Fasting has been the standard of many medical procedures such as upper endoscopic procedure, surgery, bronchoscopy and abdominal ultrasound imaging. Generally, the fasting recommendations follow The Canadian Anesthetist’s Society (CAS) and American Society of Anesthesiologists (ASA) guidelines. In that recommendation, patients only received clear liquid which contains simple carbohydrate or water two to six hours prior to surgery. After three hours of meal body has to provide nutritions for itself by gluconeogenesis.

Surgical repair of traumatic fractured neck of femur (DHS or hemiarthroplasty) in elderly patients is a frequent procedure performed in acute theatres in New Zealand. National data using public theatre coding statistics show that close to 2800 procedures for surgical repair of fractured neck of femur are performed per annum in New Zealand. This number has more than doubled over the past 5 years. International data on fractured neck of femur predict a 3-4 fold increase in the numbers presenting by 2050. (1) These rising trends are related to our aging population.

One of the most difficult organs to procure for donation is the lung. A detailed understanding of the physiology of mechanical ventilation and its effect on donor lungs is needed to impact on the outcome of lung transplantation. An organized protocol for mechanical ventilation management of the organ donor using the Open Lung Model may positively affect the number of organs that can be procured, and the function of these organs post transplant.

Health care costs represent a large percentage of the gross domestic product all over the world. According to the National Health Statistics Group, health care expenditure in the United States accounted for as much as 14% of the gross national product in 1992 and it is projected to reach 30% by 2030.
The intensive care unit (ICU) represents the hallmark of highly competent modern hospitals, offering highly trained staff and life-saving technology and it is also one of the most expensive units in the hospital.

Intensive Care Units (ICUs) are equiped with many complex life support devices, which are key to monitoring intensive procedures performed by highly trained medical personels 24 hours a day. It is obvious that ICUs consume considerable operational resources and require very high maintenance cost. However, mortality rates of critically ill surgical patients remain very high regardless of technologically advanced centers. Dr. Hasan Sadikin ICU is the provincial referral ICU for West Java province.