NIH Intervention to Reduce Opioid-Related Overdose Deaths In ICU Sun, 16 Jun 2024 A National Institutes of Health’s HEALing (Helping to End Addiction Long-Term) Communities Study evaluated a data-driven intervention aimed at reducing opioid-related overdose deaths by engaging communities to implement evidence-based practices, such as increasing naloxone distribution and enhancing access to medication for opioid use disorder. The findings are published ...

Machine Learning Alerts to Prevent Escalation of Care In ICU Fri, 14 Jun 2024 Deploying and evaluating a machine learning intervention to improve clinical care and patient outcomes is a key step in moving clinical deterioration models from byte to bedside. A Mount Sinai study found that hospitalised patients were 43% more likely to have their care escalated and significantly less likely to die if their care team received AI-generated alerts signalling ...

Matters Arising Open access Published: 05 August 2024 Probing the efficacy of high-flow nasal cannula in the treatment of acute exacerbations of COPD with acute-moderate hypercapnic respiratory failure Ioannis Pantazopoulos, Georgios Mavrovouni  Critical Care volume 28, Article number: 264 (2024)  Dear Sir, We have read with great interest the single-centre study by Tan, et al. [1], which concluded that high-flow nasal cannula (HFNC) was not no...

Ventilator-Induced Lung Injury and Mechanical Power In ICU Mon, 16 Sep 2024 Mechanical ventilation is essential for managing acute respiratory failure but can cause ventilator-induced lung injury (VILI). VILI arises from four main mechanisms: alveolar over-distention (volutrauma), over-pressurisation (barotrauma), cyclic opening and collapse of alveoli (atelectotrauma), and inflammation (biotrauma), leading to alveolar damage and impaired gas exchange....

COMMENT Success of the CLEEN study Dinah Gould, Nicolas Drey Lancet Infect Dis 2024 Online first August 13, 2024 https://doi.org/10.1016/S1473-3099(24)00454-7 Health-care-associated infections (HAIs) are the most frequently occurring adverse events in health care. These infections pose a major threat to patient safety and were regarded as an inevitable risk of health care for many years; however, contemporary opinion is that 50% of HAIs are avoidable.1 ...

Digital Twins of Acute Hypoxaemic Respiratory Failure and Noninvasive Ventilation In ICU Mon, 16 Sep 2024 Noninvasive ventilation (NIV) is increasingly used to assist spontaneous breathing in patients with acute hypoxaemic respiratory failure (AHRF) and can reduce the need for intubation, mortality, and ICU stay. However, if NIV fails, it can increase mortality if intubation is necessary, and high respiratory effort not controlled by NIV might cause ad...

COMMENT REVISITing treatment of metallo-β-lactamases Emily L Heil, Erin K McCreary Lancet Infect Dis 2024 Online first October 07, 2024 https://doi.org/10.1016/S1473-3099(24)00561-9 Metallo-β-lactamase enzymes, named because of the presence of one or two zinc ions at the catalytic site, are responsible for β-lactam antibiotic hydrolysis and are increasing in prevalence worldwide.1 Despite the increase in antibiotic development over the past decade, a β...

Editorials Just-in-time training could be just what the doctor ordered Justine M Naylor BMJ 2024; 387 doi: https://doi.org/10.1136/bmj.q2747 (Published 16 December 2024)Cite this as: BMJ 2024;387:q2747 A new approach for teaching clinical skills At the heart of the practice of medicine is the tenet “to do good or to do no harm.”1 Fundamental to achieving this objective is continuing professional development (CPD), which should be lifelong and learner-c...

Metabolomics and Pulmonary and Critical Care Medicine In ICU Mon, 23 Sep 2024 Over the past two decades, systems biology has made significant progress, with metabolomics emerging as the latest field. Metabolomics involves the systematic study of metabolites, which reflect the physiological state of a biological system. This field has been applied to various disciplines, including pulmonary and critical care medicine. Metabolomics provides insights i...

Ethical Challenges With Pragmatic and Cluster RCTs In ICU Mon, 23 Sep 2024 Traditional explanatory randomised controlled trials (RCTs), often used for drug or device approval, assess interventions under ideal conditions but may not reflect real-world clinical practice, as they typically involve younger patients with fewer coexisting conditions. These trials also struggle to detect treatment effect differences among subgroups and rarely compare alternat...