Journal of the Intensive Care Society最新文献

{"title":"What are the benefits and harms of delayed enteral feeding in acute spinal cord injury patients in critical care units? A systematic review.","authors":"Alex Gordon, Carla O' Hagan, Jessie Welbourne","doi":"10.1177/17511437251328151","DOIUrl":"https://doi.org/10.1177/17511437251328151","url":null,"abstract":"<p><strong>Background: </strong>Spinal cord injury (SCI) is a devastating condition with a high burden of morbidity and mortality. National guidelines state that patients should not receive enteral feeding for 48 hours after inury, which may be detrimental if a patient experiences a hypercatabolic response to polytrauma. We conducted a systematic review of the benefits and harms of delayed enteral feeding in this population.</p><p><strong>Methods: </strong>We searched MEDLINE, EMBASE and Cochrane CENTRAL for studies which had a time parameter as part of their evaluation of feeding in the acute phase of spinal cord injury in a critical care setting. Required outcomes for inclusion were neurological improvement, neurological complications, time spent in an ICU, time to ICU discharge, incidence of secondary complications, other adverse effects and mortality. Risk of bias was assessed with the Downs and Black checklist.</p><p><strong>Results: </strong>Four studies met the inclusion criteria. There was no high-quality evidence of worsened outcomes with earlier feeding compared to delayed enteral feeding. One study demonstrated that patients fed before 24 h in conjunction with a broader bundle of care had improved neurological outcomes compared to previous non-standardised practice. There was no evidence of difference in frequency of infections or mortality in early or late feeding groups.</p><p><strong>Conclusions: </strong>We find no clear evidence of increased risk of harm from earlier enteral feeding strategies, nor clear evidence of benefit of earlier feeding as an isolated intervention.</p>","PeriodicalId":39161,"journal":{"name":"Journal of the Intensive Care Society","volume":" ","pages":"17511437251328151"},"PeriodicalIF":2.1,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948253/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754899","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 hemodynamic effects of IV paracetamol in intensive care patients.","authors":"Ohad Gabay, Hodaya Miller, Benjamin Fredrick Gruenbaum, Avia Ashur, Amit Frenkel, Adam Zafarov, Yoav Bichovsky, Leonid Koyfman, Evgeni Brotfain","doi":"10.1177/17511437251327566","DOIUrl":"https://doi.org/10.1177/17511437251327566","url":null,"abstract":"<p><strong>Objective: </strong>This retrospective observational study conducted in a general ICU aimed to evaluate the hemodynamic impact of IV paracetamol by monitoring blood pressure, urine output, and core temperature post-administration.</p><p><strong>Design: </strong>The study was designed as a retrospective observational study in a general ICU setting.</p><p><strong>Setting: </strong>The study was conducted in a general intensive care unit (ICU).</p><p><strong>Patients: </strong>Data from 498 patients receiving IV paracetamol in various clinical contexts were analyzed.</p><p><strong>Interventions: </strong>Patients received IV paracetamol for analgesia and fever reduction as part of their clinical care.</p><p><strong>Measurements and main results: </strong>The study analyzed the hemodynamic effects of IV paracetamol by monitoring blood pressure, urine output, and core temperature post-administration. A significant decrease in mean systolic and diastolic blood pressure values was observed across different patient subgroups, notably 45-60 min post-infusion. An increase in noradrenaline dosage and a decrease in urine output indicated a decline in end-organ perfusion following IV paracetamol administration. Multivariate analysis identified associations between clinical factors (such as general anesthesia and cardiac conditions) and changes in blood pressure.</p><p><strong>Conclusions: </strong>While IV paracetamol remains a valuable therapeutic option for pain and fever management, especially in hypertensive patients with specific conditions like traumatic brain injury and cerebral vascular accident, careful monitoring, and individualized dosing strategies are recommended in critically ill patients to maintain hemodynamic stability and optimize clinical outcomes. These findings contribute to enhancing our understanding of IV paracetamol hemodynamic effects and inform evidence-based practices for its use in ICU settings.