Speaker: Aarti Sarwal, MD, FAAN, FNCS, FCCM
Aarti Sarwal, MD, FAAN, FNCS, FCCM: Hello, I'm Aarti Sarwal, the Social Media Editor of Critical Care Medicine. We are bidding farewell to 2023 with a rich issue of Critical Care Medicine in December. Here are my top highlights from this issue. Pilcher and the group report their approach on ICU strain by evaluating an activity index. They used this during the pandemic and now report this as an independent predictor of mortality. They apply this index to a little over 300,000 patients from the Adult Patient Database maintained by the Australian and New Zealand Intensive Care Society. An editorial by Ryan Maves provides a broader perspective to such strain and surge indices and their implications on our health care system. The second article by Mehta and group provides a sobering review of outcomes and trajectories in the first year after tracheostomy from a study of the California Patient Discharge Database reporting on 8,500 some patients. Savel and Shiloh's editorial on this article reflects on how such findings can be contextualized with prognostication, informed consent and moral distress in the ICU. The third article that caught my attention is from Amorim and group describing the I-CARE consortium. This EEG database from seven institutions in the US and Europe provides a real world clinical and EEG dataset to help with neurophysiology research of comatose patients after cardiac arrest. Database curation efforts like these may lead to the evaluation of our best practices and current recommendations for the gray scenarios in coma recovery that we often encounter in this difficult population. Time will tell. Lastly, don't miss out on a systematic review of 57 studies by Belletti and group analyzing data from 467 awake ECMO patients. This article delves into the reasons for ECMO failure when the patient is awake and complications related to it that are relevant for ICU teams to know. For more articles. please follow us on X and Facebook.
