Articles: intensive-care-units.
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Critical care clinics · Oct 2023
ReviewImplementing Artificial Intelligence: Assessing the Cost and Benefits of Algorithmic Decision-Making in Critical Care.
This article provides an overview of the most useful artificial intelligence algorithms developed in critical care, followed by a comprehensive outline of the benefits and limitations. We begin by describing how nurses and physicians might be aided by these new technologies. We then move to the possible changes in clinical guidelines with personalized medicine that will allow tailored therapies and probably will increase the quality of the care provided to patients. Finally, we describe how artificial intelligence models can unleash researchers' minds by proposing new strategies, by increasing the quality of clinical practice, and by questioning current knowledge and understanding.
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Acta Anaesthesiol Scand · Mar 2024
Multicenter Study Observational StudyValidation of PRE-DELIRIC and E-PRE-DELIRIC in a Danish population of intensive care unit patients-A prospective observational multicenter study.
Delirium is a clinical condition characterized by an acute change in brain function and is frequently observed in critically ill patients. The condition has been associated with negative outcomes, making it crucial to identify patients who are at risk. Two recent prediction models have been developed to estimate the risk of delirium in intensive care unit (ICU) patients; the prediction model for delirium (PRE-DELIRIC) and the early prediction model for delirium (E-PRE-DELIRIC). We aimed to perform an external validation of these models in a Danish cohort of critically ill patients. ⋯ In a Danish cohort, we found that the PRE-DELIRIC model demonstrated acceptable performance and E-PRE-DELIRIC demonstrated poor performance. In critically ill adult patients PRE-DELIRIC may be useful in identifying patients at high risk of delirium.
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Semin Respir Crit Care Med · Apr 2024
ReviewSevere Community-Acquired Pneumonia in Immunocompromised Patients.
Due to higher survival rates with good quality of life, related to new treatments in the fields of oncology, hematology, and transplantation, the number of immunocompromised patients is increasing. But these patients are at high risk of intensive care unit admission because of numerous complications. Acute respiratory failure due to severe community-acquired pneumonia is one of the leading causes of admission. ⋯ For patients with an undetermined etiology despite comprehensive diagnostic workup, the hospital mortality rate is very high. Thus, a standardized diagnosis strategy should be defined to increase the diagnosis rate and prescribe the appropriate treatment. This review focuses on the benefit-to-risk ratio of invasive or noninvasive strategies, in the era of omics, for the management of critically ill immunocompromised patients with severe pneumonia in terms of diagnosis and oxygenation.
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To evaluate the impact of COVID-19 positivity on outcomes and resource utilization in the trauma population. ⋯ Asymptomatic COVID-19 trauma patients have significantly higher rates of cardiac events, longer LOS, and higher hospital charges when compared with similar trauma patients who are COVID-19-negative.
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Am. J. Respir. Crit. Care Med. · Dec 2023
Changes in Restricting Symptoms after Critical Illness among Community-Living Older Adults.
Rationale: Survivors of critical illness have multiple symptoms, but how restricting symptoms change after critical illness and whether these changes differ among vulnerable subgroups is unknown. Objectives: To evaluate changes in restricting symptoms over the six months after critical illness among older adults and to determine whether these changes differ by sex, multimorbidity, and individual- and neighborhood-level socioeconomic disadvantage. Methods: From a prospective longitudinal study of 754 community-living adults ⩾70 years old interviewed monthly (1998-2018), we identified 233 admissions from 193 participants to the ICU. ⋯ Increases in restricting symptoms did not differ significantly by sex, multimorbidity, or individual- or neighborhood-level socioeconomic disadvantage. Conclusions: Restricting symptoms increase substantially after a critical illness before returning to baseline three months after hospital discharge. Our findings highlight the need to incorporate symptom management into post-ICU care and for further investigation into whether addressing restricting symptoms can improve quality of life and functional recovery among older ICU survivors.