Clinical Research Directory

Supply Induced Demand in Intensive Care Unit: a Retrospective Trial

Intensive Care Unit (ICU) represents a high-level healthcare and expensive resource in hospitals. The causes of hospitalization in critical care are therefore multiple, and over the years numerous prognostic scores have been proposed, which therefore correlate the severity of the pathology with the predicted mortality from a statistical point of view. The function of the scores is also to assist the physician in clinical choices. The two most frequently used prognostic scores in critical care are the Acute Physiology And Chronic Health Evaluation (APACHE) II score and the Simplified Acute Physiology Score (SAPS) II. The choice to admit a patient to Intensive Care, therefore, is a clinical, economic and managerial choice. Due to the costs of the ICU beds, as well as to the fact that shortage of beds may have a significant clinical impact on patients, many studies addressed the issue of supply-induced scarcity (SIS), i.e. scarcity due to a lack of supply and not to an excess of demand. On the other side, Health Economics has demonstrated that often an increase in supply can generate an increase in demand, even when this increase is not strictly necessary or appropriate. This phenomenon, called supply-induced demand (SID), to the best of our knowledge, few studies have been conducted in critical care settings; moreover, the correlation between SID and outcomes, specifically mortality, has never been demonstrated. The aim of this retrospective, single-center study, therefore, is to investigate the presence of SID, and the consequent effects on mortality outcome, in a multispecialty Postoperative Intensive Care Unit.

Assessing Intensive Care Unit (ICU) Indications: Human vs. ChatGPT-4o Predictions

This retrospective study evaluates the accuracy of ICU admission indications by comparing clinical decisions with predictions from ChatGPT-4. Patient data, including demographics, vital signs, laboratory results, imaging findings, and clinical decisions, will be retrospectively collected and documented systematically using Case Report Forms. The model will be trained using ICU admission guidelines and tasked to predict ICU needs based on collected patient data. This study aims to systematically assess the alignment between AI-based predictions and clinical decisions for ICU admissions.

Biomarker Signature-Supported Antibiotic Treatment Decisions in ICU

The goal of this randomized clinical trial is to determine whether a biomarker-signature (BV) supported antibiotic treatment decision matrix can have a beneficial impact on antibiotic use and patient outcomes in an ICU population.

Impact of Information and Participation on Decision Time for Tracheostomy or PEG in ICU Families

Decisions regarding tracheostomy and percutaneous endoscopic gastrostomy (PEG) in the intensive care unit (ICU) are frequently associated with substantial uncertainty, decisional conflict, and psychosocial burden among patients' relatives. Inadequate or non-tailored information may negatively influence anxiety levels, decision satisfaction, and subsequent adaptation to care responsibilities. Differences in communication patterns and educational background may further affect how families perceive the risks, benefits, and long-term implications of these procedures. This prospective study aims to evaluate the impact of relatives' educational level and different information delivery methods on anxiety, decision satisfaction, and the overall decision-making process related to tracheostomy and PEG in the ICU setting. The findings are expected to contribute to the development of structured, education-level-tailored information strategies to improve shared decision-making and family-centered care in critical care practice.

The PRE-VAIL Study

During the prone position, there may be an increase in intragastric pressure. The investigators focus on a scientific question: Whether reducing enteral nutrition before the prone position will benefit patients with severe mechanically ventilated acute respiratory distress syndrome (ARDS). The experimental group had the enteral nutrition dose reduced before the prone position, while the control group did not have the enteral nutrition dose reduced