Journal of the Intensive Care Society最新文献

{"title":"Service evaluation: Accuracy of using end-tidal CO₂ to estimate PaCO₂ values in suspected traumatic brain injury patients requiring mechanical ventilation.","authors":"Johan Victor Rehnberg, Julian Hannah, James Plumb, Peter Owen","doi":"10.1177/17511437261444655","DOIUrl":"https://doi.org/10.1177/17511437261444655","url":null,"abstract":"<p><p>This service evaluation assessed the accuracy of estimating arterial partial pressure of carbon dioxide (PaCO₂) from end-tidal CO₂ (ETCO₂) in prehospital suspected traumatic brain injury (TBI) patients requiring mechanical ventilation. Thirty-one cases with paired ETCO₂ and emergency department (ED) PaCO₂ measurements were analysed. Estimated PaCO₂ (ETCO₂ + 0.5 kPa) significantly underestimated measured PaCO₂, with a mean bias of 1.17 kPa and wide limits of agreement. Nearly half of patients were outside the normocapnic range despite apparently acceptable estimated values. Findings highlight the risk of inadvertent hypercapnia when relying on ETCO₂-based estimation alone. Lower ETCO₂ targets or point-of-care PaCO₂ measurement may improve ventilation accuracy and reduce secondary brain injury.</p>","PeriodicalId":39161,"journal":{"name":"Journal of the Intensive Care Society","volume":" ","pages":"17511437261444655"},"PeriodicalIF":1.4,"publicationDate":"2026-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13111533/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147784270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Triad of Dying: A framework for palliation and compassionate decision-making in the ICU.","authors":"Ned Gilbert-Kawai, Edward Presswood","doi":"10.1177/17511437261429269","DOIUrl":"https://doi.org/10.1177/17511437261429269","url":null,"abstract":"<p><strong>Background: </strong>End-of-life decision-making in the intensive care unit (ICU) remains ethically complex and emotionally charged. There is a need for frameworks that support compassionate, values-based care when curative treatment is no longer appropriate.</p><p><strong>Methods: </strong>This paper introduces the 'Triad of Dying', an easy to recall, clinical and ethical framework comprising comfort, dignity, and the presence of loved ones, to guide ICU clinicians in withdrawing life-sustaining treatment.</p><p><strong>Results: </strong>The framework integrates established palliative principles into a cohesive and memorable tool for bedside decision-making, interdisciplinary practice, and trainee education. It enhances communication with families and promotes person-centred care.</p><p><strong>Conclusion: </strong>The Triad of dying provides a practical scaffold for reframing ICU death as a meaningful, human event rather than a medical failure. It fosters ethically grounded palliation that honours the values and identities of patients at life's end.</p>","PeriodicalId":39161,"journal":{"name":"Journal of the Intensive Care Society","volume":" ","pages":"17511437261429269"},"PeriodicalIF":1.4,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13095996/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147784321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Infectious meningitis and encephalitis: A primer for acute care practitioners.","authors":"Martin Beed, Chit Wong, Rob A Dineen, Louise Berry, Peter G Brindley","doi":"10.1177/17511437261437982","DOIUrl":"https://doi.org/10.1177/17511437261437982","url":null,"abstract":"&lt;p&gt;&lt;p&gt;Meningitis and encephalitis affect all ages, are prone to misdiagnosis and outcome can be devastating. We provide this common primer for all in the sepsis \"chain-of-survival.\" Meningitis equals inflammation/infection of the protective membranes that cover the brain; whereas encephalitis affects the brain parenchyma. Meningitis is more common, but they can co-exist as meningoencephalitis. Encephalitis can also affect the spinal cord (encephalomyelitis). Worldwide, meningitis affects 2.5 million people annually, and kills over 200,000. Central nervous system (CNS) infections account for 3.9% of all UK intensive care unit (ICU) infections, and 0.7% of adult ICU admissions. While this means these are not common causes for admission, they do have high morbidity and mortality. The median ICU stay is 4 days, of which 3 days was the median spent requiring advanced respiratory support or support for more than one organ. The median in-hospital stay is 20 days. Most admissions come through the emergency department (ED). Signs and symptoms can be vague and varied; hence potential misdiagnosis as flu, psychiatric disorders, intoxication, even hangover. The median time between hospital admission and transfer to ICU is 1 day, and by this time approximately one-third are comatose and one-sixth need respiratory support. The