EDITORIAL| VOLUME 164, ISSUE 4, P812-813, OCTOBER 2023 Fluid Therapy in Sepsis: Does It Matter How Much? Jonathan A. Silversides, Bram Rochwerg Chest 2023; 164: 812-813 DOI:https://doi.org/10.1016/j.chest.2023.05.027 Although IV fluid resuscitation is a fundamental element of sepsis management, debate regarding the ideal volume, type, timing, and physiologic targets is ongoing. A number of large randomized trials have been published addressing this importan...

Angiotensin II in Critically Ill Patients In December 2017, angiotensin II (ATII) intravenous infusion gained approval in the U.S. for treating septic or other distributive shock in adults. This approval was based on results from a phase II clinical trial which showed higher mean arterial pressure in septic shock patients on norepinephrine, who were randomly assigned to titrated ATII compared to placebo. However, the adoption and usage of ATII in clinical practice ...

EDITORIAL| VOLUME 164, ISSUE 4, P814-815, OCTOBER 2023 Lung-Protective Concept and Noninvasive Respiratory Support Masaaki Sakuraya Chest 2023; 164: 814-815 DOI:https://doi.org/10.1016/j.chest.2023.05.014 Noninvasive respiratory support (NIRS), which includes high-flow nasal cannula (HFNC) and noninvasive ventilation (NIV), has been used for initial respiratory treatment in patients with respiratory failure. However, conclusive evidence is insufficient for ...

Awake Prone Position in Acute Hypoxaemic Respiratory Failure A study aimed to improve understanding of the impact of the awake prone position on the breathing patterns of patients with low oxygen levels. The researchers carried out a crossover trial examining how awake prone position use in patients with acute hypoxaemic respiratory failure affected their physiological responses. The study involved 15 patients with acute hypoxaemic respiratory failure and PaO2/F...

Ultra-Low Tidal Volume Ventilation for COVID-19-ARDS A new study aimed to evaluate the effectiveness of ventilation with ultra-low tidal volume (ULTV) compared to low tidal volume (LTV) in patients suffering from COVID-19-related acute respiratory distress syndrome (ARDS). COVID-19-related ARDS is associated with a high mortality rate and extended mechanical ventilation duration.  The study was conducted in ten ICUs in France and included patients who were ...

Editorial  August 28, 2023 The Need for Randomized Clinical Trials Demonstrating Reduction in All-Cause Mortality With Blood Tests for Cancer Screening Sanket S. Dhruva, Rebecca Smith-Bindman, Rita F. Redberg JAMA Intern Med. 2023;183(10):1051-1053. doi:10.1001/jamainternmed.2023.3610 In recent years, blood tests that look for circulating tumor DNA and biomarkers (termed liquid biopsies) have been developed. As Carr and Welch describe in this issu...

Sepsis-Associated Acute Kidney Injury in the ICU Sepsis is a frequently encountered condition that leads to severe illness and is associated with significant morbidity and mortality. It is commonly accompanied by acute kidney injury (AKI), known as sepsis-associated acute kidney injury (SA-AKI). The relationship between sepsis and AKI has been investigated in prior studies. However, the absence of a consistent and standardised definition has hindered the interpreta...

Intraoperative Oxygen Administration in OPCAB Maintaining adequate oxygen delivery (DO2) to peripheral tissues during surgery is crucial, as factors like acute blood loss or fluid shifts can threaten oxygen supply. Surgery patients often receive higher fractions of inspired oxygen (FiO2) to ensure sufficient oxygen and perfusion. However, this practice can lead to supraphysiological oxygen levels, resulting in oxidative stress, vasoconstriction, and microcirculator...

Tranexamic Acid for Intracerebral Haemorrhage in Patients on NOAC There is a lack of evidence-based haemostatic treatment for intracerebral haemorrhage (ICH) associated with non-vitamin K antagonist oral anticoagulants (NOACs). Tranexamic acid (TXA) is an antifibrinolytic drug that helps limit haematoma expansion. A study was conducted to evaluate the effectiveness and safety of using TXA in NOAC-related ICH cases. The trial was performed at six Swiss stroke centres...

Invited Commentary  Pediatrics July 20, 2020 Leveraging Tweets, Citations, and Social Networks to Improve Bibliometrics N. Seth Trueger, Yusuf Yilmaz, Teresa M. Chan JAMA Netw Open. 2020;3(7):e2010911. doi:10.1001/jamanetworkopen.2020.10911 Citations have long been the leading metric for articles, with the citation-based journal impact factor being the primary journal metric. As the world becomes increasingly digital, altmetrics (“alternat...