Original Investigation  March 13, 2024 Accreditation Council for Graduate Medical Education Milestone Training Ratings and Surgeons’ Early Outcomes Brigitte K. Smith, Kenji Yamazaki, Ara Tekian, et al JAMA Surg. Published online March 13, 2024. doi:10.1001/jamasurg.2024.0040 Key Points Question  Does assessment of surgical competence using Accreditation Council for Graduate Medical Education Milestones during training predict fut...

ICU Management & Practice, Volume 24 - Issue 1, 2024 Corticosteroids in the Intensive Care Unit: Evidence-Based Recommendations Corticosteroids are commonly used drugs in multiple diseases and conditions of critically ill patients. In this article, we review the pharmacology of corticosteroids and provide recommendations for their use in the ICU based on the best available evidence. Corticosteroids: Pharmacology and General Aspects Corticosteroids are...

Original Investigation  Infectious Diseases March 13, 2024 Bacteremia From a Presumed Urinary Source in Hospitalized Adults With Asymptomatic Bacteriuria Sonali D. Advani, David Ratz, Jennifer K. Horowitz, et al JAMA Netw Open. 2024;7(3):e242283. doi:10.1001/jamanetworkopen.2024.2283 Key Points Question  What is the prevalence of bacteremia from a presumed urinary source in hospitalized patients with asymptomatic bacteriuria (...

Original Investigation  Surgery February 2, 2024 Risk of Venous Thromboembolic Events After Surgery for Cancer Johan Björklund, Juhana Rautiola, Renata Zelic, et al JAMA Netw Open. 2024;7(2):e2354352. doi:10.1001/jamanetworkopen.2023.54352 Key Points Question  Is major cancer surgery associated with an increased risk of venous thromboembolism after surgery? Findings  This population-based nationwide cohort study c...

Editorial Venous Doppler for Echocardiographic Right Atrial Pressure Estimation: Ready for Primetime? Jean Deschamps, William Beaubien-Souligny Chest 2024; 165: 478-481 https://doi.org/10.1016/j.chest.2023.11.007 For the last decade, inferior vena cava (IVC) measurements and variability have been the de facto noninvasive echocardiographic measurement to infer right-sided filling pressures and remain at the forefront of current echocardiography guidelines.1D...

ORIGINAL ARTICLE Oral Iptacopan Monotherapy in Paroxysmal Nocturnal Hemoglobinuria Régis Peffault de Latour, Alexander Röth, Austin G. Kulasekararaj, et al N Engl J Med 2024; 390:994-1008DOI: 10.1056/NEJMoa2308695 Abstract BACKGROUND Persistent hemolytic anemia and a lack of oral treatments are challenges for patients with paroxysmal nocturnal hemoglobinuria who have received anti-C5 therapy or have not received complement inhibitors. Iptacopan, a first-...

Improving Management of ARDS Acute respiratory distress syndrome (ARDS) poses a significant global health challenge, with high in-hospital mortality rates of approximately 40% despite advancements in supportive care. There's notable variability in patient management across different regions, with proven life-saving treatments like low tidal volume ventilation not uniformly implemented. ARDS is a diverse condition, suggesting that therapeutic responses can vary amon...

Chest Infections: Original Research Using Trajectories of Bedside Vital Signs to Identify COVID-19 Subphenotypes Sivasubramanium V. Bhavani, Chad Robichaux, Philip A. Verhoef, et al Chest 2024; 165: 529-539 https://doi.org/10.1016/j.chest.2023.09.020 Background Trajectories of bedside vital signs have been used to identify sepsis subphenotypes with distinct outcomes and treatment responses. The objective of this study was to validate the vitals trajector...

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...