Journal of the Intensive Care Society最新文献

{"title":"Surrogate patient and relative communication feedback for senior ICU doctors.","authors":"Sam Waddy","doi":"10.1177/17511437261415834","DOIUrl":"10.1177/17511437261415834","url":null,"abstract":"<p><p>Obtaining patient feedback for personal reflection, development and GMC revalidation as an ICU consultant is complex. Various options for alternative evidence for revalidation have been suggested by FICM guidance. Communication with families at a time of crisis is core to the role of an ICU consultant and is something we should endeavour to seek feedback on to enable reflection and personal development, and which may also be useful evidence for GMC revalidation. In this article we propose a method for obtaining third party feedback on key communication events which we have demonstrated to be workable and useful.</p>","PeriodicalId":39161,"journal":{"name":"Journal of the Intensive Care Society","volume":" ","pages":"17511437261415834"},"PeriodicalIF":1.4,"publicationDate":"2026-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12827031/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146054265","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":"Socioeconomic status and critical care outcomes: Time for ICNARC to reconsider?","authors":"Ned Gilbert-Kawai, Tom Syratt","doi":"10.1177/17511437261415831","DOIUrl":"10.1177/17511437261415831","url":null,"abstract":"","PeriodicalId":39161,"journal":{"name":"Journal of the Intensive Care Society","volume":" ","pages":"17511437261415831"},"PeriodicalIF":1.4,"publicationDate":"2026-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12804060/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145999149","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":"Discharging people home editorial: Article against-Should patients be discharged directly home (DDH) from critical care?","authors":"James Watts","doi":"10.1177/17511437251408629","DOIUrl":"10.1177/17511437251408629","url":null,"abstract":"<p><p>This is the opposing view editorial to the one produced by Dr. Crossingham and argues that CCU doctors should not be discharging patients home without appropriate investment in training and support.</p>","PeriodicalId":39161,"journal":{"name":"Journal of the Intensive Care Society","volume":" ","pages":"18-21"},"PeriodicalIF":1.4,"publicationDate":"2026-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12804061/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145999155","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":"Encouraging direct discharges home from Critical Care.","authors":"Iain Crossingham","doi":"10.1177/17511437251394265","DOIUrl":"10.1177/17511437251394265","url":null,"abstract":"","PeriodicalId":39161,"journal":{"name":"Journal of the Intensive Care Society","volume":" ","pages":"15-17"},"PeriodicalIF":1.4,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12779534/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145953249","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":"Recurrent ICU admissions following deliberate self-poisoning: Clinical, ethical, and emotional pressures on critical care services.","authors":"Harry Calder, Ayush Sinha","doi":"10.1177/17511437251410035","DOIUrl":"10.1177/17511437251410035","url":null,"abstract":"","PeriodicalId":39161,"journal":{"name":"Journal of the Intensive Care Society","volume":" ","pages":"17511437251410035"},"PeriodicalIF":1.4,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12779531/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145953300","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":"A prospective cohort feasibility study of real-time beta-lactam antimicrobial therapeutic drug monitoring in critically ill patients with lower respiratory infection: The TDM-TIME study.","authors":"Jan Hansel, Jake Lain, Emmanuel O Erhieyovwe, Aybaniz Ismayilli, James Orr, Brian G Keevil, Kayode Ogungbenro, Paul M Dark, Timothy W Felton","doi":"10.1177/17511437251404324","DOIUrl":"10.1177/17511437251404324","url":null,"abstract":"<p><strong>Background: </strong>Critically ill patients with lower respiratory tract infections often fail to achieve therapeutic beta-lactam antibiotic concentrations, despite standard dosing. Therapeutic drug monitoring (TDM) may improve attaining drug exposure, but delayed turnaround times limit its clinical impact. The objective of this study was to evaluate the feasibility of delivering real-time beta-lactam TDM results within two dosing intervals.</p><p><strong>Methods: </strong>We conducted a single-centre prospective cohort feasibility study in two ICUs in Manchester, UK. Critically ill adult patients receiving piperacillin/tazobactam or meropenem for suspected or confirmed lower respiratory infection were enrolled. Blood samples were collected for analysis and drug quantification, with the primary outcome being the proportion of TDM results returned within two dosing intervals. Secondary outcomes included detailed time-to-result, clinical and microbiological outcomes. TDM results were not released to clinical teams.</p><p><strong>Results: </strong>We recruited 30 participants, of whom 20 (67%) had TDM results available within two dosing intervals. The median time from blood sampling to TDM result was 10.9 h, with a median time from antimicrobial initiation to result of 25.4 h. At 28 days, 70% of participants were alive, with a median (IQR) ICU and hospital length of stay of 7 (5-25) and 17 (10-27) days, respectively. Resistant pathogen strains were isolated in 4/21 (19%) participants.</p><p><strong>Discussion: </strong>Recruitment of critically ill participants into a time-sensitive trial of TDM is feasible. Timely feedback of beta-lactam TDM results to clinicians is achievable, however, barriers to streamlined around-the-clock implementation remain. Future clinical trials of beta-lactam TDM should factor turnaround times into study design.</p><p><strong>Registration: </strong>NCT05971979.