The diagnostic process in Intensive Care Units has been revolutionized by ultrasonography and accelerated by artificial intelligence. Patients in critical condition are often sonoanatomically challenging, with time constraints being an additional stress factor. In this paper, we describe the technology behind the development of AI systems to support diagnostic ultrasound in intensive care units. Among the AI-based solutions, the focus was placed on systems supporting cardiac ultrasound, such as Smart-VTI, Auto-VTI, SmartEcho Vue, AutoEF, Us2.ai, and Real Time EF. Solutions to assist hemodynamic assessment based on the evaluation of the inferior vena cava, such as Smart-IVC or Auto-IVC, as well as to facilitate ultrasound assessment of the lungs, such as Smart B-line or Auto B-line, and to help in the estimation of gastric contents, such as Auto Gastric Antrum, were also discussed. All these solutions provide doctors with support by making it easier to obtain appropriate diagnostically correct ultrasound images by automatically performing time-consuming measurements and enabling real-time analysis of the obtained data. Artificial intelligence will most likely be used in the future to create advanced systems facilitating the diagnostic and therapeutic process in intensive care units.
Artificial intelligence has now changed regional anesthesia, facilitating, therefore, the application of the regional block under the USG guidance. Innovative technological solutions make it possible to highlight specific anatomical structures in the USG image in real time, as needed for regional block. This contribution presents such technological solutions as U-Net architecture, BPSegData and Nerveblox and the basis for independent assisting systems in the use of regional blocks, e.g., ScanNav Anatomy PNB or the training system NeedleTrainer. The article describes also the systems integrated with the USG devices, such as Mindray SmartNerve or GE cNerve as well as the robotic system Magellan which substantially increases the patient’s safety, time needed for the regional block and quality of the procedure. All the solutions presented in this article facilitate the performance of regional blocks by less experienced physicians and appear as an excellent educational tool which, at the same time, improves the availability of the more and more popular regional anesthesia. Will, therefore, artificial intelligence replace physicians in regional block procedures? This seems unlikely. It will, however, assist them in a significant manner, contributing to better effectiveness and improved safety of the patient.
Background: Ischemia-reperfusion injury (IRI) impairs kidney transplants. Diazepam can reduce IRI through peripheral benzodiazepine receptors. We aimed to evaluate the effect of diazepam premedication on the IRI of the rat kidney. Methods: Fourteen days after unilateral nephrectomy, male Sprague-Dawley rats underwent a 45 min sole kidney ischemia. Sixty minutes prior to ischemia, the animals were randomly assigned to a subcutaneous injection of 0.75 mg diazepam (n = 28) or 0.5 mL 0.9% NaCl (n = 31). Results: After 48 h, serum creatinine of diazepam-administered rats was lower and creatinine clearance was higher than in controls (119.8 ± 73.3 vs. 217.5 ± 105.3 µmol/L, p < 0.01 and 0.14 ± 0.07 vs. 0.08 ± 0.05 mL/min/100 g BM, p < 0.01, respectively). Moreover, the former had lower urinary losses of sodium and potassium (fractional excretions of 1.24 ± 1.39% vs. 2.87 ± 3.66%, p = 0.02 and 111.1 ± 95.7% vs. 199.0 ± 143.3%, p < 0.01, respectively). After 7 days, diazepam-treated rats remained superior vs. controls, regarding serum creatinine (53.7 ± 12.7 vs. 77.6 ± 21.3 µmol/L, p < 0.01), creatinine clearance (0.22 ± 0.08 vs. 0.17 ± 0.06 mL/min/100 g BM, p < 0.01), potassium sparing (50.2 ± 31.7% vs. 73.4 ± 38.7% excretion, p < 0.01), and renal edema (1.92 ± 0.45 vs. 2.30 ± 0.61 g of kidney mass, p < 0.01). Furthermore, their 24 h proteinuria was marginally reduced (4.03 ± 2.62 vs. 5.06 ± 2.74 mg, p = 0.06). Conclusions: Administration of diazepam preceding renal ischemia attenuates subsequent kidney injury in rats. Benzodiazepines may be beneficial prior to kidney transplantation.