</p>","PeriodicalId":39161,"journal":{"name":"Journal of the Intensive Care Society","volume":" ","pages":"17511437251327566"},"PeriodicalIF":2.1,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948232/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754840","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":"Emotional exhaustion among critical care nurses and its link to occupational stress, structural empowerment, and perceived work environment: Is there a generational difference?","authors":"Sulaiman Al Sabei, Leodoro Labrague, Arcalyd Cayaban, Omar Al-Rawjafah, Ikram Burney, Raeda AbulRub","doi":"10.1177/17511437251328991","DOIUrl":"https://doi.org/10.1177/17511437251328991","url":null,"abstract":"<p><strong>Background: </strong>Critical care nurses experiencing high levels of emotional exhaustion (EE). However, limited studies explored the association between generational differences and nurses' perceived EE. The objectives of the current study were to: (1) assess generational differences in EE among critical care nurses and (2) examine the link between nurses' EE and the generational differences, occupational stress, structural empowerment, and nurses' perceived work environment.</p><p><strong>Methods: </strong>A proportional stratified clustered sampling technique was utilized. The hospitals were stratified according to their location. Data were collected from nurses working at 19 hospitals in Oman. The emotional exhaustion sub-scale of the Maslach Burnout Inventory was used to assess the level of EE among nurses working in critical care units.</p><p><strong>Results: </strong>A total of 714 staff nurses participated. The majority (78%) were from generation Y and 22% were from generation X. Regression analysis showed that generation Y critical care nurses experienced higher EE levels than generation X nurses. Increased psychological stress among nurses was associated with increased EE. Higher levels of access to support, resources, and information, as well as supportive managerial leadership and sufficient staffing and resources, were associated with significant reductions in EE.</p><p><strong>Conclusion: </strong>To reduce job burnout among critical care nurses, healthcare leaders are required to ensure adequate staffing, provide managerial support, and monitor stress and EE levels frequently, particularly among generation Y nurses.</p>","PeriodicalId":39161,"journal":{"name":"Journal of the Intensive Care Society","volume":" ","pages":"17511437251328991"},"PeriodicalIF":2.1,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948254/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754719","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":"Admissions, mortality and financial burden associated with acute hospitalisations for sepsis between 2006 and 2018: A national population-level study.","authors":"Tamas Szakmany, Rowena Bailey, Rowena Griffiths, Richard Pugh, Joe Hollinghurst, Ashley Akbari, Ronan A Lyons","doi":"10.1177/17511437251326774","DOIUrl":"10.1177/17511437251326774","url":null,"abstract":"<p><strong>Background: </strong>We assessed the healthcare and economic burden of sepsis in adult hospitalised patients in Wales, UK.</p><p><strong>Methods: </strong>We analysed hospital admissions to all acute hospitals in Wales via the Secure Anonymised Information Linkage Databank. We included all adult patients, 2006-2018, with an inpatient admission including one or more explicit sepsis codes.</p><p><strong>Results: </strong>38,564 patients had at least one admission for sepsis between 2006 and 2018. Most persons (86.7%) had just one admission. 3398 patients (8.4%) were admitted to ICU. The number of admissions increased yearly over the study period from 1548 in 2006 to 8708 in 2018. The largest annual increase (141.7% compared to the previous year) occurred in 2017. Admission numbers increased disproportionately amongst patients with high levels of comorbidities, but changes were consistent across all age groups, areas of deprivation and ICU admissions. Estimated inpatient sepsis costs were £340.34 million in total during the study period. The average cost per hospital spell was £7270. Patients readmitted to the hospital for sepsis amassed estimated treatment costs of over £72 million during the study period. Out of the 38,564 persons, 21,275 (55.2%) died within 3 years of their first admission. Inpatient mortality halved from 40.5% to 19.5%, and there was a trend towards reduced mortality at 6 months, 1 and 3 years post hospital discharge.</p><p><strong>Conclusion: </strong>Sepsis related hospital admissions are increasing over time and still likely to be underreported. Although mortality appears to have fallen, prolonged hospitalisation and readmissions place a significant burden on healthcare system resources and costs.