Early Systemic Insults Following Traumatic Brain Injury In ICU Tue, 9 Apr 2024 Traumatic brain injury (TBI) is a major cause of death and disability globally, with outcomes heavily influenced by both the severity of the initial injury and subsequent secondary injury mechanisms. Systemic insults (SIs), such as hypoxaemia and hypotension, can worsen outcomes by exacerbating the cascade of events following the initial damage. Previous studies have high...

Editor's Note  March 4, 2024 Judicious Use of Rapid Viral Tests in Emergency Departments Lona Mody JAMA Intern Med. 2024;184(5):537. doi:10.1001/jamainternmed.2024.0044 Acute viral illnesses are common, pervasive, and burdensome to patients, families, and health care systems.1Patients often present to emergency departments (EDs), which is followed by extensive diagnostic investigations, such as blood tests, cultures, chest radiography, and computed tom...

Molecular Phenotypes to Advance Precision Care in ARDS In ICU Tue, 9 Apr 2024 The heterogeneity of acute respiratory distress syndrome (ARDS) has played a role in hindering successful pharmacotherapy in clinical trials. To address this, researchers have identified two molecular phenotypes of ARDS - hypoinflammatory and hyperinflammatory - through latent class analysis (LCA) applied to protein biomarkers and clinical data across various cohorts. These p...

Invited Commentary  March 4, 2024 Enhancing Quality and Safety in Critical Care—Challenges and Strategies for Central Venous Catheters Elie A. Saade, Francis T. Lytle, Peter J. Pronovost JAMA Intern Med. 2024;184(5):482-483. doi:10.1001/jamainternmed.2023.8243 related articles icon  Related  Articles Central venous catheters (CVCs) are widely used in US critical care settings, providing essential functions such as medication ad...

Editor's Note  June 17, 2024 Skin Antisepsis to Prevent Surgical Site Infections: Implications for Global Surgery Anthony Charles, Preeti N. Malani JAMA. Published online June 17, 2024. doi:10.1001/jama.2024.9622 Surgical site infections (SSIs) are the most common health care–associated infection. Often preventable, SSIs are associated with substantial morbidity and mortality as well as prolonged hospitalizations and readmissions, and these i...

EDITORIAL Uncertain Answers — Proton-Pump Inhibition in the ICU Samuel M. Brown N Engl J Med Published June 14, 2024 DOI: 10.1056/NEJMe2405782 A critical care clinician’s job includes administering timely and tailored antibiotics, expediting appropriate surgery, supporting a patient’s beleaguered body and mind until they are ready to recover, and preventing complications in this vulnerable state. This is surprisingly strenuous work, even if it is often, app...

Editorial  June 14, 2024 Sodium-Glucose Cotransporter 2 Therapy for Acute Organ Dysfunction in Critically Ill Patients Hernando Gómez, Lennie P. G. Derde JAMA. Published online June 14, 2024. doi:10.1001/jama.2024.10171 Multisystem organ dysfunction can follow several acute injury mechanisms, including trauma, sepsis, and shock and is the leading cause of death in critically ill patients.1 Even after the initial cause of organ injury has...

Unravelling the Role of HIF-1α in Sepsis In Sepsis Tue, 2 Apr 2024 A recent review explores the crucial role of hypoxia-inducible factor-1α (HIF-1α) in the development and progression of sepsis.  Hypoxia-inducible factor (HIF) is a protein complex consisting of a constitutively expressed subunit β and an oxygen-dependent subunit α. HIF-1α is associated with acute hypoxia and regulates glycolytic genes, oxygen consumption, and reactive oxygen sp...

Ventilator-Associated Brain Injury - A Priority for Research in Mechanical Ventilation In ICU Tue, 2 Apr 2024 Mechanical ventilation can lead to complications like ventilator-induced lung injury and ventilator-induced diaphragm dysfunction. However, there may be other forms of ventilator-associated issues that require understanding to improve outcomes for patients on mechanical ventilation. In particular, ventilator-associated brain injury (VABI) shoul...

Fluid and Vasopressor Decisions in Early Sepsis Management In Sepsis Tue, 30 Apr 2024 A recent study investigates the clinical factors influencing clinician decisions regarding fluid administration, vasopressor initiation, and vasopressor route in early sepsis. Previous concerns about fluid overload in sepsis have prompted interest in early vasopressor initiation, especially through peripheral IVs, as an alternative to central lines. While cl...