Tracheostomy Practice in the Italian Intensive Care Units: A Point-Prevalence Survey.

: A tracheostomy is a frequently performed surgical intervention in intensive care units (ICUs) for patients requiring prolonged mechanical ventilation. This procedure can offer significant benefits, including reduced sedation requirements, improved patient comfort, and enhanced airway management. However, it is also associated with various risks, and the absence of standardized clinical guidelines complicates its implementation.

Transitioning to high-sensitivity troponin: 1-year mortality outcomes in patients with suspected acute coronary syndrome presenting to emergency departments.

Background: Switching from a conventional to a high-sensitivity cardiac troponin (hs-cTn) assay enables detection of smaller amounts of myocardial damage, but the clinical benefit is unclear. We investigated whether switching to a hs-cTnI assay with a sex-specific 99th centile diagnostic threshold was associated with lower 1-year death or new myocardial infarction (MI) in patients with suspected acute coronary syndrome (ACS).

Methods: This pre-post study included nine tertiary hospitals in Australia.

Deep Serratus Anterior Plane Block for Multimodal Analgesia in Minimally Invasive Mitral Valve Surgery Performed via Right Anterior Mini-Thoracotomy.

Objective: This study investigated if the serratus anterior plane block (SAPB) within a multimodal analgesia scheme would reduce acute post-operative pain and intravenous opioid consumption in patients admitted to the intensive care unit after isolated minimally invasive mitral valve surgery.

Design: Retrospective study.

Setting: Patients were admitted to the intensive care unit (ICU) of the University Hospital of Siena (Italy).

Establishing an Extracorporeal Cardiopulmonary Resuscitation Program.

Extracorporeal cardiopulmonary resuscitation (ECPR) is a complex, life-saving procedure that uses mechanical support for patients with refractory cardiac arrest, representing the pinnacle of extracorporeal membrane oxygenation (ECMO) applications. Effective ECPR requires precise patient selection, rapid mobilization of a multidisciplinary team, and skilled cannulation techniques. Establishing a program necessitates a cohesive ECMO system that promotes interdisciplinary collaboration, which is essential for managing acute cardiogenic shock and severe pulmonary failure.

Articulating Video Stylets in the Setting of Simulated Traumatic Cervical Spine Injury: A Comparison with Four Other Devices and Approaches to Endotracheal Intubation.

Simulation offers the opportunity to train healthcare professionals in complex scenarios, such as those with as traumatized patients. We conducted an observational cross-sectional research simulating trauma with cervical immobilization. We compared five techniques/devices: direct laryngoscopy (DL), videolaryngoscopy (VLS, Glidescope or McGrath), combined laryngo-bronchoscopy intubation (CLBI) and articulating video stylet (ProVu).

Comparative Algorithms for Identifying and Counting Hospitalisation Episodes of Care for Coronary Heart Disease Using Administrative Data.

Purpose: Measures of disease burden using hospital administrative data are susceptible to over-inflation if the patient is transferred during their episode of care. We aimed to identify and compare measures of coronary heart disease (CHD) and myocardial infarction (MI) episodes using six algorithms that account for transfers.

Patient And Methods: We used person-linked hospitalisations for CHD and MI for 2000-2016 in Western Australia based on the interval between discharge and subsequent admission (date, datetime algorithms), pathway (admission source, discharge destination) and any combination to generate machine learning models (random forest [RF], gradient boosting machine [GBM]).

Investigating health care pathways for anaphylaxis: Seeing the bigger picture through linked data.

Background: Anaphylaxis is increasing in Australia involving all levels of the health care system. Although guidelines recommend calling an ambulance and 4-hour observation, knowledge gaps exist regarding where people experiencing anaphylaxis receive care.

Objective: We sought to examine care pathways for anaphylaxis in Western Australia and factors associated with seeking care from ambulance versus the emergency department (ED), and subsequent hospital admission.

Automated and reference methods for the calculation of left ventricular outflow tract velocity time integral or ejection fraction by non-cardiologists: a systematic review on the agreement of the two methods.

Echocardiography is crucial for evaluating patients at risk of clinical deterioration. Left ventricular ejection fraction (LVEF) and velocity time integral (VTI) aid in diagnosing shock, but bedside calculations can be time-consuming and prone to variability. Artificial intelligence technology shows promise in providing assistance to clinicians performing point-of-care echocardiography.

Effects of very early hyperoxemia on neurologic outcome after out-of-hospital cardiac arrest: A secondary analysis of the TTM-2 trial.

Purpose: Hyperoxemia is common in patients resuscitated after out-of-hospital cardiac arrest (OHCA) admitted to the intensive care unit (ICU) and may increase the risk of mortality. However, the effect of hyperoxemia on functional outcome, specifically related to the timing of exposure to hyperoxemia, remains unclear.

Methods: The secondary analysis of the Target Temperature Management 2 (TTM-2) randomized trial.

Recommendations for fast-track extubation in adult cardiac surgery patients: a consensus statement.

Introduction: Enhanced recovery after cardiac surgery in selected low-risk patients, has the potential to improve outcomes and reduce the burden of healthcare costs. Anesthesia-related challenges play a major role in the successful implementation of Enhanced Recovery After Surgery (ERAS) protocols, with particular emphasis placed on fast-track extubation. Acknowledging the importance of this practice, the Italian Association of Cardiac Anesthesiologists and Intensive Care (ITACTAIC) has advocated for an initiative to establish a consensus offering practical recommendations for fast-track extubation after adult cardiac surgery.

Determinants and Outcomes of Invasive Coronary Angiography in Unselected Patients Presenting With Chest Pain to Emergency Departments in Western Australian Teaching Hospitals.