</p>","PeriodicalId":39161,"journal":{"name":"Journal of the Intensive Care Society","volume":" ","pages":"17511437251326774"},"PeriodicalIF":2.1,"publicationDate":"2025-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11912151/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143658972","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":"Point-of-care ultrasound of the brain: A systematic review of competencies and training frameworks for intensivists.","authors":"Adrian Wong, Richard Cashmore, Nurul Liana Roslan, Nourhan Ahmed, Mohamed Ibrahim, Isla Kuhn, Masumi Tanaka Gutiez","doi":"10.1177/17511437251326744","DOIUrl":"10.1177/17511437251326744","url":null,"abstract":"<p><strong>Background: </strong>POCUS is increasingly in utility and application across a variety of specialities. Although several professional societies, including the European Society of Intensive Care Medicine (ESICM) have recommended focussed Neurological ultrasound be a core competency, recommendations on how best to achieve this competency are lacking.</p><p><strong>Aim: </strong>The purpose of this systematic review was to assess what best-practice and evidence-based recommendations are available to achieve competency in Neurological Point-of-care ultrasound (NeuroPOCUS).</p><p><strong>Methods: </strong>We undertook a structured systematic review of publications and studies on the training of NeuroPOCUS for intensive care.</p><p><strong>Results: </strong>Our search strategy yielded a total of 4965 publications, reduced to 3551 following de-duplication. Despite this, only 28 publications were relevant following review of title and abstract and only 12 of these on full-text review. We identified three prospective studies, four consensus statements and five publications as posters and published abstracts. Structured analysis of these revealed minimal evidence-based teaching recommendations, and significant variability in teaching method.</p><p><strong>Conclusion: </strong>Compared to other modalities of POCUS (e.g. Cardiac and Lung), NeuroPOCUS lags behind with regards to utilisation and training in the general intensive care setting. Further work is needed to establish how this technique can be effectively taught and assessed for clinical application.</p>","PeriodicalId":39161,"journal":{"name":"Journal of the Intensive Care Society","volume":" ","pages":"17511437251326744"},"PeriodicalIF":2.1,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11910740/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143650773","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":"Qualitative exploration of consultant level therapy practice in critical care.","authors":"Paul Twose, Ella Terblanche, Laura Jones, Gabriella Cork, Una Jones","doi":"10.1177/17511437251326776","DOIUrl":"10.1177/17511437251326776","url":null,"abstract":"<p><strong>Introduction: </strong>Non-medical consultant level roles have been in existence for over 30 years, however the number of allied health professionals (AHPs) working at this level, particularly in critical care, remains relatively small. National guidance highlights the importance of clinicians in these roles to work across the four pillars of practice. However, little research exists regarding the roles undertaken by these consultant-level practitioners, the contributions made to service delivery and their perceived impact on patient and service outcomes. Based on this, the aim of this project was to explore the perceived impact of consultant-level AHPs working within critical care.</p><p><strong>Methods: </strong>Qualitative methodology was used involving a combination of interviews and focus groups. Purposeful sampling was used to recruit AHPs in consultant-level positions within critical care. Senior medical and nursing staff were then recruited via the AHPs. Data were analysed thematically using the Braun and Clarke methodology.</p><p><strong>Results: </strong>Five consultant-level AHPs were recruited to participate in interviews, with a further 7 participants from senior medical and nursing roles participating in one of two focus groups. The AHPs had been in a consultant-level role for an average of 3.2 years, with all participants reporting over 15 years' experience within critical care. Four core themes were generated from 105 unique codes and 13 subthemes. Personal characteristics were apparent across all themes and therefore was included as a central element. The core themes were (1) scope; (2) status; (3) supportive leadership and (4) impact.</p><p><strong>Discussion: </strong>Through four core themes, this study has highlighted the roles undertaken by consultant-level AHPs working in critical care, their perceived impact on patient and service outcomes, and their contribution to local, regional and national workstreams. Where these roles exist, they appear to be well received by senior medical and nursing staff, reporting the benefits of highly experienced members of clinical staff to improve service delivery, patient outcomes and contribute to strategic planning.