Critical Care Medicine I

Basic ICU Principles

Course Master(s):

Prof. Dr. Katja-Nicole Adamik, Dipl. ACVECC/ECVECC (CH)

Course Overview

This module provides advanced postgraduate training in the principles of intensive care medicine in small animal patients. The course focuses on intensive care unit (ICU) organization, advanced fluid therapy, sepsis management, nutritional support, respiratory and cardiovascular monitoring, and practical intensive care procedures. Emphasis is placed on evidence-based critical care medicine, patient monitoring, clinical reasoning, and hands-on ICU skills relevant to the management of critically ill veterinary patients.

Indicative Content

ICU Organization and Principles

• ICU planning and staffing
• ICU workflow and organization
• Introduction to the Rule of 20
• Hygiene protocols and infection prevention in the ICU
• Antibiotic therapy principles in critically ill patients

Advanced Fluid Therapy

• Fluid therapy refresher
• Fluid therapy in patients with increased vascular permeability
• Fluid therapy in patients with renal disease or cardiac disease
• Recognition and management of fluid overload
• Hemodynamic stabilization principles

Sepsis and Septic Patient Management

• Pathophysiology and diagnosis of sepsis
• Current sepsis guidelines and updates
• Septic peritonitis stabilization and treatment
• Postoperative management of septic peritonitis
• Vasopressor therapy in critically ill patients

Intensive Care Monitoring

• Respiratory monitoring techniques
• Cardiovascular monitoring including advanced monitoring techniques
• Blood gas interpretation and acid–base analysis
• Blood gas case discussions
• Monitoring of the comatous patient
• Central venous pressure (CVP) interpretation

ICU Procedures and Nutritional Support

• Central venous catheter placement and management
• Tracheostomy tube management
• Enteral nutritional support and feeding tube management
• Parenteral nutrition principles
• Placement of feeding tubes and urinary catheters
• Practical ICU laboratory sessions

Clinical Reasoning and Case Discussions

• ICU case discussions in small groups
• ICU case presentations
• Clinical reasoning exercises in critical care medicine

Detailed topics:             

• ICU planning and staffing
• Introduction to the rule of 20
• Advanced fluid therapy including increased permeability, renal disease
• Central venous catheters: placement, Lab, CVP interpretation
• Tracheostomy tube management
• Nutrition of the ICU patient: tubes and parenteral nutrition
• Management of the septic patient, Sepsis update
• Respiratory and cardiovascular monitoring
• Hygiene and antibiotic therapy in the ICU
• Case discussions

Learning Outcomes

Upon successful completion of this module, participants will be able to:

Knowledge and Understanding

1. Critically explain the principles of intensive care medicine, ICU organization, and management of critically ill veterinary patients.
2. Evaluate advanced fluid therapy strategies in critically ill patients with sepsis, renal disease, cardiac disease, and altered vascular permeability.
3. Interpret respiratory, cardiovascular, and acid–base monitoring data relevant to intensive care medicine.
4. Explain evidence-based approaches to sepsis management, nutritional support, and ICU patient stabilization.
5. Analyze the role of advanced monitoring techniques and invasive procedures in critical care medicine.
6. Outline the principles of hygiene, infection prevention, and antimicrobial stewardship relevant to the ICU environment in small animal patients.
7. Describe the pharmacological properties and clinical applications of vasopressors, analgesics, and sedatives used in the management of critically ill ICU patients.

Clinical and Technical Skills

1. Perform systematic assessment and stabilization of critically ill ICU patients.
2. Apply advanced fluid therapy principles in complex critical care scenarios.
3. Perform placement and management of central venous catheters, feeding tubes, and urinary catheters.
4. Interpret blood gas analysis, acid–base disturbances, and cardiovascular monitoring parameters.
5. Develop nutritional support plans and monitoring protocols for critically ill veterinary patients.
6. Assess the clinical response to vasopressor therapy and adjust treatment protocols in patients with distributive or cardiogenic shock.
7. Diagnose and categorize fluid overload and recommend appropriate de-escalation strategies including diuretic approaches in the critically ill ICU patient.

Professional Competencies and Clinical Decision-Making

1. Prioritize interventions using structured clinical reasoning in critically ill patients.
2. Integrate clinical examination findings with advanced monitoring and laboratory data to guide ICU treatment plans.
3. Communicate effectively with veterinary team members regarding ICU stabilization priorities, patient monitoring, and ongoing management.
4. Apply principles of patient safety, infection control, and evidence-based medicine in intensive care settings.
5. Critically evaluate ICU case outcomes and identify opportunities for quality improvement and continued professional development.
6. Manage the welfare and ethical aspects of critically ill patients, including end-of-life decisions, in collaboration with owners and the veterinary team.
7. Coordinate multidisciplinary ICU rounds and design structured monitoring and treatment plans that promote consistent, high-quality care for critically ill veterinary patients.

Learning and Teaching Strategy

The module combines:

• Specialist-led lectures
• Interactive ICU case discussions
• Practical ICU laboratory sessions
• Small-group clinical reasoning exercises
• Hands-on catheter and feeding tube placement training
• Evidence-based critical care medicine discussions
• ICU case presentations

The course emphasizes integration of theoretical knowledge with practical intensive care procedures, specialist-level clinical reasoning, and advanced monitoring techniques for critically ill veterinary patients.

Course Program (Subject to change)