High vs Standard Protein Provision and Functional Recovery - PRECISe In ICU Mon, 26 Aug 2024 Rapid skeletal muscle wasting during critical illness negatively affects both short- and long-term outcomes after ICU admission. Increasing dietary protein intake may help reduce muscle wasting and improve post-ICU function. ICU-acquired weakness (ICU-AW) is common among ICU survivors and negatively impacts both short- and long-term outcomes. It results from...

Impact of Flexible Visitation in the ICU on Family Members In ICU Mon, 26 Aug 2024 Despite ongoing restrictive family visitation policies in ICUs worldwide, contemporary guidelines advocate for more flexible visitation. Flexible policies aim to enhance the ICU experience for both patients and their families and are linked to reduced acute anxiety in both groups and decreased depression in family members. These flexible policies do not increase the risk...

Using AI to Examine Brain Activity Following TBI In ICU Wed, 24 Jul 2024 Researchers at Johns Hopkins Medicine have identified a potential alternative, less-invasive method for measuring intracranial pressure (ICP) in patients. The research is published in Computers in Biology and Medicine. ICP can abnormally increase due to conditions such as acute brain injury, stroke, or cerebrospinal fluid flow obstruction, leading to symptoms like headaches, bl...

Invited Commentary  October 2, 2024 A Slow March Toward Eliminating Transfusion in Uro-Oncology Shawn Dason, Debasish Sundi, Akshay Sood JAMA Surg. Published online October 2, 2024. doi:10.1001/jamasurg.2024.4203 Radical cystectomy (RC) is a standard treatment for patients with bladder cancer. Despite decades of refinement in surgical technique, most patients undergoing RC will experience a surgical complication.1 Excessive surgical bloo...

Sepsis Alert Systems, Mortality, Adherence to SSC In Sepsis Wed, 24 Jul 2024 Sepsis is a global health issue with high mortality and morbidity rates among hospitalised patients. To enhance the quality of sepsis management, the Surviving Sepsis Campaign (SSC) developed an evidence-based bundle comprising five key elements to be implemented within the first hours of sepsis recognition. These elements include fluid resuscitation with 30 mL/kg of crystallo...

Invited Commentary  Equity, Diversity, and Inclusion September 24, 2024 The Glass Ceiling—Racial Disparities Among Emergency Medicine Chief Residents Alden M. Landry, Italo Brown JAMA Netw Open. 2024;7(9):e2432606. doi:10.1001/jamanetworkopen.2024.32606 The role of a chief resident extends beyond a mere title; it is a gateway to opportunities and a stepping stone to leadership roles in both academic and community emergency medicine (EM) se...

Impact of Machine Learning on Predicting Clinical Deterioration In ICU Tue, 23 Jul 2024 Machine learning algorithms are transforming healthcare by enhancing the prediction of clinical deterioration. Despite their potential, real-world efficacy data remains limited. A recent study hypothesised that real-time machine learning-generated alerts, sent directly to front-line providers, could significantly reduce patient escalations. A recent article pub...

Editorial  September 25, 2024 Feasibility of Fever Prevention in Vascular Brain Injury Teresa May, Lori Shutter JAMA. Published online September 25, 2024. doi:10.1001/jama.2024.16415 How to manage fever in the neurocritical care unit in patients with acute stroke was clearly a question in need of an answer. The association of fever burden with poor outcome for diverse conditions in the neurocritical care unit has been well described.1-3 Howev...

Perioperative Cardiac Output Monitoring: From Yellow Catheters to Green Algorithms In ICU Fri, 17 May 2024 We discuss the economic and environmental advantages of green pulse wave analysis (PWA) techniques and the integration of PWA algorithms into standard bedside monitors that will likely contribute to democratisation of perioperative cardiac output monitoring. Haemodynamic instability frequently manifests during the perioperative course of high-risk ...

Reversal of Direct Oral Anticoagulants In ICU Tue, 30 Jul 2024 Direct oral anticoagulants (DOACs) like apixaban, edoxaban, rivaroxaban (all FXa inhibitors), and dabigatran (a thrombin inhibitor) have been used for many years, with their generic versions becoming increasingly available. Though DOACs have a lower risk of serious bleeding, such as intracranial haemorrhage, compared to vitamin K antagonists, bleeding is still their most common side effect....