</p>","PeriodicalId":39161,"journal":{"name":"Journal of the Intensive Care Society","volume":" ","pages":"17511437251326776"},"PeriodicalIF":2.1,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11910737/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143650785","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":"Withdrawal of life sustaining therapies for awake patients in critical care: The benefits of a collaborative intensivist & palliative care approach.","authors":"Stuart Edwardson, Rhona Kellichan, Colette Reid, Rosaleen Baruah, Charlie Hall","doi":"10.1177/17511437251324054","DOIUrl":"10.1177/17511437251324054","url":null,"abstract":"<p><p>Around 13% of patients admitted to critical care in Europe die in the Intensive Care Unit (ICU). In the United Kingdom, 15%-20% of patients admitted to critical care do not survive to discharge. Of those that die in ICU, 80% do so following an active decision to withdraw life-sustaining therapy (WLST). With the increasingly aged and co-morbid critical care population entering the ICU, there is an ongoing need for timely, considered discussions both when initiating life sustaining therapies, and also for effective, sensitive communication and management when it comes to withdrawing. In the case of WLST, very little data exists reflecting the proportion of scenarios involving an 'awake' patient with capacity to take part in this decision. It is, however, generally thought to be a small proportion. Most intensivists will therefore have less experience in this process, which perhaps is more representative of the work of our palliative care colleagues. We aim to discuss the most common scenarios in which WLST may occur in the awake and capacitous patient in critical care, the challenges to providing this, and some practical advice on how to perform it well, including the benefits of early interdisciplinary collaboration alongside palliative care.</p>","PeriodicalId":39161,"journal":{"name":"Journal of the Intensive Care Society","volume":" ","pages":"17511437251324054"},"PeriodicalIF":2.1,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11881096/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574219","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":"Characteristics and outcomes of auto-intoxicated patients admitted to the ICU: A retrospective cohort study.","authors":"Lotte Van Nylen, Sander Swennen, Ina Callebaut, Laurien Geebelen, Jasperina Dubois, Jeroen Herbots, Marijke Nulens, Jeroen Vandenbrande, Michiel Vantornout, Björn Stessel","doi":"10.1177/17511437241311102","DOIUrl":"10.1177/17511437241311102","url":null,"abstract":"<p><strong>Introduction: </strong>Auto-intoxication represents a considerable number of Intensive care unit (ICU) admissions. Literature focusing on characteristics and outcomes of ICU-admitted auto-intoxicated patients is limited.</p><p><strong>Objectives: </strong>We aimed to identify the quantity of intensive care admissions attributable to auto-intoxication in a Belgian tertiary center, to examine characteristics and outcomes of these patients, and to assess the impact of the covid-19 pandemic on these variables.</p><p><strong>Methods: </strong>In this retrospective cohort study, all patients admitted to the ICU of JESSA hospital, Hasselt, Belgium with a diagnosis of auto-intoxication between January 1st 2017 and December 31st 2022, were included in the study. We collected data on patient characteristics, comorbidities, type of intoxication and outcomes including the length of ICU and hospital stay and mortality.</p><p><strong>Results: </strong>In total, 342 patients were included in the dataset, covering 2.44% of all ICU admissions from January 1st 2017 to December 31st 2022. Although auto-intoxication occurred in all age-categories, the age group from 18 to 29 years old, showed the highest prevalence (24%). More woman (57.6%) than man (42.4%) were included in the study. Of all included patients, 21.6% had a history of previous suicide attempt and 36.5% of previous auto-intoxication. The most common substances ingested were sedatives (44.4%), illicit drugs (20.2%), analgesics (17.8%), and antidepressants (16.7%) whereas in 54.1% of the cases, a combination of substances was ingested. Type of intoxication was separated into four groups: suicide attempt, accidental, iatrogenic and recreational use with suicide attempt accounting for 71.3% of all auto-intoxications. The prevalence of ICU-admitted auto-intoxicated patients remained stable over the 5-year study period. An impact of the Covid-19 pandemic on this prevalence could not be established. Overall mortality was low with an ICU- and hospital mortality of 1.75% and 2.6% respectively. Total mortality at time of dataset closure, on the other hand, was 7.2%.