Pub Date : 2025-09-01DOI: 10.1016/j.ccrj.2025.100140
Michael Bailey PhD , Sean M. Bagshaw MD, MSc , Graeme K. Hart MBBS , David Pilcher MBBS
Rinaldo Bellomo advanced critical care not only through randomised trials but also through rigorous use of observational data, particularly from the ANZICS Centre for Outcome and Resource Evaluation (ANZICS CORE) Registry. At a time when retrospective analyses were often confined to hypothesis generation, he showed that carefully curated, clinically grounded registry studies could inform policy and change practice. Recognising early the potential of ANZICS CORE to become a leading registry, he worked to strengthen its data architecture and published in journals such as The New England Journal of Medicine and JAMA, helping to spark global dialogue and shape guidelines. Using the Adult Patient Database, he described epidemiological trends, identified clinically relevant questions, designed, justified and evaluated randomised trials, and monitored the uptake of evidence-based practice. His work addressed key challenges in sepsis, acute kidney injury, glycaemic control, temperature management and health equity, and was marked by clear case definitions, extensive sensitivity analyses and transparent reporting. This article reviews selected contributions using ANZICS CORE data and outlines how his legacy endures through the value of these datasets and the many researchers he mentored.
{"title":"Rinaldo Bellomo's seminal contribution to observational research using the ANZICS CORE registry","authors":"Michael Bailey PhD , Sean M. Bagshaw MD, MSc , Graeme K. Hart MBBS , David Pilcher MBBS","doi":"10.1016/j.ccrj.2025.100140","DOIUrl":"10.1016/j.ccrj.2025.100140","url":null,"abstract":"<div><div>Rinaldo Bellomo advanced critical care not only through randomised trials but also through rigorous use of observational data, particularly from the ANZICS Centre for Outcome and Resource Evaluation (ANZICS CORE) Registry. At a time when retrospective analyses were often confined to hypothesis generation, he showed that carefully curated, clinically grounded registry studies could inform policy and change practice. Recognising early the potential of ANZICS CORE to become a leading registry, he worked to strengthen its data architecture and published in journals such as <em>The New England Journal of Medicine</em> and <em>JAMA</em>, helping to spark global dialogue and shape guidelines. Using the Adult Patient Database, he described epidemiological trends, identified clinically relevant questions, designed, justified and evaluated randomised trials, and monitored the uptake of evidence-based practice. His work addressed key challenges in sepsis, acute kidney injury, glycaemic control, temperature management and health equity, and was marked by clear case definitions, extensive sensitivity analyses and transparent reporting. This article reviews selected contributions using ANZICS CORE data and outlines how his legacy endures through the value of these datasets and the many researchers he mentored.</div></div>","PeriodicalId":49215,"journal":{"name":"Critical Care and Resuscitation","volume":"27 3","pages":"Article 100140"},"PeriodicalIF":1.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145278195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-01DOI: 10.1016/j.ccrj.2025.100122
Glenn Eastwood
{"title":"One hundred trials of solitude: A call to action","authors":"Glenn Eastwood","doi":"10.1016/j.ccrj.2025.100122","DOIUrl":"10.1016/j.ccrj.2025.100122","url":null,"abstract":"","PeriodicalId":49215,"journal":{"name":"Critical Care and Resuscitation","volume":"27 3","pages":"Article 100122"},"PeriodicalIF":1.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145278132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-01DOI: 10.1016/j.ccrj.2025.100143
Carol L. Hodgson PhD, PT, Sue Berney BPhysio, PhD
