ARTICLES|ONLINE FIRST Viral emissions into the air and environment after SARS-CoV-2 human challenge: a phase 1, open label, first-in-human study Jie Zhou, Anika Singanayagam, Niluka Goonawardane, et al. Lancet Microbe Published:June 09, 2023 DOI:https://doi.org/10.1016/S2666-5247(23)00101-5 Summary Background Effectively implementing strategies to curb SARS-CoV-2 transmission requires understanding who is contagious and when. Although viral load on up...

ORIGINAL ARTICLE Prehospital Tranexamic Acid for Severe Trauma The PATCH-Trauma Investigators and the ANZICS Clinical Trials Group N Engl J Med June 14, 2023DOI: 10.1056/NEJMoa2215457 Abstract BACKGROUND Whether prehospital administration of tranexamic acid increases the likelihood of survival with a favorable functional outcome among patients with major trauma and suspected trauma-induced coagulopathy who are being treated in advanced trauma systems is ...

ORIGINAL ARTICLE Dexamethasone versus Surgery for Chronic Subdural Hematoma Ishita P. Miah, Dana C. Holl, Jurre Blaauw, et al N Engl J Med 2023; 388:2230-2240DOI: 10.1056/NEJMoa2216767 Abstract BACKGROUND The role of glucocorticoids without surgical evacuation in the treatment of chronic subdural hematoma is unclear. METHODS In this multicenter, open-label, controlled, noninferiority trial, we randomly assigned symptomatic patients with chronic sub...

ARTICLES|ONLINE FIRST The third Intensive Care Bundle with Blood Pressure Reduction in Acute Cerebral Haemorrhage Trial (INTERACT3): an international, stepped wedge cluster randomised controlled trial Lu Ma, Xin Hu, Lili Song, et al. Lancet Published: May 25, 2023 DOI:https://doi.org/10.1016/S0140-6736(23)00806-1 Summary Background Early control of elevated blood pressure is the most promising treatment for acute intracerebral haemorrhage. We aimed to...

Original Investigation  June 6, 2023 The Volume and Cost of Quality Metric Reporting Anirudh Saraswathula, Samantha J. Merck, Ge Bai, et al JAMA. 2023;329(21):1840-1847. doi:10.1001/jama.2023.7271 Key Points Question  What is the annual cost to an acute care hospital of measuring and reporting quality metric data, excluding resources spent on quality improvement interventions? Findings  Preparing and reporting data f...

ORIGINAL ARTICLE Transplantation Outcomes with Donor Hearts after Circulatory Death Jacob N. Schroder, Chetan B. Patel, Adam D. DeVore, et al N Engl J Med 2023; 388:2121-2131DOI: 10.1056/NEJMoa2212438 Abstract BACKGROUND Data showing the efficacy and safety of the transplantation of hearts obtained from donors after circulatory death as compared with hearts obtained from donors after brain death are limited. METHODS We conducted a randomized, nonin...

Original Investigation  June 2, 2023 Direct Oral Anticoagulants vs Low-Molecular-Weight Heparin and Recurrent VTE in Patients With Cancer: A Randomized Clinical Trial Deborah Schrag, Hajime Uno, Rachel Rosovsky, et al JAMA. Published online June 2, 2023. doi:10.1001/jama.2023.7843 Key Points Question  Among patients with cancer and a venous thromboembolism (VTE) event, are direct oral anticoagulants noninferior to low-molecular-w...

Cardiovascular Subphenotypes in ARDS Acute respiratory distress syndrome (ARDS) is a frequently observed condition in mechanically ventilated patients in ICUs and is associated with a high mortality rate. The presence of shock in ARDS indicates poor prognosis, with echocardiography studies suggesting that right ventricular dysfunction (RVD) plays a significant role in the cardiovascular dysfunction observed in this condition. However, the definition of RVD in the c...

Practice Practice Pointer Towards net zero: critical care Heather Baid, Eleanor Damm, Louise Trent, et al BMJ 2023; 381 doi: https://doi.org/10.1136/bmj-2021-069044 (Published 01 June 2023)Cite this as: BMJ 2023;381:e069044 What you need to know Critical care is resource intensive, using large amounts of energy, pharmaceuticals, and single-use consumables, all of which potentially have a harmful impact on the environment We can view environmental s...

ARTICLES|ONLINE FIRST Risk and accuracy of outpatient-identified hypoxaemia for death among suspected child pneumonia cases in rural Bangladesh: a multifacility prospective cohort study Eric D McCollum, Salahuddin Ahmed, Arunangshu D Roy, et al. Lancet Respir Med Open Access Published:April 07, 2023 DOI:https://doi.org/10.1016/S2213-2600(23)00098-X Summary Background Hypoxaemic pneumonia mortality risk in low-income and middle-income countries is high...