</p><p><strong>Conclusions: </strong>The impact of auto-intoxication on ICU resource utilization is relatively high and the risk of recidivism is substantial. ICU- and in-hospital mortality after auto-intoxication is low, although these patients have a substantial risk for death in years to come after hospital discharge.</p>","PeriodicalId":39161,"journal":{"name":"Journal of the Intensive Care Society","volume":" ","pages":"17511437241311102"},"PeriodicalIF":2.1,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11881095/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574205","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":"Levetiracetam dosing in continuous renal replacement therapy: A systematic review and development of a novel pharmacokinetic model to optimise dosing in critically ill patients. Do recommended doses achieve therapeutic drug concentrations?","authors":"James Sweatman, Sarraa Al-Mahdi, Dagan O Lonsdale, Susannah Leaver, Andrew Rhodes","doi":"10.1177/17511437251320557","DOIUrl":"10.1177/17511437251320557","url":null,"abstract":"<p><strong>Aim: </strong>Levetiracetam is a widely used anti-epileptic in the critical care setting that is almost exclusively (>90%) renally excreted. The altered pharmacokinetics of levetiracetam have been widely studied in intermittent haemodialysis but the evidence and guidance on dosage in continuous renal replacement therapy is varied and poorly defined. Understanding this is critical as a significant number of critically unwell patients develop renal failure requiring continuous renal replacement therapy. The aim of this systematic review is to investigate the pharmacokinetics of levetiracetam in such patients and to understand the implications on dosing strategies.</p><p><strong>Methods: </strong>A systematic review of the available literature from 2000 to November 2022 was conducted. Seven articles were identified for inclusion from 54 records. A novel hybrid model was developed to evaluate the quality of pharmacokinetic and haemofiltration data. This data was used to develop a one-compartment model that simulated dosing strategies in 10,000 patients based on an assumed steady state of 72 hr and target trough concentrations of 12-46 mcg/mL.</p><p><strong>Results: </strong>From the seven articles included, pharmacokinetic data was retrieved for 24 individual patients. Total clearance was 3.49-4.63 L/hr (mean 3.55, S.D. 0.52). Elimination half-life was 5.66-12.88 hr (mean 9.41, S.D. 2.86). Volume of distribution was 0.45-0.73 L/kg. The proportion of total clearance attributable to continuous renal replacement therapy was 52%-73% (mean 54.7%, S.D. 13.5). Our simulations demonstrate that more than half of patients who received twice daily doses of 750 mg or greater without a loading dose achieved therapeutic drug concentrations. The time to achievement of therapeutic drug concentrations was greatly reduced by the addition of a 60 mg/kg loading dose (up to a maximum of 4.5 g). The use of a reduced loading dose or twice daily doses of 500 mg or less without loading were more likely to result in prolonged sub-therapeutic drug concentrations.</p><p><strong>Conclusion: </strong>Levetiracetam clearance in haemofiltration is similar to healthy adults with normal renal function (GFR > 90 mL/min). The use of reduced doses due to renal failure in critically ill patients may result in sub-therapeutic drug concentrations in a high number of patients. A twice daily dosing of 750-1000 mg with an initial loading dose of 60 mg/kg should be considered in such patients alongside therapeutic drug monitoring.</p>","PeriodicalId":39161,"journal":{"name":"Journal of the Intensive Care Society","volume":" ","pages":"17511437251320557"},"PeriodicalIF":2.1,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11851601/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143516833","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 MRC CRASH trial at 20: Time to reappraise corticosteroids for traumatic brain injury?","authors":"Matt Thomas, Charis Banks, Andy Ray","doi":"10.1177/17511437251323087","DOIUrl":"10.1177/17511437251323087","url":null,"abstract":"","PeriodicalId":39161,"journal":{"name":"Journal of the Intensive Care Society","volume":" ","pages":"17511437251323087"},"PeriodicalIF":2.1,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11847313/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494018","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}