ARTICLES| VOLUME 24, ISSUE 4, P375-385, APRIL 2024 Efficacy and safety of a structured de-escalation from antipseudomonal β-lactams in bloodstream infections due to Enterobacterales (SIMPLIFY): an open-label, multicentre, randomised trial Luis Eduardo López-Cortés, Mercedes Delgado-Valverde, Elisa Moreno-Mellado, et al Lancet Infect Dis 2024; 24: 375-385 DOI:https://doi.org/10.1016/S1473-3099(23)00686-2 Summary Background De-escalation from broad-spec...

Multidisciplinary Management of Gram-Negative Bloodstream Infections In ICU Tue, 12 Mar 2024 Bloodstream infections (BSIs) caused by Gram-negative pathogens pose significant challenges in ICU patients due to their high prevalence and severity, with mortality rates reported as high as 40%. The widespread prevalence of multidrug-resistant organisms (MDRO) further complicates antibiotic treatment choices, with mortality rates reaching 43% when MDROs are i...

Research Glucagon-like peptide 1 receptor agonist use and risk of thyroid cancer: Scandinavian cohort study Björn Pasternak, Viktor Wintzell, Anders Hviid, et al BMJ 2024; 385 doi: https://doi.org/10.1136/bmj-2023-078225 (Published 10 April 2024)Cite this as: BMJ 2024;385:e078225 Abstract Objective To investigate whether use of glucagon-like peptide 1 (GLP1) receptor agonists is associated with increased risk of thyroid cancer. Design Scandinav...

ORIGINAL ARTICLE Intensive Ambulance-Delivered Blood-Pressure Reduction in Hyperacute Stroke Gang Li, Yapeng Lin, Jie Yang, et al N Engl J Med 2024;390:1862-1872 DOI: 10.1056/NEJMoa2314741 Abstract BACKGROUND Treatment of acute stroke, before a distinction can be made between ischemic and hemorrhagic types, is challenging. Whether very early blood-pressure control in the ambulance improves outcomes among patients with undifferentiated acute stroke is ...

Original Investigation  Emergency Medicine April 9, 2024 Emergency Nurses’ Reasons for Not Recommending Their Hospital to Clinicians as a Good Place to Work K. Jane Muir, Raina M. Merchant, Karen B. Lasater, et al JAMA Netw Open. 2024;7(4):e244087. doi:10.1001/jamanetworkopen.2024.4087 Key Points Question  Why do emergency nurses not recommend their hospital to clinicians as a good place to work? Findings  This qu...

Respiratory Muscle Assessments to Predict Weaning Outcomes In ICU Tue, 12 Mar 2024 Various factors influence failure to wean from mechanical ventilation, including respiratory muscle dysfunction, which is strongly associated with weaning failure and mortality. However, respiratory muscle function assessment is not routinely performed in most ICUs.  Various bedside tools are available for assessing respiratory muscle function, including non-voli...

Original Investigation  April 10, 2024 Automated CT Analysis of Body Composition as a Frailty Biomarker in Abdominal Surgery Ijeamaka Anyene Fumagalli, Sidney T. Le, Peter D. Peng, et al JAMA Surg. Published online April 10, 2024. doi:10.1001/jamasurg.2024.0628 Key Points Question  Can preoperative computed tomography (CT) scans provide patient frailty assessments that are associated with outcomes of abdominal surgery? Finding...

Research Letter  April 8, 2024 Cardiac Function Before Sepsis and Clinical Outcomes Stuthi Iyer, Jason N. Kennedy, Jacob C. Jentzer, et al JAMA. Published online April 8, 2024. doi:10.1001/jama.2024.3917 Between 2009 and 2014, 21% of US adults with sepsis did not survive.1 Guidelines recommend urgent resuscitation of patients with sepsis, although the ideal treatment regimen is not clear2 and challenges to resuscitation, including t...

Research Letter  April 10, 2024 Intravascular Microaxial Left Ventricular Assist Device Manufacturer Payments to Cardiologists and Use of Devices Sanket S. Dhruva, Joseph S. Ross, Michael A. Steinman, et al JAMA. Published online April 10, 2024. doi:10.1001/jama.2024.4682 Mechanical circulatory support devices are increasingly used by physicians for patients receiving percutaneous coronary intervention (PCI).1 Use of intra-aortic balloon...

Ventilator Parameters During OR–to–ICU Transition In ICU Tue, 5 Mar 2024 Lung-protective mechanical ventilation strategies are beneficial both in the operating room (OR) and the ICU. However, there are variations in ventilator management practices between these settings, leading to adjustments in ventilator parameters when patients transition from the OR to the ICU. The impact of changes in ventilator settings during transitions between these settings ...