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Editorial February 17, 2020 Randomized Clinical Trials of Artificial Intelligence Derek C.?Angus JAMA.?Published online February 17, 2020. doi:10.1001/jama.2020.1039 As patient data are increasingly captured digitally, the opportunities to deploy artificial intelligence (AI), especially machine learning, are increasing rapidly. Machine learning is automated learning by computers using tools such as artificial neural networks to search data itera...
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Potentially Preventable ICU Admissions Interior of an empty intensive care unit. As our population continues to age, and as medical conditions become more complex, the need for intensive care unit beds continues to increase. One possible way to ensure adequate capacity is by reducing potentially preventable ICU stays.? Increased demand for critical care services could be managed through improved ICU triage and increased interprofessional ICU staffing. Also, recog...
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Editorial February 17, 2020 Lack of Clinical Benefit of Interferon β-1a Among Patients With Severe Acute Respiratory Distress Syndrome: Time to Overhaul Drug Trials in ARDS? Manu?Shankar-Hari,?Carolyn S.?Calfee JAMA.?Published online February 17, 2020. doi:10.1001/jama.2019.2252 In acute respiratory distress syndrome (ARDS), the alveolar-capillary units are disrupted, with lung endothelial and epithelial injury resulting in exudative pulmonary e...
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Targeted Temperature Management After Cardiac Arrest Medical nurse cares about patient in ICU. Post-anoxic brain damage after cardiac arrest is a complex condition that is managed through targeted temperature management (TTM) as it is currently the only neuroprotective intervention recommended after out-of-hospital cardiac arrest (OHCA). However, experts have raised concerns about the level of evidence supporting this intervention. Two early clinical trials have ...
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Treatment of High Intracranial Pressure After Traumatic Brain Injury One of the most frequent causes of death and disability after severe traumatic brain injury (TBI) is high intracranial pressure (ICP). ICP is generally treated with usual techniques?such as normothermia, sedation, etc. and first-line therapeutic strategies such as moderate hypocapnia, mannitol etc. However, in patients where these measures do not work, second-line therapies are usually initiated. ...
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In-line Filtration Reduces Organ Dysfunction, Inflammation Patients admitted to the intensive care unit are administered drugs, fluid, and blood products intravenously. In the vast majority of these patients, there are no untoward effects of the intravenous infusion. However, young children and neonates who are ill are usually administered intravenous infusions with the use of in-line filters. The philosophy behind this approach is that the filters may not only block/f...
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Using Biomarkers for Mortality Prediction in Patients With Sepsis Sepsis has always carried high mortality. Even today, with all the latest technology and newer antibiotics, sepsis continues to be a major risk factor for death. It is important to understand that the earlier sepsis is diagnosed and treated, the better the prognosis. Each year, nearly 6 million people die of sepsis in the US.? Because of its aggressive course, sepsis? necessitates early diagnosis and imm...
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ICU Management & Practice, Volume 19 - Issue 3, 2019 New Trends in ICU Nutrition The new trends in nutrition management included in the last guidelines are discussed, in particular the route and the dose of calories and proteins recommended. During the last decade, numerous paradigms and dogmas based on observational cohort studies were challenged by the publication of large multicentre prospective randomised controlled trials (RCT). Actually, until rece...
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Machine Learning to Predict Severe Sepsis and Septic Shock Sepsis is a major cause of death among hospitalised patients. It affects nearly 6% of all admissions and results in in-hospital mortality of greater than 15%. Early detection could reduce mortality, as it would result in the timely implementation of evidence-based interventions.? Clinical researchers have developed and implemented a machine-learning algorithm to predict severe sepsis and septic shock. The go...
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Nutritional Support in Malnourished Medical Inpatients Patients who are malnourished or at nutritional risk do tend to have poorer outcomes compared to patients who are relatively healthier when they undergo surgery or are sick. Poorly nourished patients do not have the reserves to fight off illness, and in many cases, are also immunosuppressed with delayed wound healing. Malnutrition is a major public health problem. Approximately 30% of patients who are admitted t...
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