Invited Commentary  Equity, Diversity, and Inclusion September 24, 2024 The Glass Ceiling—Racial Disparities Among Emergency Medicine Chief Residents Alden M. Landry, Italo Brown JAMA Netw Open. 2024;7(9):e2432606. doi:10.1001/jamanetworkopen.2024.32606 The role of a chief resident extends beyond a mere title; it is a gateway to opportunities and a stepping stone to leadership roles in both academic and community emergency medicine (EM) se...

Impact of Machine Learning on Predicting Clinical Deterioration In ICU Tue, 23 Jul 2024 Machine learning algorithms are transforming healthcare by enhancing the prediction of clinical deterioration. Despite their potential, real-world efficacy data remains limited. A recent study hypothesised that real-time machine learning-generated alerts, sent directly to front-line providers, could significantly reduce patient escalations. A recent article pub...

Editorial  September 25, 2024 Feasibility of Fever Prevention in Vascular Brain Injury Teresa May, Lori Shutter JAMA. Published online September 25, 2024. doi:10.1001/jama.2024.16415 How to manage fever in the neurocritical care unit in patients with acute stroke was clearly a question in need of an answer. The association of fever burden with poor outcome for diverse conditions in the neurocritical care unit has been well described.1-3 Howev...

Perioperative Cardiac Output Monitoring: From Yellow Catheters to Green Algorithms In ICU Fri, 17 May 2024 We discuss the economic and environmental advantages of green pulse wave analysis (PWA) techniques and the integration of PWA algorithms into standard bedside monitors that will likely contribute to democratisation of perioperative cardiac output monitoring. Haemodynamic instability frequently manifests during the perioperative course of high-risk ...

Reversal of Direct Oral Anticoagulants In ICU Tue, 30 Jul 2024 Direct oral anticoagulants (DOACs) like apixaban, edoxaban, rivaroxaban (all FXa inhibitors), and dabigatran (a thrombin inhibitor) have been used for many years, with their generic versions becoming increasingly available. Though DOACs have a lower risk of serious bleeding, such as intracranial haemorrhage, compared to vitamin K antagonists, bleeding is still their most common side effect....

Recommendations for Management of Central Airway Obstruction In ICU Tue, 30 Jul 2024 Central airway obstruction (CAO) is a life-threatening condition characterised by significant airway blockage, leading to severe breathing difficulties and poor prognosis, particularly with proximal obstructions. It is defined by a 50% or greater occlusion of major airways like the trachea or main bronchi. The most common cause of malignant CAO is lung cancer, though o...

Call to Action: Artificial Intelligence in Acute Medicine In ICU Tue, 30 Jul 2024 On November 30, 2022, OpenAI released ChatGPT, the first chatbot and virtual assistant powered by large language models (LLMs). Within five days, ChatGPT attracted over 1 million users and reached 200 million monthly active users worldwide within fifteen months. This rapid surge in interest transformed artificial intelligence (AI) from a niche concept into a mainstream ph...

EDITORIAL Making Long-Term Oxygen Therapy Less Burdensome Darren B. Taichman, Jeffrey M. Drazen N Engl J Med 2024;391:1050-1051 Long-term oxygen therapy, the first intervention that was shown to improve survival in patients with both severe hypoxemia and chronic obstructive pulmonary disease (COPD), had an effect size so large that data from fewer than 300 patients were all that was needed to establish its efficacy. In the Nocturnal Oxygen Therapy Trial (NOTT)...

ICU Syndromes and Subphenotypes - Sepsis, ARDS and AKI In Sepsis Wed, 17 Jul 2024 Critical care has traditionally focused on clinical practice and research around syndromes such as sepsis, acute respiratory distress syndrome (ARDS), acute kidney injury (AKI), and traumatic brain injury (TBI). However, these syndromes, while familiar to clinicians, are inherently diverse and encompass various pathophysiological processes that vary among individual patie...

Editorial  September 16, 2024 Noninvasive Ventilation in COPD—Pressure Matters Wolfram Windisch, Sarah Bettina Stanzel, Christian Karagiannidis JAMA. Published online September 16, 2024. doi:10.1001/jama.2024.0811 High-intensity noninvasive ventilation was first used more than 20 years ago in patients with chronic obstructive pulmonary disease (COPD) and chronic hypercapnia.1-3 High-intensity noninvasive ven...