A special Journal of Intensive Medicine issue explores the depths of intensive care medicine

Intensive care medicine focuses on treating individuals facing life-threatening illnesses and diseases. Such critical care populations often need round-the-hour intensive care to facilitate their complete recovery. This special branch of medicine has constantly evolved over the years, focusing on infection control and prevention of disease complications.

In this light, the Journal of Intensive Medicine (JOIM) has now complied a special issue titled ‘New Insights in ICU Infections’ encapsulating the latest research findings, narrative reviews, and expert opinions from top specialists in the field of intensive care medicine. It establishes a robust foundation for key infection challenges encountered in the ICU, offering a fundamental framework for understanding the subject matter. “Intensive care medicine is an ever-evolving science and over the last few years, especially in the wake of the COVID-19 pandemic, it has proven to be life-saving for numerous individuals. Further research into critical care management may help in combating and preventing newer infections,” says Dr. Jordi Rello, Global Health eCore, Vall d’Hebron University Hospital Campus, Barcelona, Spain, who is the guest editor for this issue.

The series of articles included covers a variety of topics exploring diverse aspects of intensive care medicine. It encompasses investigations into preventing ventilator-associated pneumonia through care bundles, the impact of fungal co-infections in COVID-19 on morbidity and mortality, management strategies for severe dengue and malaria, contributors to poor outcomes in pancreatic infections, infectious causes of fever of unknown origin in lower-income countries, and the potential of AI in augmenting sepsis management.

The original research article, ‘Epidemiology and risk factors for mortality in critically ill patients with pancreatic infection’ delves into a secondary analysis of the international observational study named ‘AbSeS’ (Abdominal Sepsis Study). It aims to assess the risk factors for mortality in critically ill patients with pancreatic infection using the AbSeS risk classification. The study links the associated risks of mortality from pancreatic infections with age and the extent of inflammation. In contrast, ‘Prevention of ventilator-associated pneumonia through care bundles: A systematic review and meta-analysis’ provides a systematic review and meta-analysis-based insights, highlighting how interventions can significantly reduce the number of ventilator-associated pneumonia episodes and the duration of mechanical ventilation in adult ICUs. Further, ‘Infectious causes of fever of unknown origin in developing countries: An international ID-IRI study’ touches upon the clinical incidences of fever of unknown origin (FUO) spread across 15 medical centers in seven different countries. It evaluated the causes of FUO, the severity of FUO, and the diagnostic difficulties of FUO infections in lower-middle-income countries and low-income countries.

In addition to this, tailored approaches in managing severe infections and antimicrobial stewardship programs for better outcomes are elaborated. The evolving patterns of bloodstream and respiratory infections and the rise of multidrug-resistant strains are meticulously discussed. Precision medicine for diverse immunocompromised conditions gains spotlight, alongside explorations into sustainability, diversity, and technological advancements. Amid these advancements, infection control and prevention, especially in patients reliant on life support, remain pivotal yet contentious topics.

Sharing his concluding thoughts and the need for discussing them in detail, Dr. Rello says, “With an increasing population of older adults, the focus on particular immune phenotypes and the need for artificial life-support techniques, are two very important challenges in critical care medicine.”

In summary, these studies collectively shed light on the complexities, challenges, and advancements in critical care, spanning infectious diseases, complications, preventative measures, and the integration of technology to enhance diagnosis and treatment approaches within intensive care settings.

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Reference

DOI: https://doi.org/10.1016/j.jointm.2023.11.001

About Professor Jordi Rello

Jordi Rello is a Professor at the Global Health eCore, Vall d’Hebron University Hospital Campus, Barcelona, Spain. After obtaining his M.D. – Ph.D. degree in infectious diseases, he focused his research interests on intensive and critical care medicine, sepsis management, and immunology of infectious diseases. Over the last 35 years, he has published more than 700 research articles that have been cited over 60,000+ times. He is a key opinion leader in the area of intensive care medicine and has won several international awards for his excellence in research.