Opportunity Cost of Artificial Intelligence Hesitancy in the ICU In ICU Tue, 7 Jan 2025 Healthcare systems face challenges like increasing patient loads, rising costs, and staff shortages, which hinder consistent, high-quality care. Without integrating artificial intelligence (AI), these issues could worsen, leading to greater disparities in access and care quality. AI offers transformative potential by automating administrative tasks, supporting clini...

Comment Effect of normobaric hyperoxia in ischaemic stroke Diederik W J Dippel, Paula M Janssen Lancet 2025; 405: 442-443 DOI: https://doi.org/10.1016/S0140-6736(25)00153-9 In ischaemic stroke, discontinuation of local arterial blood supply to the brain leads to neurological deficits. The assumption that increased delivery of oxygen in patients with acute ischaemic stroke might lead to amelioration of neurological deficit is interesting, but almost all larg...

Management of Pain and Sedation In ICU Tue, 7 Jan 2025 The evolution of critical care medicine has greatly advanced understanding and practices in pain and sedation management. Historically, deep sedation was believed to aid recovery, but it is now recognised to delay recovery and increase harm. Current strategies emphasise carefully titrated analgesia and sedation to ensure patient comfort, safety, and procedural facilitation, while minimising risks l...

Comment On the quantification of military violence in Gaza James Smith, Duha Shellah, Zoé Samudzi Lancet 2025; 405: 440-442 DOI: https://doi.org/10.1016/S0140-6736(25)00138-2 Against a history of protracted occupation,1 an unprecedented escalation in Israeli State violence occurred throughout Palestine in the wake of violent attacks in Israel on Oct 7, 2023.2 Concerning violence throughout Gaza, mortality statistics subsequently reported by the Pa...

Timing of Invasive Mechanical Ventilation in Patients With Sepsis In Sepsis Mon, 16 Sep 2024 Mechanical ventilation (MV) can be both beneficial and harmful for critically ill patients. It improves gas exchange, reduces the work of breathing, and lowers self-inflicted lung injury risk. MV, often accompanied by sedatives and neuromuscular blockers, can also reduce oxygen consumption and carbon dioxide production, and in patients with cardiac issues, it m...

Editorial Extubation Failure Among Patients With Obesity Amit Kansal, Maurizio Cecconi Chest 2025; 167: 11-13 https://doi.org/10.1016/j.chest.2024.08.021 Up to 10% of the adult patients who are being mechanically ventilated in ICUs suffer from extubation failure after planned extubation.1 The risk may increase to 20% among the high-risk patients2; those older than 65 years; and those with underlying cardiac disease, chronic respiratory disord...

ABYSS Trial: Cardiovascular Safety of Interrupting Beta-Blockers In ICU Fri, 30 Aug 2024 New research shows that discontinuing beta-blockers in patients with a history of myocardial infarction (MI) did not demonstrate cardiovascular safety compared to continuation and provided no improvement in patients' quality of life. Advancements in MI management and findings from observational studies have led to questions about the necessity of continuing beta...

Editorial Beta Blockers and Septic Shock: More Work to Do Tony Whitehouse, Mervyn Singer Chest 2025; 167: 9-10 https://doi.org/10.1016/j.chest.2024.09.007 Despite over 40 years of research, the search for an intervention that can alter clinical outcomes from septic shock remains elusive. Survival has improved, in part because of earlier recognition and treatment and in part because of reduced iatrogenic harm. However, mortality rates remain unacceptably hig...

The Hazards of Monitoring – Alarm Fatigue in the ICU In ICU Fri, 17 May 2024 Alarm fatigue is a pressing clinical problem in our post-pandemic ICUs and can adversely impact patient outcomes. Its root causes can be classified by patient, device and organisation related. We believe it can be mitigated and we propose interventions through attention to policy, education and the creation of a meaningful culture of safety. "There are more things to alarm us t...

Clinical Application of Oesophageal & Transpulmonary Pressures in Monitoring Mechanical Ventilation In ICU Thu, 28 Nov 2024 ICU Management & Practice, Volume 24 - Issue 5, 2024 Personalisation of respiratory support may improve outcomes in patients with acute respiratory failure. Transpulmonary pressure estimate by oesophageal pressure is an essential and useful minimally invasive tool to guide the setup and monitoring of mechanical ventila...