Background: Chest pain is a common cause of presentation to the emergency department (ED), and its outcomes are affected by various diagnostic tests and timely management. Our aim was to identify determinants of invasive coronary angiography (ICA) in a chest pain cohort following ED presentation, and to compare outcomes by time to ICA.

Methods: We identified all adults aged ≥20 years presenting with chest pain to public teaching hospital EDs in Perth, Western Australia, from 1 January 2016 to 31 March 2017.

Is artificial intelligence prepared for the 24-h shifts in the ICU?

Integrating machine learning (ML) into intensive care units (ICUs) can significantly enhance patient care and operational efficiency. ML algorithms can analyze vast amounts of data from electronic health records, physiological monitoring systems, and other medical devices, providing real-time insights and predictive analytics to assist clinicians in decision-making. ML has shown promising results in predictive modeling for patient outcomes, early detection of sepsis, optimizing ventilator settings, and resource allocation.

Mortality in Patients With Sepsis Treated With Esmolol or Landiolol: A Systematic Review and Meta-Analysis of Randomized Controlled Trials With Trial Sequential Analysis.

Background: The latest meta-analysis indicated potential survival benefits from ultra-short-acting β-blockers in patients with sepsis with persistent tachycardia. However, subsequent multicenter randomized controlled trials (RCTs) have reported conflicting findings, prompting the need for an updated meta-analysis to incorporate these newly published RCTs.

Research Question: Does the use of ultra-short-acting β-blockers (esmolol or landiolol) in patients with sepsis with persistent tachycardia improve mortality?

Study Design And Methods: We conducted an updated systematic search through April 2, 2024, exploring the MEDLINE, Cochrane Central Register of Controlled Trials, and Embase databases for RCTs reporting mortality in adult patients with sepsis treated with esmolol or landiolol as compared with those treated with neither of these or receiving placebo and published in English.

Open-source design of low-cost sensorised elastic actuators for collaborative prosthetics and orthotics.

Collaborative robots, or cobots, have become popular due to their ability to safely operate alongside humans in shared environments. These robots use compliant actuators as a key design element to prevent damage during unintended collisions. In prosthetic and orthotic applications, compliant actuators are crucial for ensuring user safety and comfort.

Research Letter: Dispensing of psychotropic medications in Australia between 2013 and 2022.

Objective: The objective of this study was to determine the proportion of Australians dispensed psychotropic medications between 2013 and 2022 according to their age.

Methods: Services Australia provided a de-identified 10% random Pharmaceutical Benefits Scheme sample that allowed us to determine, for each year, the proportion of Australians dispensed at least one script for antipsychotics, antidepressants, anxiolytics, or hypnotics. The classification of medications followed Anatomical Therapeutic Chemical coding.

The MINUTES bundle for the initial 30 min management of undifferentiated circulatory shock: an expert opinion.

Acute circulatory shock is a life-threatening emergency requiring an efficient and timely management plan, which varies according to shock etiology and pathophysiology. Specific guidelines have been developed for each type of shock; however, there is a need for a clear timeline to promptly implement initial life-saving interventions during the early phase of shock recognition and management. A simple, easily memorable bundle of interventions could facilitate standardized management with clear targets and specified timeline.

Health in a Virtual Environment (HIVE): A Novel Continuous Remote Monitoring Service for Inpatient Management.

The aim of this study was to describe the implementation of a novel 50-bed continuous remote monitoring service for high-risk acute inpatients treated in non-critical wards, known as Health in a Virtual Environment (HIVE). We report the initial results, presenting the number and type of patients connected to the service, and assess key outcomes from this cohort. This was a prospective, observational study of characteristics and outcomes of patients connected to the HIVE continuous monitoring service at a major tertiary hospital and a smaller public hospital in Western Australia between January 2021 and June 2023.

Inclusive Hadronic Decay Rate of the τ Lepton from Lattice QCD: The u[over ¯]s Flavor Channel and the Cabibbo Angle.

We present a lattice determination of the inclusive decay rate of the process τ↦X_{us}ν_{τ} in which the τ lepton decays into a generic hadronic state X_{us} with u[over ¯]s flavor quantum numbers. Our results have been obtained in n_{f}=2+1+1 isosymmetric QCD with full nonperturbative accuracy, without any operator product expansion approximation and, except for the presently missing long-distance isospin-breaking corrections, include a solid estimate of all sources of theoretical uncertainties. This has been possible by using the Hansen-Lupo-Tantalo method [M.

Supply of nirmatrelvir/ritonavir and molnupiravir for patients with COVID-19 in the first eight months since listing on the Australian Pharmaceutical Benefits Scheme: A retrospective observational study.

Objectives: To compare the supply of molnupiravir and nirmatrelvir/ritonavir in relation to patient characteristics and other co-prescribed medicines and to estimate the number of patients without contraindications to nirmatrelvir/ritonavir who were treated with molnupiravir.

Study Design, Setting: Retrospective observational study of patients identified in the Pharmaceutical Benefits Scheme (PBS) 10 % sample dataset who were supplied with either molnupiravir or nirmatrelvir/ritonavir between May and December 2022. We supplemented the PBS dataset with aggregated counts from published literature to determine prevalence of clinical contraindications to nirmatrelvir/ritonavir.

Enhancing unmanned ground vehicle performance in SAR operations: integrated gesture-control and deep learning framework for optimised victim detection.

In this study, we address the critical need for enhanced situational awareness and victim detection capabilities in Search and Rescue (SAR) operations amidst disasters. Traditional unmanned ground vehicles (UGVs) often struggle in such chaotic environments due to their limited manoeuvrability and the challenge of distinguishing victims from debris. Recognising these gaps, our research introduces a novel technological framework that integrates advanced gesture-recognition with cutting-edge deep learning for camera-based victim identification, specifically designed to empower UGVs in disaster scenarios.