Half of hantavirus patients needing support went to ECMO, and the ICU's real work starts after discharge

The edition in brief

Across 31 Chilean hospitals between 2019 and 2024, 215 patients were admitted with Andes virus hantavirus cardiopulmonary syndrome. Of the 148 needing respiratory support, 14.2% received non-invasive ventilation, 36.5% invasive ventilation and 49.3% extracorporeal membrane oxygenation. In-hospital mortality was 20.5% overall, 29.6% among those ventilated and 32.9% among those on ECMO, and the pandemic period was independently associated with higher mortality (adjusted odds ratio 2.73, 95% CI 1.06-7.63). A meta-analysis of five critical care trials in 483 patients found diabetes-specific tube feeding formulas lowered mean blood glucose by 0.54 mmol/L (95% CI -0.78 to -0.31, moderate certainty) and reduced glycaemic variability with low certainty and extreme heterogeneity; no clinical outcome was reliably improved. A task-level analysis of emergency physician work classified 14 task categories and found that AI replacement is concentrated in routine cognitive tasks — documentation, records review and department operations — which consume 20 to 40% of shift time, while the nine non-routine abstract tasks are candidates for augmentation rather than replacement. The practice-changer is a review of post-intensive care syndrome: it affects survivors across physical, cognitive and mental health domains and affects 20 to 60% of their relatives, and the interventions with the best evidence sit inside the ICU stay itself — the ABCDEF bundle, light or no sedation, delirium prevention, early mobilisation and family participation.