The integration of artificial intelligence (AI) into intensive care medicine has made considerable progress in recent studies, particularly in the areas of predictive analytics, early detection of complications, and the development of decision support systems. The main challenges remain availability and quality of data, reduction of bias and the need for explainable results from algorithms and models. Methods to explain these systems are essential to increase trust, understanding, and ethical considerations among healthcare professionals and patients. Proper training of healthcare professionals in AI principles, terminology, ethical considerations, and practical application is crucial for the successful use of AI. Careful assessment of the impact of AI on patient autonomy and data protection is essential for its responsible use in intensive care medicine. A balance between ethical and practical considerations must be maintained to ensure patient-centered care while complying with data protection regulations. Synergistic collaboration between clinicians, AI engineers, and regulators is critical to realizing the full potential of AI in intensive care medicine and maximizing its positive impact on patient care. Future research and development efforts should focus on improving AI models for real-time predictions, increasing the accuracy and utility of AI-based closed-loop systems, and overcoming ethical, technical, and regulatory challenges, especially in generative AI systems.

Acute pancreatitis is agastrointestinal emergency where diagnosis is based on typical symptoms, increased serum lipase concentration, and abdominal imaging. Local complications and organ failure in severe acute pancreatitis regularly necessitate treatment in the intensive care unit and are associated with increased mortality rates. Only optimal interdisciplinary treatment can improve the prognosis of patients with severe acute pancreatitis. This article gives guidance on the initial diagnostic and etiological examinations as well as on the evaluation of organ failure and the severity assessment according to common classification systems. Furthermore, the endoscopic management of biliary pancreatitis and infected necrosis is discussed and the basics of targeted volume therapy, nutrition, and indications for antibiotic treatment are reviewed.

Good knowledge of echocardiography is essential for modern intensive care medicine. A standardized curriculum for acquiring the expertise to perform TTE and TEE is a good way to strengthen one's own diagnostic skills.The EDEC curriculum from ESICM, which has been established for years, offers a good opportunity for structural further training at the advanced level in combination with gaining a high level of professional competence.

As part of the German government's digitization initiative, the paper-based documentation that is still present in many intensive care units is to be replaced by digital patient data management systems (PDMS). In order to simplify the implementation of such systems, standards for basic functionalities that should be part of basic configurations of PDMS would be of great value. This paper describes functional requirements for PDMS in several categories. Criteria for standardized data documentation were defined by the authors and derived functional requirements were classified into two priority categories. Overall, general technical requirements, functionalities for intensive care patient care, and additional functionalities for PDMS were defined and prioritized. Using this paper as astarting point for adiscussion about basic functionalities of PDMS, it is planned to develop and obtain consensus on definitive standards with representatives from medical societies, medical informatics and PDMS manufacture.

Sepsis and septic shock, which are often caused by pneumonia, impact millions of people every year. Despite adequate antibiotic therapy, mortality remains high, up to 45% in septic shock, which is characterized by an inappropriate, excessive immune response of the host. Moreover, critical illness-related corticosteroid insufficiency often coexists. Against this background, several trials and meta-analyses evaluated corticosteroid therapy as adjuvant therapy with heterogeneous results. Indeed, before 2000, high-dosage, short courses of corticosteroid treatment resulted in no benefit on mortality and ahigher rate of adverse events. After 2000, thanks to adeeper understanding of the pathophysiology, low-dosage with longer courses of treatment were tested. With this regimen, afaster decrease in inflammation and faster resolution of shock, with alow rate of mild adverse events, was demonstrated although no clear effect on mortality was shown. To date, guidelines on sepsis and septic shock and guidelines on severe community-acquired pneumonia suggest corticosteroid use in selected patients. Furthermore, by utilizing latent class analysis, phenotypes of sepsis patients who benefit the most from corticosteroid treatment were recently identified. Future research should be guided by aprecision medicine approach to identify adequate dosage and duration of corticosteroid treatment for appropriate patients. This article is freely available.

In Germany per year approximately 60,000 and in Austria 5,000 adult patients suffer from out-of-hospital cardiac arrest. Only 10-15% of these patients survive without neurological damage. For decades hypothermic temperature control has been a central component of post-resuscitation treatment, but is controversial due to recently published studies.