INSPIRE Trial: Improving Antibiotic Selection for Pneumonia In ICU Thu, 25 Apr 2024 Over 1.5 million adults are hospitalised in the U.S. each year due to pneumonia, with about half of them receiving unnecessary extended-spectrum antibiotics. This overuse contributes to the risk of antibiotic resistance and other adverse effects. Current strategies to improve antibiotic prescribing mainly focus on shortening the duration or de-escalating antib...

Editor's Note  May 20, 2024 Tracking Physical Activity One Step at a Time Cary P. Gross, Raegan W. Durant JAMA Intern Med. Published online May 20, 2024. doi:10.1001/jamainternmed.2024.0898 Current physical activity guidelines recommend at least 150 minutes per week of moderate-intensity physical activity or 75 minutes per week of vigorous activity. These time thresholds were based on studies using self-reported activity, which is prone to bi...

Low vs High Blood Pressure Targets in Critically Ill and Surgical Patients In ICU Thu, 25 Apr 2024 The treatment of critically ill and perioperative patients often involves targeting blood pressure as a cornerstone of haemodynamic management. Current guidelines suggest maintaining high blood pressure targets for these patients based on observational studies linking hypotensive events to adverse outcomes. However, these recommendations are not...

Editorial  May 19, 2024 When the Third Time Is Not the Charm—Trial Outcomes in Idiopathic Pulmonary Fibrosis Ana C. Zamora, Victor E. Ortega, Eva M. Carmona JAMA. Published online May 19, 2024. doi:10.1001/jama.2024.8776 Idiopathic pulmonary fibrosis (IPF) is a progressive fibrotic lung disease that inevitably results in respiratory failure and death within 3 to 5 years of diagnosis.1 No effective treatment for IPF existed until the appr...

English Proficiency and Sepsis Mortality Sepsis is a leading cause of hospital deaths. Despite initiatives like the Surviving Sepsis Campaign and Centers for Medicare & Medicaid Services Severe Sepsis and Septic Shock Management Bundle (SEP-1), healthcare disparities persist. Previous studies revealed disparities in sepsis outcomes by age, sex, race, and ethnicity, but limited English proficiency (LEP) and its impact on sepsis outcomes have been understudied. ...

Ceftriaxone to Prevent Early VAP in Patients With Acute Brain Injury Patients with acute brain injury are at high risk of ventilator-associated pneumonia (VAP). The debate surrounding the benefit of short-term antibiotic prophylaxis in this population is a key aspect of the investigation. The objective of this study was to determine the impact of a single early dose of the antibiotic ceftriaxone on the incidence of early VAP in patients with severe brain injury ...

Editorial  May 13, 2024 Can Cardiovascular Risk Assessment Be Improved in the 21st Century? Thomas A. Gaziano, J. Michael Gaziano JAMA. Published online May 13, 2024. doi:10.1001/jama.2024.7644 Cardiovascular risk assessment has become an essential part of preventive strategies designed to target risk factor interventions and has contributed to dramatic reductions in cardiovascular disease mortality during the past 60 years in the US and othe...

Artificial Intelligence in Critical Care: Opportunities and Obstacles In ICU Wed, 17 Apr 2024 The increasing availability of complex health data, coupled with advancing computational capabilities, offers an opportunity to define health and disease states with greater clarity and efficiency. This potential extends to real-time diagnosis and patient management. Due to its time-critical nature, the ICU presents unique challenges in creating effective mode...

Modification in ICU Design May Affect Delirium In ICU Tue, 9 Apr 2024 Delirium is a common psychiatric syndrome in critically ill patients, associated with high mortality rates and long-term cognitive decline. Recent trials on medication-based treatments have not shown significant benefits, leading to a shift towards nonpharmacologic approaches.  The Society of Critical Care Medicine recommends comprehensive interventions, including reorientati...

Invited Commentary  January 24, 2024 Guideline Implementation Is Improving Trauma Care in the Wild, Wild West Jeffrey K. Jopling, Lisa M. Kodadek, Elliott R. Haut JAMA Surg. 2024;159(4):372-373. doi:10.1001/jamasurg.2023.7154 Acore tenet in the care of patients with brain injury is prevention of secondary brain injury. In the immediate postinjury period, the patient’s physiology must be carefully managed to adequately perfuse and oxygenate the brain. M...