Critical Care: Original Research Changes in Respiratory Mechanics With Trunk Inclination Differs Between Patients With ARDS With and Without Obesity Shailesh Bihari, Ubbo F. Wiersema Chest 2024; 165: 583-589 https://doi.org/10.1016/j.chest.2023.09.032 Background Studies investigating the effect of trunk inclination on respiratory mechanics in mechanically ventilated patients with ARDS have reported postural differences in partition respiratory ...

Monotherapy or Combination Therapy for Septic Shock International guidelines recommend using corticosteroids for adults with septic shock who require vasopressor therapy, supported by moderate-quality evidence. While corticosteroids may shorten the duration of shock, their impact on mortality remains uncertain. A recent meta-analysis found no significant reduction in mortality among septic shock patients treated with hydrocortisone compared to those given a placebo...

Invited Commentary  Nephrology March 8, 2024 Dialysis-Dependent Acute Kidney Injury—A Risk Factor for Adverse Outcomes Marlies Ostermann, Nuttha Lumlertgul, Matthew T. James JAMA Netw Open. 2024;7(3):e240346. doi:10.1001/jamanetworkopen.2024.0346 Acute kidney injury (AKI), acute kidney disease (AKD), and chronic kidney disease (CKD) have been defined as discrete entities but in practice can form a continuum whereby an initial kidney insult...

ORIGINAL ARTICLE Recombinant ADAMTS13 in Congenital Thrombotic Thrombocytopenic Purpura Authors: Marie Scully, Ana Antun, Spero R. Cataland, et al N Engl J Med 2024;390:1584-1596 DOI: 10.1056/NEJMoa2314793 Abstract BACKGROUND Congenital thrombotic thrombocytopenic purpura (TTP) results from severe hereditary deficiency of ADAMTS13. The efficacy and safety of recombinant ADAMTS13 and standard therapy (plasma-derived products) administered as routine pr...

Informative Subtyping, Targeted Immunomodulatory Therapies for Sepsis Sepsis is characterised by dysregulated immune responses. Traditional approaches to treating sepsis by targeting proinflammatory and immunosuppressive responses have been largely unsuccessful. Recent efforts have shifted towards identifying subtypes of sepsis to enable personalised treatment. However, many important immunological concepts, such as resistance, disease tolerance, resilience, resolu...

Critical Care: Original Research Prospective Evaluation of Venous Excess Ultrasound for Estimation of Venous Congestion August Longino, Katie Martin, Katarina Leyba, et al Chest 2024; 165: 590-600 https://doi.org/10.1016/j.chest.2023.09.029 Background Venous excess ultrasound (VExUS) is a novel ultrasound technique previously reported as a noninvasive measure of venous congestion and predictor of cardiorenal acute kidney injury. ...

Chest Infections: Original Research Prevalence, Risk Factors, Clinical Features, and Outcome of Influenza-Associated Pulmonary Aspergillosis in Critically Ill Patients: A Systematic Review and Meta-Analysis Lawrence Y. Lu, Hui Min Lee, Andrew Burke, et al Chest 2024; 165: 540-558 https://doi.org/10.1016/j.chest.2023.09.019 Background Influenza-associated pulmonary aspergillosis (IAPA) increasingly is being reported in critically ill patients. We conducte...

Chest Infections: Original Research Legionnaires Disease in Solid Organ Transplant Recipients: A Decade-Long Nationwide Study in France Guillaume Thizy, Adrien Flahault, Anne Scemla, et al Chest 2024; 165: 507-520 https://doi.org/10.1016/j.chest.2023.09.033 Background Legionnaires disease (LD) is a rare, life-threatening opportunistic bacterial infection that poses a significant risk to patients with impaired cell-mediated immunity such as solid organ tr...

Editor's Note  March 4, 2024 Judicious Use of Rapid Viral Tests in Emergency Departments Lona Mody JAMA Intern Med. Published online March 4, 2024. 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, ...

Original Investigation  Nephrology March 8, 2024 Recovery Dynamics and Prognosis After Dialysis for Acute Kidney Injury Heng-Chih Pan, Hsing-Yu Chen, Nai-Chi Teng, et al JAMA Netw Open. 2024;7(3):e240351. doi:10.1001/jamanetworkopen.2024.0351 Key Points Question  Are baseline kidney function, acute kidney disease (AKD) severity, and post-AKD kidney function associated with adverse outcomes in...