Article
Cardiac & Cardiovascular Systems
Mark N. Belkin, Francis J. Alenghat, Stephanie A. Besser, Ann B. Nguyen, Ben B. Chung, Bryan A. Smith, Sara Kalantari, Nitasha Sarswat, John E. A. Blair, Gene H. Kim, Sean P. Pinney, Jonathan Grinstein
Summary: The novel haemodynamic measurement API better predicted clinical outcomes in patients with congestive heart failure compared to traditional invasive haemodynamic metrics of cardiac function.
Article
Medicine, General & Internal
Marilyn M. Schapira, Rebecca A. Hubbard, Jeff Whittle, Anil Vachani, Dana Kaminstein, Sumedha Chhatre, Keri L. Rodriguez, Lori A. Bastian, Jeffrey D. Kravetz, Onur Asan, Jason M. Prigge, Jessica Meline, Susan Schrand, Jennifer V. Ibarra, Deborah A. Dye, Julie B. Rieder, Jemimah O. Frempong, Liana Fraenkel
Summary: This study aimed to evaluate the impact of an LCS Decision Tool on the quality of decision-making and LCS uptake. The results showed that the LCSDecTool group had higher scores in LCS knowledge and higher LCS uptake, but there was no significant difference in decisional conflict at 1 month.
Article
Multidisciplinary Sciences
Ryoung-Eun Ko, Sungeun Kim, Jihye Lee, Sojin Park, Daehwan Bae, Ki Hong Choi, Taek Kyu Park, Chi Ryang Chung, Jeong Hoon Yang
Summary: This study examines the clinical phenotypes of delirium in cardiac intensive care unit (CICU) patients and their relationship with clinical outcomes. The results show that delirium is common in CICU patients and is associated with increased in-hospital mortality. Septic delirium and hypoxic delirium are the most common delirium phenotypes.
Article
Cardiac & Cardiovascular Systems
Justin Ezekowitz, Robert J. Mentz, Cynthia M. Westerhout, Nancy K. Sweitzer, Michael M. Givertz, Ileana L. Pina, Christopher M. O'Connor, Stephen J. Greene, Ciaran McMullan, Lothar Roessig, Adrian F. Hernandez, Paul W. Armstrong
Summary: A registry of hospitalized patients with worsening heart failure was designed to provide context for an RCT. The study found that these patients exhibited high-risk features, with some eligible patients excluded from the RCT mainly due to existing exclusion criteria.
CIRCULATION-HEART FAILURE
(2021)
Article
Medicine, General & Internal
Vinay Kini, Monica Parks, Wenhui Liu, Stephen W. Waldo, P. Michael Ho, Steven M. Bradley, Paul L. Hess
Summary: This study investigated the proportion of patients who underwent stress testing within 2 years after elective PCI at 64 VA facilities in the US, and found that most patients who received stress testing had symptoms consistent with obstructive CAD.
Article
Critical Care Medicine
Ying-Ying Li, Yi-Hao Liu, Lin Yan, Jing Xiao, Xin-Yang Li, Jun Ma, Li-Gang Jia, Rui Chen, Chao Zhang, Zhen Yang, Ming-Bo Zhang, Yu-Kun Luo
Summary: Real-time biplane ultrasound-guided CVC offers advantages over the single-plane approach for critically ill patients, improving first-puncture success rate and reducing mechanical complications.
Article
Anesthesiology
Shahzad Shaefi, Ameeka Pannu, Ariel L. Mueller, Brigid Flynn, Adam Evans, Craig S. Jabaley, Domagoj Mladinov, Michael Wall, Shahla Siddiqui, David J. Douin, M. Dustin Boone, Erika Monteith, Vivian Abalama, Mark E. Nunnally, Miguel Cobas, Matthew A. Warner, Robert D. Stevens
Summary: This study surveyed critical care anesthesiologists in the United States to evaluate their clinical practice patterns, including compensation, types of ICUs covered, overnight ICU coverage models, and relationships between these factors. The study found significant variability in practice patterns, with female anesthesiologists reporting lower salaries but not statistically significant. These survey data can inform decision-making for the initiation and expansion of critical care services, staffing patterns, and further research on intensivist satisfaction and burnout.
