Critical Care NetWork

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On July 7, 2011, a consensus statement titled, “The Research Agenda in ICU Telemedicine” that was accepted by the Critical Care Societies Collaborative was published in CHEST.

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).

Take advantage of these mini-session slide kits, originally developed for use in the self-study library at CHEST 2010. Each mini-session features an executive summary, a 5-minute PowerPoint presentation on the topic, and references to cited literature.

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.

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.

A 59 year-old man developed severe abdominal pain radiating to the back immediately following elective colonoscopy.

Manuscripts for this section of CHEST are designed to present an unusual case, pose a question about the diagnosis, and reveal the final diagnosis.

A 64-year-old man is transferred to the ICU for acute onset of confusion, septic shock, acute renal failure and disseminated intravascular coagulation.