Crit Care Resusc
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Natural language processing (NLP) is a branch of artificial intelligence focused on enabling computers to interpret and analyse text-based data. The intensive care specialty is known to generate large volumes of data, including free-text, however, NLP applications are not commonly used either in critical care clinical research or quality improvement projects. This review aims to provide an overview of how NLP has been used in the intensive care specialty and promote an understanding of NLP's potential future clinical applications. ⋯ Natural language processing has been used for a variety of purposes in the ICU context. Increasing awareness of these techniques amongst clinicians may lead to more clinically relevant algorithms being developed and implemented.
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Modern intensive care for moderate-to-severe traumatic brain injury (msTBI) focuses on managing intracranial pressure (ICP) and cerebral perfusion pressure (CPP). This approach lacks robust clinical evidence and often overlooks the impact of hypoxic injuries. ⋯ However, there is still a lack of consensus regarding the interpretation of PbtO2 in clinical practice. This review aims to provide an overview of the pathophysiological rationales, monitoring technology, physiological determinants, and recent clinical trial evidence for PbtO2 monitoring in the management of msTBI.
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Frequent measurement of creatinine by point-of-care testing (POCT) may facilitate the earlier detection of acute kidney injury (AKI) in critically ill patients. However, no robust data exist to confirm its equivalence to central laboratory testing. We aimed to conduct a multicenter study to compare POCT with central laboratory creatinine (CrC) measurement. ⋯ In critically ill patients, measurement of creatinine by POCT yields clinically equivalent values to those obtained by central laboratory measurement and can be easily used for more frequent monitoring of kidney function in such patients. These findings open the door to the use of POCT for the earlier detection of acute kidney injury in critically ill patients.
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To determine the perceived barriers and enablers to efficient completion of the College of Intensive Care Medicine (CICM) of Australia and New Zealand Formal Project - a trainee research project mandated for award of CICM Fellowship - and to develop consensus-based recommendations to support Intensive Care trainees and supervisors. ⋯ Twenty-two recommendations were developed aiming to make the process of completing the mandatory CICM research project more efficient, and to improve the quality of research produced from these projects.
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Targeted mild hypercapnia is a potential neuroprotective therapy after cardiac arrest. In this exploratory observational study, we aimed to explore the effects of targeted mild hypercapnia on cerebral microvascular resistance assessed by middle cerebral artery pulsatility index (MCA PI) and intracranial pressure estimated by optic nerve sheath diameter (ONSD) in resuscitated out-of-hospital cardiac arrest (OHCA) patients. ⋯ Cerebral microvascular resistance assessed by MCA PI decreased over 24 h and was lower in OHCA patients treated with targeted mild hypercapnia compared with targeted normocapnia. Targeted mild hypercapnia did not exert substantial effect on intracranial pressure as estimated by ONSD.