{"title":"Rinaldo Bellomo and the evolution of critical care survivorship","authors":"Carol L. Hodgson PhD, PT, Sue Berney BPhysio, PhD","doi":"10.1016/j.ccrj.2025.100143","DOIUrl":"10.1016/j.ccrj.2025.100143","url":null,"abstract":"","PeriodicalId":49215,"journal":{"name":"Critical Care and Resuscitation","volume":"27 3","pages":"Article 100143"},"PeriodicalIF":1.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145278190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-01DOI: 10.1016/j.ccrj.2025.100141
{"title":"Unveiling “The Bellomo Effect”: A tribute from Professor Rinaldo Bellomo’s Research Fellow Family","authors":"","doi":"10.1016/j.ccrj.2025.100141","DOIUrl":"10.1016/j.ccrj.2025.100141","url":null,"abstract":"","PeriodicalId":49215,"journal":{"name":"Critical Care and Resuscitation","volume":"27 3","pages":"Article 100141"},"PeriodicalIF":1.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145278191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-01DOI: 10.1016/j.ccrj.2025.100124
Michael Bailey PhD , Ary Serpa Neto MD, PhD , Paul J. Young MD, PhD
Professor Rinaldo Bellomo's legacy as a world-leading clinician-scientist is unmatched in the field of critical care. This tribute explores the depth, breadth, and global influence of his publication record, spanning more than four decades. With over 2000 peer-reviewed articles, 81 elite journal publications, and a remarkable H-index above 200, Rinaldo's academic contributions helped shape international definitions of acute kidney injury and sepsis, advanced critical care nephrology, and guided fluid resuscitation practice worldwide. Through editorial leadership, strategic authorship, and mentorship, he transformed the landscape of intensive care research.
{"title":"A legacy in print: The publication impact of Professor Rinaldo Bellomo","authors":"Michael Bailey PhD , Ary Serpa Neto MD, PhD , Paul J. Young MD, PhD","doi":"10.1016/j.ccrj.2025.100124","DOIUrl":"10.1016/j.ccrj.2025.100124","url":null,"abstract":"<div><div>Professor Rinaldo Bellomo's legacy as a world-leading clinician-scientist is unmatched in the field of critical care. This tribute explores the depth, breadth, and global influence of his publication record, spanning more than four decades. With over 2000 peer-reviewed articles, 81 elite journal publications, and a remarkable H-index above 200, Rinaldo's academic contributions helped shape international definitions of acute kidney injury and sepsis, advanced critical care nephrology, and guided fluid resuscitation practice worldwide. Through editorial leadership, strategic authorship, and mentorship, he transformed the landscape of intensive care research.</div></div>","PeriodicalId":49215,"journal":{"name":"Critical Care and Resuscitation","volume":"27 3","pages":"Article 100124"},"PeriodicalIF":1.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145278076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-01DOI: 10.1016/j.ccrj.2025.100144
Derek C. Angus MD, MPH
{"title":"Seeking truth: Less about being right, more about being less wrong","authors":"Derek C. Angus MD, MPH","doi":"10.1016/j.ccrj.2025.100144","DOIUrl":"10.1016/j.ccrj.2025.100144","url":null,"abstract":"","PeriodicalId":49215,"journal":{"name":"Critical Care and Resuscitation","volume":"27 3","pages":"Article 100144"},"PeriodicalIF":1.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145278075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-01DOI: 10.1016/j.ccrj.2025.100127
Daryl Jones BSc(Hons), MBBS, FRACP, FCICM, MD, PhD , Donna Goldsmith BN, MN, MBA , Michael DeVita MD, FRCP, FCCM , Ken Hillman AO MBBS, FRCA, FCICM, FRCP, MD
In the 1990s, there was emerging evidence that patients admitted to hospitals frequently suffered in-hospital cardiac arrest, unplanned admission to the intensive care unit (ICU), and potentially preventable in-hospital death. These events were often preceded by objective signs of instability and suboptimal recognition and response by hospital ward staff. Rinaldo Bellomo collaborated with key Australian and international leaders to develop a novel and paradigm-shifting model of care referred to as the medical emergency team (MET). This team is comprised of senior staff members who are experts in the assessment and management of acutely deteriorating patients.