ANESTHESIA AND ANALGESIA
(2023)
Article
Anesthesiology
Lin Hou, Xuesong Song, Na Yan, Zhuang Zhao, Zhiwen Li
Summary: This study developed a single-operator laser-assisted ultrasound-guidance system that projected the path of the target artery on the skin surface to improve the first-attempt success rate of radial artery cannulation in young pediatric patients. The results showed that this system significantly improved the success rate, reduced procedure time, and lowered the incidence of hematoma.
Article
Cardiac & Cardiovascular Systems
Roberto L. da Silva, Pedro B. de Andrade, George Dangas, Rodrigo M. Joaquim, Thais R. W. da Silva, Ramiro G. Vieira, Vanderlei C. Pereira Jr, Amanda G. M. Sousa, Fausto Feres, Jose R. Costa Jr
Summary: The use of nitroglycerin at the beginning or end of a transradial approach procedure does not preserve radial artery patency. This study does not support the effectiveness of nitroglycerin in preventing radial artery occlusion.
JACC-CARDIOVASCULAR INTERVENTIONS
(2022)
Article
Multidisciplinary Sciences
Senjun Jin, Lin Chen, Kun Chen, Chaozhou Hu, Sheng'an Hu, Zhongheng Zhang
Summary: The medical specialty of critical care provides emergency medical care to patients with life-threatening complications and injuries, generating a large amount of data. In-depth mining of this data could provide insights into underlying diseases and healthcare practices. Establishing an openly accessible critical care database is crucial for research purposes in China, considering its large patient population and potential for generating large healthcare databases.
Review
Critical Care Medicine
Christopher J. Yarnell, Darryl Abrams, Matthew R. Baldwin, Daniel Brodie, Eddy Fan, Niall D. Ferguson, May Hua, Purnema Madahar, Danny F. McAuley, Laveena Munshi, Gavin D. Perkins, Gordon Rubenfeld, Arthur S. Slutsky, Hannah Wunsch, Robert A. Fowler, George Tomlinson, Jeremy R. Beitler, Ewan C. Goligher
Summary: Recent Bayesian reanalyses of prominent trials in critical illness have generated controversy by contradicting the initial conclusions based on conventional frequentist analyses. In most cases, Bayesian and frequentist analyses agreed, but Bayesian analysis identified interventions where benefit was probable despite the absence of statistical significance. Bayesian analysis in critical care medicine can help to distinguish harm from uncertainty and establish the probability of clinically important benefit for clinicians, policy makers, and patients.
LANCET RESPIRATORY MEDICINE
(2021)
Article
Medicine, General & Internal
Lennart Christian Kaplan, Ichsan Ichsan, Farah Diba, Marthoenis Marthoenis, Muhsin Muhsin, Samadi Samadi, Katharina Richert, Suryane Sulistiana Susanti, Hizir Sofyan, Sebastian Vollmer
Summary: In a cluster randomized clinical trial, health facilities that implemented the Safe Childbirth Checklist (SCC) with medium-intensity coaching showed an increased application rate for 5 out of 36 essential birth practices compared to control facilities. Medium-intensity coaching may not be enough to significantly increase the uptake of the SCC, but a redesigned coaching approach focusing on long-term behavioral change could potentially enhance effectiveness.
Article
Cardiac & Cardiovascular Systems
Akshay Bagai, Mina Madan, Christopher Overgaard, Joan Porter, Lu Han, Asim N. Cheema, Andrew T. Yan, Padma Kaul, Shaun G. Goodman, Dennis Ko
Summary: This population-based study on patients undergoing percutaneous coronary intervention (PCI) found that individuals who received cardiac stress testing (CST) had a slightly lower risk of cardiovascular events. Further research is needed to confirm these findings and determine specific aspects of care that may contribute to improved clinical outcomes.
