Brain, characterising the major target organs of therapeutic and, possibly also, prophylactic temperature management. Again, we have been able to gather most renowned scientists, neurointensivists and intensivists, emergency physicians, cardiologists and other specialists to cover the entire scientific and clinical spectrum of emergency temperature management, technical aspects of cooling and management of potential complications including shivering, but also temperature management in neurology, neurosurgery, intensive care medicine, in the operation theatre, cardiology, infectious diseases, and so forth. Beyond that we cross borders and discuss hypothermia and intracranial pressure, pharmacodynamics in hypothermic patients and the influence of hypothermia onto pharmacokinetics/pharmacodynamics, hypothermia in refractory status epilepticus or heat stroke, hypothermia and advanced neuromonitoring, hypothermia and nutrition, shivering and the critical issue of rewarming, amongst other topics. The aim of this symposium is to enhance the knowledge on temperature management, increase the readiness and stimulate the preparedness to institute therapeutic hypothermia and/or prophylactic controlled normothermia, respectively, in patients in need of tissue and organ A2 Therapeutic hypothermia: the rationale
Increasing evidence suggests that induction of mild hypothermia (32-35°C) in the fi rst hours aft... more Increasing evidence suggests that induction of mild hypothermia (32-35°C) in the fi rst hours after an ischaemic event can prevent or mitigate permanent injuries. This eff ect has been shown most clearly for postanoxic brain injury, but could also apply to other organs such as the heart and kidneys. Hypothermia has also been used as a treatment for traumatic brain injury, stroke, hepatic encephalopathy, myocardial infarction, and other indications. Hypothermia is a highly promising treatment in neurocritical care; thus, physicians caring for patients with neurological injuries, both in and outside the intensive care unit, are likely to be confronted with questions about temperature management more frequently. This Review discusses the available evidence for use of controlled hypothermia, and also deals with fever control. Besides discussing the evidence, the aim is to provide information to help guide treatments more eff ectively with regard to timing, depth, duration, and eff ective management of side-eff ects. In particular, the rate of rewarming seems to be an important factor in establishing successful use of hypothermia in the treatment of neurological injuries.
To assess and compare the structure, organisation, management, and staffing in different paediatr... more To assess and compare the structure, organisation, management, and staffing in different paediatric intensive care units (PICUs) in Europe. Descriptive study. A questionnaire was sent to physicians in PICUs. Physician's names were obtained from the membership list of the European Society of Paediatric and Neonatal Intensive Care. None. Physicians from 92 European PICUs. Responses were obtained from 92 PICUs (60% of those surveyed, 64% of hospitals with PICUs). A blank response was obtained in <2% of the questions. Considerable diversity in structure, organisation, staffing, and management in European PICUs was found. Significant differences were observed in unit size, which ranged from 2-56 (average: 8-10) beds/unit. In several--predominantly German-speaking--countries paediatric and neonatal intensive care beds are frequently combined in single units. Most European PICUs (98%) had at least part-time coverage by a paediatric intensivist; 78% had 24-h intensivist coverage. Specialized PICU nurses were present in 98% of European PICUs, and most (75%) had 24-h physician coverage by a physician with no responsibilities outside the PICU. Data obtained in our survey demonstrate the substantial structural, organisational management, and staff diversity of paediatric ICUs. Most European PICUs employ specialized PICU nurses and have at least part time coverage by paediatric intensivists.
