Netherlands Journal of Critical Care

Volume 28 - No 3 - May 2020 Netherlands Journal of Critical Care Bi-monthly journal of the Dutch Society of Intensive Care LETTER TO THE EDITOR EXPERT OPINION REVIEW Dedicated proning teams in the ICU Lung-protective mechanical ventilation in Delirium in the ICU – A structured review T.C. Roeleveld, H.J. de Vries, A. Girbes patients with COVID-19 of promising diagnostic and therapeutic H.J. de Vries, H. Endeman, approaches: Next steps in ICU delirium J.G. van der Hoeven, L.M.A. Heunks L. Smit, M. van der Jagt Netherlands Journal of Critical Care NETHERLANDS JOURNAL OF CRITICAL CARE EXECUTIVE EDITORIAL BOARD D.W. Donker, editor in chief CONTENTS I. van Stijn, managing editor H. Dupuis, language editor EDITORIAL D. van Dijk, associate editor M.M.J. van Eijk, associate editor 116 Powerful spin-offs … fostering flexibility, creativity and individualised N. Kusadasi, associate editor critical care! C.L. Meuwese, associate editor D.W. Donker [email protected] LETTER TO THE EDITOR COPYRIGHT 118 Dedicated proning teams in the ICU Netherlands Journal of Critical Care ISSN: 1569-3511 T.C. Roeleveld, H.J. de Vries, A. Girbes NVIC p/a Domus Medica P.O. Box 2124, 3500 GC Utrecht T: +31-(0)30 - 282 38 38 EXPERT OPINION 120 Lung-protective mechanical ventilation in patients with COVID-19 © 2020 NVIC. All rights reserved. Except as H.J. de Vries, H. Endeman, J.G. van der Hoeven, L.M.A. Heunks outlined below, no part of this publication may be reproduced, stored in a retrieval system or transmitted in any form or by any means, REVIEW electronic, mechanical, photocopying, recording 126 Delirium in the ICU – A structured review of promising diagnostic and or otherwise, without prior written permission of the publisher. Permission may be sought directly therapeutic approaches: Next steps in ICU delirium from NVIC. L. Smit, M. van der Jagt DERIVATIVE WORKS Subscribers may reproduce tables of contents ORIGINAL ARTICLE or prepare lists of articles including abstracts 134 A Lean approach to improve the organisation of unplanned intensive care for internal circulation within their institutions. admissions: A before-after analysis Permission of the publisher is required for resale or distribution outside the institution. Permission I.T. Spaan, A.F. van der Sluijs, A.D. Boelens, J. Binnekade, E-J. van Lieshout, of the publisher is also required for all other N.P. Juffermans, R. Mudde, P. Bouter, D.A. Dongelmans, A.P.J. Vlaar derivative works, including compilations and translations. ORIGINAL ARTICLE ELECTRONIC STORAGE 139 POCUS series: E-point septal separation, a quick assessment of reduced left Permission of the publisher is required to store or ventricular ejection fraction in a POCUS setting use electronically any material contained in this journal, including any article or part of an article. S.C. Boon, J.E. López Matta, C.V. Elzo Kraemer, P.R. Tuinman, D.J. van Westerloo SUBSCRIPTIONS CLINICAL IMAGE An annual subscription to the Netherlands Journal of Critical Care consists of 6 issues. Issues 142 Harm prevented by using ICU ultrasound prior to percutaneous dilatational within Europe are sent by standard mail and tracheostomy outside Europe by air delivery. Cancellations M.E. Seubert, M. de Mos should be made, in writing, at least two months before the end of the year. The annual subscription fee for the Netherlands 5 5 is 175, for Europe 295, for the rest of the world 144 NVIC conference and course agenda 5 390. Subscriptions are accepted on a prepaid basis only and are entered on a calendar year basis. 145 Editorial board Please transfer the fee to ABNAMRO NL55 ABNA 145 International advisory board 0524 5618 93, swift-code: ABNANL2A. Do not forget to mention the complete address for 146 Information for authors delivery of the Journal. CLAIMS Claims for missing issues should be made within two months of the date of dispatch. Missing issues will be mailed without charge. Issues claimed beyond the two-month limit must be prepaid at back copy rates. ADVERTISING/ BUSINESS CONTACTS For advertising, please contact Eventex. Eventex Sint Bernulphusstraat 13D 6861GS Oosterbeek T: +31 (0)26 – 333 75 77 E: [email protected] Netherlands Journal of Critical Care is indexed in: NETH J CRIT CARE - VOLUME 28 - NO 3 - MAY 2020 115 Netherlands Journal of Critical Care Submitted April 2020; Accepted April 2020 EDITORIAL Powerful spin-offs … fostering flexibility, creativity and individualised critical care! D.W. Donker Department of Intensive Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands Correspondence D.W. Donker - [email protected] In recent weeks we have experienced the enormous impact of elements to maintain a high level of modern ventilatory care in the current coronavirus pandemic. Excellently guided by our these difficult times; rather, we should consider this ambition of society’s president, Diederik Gommers, we have all done our our young