CANADIAN JOURNAL OF CARDIOLOGY
(2023)
Article
Critical Care Medicine
Mattia Arrigo, Susanna Price, David A. Baran, Janine Poss, Nadia Aissaoui, Antoni Bayes-Genis, Laurent Bonello, Bruno Francois, Etienne Gayat, Martine Gilard, Navin K. Kapur, Mahir Karakas, Maciej Kostrubiec, Pascal Leprince, Bruno Levy, Yves Rosenberg, Holger Thiele, Uwe Zeymer, Michael O. Harhay, Alexandre Mebazaa
Summary: AMICS is a critical syndrome with high morbidity and mortality, but current treatments are mainly based on clinical experience rather than evidence-based recommendations. Many therapeutic interventions for AMICS have not shown meaningful survival benefits, highlighting the need for accurate patient selection criteria and improved trial design to optimize outcomes.
LANCET RESPIRATORY MEDICINE
(2021)
Review
Anesthesiology
Guglielmo Imbriaco, Alessandro Monesi, Timothy R. Spencer
Summary: Radial artery catheterization is frequently performed for critically ill patients, and ultrasound guidance can improve success rates, reduce complications, and optimize catheter insertion and positioning.
ANAESTHESIA CRITICAL CARE & PAIN MEDICINE
(2022)
Article
Critical Care Medicine
David A. Harrison, Ben C. Creagh-Brown, Kathryn M. Rowan
Summary: Persistent critical illness is a common clinical syndrome in the ICU, which is associated with increased healthcare utilization and adverse outcomes. This study aimed to assess the predictive factors for survival in patients with persistent critical illness and compare the characteristics and outcomes of these patients with others. The findings suggest the need for improved understanding of long-term outcomes and the development of tools for prognostication.
JOURNAL OF THE INTENSIVE CARE SOCIETY
(2023)
Article
Critical Care Medicine
Robert Darnell, Christopher Newell, Julia Edwards, Emma Gendall, David Harrison, Stefan Sprinckmoller, Paul Mouncey, Doug Gould, Matt Thomas
JOURNAL OF THE INTENSIVE CARE SOCIETY
(2023)
Review
Immunology
Sang Ho Choi, Antoni Cesar, Timothy Arthur Chandos Snow, Naveed Saleem, Nishkantha Arulkumaran, Mervyn Singer
Summary: This study found that the efficacy of doxycycline is comparable to macrolides or fluoroquinolones in adult patients with mild-to-moderate community-acquired pneumonia (CAP), suggesting that it is a viable treatment option. However, larger trials are needed to confirm these findings due to the lack of recent studies.
CLINICAL INFECTIOUS DISEASES
(2023)
Review
Critical Care Medicine
Alexandre Tran, Shannon M. Fernando, Bram Rochwerg, Ryan P. Barbaro, Carol L. Hodgson, Laveena Munshi, Graeme Maclaren, Kollengode Ramanathan, Catherine L. Hough, Laurent J. Brochard, Kathryn M. Rowan, Niall Ferguson, Alain Combes, Arthur S. Slutsky, Eddy Fan, Daniel Brodie
Summary: This study summarized the association between pre-cannulation prognostic factors and risk of mortality in adult patients requiring venovenous ECMO for the treatment of COVID-19. The results showed that factors such as older age, male sex, chronic lung disease, longer duration of symptoms, longer duration of invasive mechanical ventilation, higher partial pressure of arterial carbon dioxide, and less previous experience with ECMO were associated with increased mortality risk.
LANCET RESPIRATORY MEDICINE
(2023)
Editorial Material
Medicine, General & Internal
Michael Klompas, Chanu Rhee, Mervyn Singer
Summary: This viewpoint discusses the failure of SEP-1 sepsis outcome improvement initiative by Centers for Medicare & Medicaid Services in improving patients' sepsis outcomes, and suggests shifting the focus of sepsis quality metrics from processes to outcomes.
