Heterogeneity in the Effect of Early Goal-Directed Therapy for Septic Shock In Sepsis Mon, 27 Jan 2025 Over 50 RCTs have examined resuscitation strategies in sepsis, but the optimal approach remains unclear. Early goal-directed therapy (EGDT), a 6-hour protocol involving fluids, vasopressors, inotropes, and blood products, showed a significant reduction in mortality in a landmark trial. However, subsequent larger trials did not replicate these benefits...

Understanding the scale of critical illness in Africa and the need for universal access to emergency and critical care Nazir I Lone, John A Masterson, Swagata Tripathy Lancet 2025; 405: 674-675 Timely access to critical care saves lives in any health-care context. In high-income settings, the term critical care is associated with a geographically defined location within a hospital, equipped with advanced technologies requiring substantial financial resourcing. Ho...

Weaning of NIV in Children With a Nurse-Driven Protocol  In ICU Thu, 28 Nov 2024 ICU Management & Practice, Volume 24 - Issue 5, 2024 Shortening the weaning process of children receiving non-invasive ventilation (NIV) is challenging. We present the results of implementing a nurse-guided weaning protocol in our PICU.  Introduction   Given the low mortality rate in paediatrics, the management of acute respiratory insufficienc...

Editor's Note  February 24, 2025 Patient Portals—Balancing Workload and Opportunity Ilana B. Richman, Ishani Ganguli, Eve Rittenberg JAMA Intern Med. Published online February 24, 2025. doi:10.1001/jamainternmed.2024.8135 Soon after the earliest email systems were developed in the late 1960s, electronic messages began to pile up. The onslaught of messages surprised early adopters and spurred the development of message management systems from ...

Artificial Intelligence to Treat Acute Kidney Injury In ICU Tue, 14 Jan 2025 Acute kidney injury (AKI) often complicates critical illness, with management focusing on supportive care per the Kidney Disease Improving Global Outcomes (KDIGO) guideline due to the lack of specific reversing therapies. Although timely implementation of these guidelines can reduce postoperative moderate and severe AKI, adherence in routine clinical practice remains low. A...

Role of Artificial Intelligence in Scientific Research and Review In ICU Tue, 14 Jan 2025 Recent advances in large language models (LLMs) and generative artificial intelligence (AI) have led to the rapid integration of AI tools into research. These tools are now used to assist with literature reviews, data management and analysis, data synthesis, and editing scientific writing. Additionally, many medical journals utilise AI for tasks such as plagiarism...

Oxygen Reactivity Index in Traumatic Brain Injury In ICU Tue, 14 Jan 2025 Moderate-to-severe traumatic brain injury (TBI) often results in impaired cerebral autoregulation (CA), making patients vulnerable to both ischaemia and hyperaemia. The capacity for CA varies between patients and can change over time, complicating the determination of an optimal cerebral perfusion pressure (CPP) target. The pressure reactivity index (PRx), a measure of CA based o...

Emergency Department Admitting Practices and Mortality In ICU Tue, 7 Jan 2025 Emergency department patients treated by physicians with a high tendency to admit them to the hospital are more likely to be discharged after a short stay, raising concerns about potentially unnecessary admissions. However, new research indicates that these patients are no less likely to die than those treated by low-admitting physicians. A recent study suggests that physi...

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...