Recommendations for Management of Central Airway Obstruction In ICU Tue, 30 Jul 2024 Central airway obstruction (CAO) is a life-threatening condition characterised by significant airway blockage, leading to severe breathing difficulties and poor prognosis, particularly with proximal obstructions. It is defined by a 50% or greater occlusion of major airways like the trachea or main bronchi. The most common cause of malignant CAO is lung cancer, though o...

Call to Action: Artificial Intelligence in Acute Medicine In ICU Tue, 30 Jul 2024 On November 30, 2022, OpenAI released ChatGPT, the first chatbot and virtual assistant powered by large language models (LLMs). Within five days, ChatGPT attracted over 1 million users and reached 200 million monthly active users worldwide within fifteen months. This rapid surge in interest transformed artificial intelligence (AI) from a niche concept into a mainstream ph...

EDITORIAL Making Long-Term Oxygen Therapy Less Burdensome Darren B. Taichman, Jeffrey M. Drazen N Engl J Med 2024;391:1050-1051 Long-term oxygen therapy, the first intervention that was shown to improve survival in patients with both severe hypoxemia and chronic obstructive pulmonary disease (COPD), had an effect size so large that data from fewer than 300 patients were all that was needed to establish its efficacy. In the Nocturnal Oxygen Therapy Trial (NOTT)...

ICU Syndromes and Subphenotypes - Sepsis, ARDS and AKI In Sepsis Wed, 17 Jul 2024 Critical care has traditionally focused on clinical practice and research around syndromes such as sepsis, acute respiratory distress syndrome (ARDS), acute kidney injury (AKI), and traumatic brain injury (TBI). However, these syndromes, while familiar to clinicians, are inherently diverse and encompass various pathophysiological processes that vary among individual patie...

Editorial  September 16, 2024 Noninvasive Ventilation in COPD—Pressure Matters Wolfram Windisch, Sarah Bettina Stanzel, Christian Karagiannidis JAMA. Published online September 16, 2024. doi:10.1001/jama.2024.0811 High-intensity noninvasive ventilation was first used more than 20 years ago in patients with chronic obstructive pulmonary disease (COPD) and chronic hypercapnia.1-3 High-intensity noninvasive ven...

Malnutrition in the Sick and Elderly In ICU Wed, 17 Jul 2024 A review article by researchers from Uppsala University and the University of Gothenburg, published in the New England Journal of Medicine, underscores that up to half of hospitalised patients and those in healthcare facilities suffer from malnutrition. This has significant implications, including unnecessary suffering, decreased quality of life, and increased mortality, particularly for elde...

Impact of Family Support Intervention on Costs, Readmissions in Patients at Risk of Death In ICU Tue, 9 Jul 2024 Approximately 500,000 Americans die annually following admission to an ICU, often lacking decision-making capacity due to advanced illness or medications. Clinicians rely on surrogate decision-makers for care decisions, but communication breakdowns are common, making the process emotionally difficult for surrogates. This often leads to patie...

COMMENTVolume 404, Issue 10457P992-993September 14, 2024 Optimal patient and mechanical circulatory support device selection in acute myocardial infarction cardiogenic shock Jacob C Jentzer, Benjamin Hibbert Lancet 2024; 404: 992-993 Temporary mechanical circulatory support (TMCS) has been used in patients with acute myocardial infarction and cardiogenic shock (AMICS) since the introduction of passive intra-aortic balloon counterpulsation more than 50 yea...

Calcium Supplementation During Trauma Resuscitation In ICU Tue, 9 Jul 2024 In major trauma patients, ionised calcium levels (iCa2+) can be disrupted by injury, physiological imbalances, resuscitation strategies, and blood transfusions. Hypocalcaemia often results from the transfusion of citrate-containing blood products, as citrate binds to calcium, and this effect is exacerbated in cases of organ failure and massive transfusion. Other fluid resuscitat...

Invited Commentary  September 9, 2024 Charting the Waters of Sickle Cell Disease With Target Trial Emulation A. Parker Ruhl, Matthew M. Hsieh, Elizabeth A. Stuart JAMA Intern Med. Published online September 9, 2024. doi:10.1001/jamainternmed.2024.4435 Large administrative databases hold promise for advancing biomedical care, like sails awaiting the winds of a clinically relevant question to navigate uncharted waters. However, making best use ...