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Timing of neuroprognostication in the ICU.
Curr Opin Crit Care
January 2025
Department of Critical Care Medicine.
Purpose Of Review: Neuroprognostication after acute brain injury (ABI) is complex. In this review, we examine the threats to accurate neuroprognostication, discuss strategies to mitigate the self-fulfilling prophecy, and how to approach the indeterminate prognosis.
Recent Findings: The goal of neuroprognostication is to provide a timely and accurate prediction of a patient's neurologic outcome so treatment can proceed in accordance with a patient's values and preferences.
Natural history of recovery and long-term outcome in critically ill patients with brain injury.
Curr Opin Crit Care
January 2025
Spaulding Rehabilitation Hospital, Department of Physical Medicine and Rehabilitation, Charlestown.
Purpose Of Review: To increase knowledge of the natural history of recovery and long-term outcome following severe traumatic brain injury (sTBI).
Recent Findings: Recovery of consciousness and complex behaviors that presage subsequent functional recovery frequently occurs well beyond the first 7 days after injury, which is typically the time period widely used in the ICU for prognostic decision-making and establishing goals of care for. Similarly, recovery of functional independence occurs between 1 and 10 years postinjury in a substantial proportion of patients who do not recover command-following during the acute hospitalization.
Objectives: Intensive care unit (ICU) clinicians stop antibiotics more often, with a negative infection: point-of-care test (PCR-POCT). Simulated cases of diagnostic uncertainty regarding infection resolution led clinicians to choose options such as procalcitonin (PCT) and/or PCR-POCTs +/- de-escalation to aid stop decisions. We hypothesised that a direct infection indicator, PCR-POCT, would influence stop judgements more than indirect PCT.
View Article and Find Full Text PDFProtocol for the impact of machine learning-based clinician decision support algorithims in perioperative care (IMAGINATIVE) in Singapore general hospital : a large prospective randomised controlled trial.
BMJ Open
December 2024
Health Services and Systems Research, Duke-NUS Medical School, Singapore.
Introduction: As surgical accessibility improves, the incidence of postoperative complications is expected to rise. The implementation of a precise and objective risk stratification tool holds the potential to mitigate these complications by early identification of high-risk patients. Moreover, it could address the escalating costs from resource misallocation.
View Article and Find Full Text PDFAI Interventions to Alleviate Healthcare Shortages and Enhance Work Conditions in Critical Care: Qualitative Analysis.
J Med Internet Res
January 2025
ETH Zurich, Zurich, Switzerland.
Background: The escalating global scarcity of skilled health care professionals is a critical concern, further exacerbated by rising stress levels and clinician burnout rates. Artificial intelligence (AI) has surfaced as a potential resource to alleviate these challenges. Nevertheless, it is not taken for granted that AI will inevitably augment human performance, as ill-designed systems may inadvertently impose new burdens on health care workers, and implementation may be challenging.
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