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Critical Care Commentary

December 16, 2011
Postoperative Complications in Patients Undergoing Thoracic Surgery

Lung cancer is on the rise with the number of reported cases up from approximately 200,000 in 2007 to an estimated 220,000 in 2011.

October 14, 2011
ICU Transitions: Patients, Families, and Staff

Patients in the ICU face a number of health transitions from the time they enter the hospital until they are discharged.

August 15, 2011
Integrative Oncology and the Memorial Sloan-Kettering Cancer Center Critical Care Experience

“Integrative Oncology” is a synthesis of mainstream treatment and complementary therapies in cancer care. Complementary therapies are noninvasive and nonpharmacologic adjuncts to mainstream cancer treatment.

June 16, 2011
Critical Care Leadership in the Greater New York Area: A New Approach to Regionalization

As the United States’ population ages and health-care technology prolongs life for increasingly sicker patients, the number of people treated in ICUs is growing. While the overall number of hospital beds is on the decline, critical care medicine beds are steadily increasing in number and represent about 15% of hospital beds in the country, as well as $82 billion annually of total hospital costs (Halpern and Pastores. Crit Care Med. 2010;38[1]:65).

April 19, 2011
Interventional Pulmonology: Advanced Bronchoscopy in the Critically Ill

The interventional pulmonologist plays an integral role in the management of critically ill patients with respiratory failure due to central airway obstruction, massive hemoptysis, and complications of thoracic surgery or radiation therapy. Bronchoscopy offers a minimally invasive diagnostic and therapeutic tool to palliate airway obstruction, providing symptomatic relief and potentially serving as a means to extubation.

February 18, 2011
Vena Cava Filters: A Call to Action

The concept of venous interruption can be traced back to Armand Trousseau’s lectures at the Hotel Dieu in Paris in the mid-19th century (Trousseau A. Phlegmasia alba dolens. In: Trousseau A, ed. Clinique Medicale de l’Hotel-Dieu de Paris. Paris, France: Balliere, 1865; 654).

October 04, 2010
Diagnostic Errors in the ICU

Hospitalized patients continue to be harmed by adverse events and medical errors (Leape. Clin Chim Acta. 2009;404[1]:2). The contribution to errors by preventable diagnostic errors is underappreciated (Newman-Toker et al. JAMA. 2009;301[10]:1060). Studies suggest that the ICU is a particularly highrisk place for diagnostic errors (Shojania et al. JAMA. 2003;289[21]:2849), given the ICU’s high stress, fast pace, and intense environment.

August 04, 2010
It’s Time To Reconsider Adult ECMO

Extracorporeal membrane oxygenation (ECMO) is a technology that provides long-term cardiopulmonary bypass support for patients with the most severe but potentially reversible forms of respiratory and/or cardiovascular derangements.

June 04, 2010
Early Mobilization in the ICU: Improving Patient Outcomes

Patients in the ICU are frequently exposed to deep sedation and prolonged immobility, with limited access to rehabilitation services (Needham. JAMA. 2008;300[14]: 1685). This patient care paradigm was developed out of concern for physiologic instability, potential dislodgement of medical equipment, and patient discomfort.

April 05, 2010
Pathophysiology and Diagnosis of Heparin-Induced Thrombocytopenia

Heparin is one of the most widely used parenteral drugs in modern medicine, with approximately 12 million patient exposures annually in the United States alone.

February 15, 2010
Caring for ICU Patients and Families Lacking English Proficiency

Effective communication between patients, families, and providers is pivotal to optimal medical care, particularly in the ICU.