risk of misdiagnosis matters given high mortality and morbidity: 18%-25% die in hospital and 1-in-10 survivors lose independence. During the past 20 years mortality has fallen, but those left with some form of permanent disability remains constant at nearly 40%. Fortunately, early recognition and treatment can greatly improve outcome. Regarding diagnosis, history and physical examination still have great value. Next, lumbar puncture (LP) should be expedited unless contraindicated by coagulopathy, skin infection, or raised ICP. LP testing should incorporate opening pressure, microscopy, culture and cell count, glucose and protein and often polymerase chain reaction (PCR) for meningococcus, pneumococcus, herpes simplex virus (HSV1&2), varicella (VZV) and enterovirus. Radiologically, head computed tomography (CT) is first line. It may reduce the risk of LP by excluding pathologies likely to trigger herniation. CT is indicated if their Glasgow Coma Score (GCS) is falling or ⩽9, or if seizures, focal neurological signs or papilloedema. Normal CT cannot rule out raised ICP, but LP is avoided if the CT shows herniation, basal cistern or foramen magnum effacement, cerebral swelling, intracranial lesions/collections with mass effect or obstructive hydrocephalus. Magnetic resonance imaging (MRI) is logistically tougher but better at detecting meningitis/encephalitis. MRI can suggest the causative organisms, along with complications such as infarct, pus and parenchymal changes. Treatment centres on prompt antimicrobials: usually a third-generation intravenous (IV) cephalosporin, typically within 1 h, and at an increased (i.e. \"meningitis\") dose. In","PeriodicalId":39161,"journal":{"name":"Journal of the Intensive Care Society","volume":" ","pages":"17511437261437982"},"PeriodicalIF":1.4,"publicationDate":"2026-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13053408/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147640259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nursing interventions to ensure the safety of critically ill patients in intrahospital transportation: A scoping review.","authors":"Ana Filipa Lemos, Diana Vareta","doi":"10.1177/17511437261422929","DOIUrl":"https://doi.org/10.1177/17511437261422929","url":null,"abstract":"<p><strong>Background: </strong>Intrahospital transportation of critically ill patients is a high-risk process, frequently linked to complications and increased vulnerability to adverse events. Ensuring safety requires nursing interventions that uphold the standards of care provided in critical care units.</p><p><strong>Objective: </strong>To identify nursing interventions that promote patient safety during intrahospital transportation. Methods: A scoping review was conducted following Arksey and O'Malley's framework. The search was performed in 2024 across PubMed and EBSCOhost (CINAHL Complete, MEDLINE Complete, Nursing & Allied Health Collection: Comprehensive, and Cochrane Central Register of Controlled Trials).</p><p><strong>Results: </strong>Seven publications met the criteria. All studies emphasized the need for strategies to prevent complications during transport. Four categories of interventions emerged: identification and management of adverse events, use of checklists, continuous nurse training, and effective communication.</p><p><strong>Conclusions: </strong>Nurses play a pivotal role in maintaining safety and quality of care. By applying evidence-based strategies, they minimize risks and ensure safer intrahospital transportation.</p>","PeriodicalId":39161,"journal":{"name":"Journal of the Intensive Care Society","volume":" ","pages":"17511437261422929"},"PeriodicalIF":1.4,"publicationDate":"2026-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13053400/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147640274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effectiveness of selective neutrophil elastase inhibitors (sivelestat) in acute lung injury or acute respiratory distress syndrome: A systematic review and meta-analysis of randomized controlled trials.","authors":"Awirut Charoensappakit, Kritsanawan Sae-Khow, Nuntanuj Vutthikraivit, Patinya Maneesow, Kent Doi, Monvasi Pachinburavan, Asada Leelahavanichkul","doi":"10.1177/17511437261425058","DOIUrl":"https://doi.org/10.1177/17511437261425058","url":null,"abstract":"<p><strong>Introduction: </strong>The neutrophil elastase (NE) inhibitor is a potential treatment strategy for acute lung injury (ALI) or acute respiratory distress syndrome (ARDS). However, the clinical effectiveness of sivelestat sodium, a selective NE inhibitor, remains controversial. We performed a systematic review and meta-analysis to evaluate the effects of sivelestat in patients with ALI/ARDS.