Despite improvements in communication, errors in end-of-life care continue to be made. For example, healthcare professionals may take direction from the wrong substitute decision-maker, or from family members when the patient is capable; permit families to propose treatment plans; conflate values and beliefs with prior expressed wishes or fail to inquire about prior expressed wishes. Sometimes ...

Analysis of Chinese ICU staffing in relation to final outcome yields comparable results as those reported in Western ICUs. This underlines the general principle that we would all like to apply in our hospitals; that is, availability of knowledgeable staff that are adequately trained to recognize and treat an acutely deteriorating critically ill patient as soon as possible.

handover is not a unilateral transfer of information and that when poorly conducted it can degrade quality of care [1]. A key feature of handover required by clinicians is the big picture, which shapes the viewpoint of the receiving party [1]. Frequently this is obscured in critically ill patients by a surfeit of physiological variables or results, and this ‘noise’ denigrates the handover proce...

Investigators continue to debate whether gender plays any role in patient outcome following injury/critical illness. We submit that age and hormonal milieu at the time of injury, rather than gender, are the critical factors influencing patient outcome under those conditions.

The re-emergence of infection due to multidrug-resistant Gram-negative bacteria in critically ill patients presents particular challenges to clinicians, given the lack of a pipeline of new antibiotics active against these resistant strains. Infected patients have a worse outcome than non-infected patients, although the additional contribution of antimicrobial resistance is less easy to define. ...

The primary concern of physicians caring for children must be the best interests of the individual child. All infants and children have intrinsic value and deserve our respect and protection. This is true whether or not they are handicapped or have the potential to be handicapped and regardless of whether this handicap is physical or mental. This means that all children, regardless of handicap ...

Since the development of intensive insulin therapy for the critically ill adult, tight glycemic control (TGC) has become increasingly complicated to apply and achieve. Software-guided (SG) algorithms for insulin dosing represent a new method to achieve euglycemia in critical illness. We provide an overview of the state of SG TGC with an eye to the future. The current milieu is disorganized, wit...