In Australia and New Zealand, staff members from the ICU are frequently the team leaders for the MET. The team is called when a patient develops objective signs of clinical deterioration, prior to the onset of cardiac arrest. Rinaldo led, mentored, and supervised a systematic and structured research program that evaluated the nature and effectiveness of the MET at Austin Health and throughout Australia. This commenced with single-centre before-and-after studies and progressed to the first Australian ICU cluster-randomised controlled trial. His unique skillset was pivotal in the emergence and promulgation of this model of care worldwide resulting in countless lives saved from preventable morbidity and mortality.
{"title":"Rinaldo’s role in the medical emergency team and rapid response systems","authors":"Daryl Jones BSc(Hons), MBBS, FRACP, FCICM, MD, PhD , Donna Goldsmith BN, MN, MBA , Michael DeVita MD, FRCP, FCCM , Ken Hillman AO MBBS, FRCA, FCICM, FRCP, MD","doi":"10.1016/j.ccrj.2025.100127","DOIUrl":"10.1016/j.ccrj.2025.100127","url":null,"abstract":"<div><div>In the 1990s, there was emerging evidence that patients admitted to hospitals frequently suffered in-hospital cardiac arrest, unplanned admission to the intensive care unit (ICU), and potentially preventable in-hospital death. These events were often preceded by objective signs of instability and suboptimal recognition and response by hospital ward staff. Rinaldo Bellomo collaborated with key Australian and international leaders to develop a novel and paradigm-shifting model of care referred to as the medical emergency team (MET). This team is comprised of senior staff members who are experts in the assessment and management of acutely deteriorating patients.</div><div>In Australia and New Zealand, staff members from the ICU are frequently the team leaders for the MET. The team is called when a patient develops objective signs of clinical deterioration, prior to the onset of cardiac arrest. Rinaldo led, mentored, and supervised a systematic and structured research program that evaluated the nature and effectiveness of the MET at Austin Health and throughout Australia. This commenced with single-centre before-and-after studies and progressed to the first Australian ICU cluster-randomised controlled trial. His unique skillset was pivotal in the emergence and promulgation of this model of care worldwide resulting in countless lives saved from preventable morbidity and mortality.</div></div>","PeriodicalId":49215,"journal":{"name":"Critical Care and Resuscitation","volume":"27 3","pages":"Article 100127"},"PeriodicalIF":1.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145278414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-01DOI: 10.1016/j.ccrj.2025.100148
Emily J. See MBBS , Lakhmir S. Chawla MD
Vasodilatory shock remains a leading cause of morbidity and mortality in the intensive care unit. Vasopressors are the cornerstone of treatment when vasodilatory shock persists despite adequate fluid resuscitation, yet their effects on organ-specific blood flow, perfusion, and oxygenation are complex and may contribute to harm. This review summarises the extensive contributions of Professor Rinaldo Bellomo to advancing our knowledge of vasopressor therapy in clinical practice. Central to his work was the concept of personalised haemodynamic targets, introduced through the concept of “mean perfusion pressure deficit”, which linked premorbid perfusion pressure to outcomes and challenged the universal application of a mean arterial pressure threshold of ≥65 mmHg. In collaboration with Professor Clive May, Bellomo established a chronically instrumented large animal model of hyperdynamic sepsis, yielding fundamental insights into the discordance between the macrocirculation and microcirculation, the vulnerability of the renal medulla to hypoxia, and the mechanisms of septic acute kidney injury. This model enabled direct comparison of vasopressor drugs in both healthy animals and during septic shock, demonstrating their heterogeneous effects on global and regional blood flow, perfusion, and tissue oxygenation. Knowledge translation to the bedside was achieved through the conduct of pivotal clinical trials, from early studies refuting the utility of “renal-dose dopamine” to landmark contributions to the ATHOS (angiotensin II treatment of high-ouput shock) program, which established angiotensin II as a novel vasopressor in refractory vasodilatory shock. Collectively, Bellomo’s work has transformed vasopressor therapy from empirical convention towards individualised practice, and it continues to inform clinical investigation and guideline development.