</p><p><strong>Method: </strong>The literature search, selection, and data extraction were conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analysis Statement (PRISMA) guidelines. The randomized controlled trials (RCTs) with reference lists were retrieved from Scopus, PubMed, and Cochrane Library, using the Cochrane risk-of-bias tool for the quality assessment. Logarithm relative risk (logRR), risk difference (RD), and standardized mean difference (SMD) were calculated using the fixed effects model or random effects model, depending on heterogeneity.</p><p><strong>Result: </strong>Ten RCTs involving 1170 patients (583 receiving sivelestat and 587 receiving standard care or placebo) were included. Sivelestat was associated with a significant reduction in 28-30-day mortality, shorter duration of mechanical ventilation, and improvement in the ratio of arterial oxygen partial pressure to fractional inspired oxygen (PaO₂/FiO₂ ratio) in a time-dependent manner. These beneficial effects were more pronounced in patients with sepsis-related ALI/ARDS. The incidence of adverse events did not differ between groups.</p><p><strong>Conclusion: </strong>Sivelestat might be a promising adjunctive treatment for ALI/ARDS, especially in the sepsis etiology, as evidenced by reduced mortality, shortened mechanical ventilation duration, and improved oxygenation. The large-scale, well-designed RCTs are warranted.</p>","PeriodicalId":39161,"journal":{"name":"Journal of the Intensive Care Society","volume":" ","pages":"17511437261425058"},"PeriodicalIF":1.4,"publicationDate":"2026-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13053393/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147640244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive models for ICU patient readmission based on machine learning: A systematic review.","authors":"Zhixiang Zheng, Wenjun Yan, Kai Cao, Zhi Zhao","doi":"10.1177/17511437261431540","DOIUrl":"https://doi.org/10.1177/17511437261431540","url":null,"abstract":"<p><strong>Background: </strong>Artificial intelligence (AI) prediction models can accurately identify high-risk populations by integrating multi-dimensional clinical data, providing decision support for doctors in formulating individualized discharge plans and optimizing follow-up intervention strategies, thereby reducing the risk of readmission from the source. Currently, the number of AI prediction models for readmission of critically ill patients is increasing, but the quality and applicability of these models in clinical practice and future research remain uncertain.</p><p><strong>Objective: </strong>To systematically evaluate published studies on AI prediction models for critically ill patients.</p><p><strong>Methods: </strong>This study conducted a computerized search of the CNKI, Wanfang Data, VIP, SinoMed, PubMed, Web of Science, Cochrane, and Embase databases, with the time range from 2020 to June 25, 2025. Information such as study design, data sources, outcome definitions, sample size, predictors, model development, and performance was extracted from the selected studies. The Prediction Model Risk of Bias Assessment Tool (PROBAST) checklist was used to evaluate the risk of bias and applicability.</p><p><strong>Results: </strong>A total of 387 studies were retrieved, and after screening, 31 studies with their 31 prediction models were included in this review. All studies developed risk prediction models for readmission of critically ill patients using artificial intelligence algorithms. The readmission risk of critically ill patients ranged from 1.3% to 13.7%. The most commonly used predictors were structured data. The reported area under the curve (AUC) ranged from 0.66 to 0.98. All studies had a high risk of bias, mainly due to poor reporting quality in the analysis domain and insufficient applicability. The pooled AUC of the 24 validation models was 0.82, with a 95% confidence interval of 0.77-0.87.</p><p><strong>Conclusion: </strong>These study results constitute a comprehensive set of high-quality evidence, demonstrating that AI prediction models exhibit moderate-to-high predictive performance and that their predictive performance is significantly higher than that of traditional prediction models.</p><p><strong>Patient or public contribution: </strong>No Patient or Public Contribution. This Meta-analysis is based on the systematic review and statistical combination of the published clinical research data. The processes of research design, data extraction, and result interpretation did not involve the participation of patients or the public.</p><p><strong>Registration: </strong>The protocol for this study has been registered in PROSPERO (registration number: CRD42025637829).