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION
(2023)
Article
Medicine, General & Internal
Alisa M. Higgins, Lindsay R. Berry, Elizabeth Lorenzi, Srinivas Murthy, Zoe McQuilten, Paul R. Mouncey, Farah Al-Beidh, Djillali Annane, Yaseen M. Arabi, Abi Beane, Wilma Van Bentum-Puijk, Zahra Bhimani, Marc J. M. Bonten, Charlotte A. Bradbury, Frank M. Brunkhorst, Aiden Burrell, Adrian Buzgau, Meredith Buxton, Walton N. Charles, Matthew Cove, Michelle A. Detry, Lise J. Estcourt, Elizabeth O. Fagbodun, Mark Fitzgerald, Timothy D. Girard, Ewan C. Goligher, Herman Goossens, Rashan Haniffa, Thomas Hills, Christopher M. Horvat, David T. Huang, Nao Ichihara, Francois Lamontagne, John C. Marshall, Daniel F. McAuley, Anna McGlothlin, Shay P. McGuinness, Bryan J. McVerry, Matthew D. Neal, Alistair D. Nichol, Rachael L. Parke, Jane C. Parker, Karen Parry-Billings, Sam E. C. Peters, Luis F. Reyes, Kathryn M. Rowan, Hiroki Saito, Marlene S. Santos, Christina T. Saunders, Ary Serpa-Neto, Christopher W. Seymour, Manu Shankar-Hari, Lucy M. Stronach, Alexis F. Turgeon, Anne M. Turner, Frank L. van de Veerdonk, Ryan Zarychanski, Cameron Green, Roger J. Lewis, Derek C. Angus, Colin J. McArthur, Scott Berry, Lennie P. G. Derde, Anthony C. Gordon, Steve A. Webb, Patrick R. Lawler
Summary: The longer-term effects of therapies for critically ill COVID-19 patients are unknown. In this study, 4869 patients were randomized to receive different interventions, and it was found that treatment with IL-6 receptor antagonists and antiplatelet agents significantly improved survival rates after 180 days. These findings suggest that most therapies have consistent effects over a 6-month period.
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION
(2023)
Article
Critical Care Medicine
James C. Doidge, Doug W. Gould, Zia Sadique, Mark Borthwick, Robert A. Hatch, Fergus J. Caskey, Lui Forni, Robert F. Lawrence, Clare MacEwan, Marlies Ostermann, Paul R. Mouncey, David A. Harrison, Kathryn M. Rowan, J. Duncan Young, Peter J. Watkinson
Summary: This study evaluated the clinical and health economic impacts of transitioning from systemic heparin anticoagulation (SHA) to regional citrate anticoagulation (RCA) for continuous kidney replacement therapy (CKRT) in intensive care units (ICUs). The results showed that transition to RCA was not associated with changes in mortality, but was associated with increases in kidney support duration, advanced cardiovascular support duration, and ICU length of stay.
JOURNAL OF CRITICAL CARE
(2023)
Article
Critical Care Medicine
Gareth A. L. Jones, Simon Eaton, Michael Orford, Samiran Ray, Daisy Wiley, Padmanabhan Ramnarayan, David Inwald, Michael P. W. Grocott, Michael Griksaitis, John Pappachan, Lauran R. O'Neill, Paul A. Mouncey, David M. Harrison, Kathryn J. Rowan, Mark Peters
Summary: The study aimed to compare the effects of conservative oxygenation targets and liberal oxygenation targets on the oxidative status of pediatric patients in the intensive care unit. The results showed that the conservative oxygenation group had higher levels of urinary nitrate/nitrite and lower expression of hypoxia-inducible factor (HIF)-1a mRNA in blood.