colleagues as a commendable example of how we can utmost as critical care professionals to respond in the best develop and implement novel elements of patient care within an possible ways to this crisis and we have succeeded in maintaining open-minded, self-improving critical care environment. a high level of patient care. Obviously, in this period, we feel the urgent need to quickly Above all, we are doing a great job by communicating effectively share our collective experience and all the latest insights on the and collaborating closely on a national and international level, coronavirus disease 2019 (COVID-19), as realised by the recent within our networks, our hospitals, units and teams. This is our webinar of the Dutch Society of Intensive Care moderated credo in the Netherlands intensive care networks, as recently by Iwan van der Horst. The link to the webinar can be found emphatically reflected by Verona Gerardu and Iwan van der at the end if this editorial. In this issue, Heder de Vries, Leo Horst in ‘In networks we trust’, as published in this journal.[1] This Heunks and collaborators have compiled a timely summary in notion sets, more than ever, the broad and solid professional order to provide us with an expert opinion on the ventilator base as also timely illustrated by Peter van der Voort and strategies advocated and likely to be pivotal in COVID-19 care collaborators in the last issue of the Netherlands Journal of as discussed in the webinar.[5] Critical Care.[2,3] In our daily practice of COVID-19 care, we are experiencing Although our intensive care units have not changed beyond a broad spectrum of disease manifestations on one side and recognition, we now encounter many ‘new’ professionals in a lack of mechanistic insights and clinical understanding on our usual workplace. Just a few examples are trauma surgeons the other side. Fortunately, as critical care physicians we are coordinating critical care logistics or clinical geneticists who used to personalising our care to the individual patient rather have taken over daily telephone updates to inform family than aiming to rely on scientific evidence that is often in great members on the status of critical care patients. Dedicated contrast with the complexity of the patients we see. anaesthesiologists are introducing the long-term use of volatile In this context, I would like to recommend a very readable and anaesthetics in our intensive care units to counterbalance important recent plea for individualised critical care by Armand the shortage of modern intravenous drugs. Numerous nurse Girbes.[6] His thoughts are gaining even more momentum anaesthetists and scrub nurses are teaming up with critical care and come to our clinical life while facing the great paucity of nurses to provide daily bedside care. Last but not least, we all scientific evidence on COVID-19 care. Although this void of appreciate the indispensable aid and fruitful exchange with our evidence is neither filled, nor are we sure that it ever will be, military colleagues and all other allied professionals involved in this notion or even a ‘renewed focus’ of critical care according managing the current crisis. to Armand Girbes should strongly remind us of the clinical In this sense, we all feel how valuable multidisciplinary care can relevance of individualised medicine. It is the continuing be and how smoothly it can be integrated into our daily routine careful and critical observation at the individual’s bedside that by fostering flexibility and creativity. will ultimately lead us to gain more clinical and ultimately In this issue, the virtue of flexibility and creativity is literally mechanistic understanding. embodied by the creation of ‘dedicated proning teams in the ICU’ authored by Timo Roeleveld, Heder de Vries and Armand In line with these thoughts on individualised care, Lisa Smit and Girbes.[4] Such initiatives are not only embraced as helpful Mathieu van der Jagt provide us with a creative and if you will a 116 NETH J CRIT CARE - VOLUME 28 - NO 3 - MAY 2020 Netherlands Journal of Critical Care Flexibility, creativity and individualised care in the ICU bit provocative, well-structured review on ‘promising diagnostic traits now cumulate into a multitude of powerful spin-offs while and therapeutic approaches’ on delirium care in the intensive converting this crisis into noticeable results intended to provide care unit. the best possible critical care for all our individual patients in We are all aware that delirium care is important in this the Dutch intensive care units. COVID-19 pandemic, especially when facing shortages of, for example, short-acting sedatives and critical care personnel, Let’s keep up the spirit ! and delirium in the intensive care unit is certainly a prominent example of how randomised trials have not been able to give us long-awaited answers.

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