</p>","PeriodicalId":39161,"journal":{"name":"Journal of the Intensive Care Society","volume":" ","pages":"17511437261431540"},"PeriodicalIF":1.4,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13050372/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147628675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Code of Practice 2025 and the medicolegal definition of death.","authors":"Liam Scott, Ian Thomas","doi":"10.1177/17511437261418498","DOIUrl":"https://doi.org/10.1177/17511437261418498","url":null,"abstract":"<p><p>In January 2025 the Academy of Medical Royal Colleges published an updated Code of Practice for the Diagnosis and Confirmation of Death, the first major update for 17 years. It represents the authoritative medical consensus on the diagnosis and confirmation of death in all contexts (and in all age groups) in the UK. This paper reviews the new Code, highlighting the major updates from the 2008 guidance and their relevance for intensive care clinicians. It goes on to explore the wider legal history and context, in particular the role that previous versions of the Academy's guidelines have played during the emergence of a common law definition of death. It examines the important legal cases in which the Code of Practice was endorsed and ultimately adopted by the courts as the definitive medical and legal definition of death in the UK.</p>","PeriodicalId":39161,"journal":{"name":"Journal of the Intensive Care Society","volume":" ","pages":"17511437261418498"},"PeriodicalIF":1.4,"publicationDate":"2026-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13033582/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147595382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the impact of occupational therapy provision in the intensive care unit: A UK single-centre service evaluation.","authors":"James Bruce, Jemma Smith, Vishnuprakash Shankaranarayanan, Ema Swingwood","doi":"10.1177/17511437261431545","DOIUrl":"https://doi.org/10.1177/17511437261431545","url":null,"abstract":"<p><strong>Background: </strong>Occupational Therapy (OT) in the Intensive Care Unit (ICU) supports recovery in physical, cognitive, emotional domains, and activities of daily living (ADL), yet. Provision across the UK remains inconsistent, with variable staffing and role integration and no data illustrating the potential impact from such roles.</p><p><strong>Method: </strong>A retrospective service evaluation was undertaken in a UK NHS adult ICU to examine the association of increased OT staffing with changes in rehabilitation activity and functional status. Patients with ICU stays over 7 days were included in line with NICE CG83 high rehabilitation risk criteria. Three 1-month timepoints were compared. Data included delivery of OT interventions, functional outcomes (Modified Barthel Index), and discharge destination.</p><p><strong>Results: </strong>Ninety-nine patients were included. Increased OT staffing was associated with a greater proportion of patients receiving OT assessments, upper limb rehabilitation, personal activities of daily living retraining, cognitive screening, delirium management, and therapy handover. Modified Barthel index scores at hospital discharge increased across timepoints 1, 2 and 3 (55, 71.5 and 82, respectively (<i>p</i> = 0.02)). Discharge destination patterns varied and could not be attributed solely to staffing changes.</p><p><strong>Discussion: </strong>Increased OT staffing was associated with greater delivery of rehabilitation interventions and potential improvements in functional outcomes. However, differences in patient clinical complexity across timepoints may also have influenced these results. Further evaluation is required to establish causal relationships.</p>","PeriodicalId":39161,"journal":{"name":"Journal of the Intensive Care Society","volume":" ","pages":"17511437261431545"},"PeriodicalIF":1.4,"publicationDate":"2026-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13033580/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147595300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physiotherapy in deceased organ donation: A mixed methods study of current practice and perceptions amongst UK-based intensive care physiotherapists.","authors":"Shannon Saunders, Ema Swingwood, Zoe van Willigen, Sarah Rand, Harriet Shannon","doi":"10.1177/17511437261423807","DOIUrl":"10.1177/17511437261423807","url":null,"abstract":"<p><strong>Background: </strong>Potential organ donors are often identified in intensive care following brainstem or circulatory death. Clinical optimisation is fundamental for maintaining organ viability and physiotherapists are well positioned to support this through targeted interventions. Despite this, the physiotherapy role in deceased organ donation remains underexplored. This study aimed to describe current practice and explore the perceptions of physiotherapists in the United Kingdom involved in managing deceased organ donors.