Intensive Care Units (ICUs) are inevitably positioned at the top of the treatment pyramid for patients with acute and life-threatening conditions according to current medical practice. The number of critically ill patients has dramatically increased owing to better treatment quality, a longer life expectancy, and the impact of modern technologies. This has raised concerns regarding the intensive care and surveillance of these patients. Compared to colleagues in non- intensive care services, the profiles of physicians and nurses/technicians working ICUs differ considerably in their patients’ approach and skills performance. Specific indications for ICU admission have been established due to the restricted number of available ICU beds. These patients are transferred to semi-intensive care (SICUs) services within the departments that correspond to their pathology once their critical condition has stabilized. The ICU patients cannot be fully recovered, but can have their conditions stabilized to the point where they may receive further treatment outside of the ICU. Thus, ICUs and SICUs represent one functional unit. The aim of this review is to present the indications for admission to the Department of Internal Medicine ICU of the Clinical Hospital Center Zemun.

Hyponatremia is an electrolyte disorder frequently encountered in clinical practice. The first step in the diagnostic evaluation of hyponatremia is the volume assessment (clinical estimation of hypo/hypervolemia presence). In the cases of euvolemic hyponatremia, followed by decreased plasma osmolality (<275mOsm/kg) with urine osmolality >100mOsm/kg, urine sodium >30mmol/L along with normal intake of salt and water, preserved pituitary, adrenal, thyroid, adrenal function as well as no recent use of diuretics, syndrome of inappropriate diuresis (SIAD) is diagnosed. In symptomatic, especially acute hyponatremia, careful and gradual substitution by 3 (10) % sodium-chloride infusion is advised with liquid intake restriction, the administration of demeclocycline, urea, or vaptans, as well as causal treatment of SIAD. SIAD is often transient and etiologically clear. In this paper, we present two cases with idiopathic, chronic SIAD with poor outcomes. During the diagnostic follow-up, the cause of SIAD was not found. The autopsy finding was also adverse. In most cases, euvolemic hyponatremia in patients with chronic, idiopathic SIAD is an ominous sign.

This article presents a case of patient with acute and complicated dyslipidaemic pancreatitis, managed by team, consisted of the endocrinologists, gastroenterologists and transfusiologists. Dyslipidaemia, predominantly type IV, is a common cause of acute pancreatitis in young patients, especially in the cases of poor compliance (irregular taking of recommended fibrates and failure to comply with the dietary regime). The treatment of acute pancreatitis, regardless of the aetiology, is due to the severity of the condition, the complexity of the treatment, and the monitoring of patients, in the Intensive Care Units. In cases where dyslipidaemia is the cause of acute pancreatitis, in the context of acute care, a therapeutic plasma exchange is often performed. It rapidly and significantly corrects lipid levels, primarily triglycerides. Therapeutic plasma exchange requires the activity of transfusiology team, which are often unavailable in smaller hospitals.