{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,16]],"date-time":"2026-08-16T05:25:20Z","timestamp":1786857920508,"version":"build-2736575974"},"reference-count":84,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T00:00:00Z","timestamp":1786665600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"FOCUS: Training and Guidance for UMFST Researchers in Health","award":["SMIS 350717"],"award-info":[{"award-number":["SMIS 350717"]}]},{"DOI":"10.13039\/501100000780","name":"European Union","doi-asserted-by":"crossref","award":["PS\/688\/PS_P3\/OP4\/ESO4.7\/PS_P3_ESO4.7_A6"],"award-info":[{"award-number":["PS\/688\/PS_P3\/OP4\/ESO4.7\/PS_P3_ESO4.7_A6"]}],"id":[{"id":"10.13039\/501100000780","id-type":"DOI","asserted-by":"crossref"}]},{"award":["PS\/688\/PS_P3\/OP4\/ESO4.7\/PS_P3_ESO4.7_A6"],"award-info":[{"award-number":["PS\/688\/PS_P3\/OP4\/ESO4.7\/PS_P3_ESO4.7_A6"]}],"id":[{"id":"https:\/\/ror.org\/019w4f821","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Bioengineering"],"abstract":"<jats:p>Contemporary intensive care operates in an environment with high-complexity cases, large volumes of information, and vast physiological, biological, and therapeutic data, collected from laboratory results, investigations, and therapies for organ support, as well as from systems that operate in parallel. The lack of interoperability contributes to information overload, alarm fatigue, and delayed decision-making. The Smart ICU concept has been developed to address these limitations by integrating medical devices, information systems, and artificial intelligence into a unified system that allows interoperable data integration and predictive analytics. Aim: The purpose of this article is to provide a narrative review of the Smart ICU concept, with a specific focus on the cardiac intensive care unit. It summarizes Smart ICU architecture, data integration, clinical support, and applicability in monitoring perioperative inflammation in cardiac surgery. We describe the Smart ICU architecture, from data acquisition to storage and analytics, highlighting the differences between Smart ICU, artificial intelligence, and Tele-ICU, and we underline predictive analytics as a supportive tool, as well as its influence on clinical outcomes. Cardiac ICU application: Cardiac ICUs offer a data-dense, temporally well-defined model following cardiac surgery with cardiopulmonary bypass, where data concerning patients\u2019 hemodynamics, perfusion data, and biological and inflammatory markers intertwine. Cardiac Smart ICU models could recognize early signs of hemodynamic compromise and low cardiac output states and identify early indicators of post-cardiac surgery complications. Neutrophil activation and complete blood count-derived indices may be used as dynamic biological data for Smart Cardiac ICU models. Conclusion: The Smart Cardiac ICU may support earlier risk stratification, and therefore earlier diagnostic and therapeutic interventions, but its clinical value requires prospective, multicenter validation. Cardiopulmonary bypass-induced inflammation may offer an ideal setting to integrate physiological, procedural, and immunological data into bedside predictive models.<\/jats:p>","DOI":"10.3390\/bioengineering13080921","type":"journal-article","created":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T10:39:01Z","timestamp":1786703941000},"page":"921","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Smart Cardiac ICU: Digital Integration, Predictive Analytics, and Perioperative Inflammation"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3220-2267","authenticated-orcid":false,"given":"Leonard","family":"Azamfirei","sequence":"first","affiliation":[{"name":"Department of Anesthesiology and Intensive Care, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Targu Mures, 540142 Targu Mures, Romania"},{"name":"Doctoral School of Medicine and Pharmacy, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Targu Mures, 540139 Targu Mures, Romania"},{"name":"Department of Anesthesiology and Intensive Care Medicine, Emergency County Hospital, 540136 Targu Mures, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mihaly","family":"Veres","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Intensive Care, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Targu Mures, 540142 Targu Mures, Romania"},{"name":"Doctoral School of Medicine and Pharmacy, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Targu Mures, 540139 Targu Mures, Romania"},{"name":"Department of Anesthesiology and Intensive Care, Emergency Institute for Cardiovascular Diseases and Transplantation, 540136 Targu Mures, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanziana","family":"Bora","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Intensive Care, Emergency Institute for Cardiovascular Diseases and Transplantation, 540136 Targu Mures, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mirela Cecilia","family":"Oiaga","sequence":"additional","affiliation":[{"name":"Doctoral School of Medicine and Pharmacy, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Targu Mures, 540139 Targu Mures, Romania"},{"name":"George Emil Palade University Hospital, 540142 Targu Mures, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-9666-0862","authenticated-orcid":false,"given":"Mihaela","family":"Butiulca","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Intensive Care, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Targu Mures, 540142 Targu Mures, Romania"},{"name":"Doctoral School of Medicine and Pharmacy, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Targu Mures, 540139 Targu Mures, Romania"},{"name":"Department of Anesthesiology and Intensive Care Medicine, Emergency County Hospital, 540136 Targu Mures, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra Elena","family":"Lazar","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Intensive Care, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Targu Mures, 540142 Targu Mures, Romania"},{"name":"Doctoral School of Medicine and Pharmacy, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Targu Mures, 540139 Targu Mures, Romania"},{"name":"Department of Anesthesiology and Intensive Care Medicine, Emergency County Hospital, 540136 Targu Mures, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9359-6058","authenticated-orcid":false,"given":"Janos","family":"Szederjesi","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Intensive Care, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Targu Mures, 540142 Targu Mures, Romania"},{"name":"Doctoral School of Medicine and Pharmacy, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Targu Mures, 540139 Targu Mures, Romania"},{"name":"Department of Anesthesiology and Intensive Care Medicine, Emergency County Hospital, 540136 Targu Mures, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bianca Liana","family":"Grigorescu","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Intensive Care, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Targu Mures, 540142 Targu Mures, Romania"},{"name":"Doctoral School of Medicine and Pharmacy, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Targu Mures, 540139 Targu Mures, Romania"},{"name":"Department of Anesthesiology and Intensive Care Medicine, Emergency County Hospital, 540136 Targu Mures, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"750","DOI":"10.1007\/s00134-021-06446-7","article-title":"Moving from bytes to bedside: A systematic review on the use of artificial intelligence in the intensive care unit","volume":"47","author":"Huiskens","year":"2021","journal-title":"Intensive Care Med."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Chromik, J., Klopfenstein, S.A.I., Pfitzner, B., Sinno, Z.-C., Arnrich, B., Balzer, F., and Poncette, A.-S. 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