It is a pleasure to announce the 2nd Innsbruck Hypothermia Symposium. We are very happy that Crit... more It is a pleasure to announce the 2nd Innsbruck Hypothermia Symposium. We are very happy that Critical Care has agreed to publish extended abstracts submitted by invited renowned scientists from all over the world; that is, Europe, the Americas, Asia. Neuroprotection-potentially achieved by targeted temperature management (that is, therapeutic hypothermia or prophylactic controlled normothermia)-is essential in emergency and acute care management of various severe neurologic and cardiologic diseases. Beyond neuroprotection-for this aim, therapeutic hypothermia has been established after resuscitation of patients with cardiac arrest due to a shockable arrhythmia and in neonatal asphyxic encephalopathytherapeutic hypothermia and prophylactic controlled normothermia have been published in single case reports, retrospective, open, but also in prospective randomised controlled trials in many other emergency disciplines in which both neuroprotection and protection of other organs and tissues are the target of our therapeutic endeavours. The Medical University Innsbruck, Austria, is happy to organise this conference on temperature management, therapeutic hypothermia and prophylactic normothermia respectively, to be held in Portoroz, Slovenia. In accordance with the first Meeting on Hypothermia, which was held in Miami, Florida, USA (CHilling At the Beach), we are proud to suggest the acronym CHAB standing for take Care for Heart And Brain, characterising the major target organs of therapeutic and, possibly also, prophylactic temperature management. Again, we have been able to gather most renowned scientists, neurointensivists and intensivists, emergency physicians, cardiologists and other specialists to cover the entire scientific and clinical spectrum of emergency temperature management, technical aspects of cooling and management of potential complications including shivering, but also temperature management in neurology, neurosurgery, intensive care medicine, in the operation theatre, cardiology, infectious diseases, and so forth. Beyond that we cross borders and discuss hypothermia and intracranial pressure, pharmacodynamics in hypothermic patients and the influence of hypothermia onto pharmacokinetics/pharmacodynamics, hypothermia in refractory status epilepticus or heat stroke, hypothermia and advanced neuromonitoring, hypothermia and nutrition, shivering and the critical issue of rewarming, amongst other topics. The aim of this symposium is to enhance the knowledge on temperature management, increase the readiness and stimulate the preparedness to institute therapeutic hypothermia and/or prophylactic controlled normothermia, respectively, in patients in need of tissue and organ A2 Therapeutic hypothermia: the rationale
Increasing evidence suggests that induction of mild hypothermia (32-35°C) in the fi rst hours aft... more Increasing evidence suggests that induction of mild hypothermia (32-35°C) in the fi rst hours after an ischaemic event can prevent or mitigate permanent injuries. This eff ect has been shown most clearly for postanoxic brain injury, but could also apply to other organs such as the heart and kidneys. Hypothermia has also been used as a treatment for traumatic brain injury, stroke, hepatic encephalopathy, myocardial infarction, and other indications. Hypothermia is a highly promising treatment in neurocritical care; thus, physicians caring for patients with neurological injuries, both in and outside the intensive care unit, are likely to be confronted with questions about temperature management more frequently. This Review discusses the available evidence for use of controlled hypothermia, and also deals with fever control. Besides discussing the evidence, the aim is to provide information to help guide treatments more eff ectively with regard to timing, depth, duration, and eff ective management of side-eff ects. In particular, the rate of rewarming seems to be an important factor in establishing successful use of hypothermia in the treatment of neurological injuries.
To assess and compare the structure, organisation, management, and staffing in different paediatr... more To assess and compare the structure, organisation, management, and staffing in different paediatric intensive care units (PICUs) in Europe. Descriptive study. A questionnaire was sent to physicians in PICUs. Physician's names were obtained from the membership list of the European Society of Paediatric and Neonatal Intensive Care. None. Physicians from 92 European PICUs. Responses were obtained from 92 PICUs (60% of those surveyed, 64% of hospitals with PICUs). A blank response was obtained in <2% of the questions. Considerable diversity in structure, organisation, staffing, and management in European PICUs was found. Significant differences were observed in unit size, which ranged from 2-56 (average: 8-10) beds/unit. In several--predominantly German-speaking--countries paediatric and neonatal intensive care beds are frequently combined in single units. Most European PICUs (98%) had at least part-time coverage by a paediatric intensivist; 78% had 24-h intensivist coverage. Specialized PICU nurses were present in 98% of European PICUs, and most (75%) had 24-h physician coverage by a physician with no responsibilities outside the PICU. Data obtained in our survey demonstrate the substantial structural, organisational management, and staff diversity of paediatric ICUs. Most European PICUs employ specialized PICU nurses and have at least part time coverage by paediatric intensivists.
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