{"title":"Redefining the modern paradigm of vasopressor therapy for vasodilatory shock","authors":"Emily J. See MBBS , Lakhmir S. Chawla MD","doi":"10.1016/j.ccrj.2025.100148","DOIUrl":"10.1016/j.ccrj.2025.100148","url":null,"abstract":"<div><div>Vasodilatory shock remains a leading cause of morbidity and mortality in the intensive care unit. Vasopressors are the cornerstone of treatment when vasodilatory shock persists despite adequate fluid resuscitation, yet their effects on organ-specific blood flow, perfusion, and oxygenation are complex and may contribute to harm. This review summarises the extensive contributions of Professor Rinaldo Bellomo to advancing our knowledge of vasopressor therapy in clinical practice. Central to his work was the concept of personalised haemodynamic targets, introduced through the concept of “mean perfusion pressure deficit”, which linked premorbid perfusion pressure to outcomes and challenged the universal application of a mean arterial pressure threshold of ≥65 mmHg. In collaboration with Professor Clive May, Bellomo established a chronically instrumented large animal model of hyperdynamic sepsis, yielding fundamental insights into the discordance between the macrocirculation and microcirculation, the vulnerability of the renal medulla to hypoxia, and the mechanisms of septic acute kidney injury. This model enabled direct comparison of vasopressor drugs in both healthy animals and during septic shock, demonstrating their heterogeneous effects on global and regional blood flow, perfusion, and tissue oxygenation. Knowledge translation to the bedside was achieved through the conduct of pivotal clinical trials, from early studies refuting the utility of “renal-dose dopamine” to landmark contributions to the ATHOS (angiotensin II treatment of high-ouput shock) program, which established angiotensin II as a novel vasopressor in refractory vasodilatory shock. Collectively, Bellomo’s work has transformed vasopressor therapy from empirical convention towards individualised practice, and it continues to inform clinical investigation and guideline development.</div></div>","PeriodicalId":49215,"journal":{"name":"Critical Care and Resuscitation","volume":"27 3","pages":"Article 100148"},"PeriodicalIF":1.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145278413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-06-01DOI: 10.1016/j.ccrj.2025.100112
Tarren Zimsen MBBS, MPH (Dr) , Lachlan Quick MBBS, FCICM (Dr) , Gentry White PhD (Prof) , Rahul Costa-Pinto PhD (Dr) , Stephen Whebell MBBS, FCICM (Dr) , Jason Meyer BN, RN, MSc , James McCullough FCICM, MMed (Dr) , Kiran Shekar MBBS, FCICM, PhD (Prof) , Kevin B. Laupland MD, PhD (Prof) , Mahesh Ramanan BSc(Med), MBBS(Hons), MMed(Clin Epi), FCICM (Prof) , Sebastiaan Blank FCICM (Dr) , Alexis Tabah MD, FCICM (Prof) , Stephen Luke MBBS, BSc(Hons), FCICM (Dr) , Peter Garrett MBBS, BSc(hons), FCICM, FACEM, FCEM , Antony G. Attokaran MBBS, FCICM, FRACP (Dr) , Aashish Kumar MBBS, FCICM (Dr) , Kyle C. White BSc, MPH, MBBS, FCICM, FRACP (Dr) , the Queensland Critical Care Research Network (QCCRN)
Background
Noradrenaline is the most prescribed vasopressor in intensive care units (ICUs). Although there is limited supporting evidence, metaraminol is often used as an alternative agent in some regions. We aimed to describe current practice and elucidate the factors associated with metaraminol prescription in a large cohort of ICU patients.
Method
A multicenter, retrospective cohort study of granular, routinely collected electronic medical record–based clinical data was performed in 12 ICUs in Queensland, Australia, between January 1, 2015, and December 31, 2021. Patients who received at least four consecutive hours of either metaraminol or noradrenaline in the first 24 h of their ICU stay were included.