</p>","PeriodicalId":39161,"journal":{"name":"Journal of the Intensive Care Society","volume":" ","pages":"22-29"},"PeriodicalIF":1.4,"publicationDate":"2025-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12738274/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145850686","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":"Sand aspiration managed with extracorporeal membrane oxygenation and a mechanical insufflation-exsufflation device: A case report.","authors":"Raphael Holmes, Mike Brown, Charlotte Atkinson, Lajos Szentgyorgyi","doi":"10.1177/17511437251401434","DOIUrl":"10.1177/17511437251401434","url":null,"abstract":"<p><p>We present a case of a class 3 drowning event with severe sand aspiration, successfully managed with mechanical ventilation, bronchoalveolar lavage, ECMO, and the use of a mechanical insufflation-exsufflation device (MI-E). Sand aspiration is a potentially lethal consequence of near-drowning events. It may cause respiratory failure by several mechanisms, including laryngospasm, upper or lower airway obstruction and an intrinsic acute respiratory distress syndrome (ARDS) related to the sand itself. Its standard management involves lung-protective mechanical ventilation strategies, bronchoalveolar lavage, and, more recently, extracorporeal membrane oxygenation (ECMO) in adult and paediatric cases. MI-E devices are commonly used by physiotherapists in the intensive care setting to facilitate secretion clearance in extubated patients, reducing the occurrence of ventilator-associated pneumonia. However, their use in intubated patients in the UK is not as common due to a lack of evidence and experience. The evidence supporting their use in intubated patients is of low quality, and we have not found any examples of their use for clearing aspirated particulate matter or in conjunction with ECMO in the literature. We believe this is the first time MI-E has been used this way. We argue that it could be a valuable addition to the management of sand and other particulate aspirations, even in severe cases requiring ECMO, and it warrants further exploration. Using a MI-E device may significantly decrease the duration of ECMO treatment, reducing its associated complications and expenses.</p>","PeriodicalId":39161,"journal":{"name":"Journal of the Intensive Care Society","volume":" ","pages":"107-112"},"PeriodicalIF":1.4,"publicationDate":"2025-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12716973/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145805790","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":"ERRATUM to \"Volume 26 Issue 1_suppl, February 2025\".","authors":"","doi":"10.1177/17511437251374125","DOIUrl":"https://doi.org/10.1177/17511437251374125","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1177/17511437241311087.].</p>","PeriodicalId":39161,"journal":{"name":"Journal of the Intensive Care Society","volume":"26 1 Suppl","pages":"29"},"PeriodicalIF":1.4,"publicationDate":"2025-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12701271/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145757739","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":"Does in-bed cycling delivered within 48 hours of mechanical ventilation, reduce the occurrence of delirium in critically ill patients: A mixed-methods feasibility randomised controlled trial protocol.","authors":"Jacqueline Bennion, Mark Hudson, Mary Hickson, Victoria Allgar, Bridie Kent, David McWilliams, Daniel Martin","doi":"10.1177/17511437251400612","DOIUrl":"10.1177/17511437251400612","url":null,"abstract":"<p><strong>Background: </strong>Delirium is a severe neuropsychiatric clinical state presenting as an acute onset of cognitive deficits. Patients receiving invasive mechanical ventilation (IMV), have the highest incidence (50%-80%) of delirium amongst patients admitted to intensive care units. Preliminary data indicates that early mobilisation is associated with reduced delirium in critically ill patients. However, definitive evidence is lacking. Current practice varies due to many barriers to patients, who require IMV, receiving early mobilisation interventions. In-bed cycling may address some of these barriers. This research aims to evaluate the feasibility and acceptability of early in-bed cycling to reduce delirium in critically ill patients.</p><p><strong>Methods: </strong>This multi-site feasibility randomised controlled trial will evaluate early (⩽48 h following IMV), in-bed cycling as a method of early mobilisation, to reduce delirium. Eighty-four participants will be randomised across three sites in a 1:1 ratio, to receive either early in-bed cycling in addition to usual care or usual care alone. The primary outcome is feasibility (recruitment, retention, intervention fidelity). Secondary outcomes include different methods of measuring delirium, physical function, length of stay, ventilator free days, sedation free days, Richmond Agitation Sedation Scale, adverse events and mortality. Descriptive statistical analyses will be conducted. Hypothesis testing will be used for exploratory analysis of the mechanistic sub-study outcomes. An embedded qualitative interview study will evaluate the acceptability of this research.</p><p><strong>Conclusion: </strong>This trial has been prospectively registered (ISRCTN74277350) and received full ethical approval (REC reference: 24/SC/0096). The trial opened to recruitment in July 2024. Recruitment will take place across 18-months.</p>","PeriodicalId":39161,"journal":{"name":"Journal of the Intensive Care Society","volume":" ","pages":"90-97"},"PeriodicalIF":1.4,"publicationDate":"2025-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12685707/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145726586","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":"Diagnosing death, best interests, consent and the law.","authors":"Liam Scott","doi":"10.1177/17511437251404337","DOIUrl":"https://doi.org/10.1177/17511437251404337","url":null,"abstract":"","PeriodicalId":39161,"journal":{"name":"Journal of the Intensive Care Society","volume":" ","pages":"17511437251404337"},"PeriodicalIF":1.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12668982/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145670211","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}