European Guidelines: Management of Bleeding, Coagulopathy Following Trauma According to the Global Burden of Diseases, Injuries, and Risk Factors Study, trauma accounted for 8% of total deaths annually. Among adolescents aged 10-24 years, road injuries, self-harm, and interpersonal violence are the top causes of disability-adjusted life-years, and road injuries are ranked first in the 25-49 year age group. Post-traumatic bleeding and associated traumatic coagulopat...

Sepsis Through the Lens of Complexity Theory Sepsis is a complex and dysregulated state involving various factors, including pathogens, host response, organ failure, and medical interventions. Despite this complexity, the necessary concepts, approaches, and methods to understand sepsis are underappreciated. In a recent review, the authors highlight the need to understand sepsis through the lens of complexity theory. Complex systems science aims to understand sys...

Family-Centred Care at End of Life in the ICU Recent research on end-of-life (EOL) care in the ICU has focused on the importance of communication between ICU clinicians and patients' families. This research has highlighted the impact of such communication on family symptoms in the months following a patient's death. During the COVID-19 pandemic, restricted visiting policies in ICUs have undermined the quality of communication between clinicians and families, whi...

Invited Commentary  April 28, 2023 How Chatbots and Large Language Model Artificial Intelligence Systems Will Reshape Modern Medicine: Fountain of Creativity or Pandora’s Box? Ron Li, Andre Kumar, Jonathan H. Chen JAMA Intern Med. Published online April 28, 2023. doi:10.1001/jamainternmed.2023.1835 In an era of clinicians being burnt out by electronic medical records and documentation burdens, we might all dream of having a personal scribe to...

ICU Management & Practice, Volume 22 - Issue 5, 2022 Guiding Clinical Care Using Pancreatic Stone Protein The role of point-of-care testing in the early identification and management of sepsis, the need for better markers to identify sepsis, an overview of the Pancreatic Stone Protein (PSP) and clinical evidence highlighting its effectiveness as a biomarker. Pancreatic Stone Protein Infections are a leading cause of morbidity and mortality among criti...

EDITORIAL Traumatic Acute Subdural Hematoma — Should the Bone Flap Be Removed or Replaced? Shankar Gopinath N Engl J Med April 23, 2023DOI: 10.1056/NEJMe2302936 Traumatic acute subdural hematomas often warrant emergency evacuation of the blood clot to avoid further cerebral compression and its sequelae. Once the subdural clot is removed, the million-dollar question in the mind of the neurosurgeon is to whether to replace the bone flap (craniotomy) or not (deco...

Safety Outcomes of Direct Discharge From ICU Patients discharged from ICUs are traditionally transferred to a hospital ward to facilitate recovery and rehabilitation and to organise discharge planning. However,  direct discharge home (DDH) from ICUs is becoming more common due to high hospital ward censuses and transfer delays. This increase is mainly due to strained ward capacity and high costs. Prior research shows an inverse correlation between DDH and ICU ...

COMMENT|ONLINE FIRST Guidelines adherence as a major protective aspect to increase survival rate in patients with candidaemia in Europe Mohammad Sadegh Rezai, Fatemeh Ahangarkani Lancet Infect Dis Published:February 15, 2023 DOI:https://doi.org/10.1016/S1473-3099(23)00046-4 Despite improvements in medical interventions and new antifungal drugs, candidaemiais widely recognised as a major cause of morbidity and mortality worldwide.1, 2 Not...

ICU Diaries and Post-ICU Distress Symptoms In recent years, health diaries have become an important tool for patients and providers to manage personal health. A health diary is a record of a patient's overall health and wellness, which the patient writes to keep track of different aspects of their health. Studies show that greater self-care behaviours, such as the use of symptom diaries, improve survival for patients with heart failure. Health diaries, either in wr...

Socioeconomic Status and Outcomes in Critical Care Socioeconomic status is a known determinant of health inequalities. However, previous studies on the impact of socioeconomic status on outcomes in critical care have produced inconsistent findings.  A new review analyses available evidence on the relationship between socioeconomic status and outcomes in critical care. The analysis included observational cohort studies of adults that examined the association...