In the last Congress of Argentinean Society of Intensive Care Medicine (SATI) held in Salta, there was a gale of news.
A difference from previous years, news came not only from classical areas of intensive care such as shock, acute distress respiratory syndrome or sepsis, but we saw the appearance of humanizing intensive care on the scene and the increasingly more finished idea that today more than ever “primum non nocere” should prevail.
From the time of Ibsen, Danish anesthesiologist who in full epidemic of polio in the 50’s first proposed the use of positive pressure ventilation and teamworked for the treatment of these patients (at that time, the birth of the modern ICU), critical care has come a long way.
The most of the patients survive to the ICU but, How do they do? In which state do they come back to their homes? How do they return to their lives?
And even though many of the consequences of the critical illness are inevitable, many others are the product of customs and usages coined at the time, but without any evidence.
What is the risk for a child visiting his father?. What about a grandfather to his grandson?. The lights at night in the entire unit, what is the advantage for us?. For the treatment of serious illnesses, could be sedation many times deleterious?.
We had the honor to have among our guests to Gabi Heras from Spain, fervent and motivating leader of the IC-HU Project. Also Thomas Strøm, a Danish physician who comes preaching non-sedation from long ago, and with much evidence in favor! Dr. Jukka Takala, from Finland, was also devoted to this issue, making clear that no sedation certainly isn’t for everyone and always, but is key for a comprehensive approach and the use of tools and appropriate goals. Another visitor of honor was Nathan Brummel, from the team of Dr. Wesley Ely at Vanderbilt, who stressed the importance of including family in the who stressed the importance of including the family in the process of care, in addition to the fundamental work of early rehabilitation and long-term follow-up.
In the Hospital Italiano de Buenos Aires we have a family-centered care ICU and undoubtedly has meant a positive change in our way of working and relationship with patients and their loved.
As Thomas Strøm, the barriers of space and time should not be insurmountable. The key message is that any external program that will attempt to insert as is on a different system will have no real chance of success.
The multidisciplinary work, the training of leaders of opinion, the positive reinforcements and the constant evaluation of results are fundamental at the time of implementing the change.
There we go in Argentina and we join this movement clearly unstoppable.