EDITORIAL The Emerging Threat of H5N1 to Human Health Michael G. Ison N Engl J Med Published December 31, 2024 Highly pathogenic avian influenza (HPAI) A(H5N1) emerged in 1997.1 Since then, it has spread globally by migratory birds, resulting in infections in animals on every continent. HPAI A(H5N1) clade 2.3.4.4b emerged in 2021 and resulted in fatal infections in poultry as well as terrestrial and marine mammals.1 In early 2024, influenza A infecti...

Non-Pharmacological Interventions for Preventing Ventilator-Associated Pneumonia In ICU Tue, 12 Nov 2024 Ventilator-associated pneumonia (VAP) is a serious complication in critically ill, intubated ICU patients, contributing to high rates of mortality, morbidity, extended ICU stays, and increased healthcare costs. Preventing VAP is crucial for patient safety and healthcare sustainability.  A recent review explores non-pharmacological interventi...

Cardiogenic Shock: Definitions, Pathophysiology, Management Approaches  In ICU Mon, 18 Nov 2024 Cardiogenic shock (CS) is a life-threatening condition resulting from inadequate tissue perfusion due to reduced cardiac output. Despite advancements in cardiovascular care, its short-term mortality rate remains high, around 40-50%. CS can arise from diverse causes, including acute myocardial infarction (AMI), heart failure, post-surgical complications,...

Impact of Emergency Department to ICU Time on Hospital Mortality In ICU Mon, 18 Nov 2024 What is the impact of prolonged emergency department (ED) length of stay (LOS), particularly ED-to-ICU time (from ED admission to ICU admission) and ED-boarding time (time between ICU admission decision and transfer), on hospital outcomes? Studies suggest prolonged ED-to-ICU times may increase ICU and hospital mortality, though findings are mixed.  Some EDs...

Hypotension and Adverse Outcomes in Traumatic Brain Injury In ICU Mon, 18 Nov 2024 Traumatic brain injury (TBI) is a major cause of death and disability, with 60 million cases annually and 8.1 million years of disability worldwide. Hypotension, a common secondary injury in TBI, often results from blood loss or neurogenic causes like myocardial depression or brainstem herniation disrupting autonomic control. Hypotension significantly worsens outcomes, i...

Fresenius Study Confirms Anaemia Therapy Software Boosts Clinical Outcomes in Haemodialysis Patients In ICU Thu, 24 Oct 2024 This randomised controlled study demonstrates that patients achieved a higher percentage of target haemoglobin levels Patients receiving anaemia management assistance via the software tools saw a 25% reduction in erythropoiesis-stimulating agent (ESA) usage The software's physiology-based model and predictive controller we...

Regulation of AI in Healthcare and Biomedicine - FDA Perspective  In ICU Mon, 4 Nov 2024 Emerging technologies, particularly Artificial Intelligence (AI), are often declared to be transformative in healthcare, with high hopes, expectations, and concerns surpassing those for EHRs, digital health tools, and telemedicine. The FDA has proactively prepared for AI’s integration into healthcare and biomedical product development yet faces distinct challe...

Invited Commentary  Infectious Diseases December 20, 2024 The Inoculum Effect and Staphylococcus aureus Infective Endocarditis—Time to Reconsider Treatment? Sara E. Cosgrove, Loren G. Miller JAMA Netw Open. 2024;7(12):e2451300. doi:10.1001/jamanetworkopen.2024.51300 Infective endocarditis (IE) caused by Staphylococcus aureus remains a deadly disease, with up to one-third of patients dying within 30 d...

Mechanical Circulatory Support in Cardiogenic Shock In ICU Mon, 4 Nov 2024 The 1967 case series by Killip and Kimball is a landmark study that reported an 81% in-hospital mortality rate for patients with acute myocardial infarction complicated by cardiogenic shock (AMICS). Since then, survival rates have improved significantly, with current in-hospital mortality reduced to approximately 40%. This progress is attributed to advancements in care systems, ...

Invited Commentary  Health Informatics December 18, 2024 Characterizing Residents’ Clinical Experiences—A Step Toward Precision Education Jesse Burk-Rafel, Carolyn B. Drake, Daniel J. Sartori JAMA Netw Open. 2024;7(12):e2450774. doi:10.1001/jamanetworkopen.2024.50774 Experiential learning from patient care activities is the primary means by which residents develop the skills that shape their future practice. However, these clinical learnin...