Introduction

Article Outline

• Copyright

This issue of the Journal of Critical Care (JCC) previews several new initiatives with a theme focus on sepsis. New sections include Letters to the Editor, Invited Commentaries, and a Book Review. The journal invites your comments and suggestions for future features at journal.criticalcare@gmail.com.

One of our letters suggests that sepsis should be defined as a “public health problem,” and it is interesting to note that this issue's focus parallels recent interest in Critical Care Medicine (Crit Care Med 2008;36:10). Sepsis continues to be a major challenge for critical care professionals worldwide, and attention to recommended therapeutic algorithms remains variable at best. This issue will not answer an obvious question for any institution practicing with constrained resources (who is not?); of the available therapeutic options, how should I prioritize the resources I have to maximize benefit? The answer is not simple and is underscored by the manner in which practices vary worldwide. The World Federation of Societies of Intensive and Critical Care Medicine (WFSICCM) has addressed the question in panel discussions presented at international meetings in Brazil, Argentina, Uruguay, and Italy.

In this issue, we also feature 2 invited commentaries that address the specific articles on sepsis associated with liver failure and whether the training level of providers impacts outcome in the face of adequate supervision. Finally, we learn that a recently popularized mechanical ventilatory adjunct has deeper roots than many of us may have imagined.

The decision to publish an article is one that is interesting and complex. Reviewers are integral to the process, and I would like to thank all our volunteers who have made 2008 a year in which our average time to review has decreased while we have tried to retire a backlog of articles for which I apologize to our patient authors. I hope all subscribers and authors appreciate the electronic availability of accepted articles before publication. Because of the increasing popularity of the journal as a venue for excellent submissions from increasingly international sources, I urge you to review this area of the Web site to ensure your timely acquisition of important information. However, this does not answer the question of what information is appropriate for publication in JCC. Should case reports be restricted? Will new authors discuss problems encountered in technologic interfaces? Do resource constraints promote greater adherence to practice guidelines? Is there a need/role for increased representation to basic science? In summary, what information is important to practicing Critical Care Medicine physicians in the complex and resource variable international communities we represent? The only manner in which logical answers can be obtained to the questions is to invite your opinion and requests. Journal of Critical Care is the official journal of the WFSICCM and the Society for Complexity in Acute Illness; as the editorial and peer reviewed scientific voice of these organizations, it is important that we understand the important areas in which our publication can make a difference under the difficult situations in which the cost-effective compassionate management of the critically ill is practiced. I look forward to your comments and suggestions as the journal continues to publish relevant and timely articles from the international community.

The JCC's publication philosophy will continue to evolve as it meets the needs of its constituents: readers, authors, and the societies it represents. Recent ideas include publishing prizewinning abstracts from WFSICCM-sponsored international congresses, targeting certain issues with a particular focus (simulation, sepsis in 2008 and muscle relaxants in March 2009) and encouraging editorial commentary from subscribers. Additional activities will depend upon the future strength of the journal and may include an internet-based rapid response section and greater Web-based interaction between the journal and its target audience, you the reader and subscriber. A primary goal will be to bridge the gap between textbook source materials and practice realities in residency and fellowship programs; the focus on systems-based practice will continue to provide important support for this activity.

Thank you for your continued support of JCC and its mission.