PEDIATRIC CRITICAL CARE MEDICINE
(2023)
Article
Oncology
Jennifer Bre, Alison L. Dickson, Oliver J. Read, Ying Zhang, Fiona G. McKissock, Peter Mullen, Peijun Tang, Greice M. Zickuhr, Clarissa M. Czekster, David J. Harrison
Summary: NUC-3373 is a modified version of 5-fluorodeoxyuridine that shows higher anti-cancer activity and better safety profile compared to 5-FU, overcoming its limitations and pharmacologic challenges in clinical use.
CANCER CHEMOTHERAPY AND PHARMACOLOGY
(2023)
Article
Multidisciplinary Sciences
Christina Fell, Mahnaz Mohammadi, David Morrison, Ognjen Arandjelovic, Sheeba Syed, Prakash Konanahalli, Sarah Bell, Gareth Bryson, David J. Harrison, David Harris-Birtill
Summary: In this study, AI was used to categorise endometrial biopsy whole slide images into malignant, other, benign, or insufficient categories. The digitalisation of pathology has led to the automation of image analysis, and a model that can classify slides in this way would help prioritise pathologists' workload and reduce diagnosis time for cancer patients. The final model achieved an accuracy of 90% in classifying slides correctly and 97% in the malignant class, demonstrating its effectiveness in assisting pathologists.
Article
Multidisciplinary Sciences
Nishkantha Arulkumaran, Mervyn Singer, Stefan Howorka, Jonathan R. R. Burns
Summary: In this study, the authors assemble DNA subunits into structural frameworks to support the formation of membrane-based protocells and prototissues, harnessing simplicity to create complexity.
NATURE COMMUNICATIONS
(2023)
Article
Computer Science, Information Systems
Georg Wolflein, In Hwa Um, David J. Harrison, Ognjen Arandjelovic
Summary: In recent years, efforts have been made to digitize whole-slide images of cancer tissue, providing new opportunities for deep learning in oncology. One promising application is virtual staining, where a deep learning model reproduces the appearance of stained tissue sections based on different input stains. However, there is a scarcity of supervised training data with aligned input and output stains on the same tissue sections. In this work, a dataset of ten whole-slide images of clear cell renal cell carcinoma tissue sections, along with over 600,000 patches and cell segmentation masks, is introduced to facilitate the development of deep learning methods for digital pathology and benchmark virtual staining models.
Article
Computer Science, Artificial Intelligence
Clarisse F. de Vries, Samantha J. Colosimo, Roger T. Staff, Jaroslaw A. Dymiter, Joseph Yearsley, Deirdre Dinneen, Moragh Boyle, David J. Harrison, Lesley A. Anderson, Gerald Lip
Summary: Artificial intelligence (AI) tools may be helpful in breast screening mammography programs, but their generalizability to new settings should be validated. This study assessed the performance of a commercially available breast screening AI algorithm in a specific clinical site using a 3-year dataset. The algorithm's recall rates were high initially but reduced after threshold calibration and were influenced by software upgrades. Validating AI performance and thresholds in new clinical settings is important, and quality assurance systems should ensure consistency.
RADIOLOGY-ARTIFICIAL INTELLIGENCE
(2023)
Correction
Critical Care Medicine
Peter J. McGuigan, Elisa Giallongo, Bronagh Blackwood, James Doidge, David A. Harrison, Alistair D. Nichol, Kathryn M. Rowan, Manu Shankar-Hari, Markus B. Skrifvars, Karen Thomas, Danny F. McAuley
Article
Critical Care Medicine
Peter J. McGuigan, Elisa Giallongo, Bronagh Blackwood, James Doidge, David A. Harrison, Alistair D. Nichol, Kathryn M. Rowan, Manu Shankar-Hari, Markus B. Skrifvars, Karen Thomas, Danny F. McAuley, Peter J. McGuigan
Summary: This retrospective analysis found an association between hypotension and hypertension in the first 24 h in ICU and mortality following OHCA. Patients with a lowest recorded MAP in the range 60-63 mmHg and a highest recorded MAP in the range 95-104 mmHg had the lowest associated mortality. Research into individualized blood pressure targets for survivors following OHCA is needed.
