Clinical Cognition in the Context of Artificial Intelligence In ICU Mon, 5 Aug 2024 Medical decision systems powered by artificial intelligence (AI) are widely used in healthcare. The rapid development and commercialisation of these systems outpace the understanding of their clinical value, creating an "AI chasm." This gap is due to various technical and logistical challenges and issues in clinical implementation.  The relationship between huma...

HEMOPRED Study: Fluid Responsiveness in ARDS In ICU Mon, 23 Sep 2024 Optimal fluid management in patients with acute respiratory distress syndrome (ARDS) poses significant challenges. A positive fluid balance is linked to extended mechanical ventilation, longer ICU stays, and increased mortality due to increased pulmonary capillary pressure, which exacerbates inflammation and causes alveolar flooding. On the other hand, haemodynamic instability is comm...

Editorial  December 10, 2024 Do Sepsis Alerts Help? Derek C. Angus JAMA. Published online December 10, 2024. doi:10.1001/jama.2024.25818 A great hope of moving from paper to electronic health records (EHRs) is that health data could be scanned in real-time, alerting the care team of potential gaps in care before untoward consequences occur. While leveraging this type of case-specific clinical decision support could dramatically improve the qu...

Editorial  December 10, 2024 Reevaluating Respiratory Support in Acute Respiratory Failure—Insights From the RENOVATE Trial and Implications for Practice Yonathan Freund, Amelie Vromant JAMA. Published online December 10, 2024. doi:10.1001/jama.2024.25869 There is a fundamental question in emergency medicine: Is high-flow nasal oxygen an appropriate alternative to noninvasive ventilation across varied presentations of acute respiratory failur...

Editorial  December 10, 2024 Is High-Flow Oxygen the Standard for All Patients With Acute Respiratory Failure? Jean-Pierre Frat, Sylvain Le Pape, Arnaud W. Thille JAMA. Published online December 10, 2024. doi:10.1001/jama.2024.25906 Hypoxemic acute respiratory failure denotes oxygenation failure attributable to various mechanisms, including ventilation-perfusion mismatch, increased shunt, diffusion impairment, and alveolar hypoventilation. Th...

eHealth Interventions to Treat Post-Intensive Care Syndrome In ICU Thu, 3 Oct 2024 Post Intensive Care Syndrome (PICS) is a critical issue affecting survivors of intensive care. PICS involves new or worsened physical, psychological, and cognitive impairments after critical illness, significantly impacting health-related quality of life (HRQoL), functional outcomes, and employment.  Critical care rehabilitation occurs in four phases: acute recov...

Physiologic Effects of ECMO in Patients With Severe ARDS In ICU Mon, 9 Sep 2024 In patients with severe acute respiratory distress syndrome (ARDS), managing gas exchange and avoiding ventilation-induced lung injury (VILI) are key challenges. Venovenous extracorporeal membrane oxygenation (ECMO) is used for severe ARDS with persistent hypoxaemia, effectively improving gas exchange and reducing ventilation pressures, though it doesn't support the cardiov...

ESICM Webinar – Cardiovascular Management After Surgery In ICU Tue, 1 Oct 2024 In a webinar at the ESICM Congress, Dr Aretha and Dr Garcia-Alvarez spoke about cardiovascular management after surgery. More specifically, Dr Aretha spoke about the management of post-operative atrial fibrillation, and Dr Garcia-Alvarez spoke about the importance of early application of vasopressin in septic shock patients. Management of Postoperative Atrial Fibrillation Aft...

Human-Centred AI Tool for Sepsis Management In Sepsis Thu, 29 Aug 2024 A new artificial intelligence tool, SepsisLab, has been developed to assist clinicians in making decisions about hospital patients at risk for sepsis, with a distinctive feature: it acknowledges its uncertainty. It indicates which demographic data, vital signs, and lab test results are needed to enhance its predictive accuracy. The research was published in KDD '24: Proceedings of t...

Fever Prevention in Patients With Acute Vascular Brain Injury In ICU Thu, 3 Oct 2024 Stroke is a leading cause of death and disability. Fever occurs in up to 90% of stroke patients within the first seven days and is linked to secondary brain injury and worse outcomes. For every 1°C increase in temperature, the odds of poor outcomes and short-term mortality increase by 2.2, particularly within the first 24 hours. Fever has a similarly negative impact on...