Results
In total, 17,432 patients received single-agent vasopressor therapy and 1,963 (11.3 %) patients were administered metaraminol. For the entire cohort, the median age was 61 (interquartile range, IQR: 47–71), and the median Charlson Comorbidity Index was 3 (IQR: 1–5). The patients who received metaraminol had less ischaemic heart disease (5.5 % vs 7.6 %; p < 0.001) and were more likely to have localised cancer (16 % vs 14 %; p < 0.004). The patients receiving metaraminol were less likely to be ventilated on admission (39 % vs 73 %; p < 0.001) and had lower median Acute Physiology and Chronic Health Evaluation III scores (51 vs 56; p < 0.001). The median duration of metaraminol was 10 h (IQR: 6–18) and two-thirds (65 %) did not convert to noradrenaline infusion. After adjustment for confounders, after-hours admission (odds ratio, OR: 1.55; 95 % confidence interval [CI]: 1.40–1.71; p < 0.001), treatment limitation orders (OR: 1.35; 95 % CI: 1.10–1.64; p < 0.004), and admission to a regional ICU (OR: 1.47; 95 % CI: 1.27–1.68; p < 0.001) were independently associated with metaraminol use.
Conclusion
Metaraminol is a widely used vasoconstrictor in Queensland ICUs. Patients who receive metaraminol have specific characteristics but are overall less unwell than patients who receive noradrenaline. Most patients who receive metaraminol do not require an alternative vasoactive medication.
{"title":"Prevalence and characteristics of metaraminol usage in a large intensive care patient cohort. A multicentre, retrospective, observational study","authors":"Tarren Zimsen MBBS, MPH (Dr) , Lachlan Quick MBBS, FCICM (Dr) , Gentry White PhD (Prof) , Rahul Costa-Pinto PhD (Dr) , Stephen Whebell MBBS, FCICM (Dr) , Jason Meyer BN, RN, MSc , James McCullough FCICM, MMed (Dr) , Kiran Shekar MBBS, FCICM, PhD (Prof) , Kevin B. Laupland MD, PhD (Prof) , Mahesh Ramanan BSc(Med), MBBS(Hons), MMed(Clin Epi), FCICM (Prof) , Sebastiaan Blank FCICM (Dr) , Alexis Tabah MD, FCICM (Prof) , Stephen Luke MBBS, BSc(Hons), FCICM (Dr) , Peter Garrett MBBS, BSc(hons), FCICM, FACEM, FCEM , Antony G. Attokaran MBBS, FCICM, FRACP (Dr) , Aashish Kumar MBBS, FCICM (Dr) , Kyle C. White BSc, MPH, MBBS, FCICM, FRACP (Dr) , the Queensland Critical Care Research Network (QCCRN)","doi":"10.1016/j.ccrj.2025.100112","DOIUrl":"10.1016/j.ccrj.2025.100112","url":null,"abstract":"<div><h3>Background</h3><div>Noradrenaline is the most prescribed vasopressor in intensive care units (ICUs). Although there is limited supporting evidence, metaraminol is often used as an alternative agent in some regions. We aimed to describe current practice and elucidate the factors associated with metaraminol prescription in a large cohort of ICU patients.</div></div><div><h3>Method</h3><div>A multicenter, retrospective cohort study of granular, routinely collected electronic medical record–based clinical data was performed in 12 ICUs in Queensland, Australia, between January 1, 2015, and December 31, 2021. Patients who received at least four consecutive hours of either metaraminol or noradrenaline in the first 24 h of their ICU stay were included.</div></div><div><h3>Results</h3><div>In total, 17,432 patients received single-agent vasopressor therapy and 1,963 (11.3 %) patients were administered metaraminol. For the entire cohort, the median age was 61 (interquartile range, IQR: 47–71), and the median Charlson Comorbidity Index was 3 (IQR: 1–5). The patients who received metaraminol had less ischaemic heart disease (5.5 % vs 7.6 %; p < 0.001) and were more likely to have localised cancer (16 % vs 14 %; p < 0.004). The patients receiving metaraminol were less likely to be ventilated on admission (39 % vs 73 %; p < 0.001) and had lower median Acute Physiology and Chronic Health Evaluation III scores (51 vs 56; p < 0.001). The median duration of metaraminol was 10 h (IQR: 6–18) and two-thirds (65 %) did not convert to noradrenaline infusion. After adjustment for confounders, after-hours admission (odds ratio, OR: 1.55; 95 % confidence interval [CI]: 1.40–1.71; p < 0.001), treatment limitation orders (OR: 1.35; 95 % CI: 1.10–1.64; p < 0.004), and admission to a regional ICU (OR: 1.47; 95 % CI: 1.27–1.68; p < 0.001) were independently associated with metaraminol use.