</p><p><strong>Methodology: </strong>An explanatory sequential mixed methods design was utilised. An online survey was used to describe the national picture of current physiotherapy practice. Online semi-structured interviews were undertaken to explore perceptions and attitudes of physiotherapists towards the physiotherapy management of deceased organ donors.</p><p><strong>Results: </strong>Fifty-six physiotherapists completed the survey, with 52% (<i>n</i> = 29) reporting involvement in donor management \"always,\" or \"most of the time.\" Treatment aims included secretion clearance (49%, <i>n</i> = 26) and lung optimisation (45%, <i>n</i> = 24). Suctioning was the most frequently performed intervention (95%, <i>n</i> = 53), followed by positioning (71%, <i>n</i> = 40) and manual techniques (71%, <i>n</i> = 40). Only 5% (<i>n</i> = 3) reported having local guidelines. Seven physiotherapists participated in interviews, identifying six key themes: experiences, barriers, role perceptions, physiotherapist learning needs, multidisciplinary team learning needs, and future needs.</p><p><strong>Discussion: </strong>The role of physiotherapy in organ donor management is under-recognised and lacks national consensus. Findings highlight disparities in practice, limited guidance and the need for further training to strengthen clinical reasoning. Guidance development that addresses the practical, ethical and emotional complexities of this work is urgently needed to support physiotherapists in this evolving area.</p>","PeriodicalId":39161,"journal":{"name":"Journal of the Intensive Care Society","volume":" ","pages":"17511437261423807"},"PeriodicalIF":1.4,"publicationDate":"2026-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13005764/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147505209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Paediatric and adult neurological point-of-care ultrasound: Review of the evidence, and the UK accreditation pathway.","authors":"Manprit Waraich, Bogdana Zoica, Emma Alexander, Jennie Stephens, Hannah Conway, Michael Griksaitis, Justin Kirk-Bayley, Ashley Miller, Prashant Parulekar, Marcus Peck, Antonio Rubino, Jonathan Nicholas Wilkinson","doi":"10.1177/17511437261428885","DOIUrl":"https://doi.org/10.1177/17511437261428885","url":null,"abstract":"<p><p>Neurological emergencies such as stroke and traumatic brain injury are major contributors to morbidity and mortality in critically ill patients. These conditions frequently result in alterations in cerebral haemodynamics, including raised intracranial pressure, which require timely recognition and management to optimise outcomes. Neuro point-of-care ultrasound (NeuroPOCUS), incorporating transcranial Doppler (TCD), transcranial colour-coded duplex (TCCD) ultrasound, and optic nerve sheath diameter (ONSD) measurement, offers a non-invasive, bedside means of assessing cerebral physiology and is increasingly recognised as a valuable adjunct in neurocritical care. Despite the successful adoption of point-of-care ultrasound in critical care through established accreditation pathways such as FUSIC^® and CACTUS^®, the UK has lacked a dedicated framework for NeuroPOCUS. To address this gap, we have developed and launched a UK-specific NeuroPOCUS accreditation programme, combining structured theoretical teaching with supervised practical training. The pathway addresses the distinct needs of both paediatric and adult populations, combining theoretical learning with practical application. Core learning materials include neuroanatomy, Doppler principles, standardised insonation techniques, and interpretation of cerebral blood flow velocities and indices such as pulsatility (PI) and resistivity (RI). Supporting resources feature videos of transcranial colour-coded Duplex (TCCD) imaging in normal subjects and clinical case examples. Participants will complete a logbook of 50 supervised cases, facilitated by remote mentorship. A novel accreditation pathway provides an opportunity for further research into the use of NeuroPOCUS in neurocritical care. This article outlines the core techniques of NeuroPOCUS, the physiological insights it offers, key clinical applications, and the proposed accreditation pathway aimed at standardising practice and clinician training in the care of critically ill patients with neurological injury or dysfunction.</p>","PeriodicalId":39161,"journal":{"name":"Journal of the Intensive Care Society","volume":" ","pages":"17511437261428885"},"PeriodicalIF":1.4,"publicationDate":"2026-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12982147/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147469507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}