Original Investigation  Caring for the Critically Ill Patient Augmented Enteral Protein During Critical Illness: The TARGET Protein Randomized Clinical Trial Matthew J. Summers, Lee-anne S. Chapple, Amalia Karahalios, et al JAMA Published Online: June 11, 2025 doi: 10.1001/jama.2025.9110 Key Points Question  Does augmentation of enteral protein improve outcomes in critically ill patients? Findings  In this cluster randomize...

Invited Commentary  April 10, 2025 Cutting the Antibiotic Spectrum for Low-Risk Abdominal Infection Joshua B. Brown JAMA Surg. Published online April 10, 2025. doi:10.1001/jamasurg.2025.1107 The rise of antibiotic stewardship efforts has seen success, but evidence is heterogeneous across different conditions. Intra-abdominal infection is one such area where there is a relative paucity of data for effective stewardship interventions. Given the...

ORIGINAL ARTICLE A Randomized Trial of Acute Normovolemic Hemodilution in Cardiac Surgery Fabrizio Monaco, Chong Lei, Matteo Aldo Bonizzoni, et al N Engl J Med Published June 12, 2025 DOI: 10.1056/NEJMoa2504948 Abstract BACKGROUND Patients undergoing cardiac surgery often receive red-cell transfusions, along with the associated risks and costs. Early intraoperative normovolemic hemodilution (i.e., acute normovolemic hemodilution [ANH]) is a blood-cons...

ORIGINAL ARTICLE A Crossover Trial of Hospital-Wide Lactated Ringer’s Solution versus Normal Saline Lauralyn McIntyre, Dean Fergusson, Tracy McArdle, et al N Engl J Med Published June 12, 2025 DOI: 10.1056/NEJMoa2416761 Abstract BACKGROUND Whether lactated Ringer’s solution is clinically superior to normal saline for routine intravenous administration of fluids is uncertain. METHODS In an open-label, two-period, two-sequence, cross-sectional, cl...

Editorial  Patient, Treatment, Outcome, Large Simple Trials of Common Therapies Kevin P. Seitz, Jonathan D. Casey, Matthew W. Semler JAMA Published Online: June 12, 2025 doi: 10.1001/jama.2025.9657 Each year, as many as 20 million critically ill adults receive mechanical ventilation worldwide, and approximately 1 in 3 die before hospital discharge.1-3 For every patient receiving mechanical ventilation, the fraction of inspired oxygen (Fio2) must b...

Original Investigation  April 10, 2025 Improving Empiric Antibiotic Selection for Patients Hospitalized With Abdominal Infection: The INSPIRE 4 Cluster Randomized Clinical Trial Shruti K. Gohil, Edward Septimus, Ken Kleinman, et al JAMA Surg. Published online April 10, 2025. doi:10.1001/jamasurg.2025.1108 Key Points Question  Can computerized provider order entry (CPOE) prompts with patient-spec...

Original Investigation  Caring for the Critically Ill Patient Conservative Oxygen Therapy in Mechanically Ventilated Critically Ill Adult Patients: The UK-ROX Randomized Clinical Trial Daniel S. Martin, Doug W. Gould, Tasnin Shahid, et al JAMA Published Online: June 12, 2025 doi: 10.1001/jama.2025.9663 Key Points Question  Does reducing exposure to supplemental oxygen by using a reduced peripheral oxygen saturation (Spo2) target of 90% ...

Benefit From Adjuvant Therapy With Corticosteroids in Community-Acquired Pneumonia In ICU Wed, 12 Mar 2025 Community-acquired pneumonia (CAP) is a leading cause of hospitalisation with high mortality. It can be caused by various pathogens, including viruses, bacteria, and fungi, complicating treatment. Adjuvant corticosteroid treatment may help reduce excessive inflammation, which is linked to higher mortality.  While RCTs and a meta-analysis s...

Editorial  April 10, 2025 Electronic Stewardship Prompts—Exploring the Why Behind the What Shinya Hasegawa, Daniel J. Livorsi JAMA Netw Open. 2025;8(4):e2512634. doi:10.1001/jamanetworkopen.2025.12634 Increasing antibiotic resistance is an urgent public health threat, and antibiotic stewardship is an important strategy for mitigating this threat.1 Antibiotic stewardship programs strive to improve patient safety by opt...

Original Investigation  April 16, 2025 Operative vs Nonoperative Treatment of Acute Cholecystitis in Older Adults With Multimorbidity Rachael C. Acker, Sara P. Ginzberg, James Sharpe, et al JAMA Surg. Published online April 16, 2025. doi:10.1001/jamasurg.2025.0729 Key Points Question  Is operative or nonoperative treatment better for treating acute cholecystitis in older adults with multimorbidi...