</div></div><div><h3>Conclusion</h3><div>Metaraminol is a widely used vasoconstrictor in Queensland ICUs. Patients who receive metaraminol have specific characteristics but are overall less unwell than patients who receive noradrenaline. Most patients who receive metaraminol do not require an alternative vasoactive medication.</div></div>","PeriodicalId":49215,"journal":{"name":"Critical Care and Resuscitation","volume":"27 2","pages":"Article 100112"},"PeriodicalIF":1.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144366521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-06-01DOI: 10.1016/j.ccrj.2025.100115
Sing Chee Tan FCICM, MMed(ClinEpi), MIS(Health), MBBS(Hons) , Lucy Modra FCICM, MPH, MBBS(Hons) , Tamishta Hensman FCICM, MBBS
In Australian intensive care units (ICUs), Artificial Intelligence (AI) promises to enhance efficiency and improve patient outcomes. However, ethical concerns surrounding AI must be addressed before widespread adoption. We examine the ethical challenges of of AI using the framework of the four pillars of biomedical ethics—beneficence, nonmaleficence, autonomy, and justice, and discuss the need for a fifth pillar of explicability. We consider the risks of perpetuating inequities, privacy breaches, and unintended harms, particularly in disadvantaged populations such as First Nations people. We advocate for a national strategy for ICUs to guide the ethical implementation of AI, that aligns with existing National AI Frameworks. Our recommendations for implementation of safe and ethical AI in ICU include education, developing guidelines, and ensuring transparency in AI decision-making. A coordinated strategy is essential to balance AI’s benefits with the ethical responsibility to protect patients and healthcare providers in critical care settings.
{"title":"AI ethics for the everyday intensivist","authors":"Sing Chee Tan FCICM, MMed(ClinEpi), MIS(Health), MBBS(Hons) , Lucy Modra FCICM, MPH, MBBS(Hons) , Tamishta Hensman FCICM, MBBS","doi":"10.1016/j.ccrj.2025.100115","DOIUrl":"10.1016/j.ccrj.2025.100115","url":null,"abstract":"<div><div>In Australian intensive care units (ICUs), Artificial Intelligence (AI) promises to enhance efficiency and improve patient outcomes. However, ethical concerns surrounding AI must be addressed before widespread adoption. We examine the ethical challenges of of AI using the framework of the four pillars of biomedical ethics—beneficence, nonmaleficence, autonomy, and justice, and discuss the need for a fifth pillar of explicability. We consider the risks of perpetuating inequities, privacy breaches, and unintended harms, particularly in disadvantaged populations such as First Nations people. We advocate for a national strategy for ICUs to guide the ethical implementation of AI, that aligns with existing National AI Frameworks. Our recommendations for implementation of safe and ethical AI in ICU include education, developing guidelines, and ensuring transparency in AI decision-making. A coordinated strategy is essential to balance AI’s benefits with the ethical responsibility to protect patients and healthcare providers in critical care settings.</div></div>","PeriodicalId":49215,"journal":{"name":"Critical Care and Resuscitation","volume":"27 2","pages":"Article 100115"},"PeriodicalIF":1.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144481432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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