ICU Management & Practice, Volume 23 - Issue 1, 2023 Biomarkers of Infection in the Intensive Care Unit Biomarkers are an area of rapid discovery in critical care medicine today. They have the potential to improve our ability to identify and manage patients at increased risk of organ failure and death. This article provides an overview of biomarkers of infection in the intensive care unit. The heterogeneity of sepsis makes its identification challenging ...

#ISICEM23: Effects of Therapeutic-Dose Heparin in Hospitalised Patients With COVID-19 At the #ISICEM23 this week in Brussels, the benefits and harms of therapeutic-dose heparin varied by hospitalised COVID-19 patient characteristics were discussed, and the importance of considering the heterogeneity of treatment effect (HTE) in the design and analysis of randomised clinical trials was highlighted. To date, RCTs that have tested therapeutic-dose heparin in COVID-...

ICU Management & Practice, Volume 23 - Issue 1, 2023 Biomarkers in Sepsis This article describes the application of existing and emerging biomarkers in the diagnosis and management of sepsis and pneumonia. Introduction: The Need for Biomarkers in Sepsis Sepsis is defined as a dysregulated host response to infection that results in life threatening organ dysfunction. It carries an estimated 30-day mortality rate of 24.4% and increases to ...

Editorial  May 9, 2023 The Future of Clinical Trials in Idiopathic Pulmonary Fibrosis Anna J. Podolanczuk, Luca Richeldi, Fernando J. Martinez JAMA. 2023;329(18):1554-1555. doi:10.1001/jama.2022.23955 Idiopathic pulmonary fibrosis (IPF) currently affects about 100 000 individuals in the US, and millions globally. Patients living with IPF experience disabling symptoms and progressive loss of lung function.1 The 2 treatments approved by th...

Editorial  May 25, 2023 Disentangling the Postacute Sequelae of SARS-CoV-2: E Unibus Pluram (From One, Many) Robert Gross, Vincent Lo Re III JAMA. Published online May 25, 2023. doi:10.1001/jama.2023.8961 Early in the COVID-19 pandemic, patients and clinicians reported the persistence of initial symptoms and the onset of new symptoms after the acute phase of SARS-CoV-2 infection, collectively referred to as postacute sequelae of SARS-CoV...

Editorial  April 20, 2023 Informing a Rational Approach to Antimicrobial Prophylaxis in Open Pancreatoduodenectomy Anthony Charles, Preeti N. Malani JAMA. 2023;329(18):1556-1557. doi:10.1001/jama.2023.6275 Despite numerous advances in perioperative care, surgical site infection (SSI) remains a frequent complication after major abdominal surgery, with gastrointestinal procedures among the highest risk for infection.1Besides the increased length of stay ...

ICU Management & Practice, Volume 23 - Issue 1, 2023 Tachycardia in Sepsis: Friend or Foe? An overview of tachycardia in sepsis, the importance of rate control and the beneficial effects of beta-blockers. Sepsis and Tachycardia – Aetiologic Factors During sepsis, the sympathetic nervous system plays a key role in maintaining cardiac output and blood pressure. This is achieved through changes in heart rate, contractility, and vascular tone. The proper ...

Editorial  May 9, 2023 The Role of Prophylactic Antibiotics for Patients With Severe Alcohol-Related Hepatitis Ewan Forrest, William Bernal JAMA. 2023;329(18):1552-1553. doi:10.1001/jama.2023.1729 Few effective pharmacologic therapies are available for alcohol-related hepatitis. In patients diagnosed with alcohol-related hepatitis, greater severity of liver injury and systemic inflammation are associated independently with early mortality.1&n...

ICU Management & Practice, Volume 23 - Issue 1, 2023 Sepsis Diagnosis: Clinical Signs, Scores, and Biomarkers Abstract Sepsis and antimicrobial resistance are two major public health problems. Sepsis is defined as a dysregulated response of the body to a bacterial infection with organ dysfunction. The 2021 Surviving Sepsis Campaign SSC guidelines proposed characterising the infection based on clinical assessment an...

Invited Commentary  May 1, 2023 The Disappointing Impact of Interventions to Prevent Hospital Readmissions Robert M. Wachter JAMA Intern Med. Published online May 1, 2023. doi:10.1001/jamainternmed.2023.0804 When it comes to intervention trials in health services research, we are often left with the challenge of interpreting the generalizability of a positive study, particularly when the intervention involved humans interacting with other hum...