Research Letter  October 9, 2023 Analysis of Devices Authorized by the FDA for Clinical Decision Support in Critical Care Jessica T. Lee, Alexander T. Moffett, George Maliha, et al JAMA Intern Med. Published online October 9, 2023. doi:10.1001/jamainternmed.2023.5002 The use of predictive clinical decision support (CDS) devices (ie, those that use machine learning [ML] or artificial intelligence [AI]) has the potential to improve outcomes in ...

Angiotensin II in Critically Ill Patients In December 2017, angiotensin II (ATII) intravenous infusion gained approval in the U.S. for treating septic or other distributive shock in adults. This approval was based on results from a phase II clinical trial which showed higher mean arterial pressure in septic shock patients on norepinephrine, who were randomly assigned to titrated ATII compared to placebo. However, the adoption and usage of ATII in clinical practice ...

ORIGINAL ARTICLE Restrictive or Liberal Transfusion Strategy in Myocardial Infarction and Anemia Jeffrey L. Carson, Maria Mori Brooks, Paul C. Hébert, et al N Engl J Med November 11, 2023DOI: 10.1056/NEJMoa2307983 Abstract BACKGROUND A strategy of administering a transfusion only when the hemoglobin level falls below 7 or 8 g per deciliter has been widely adopted. However, patients with acute myocardial infarction may benefit from a higher hemoglobin lev...

EDITORIAL| VOLUME 164, ISSUE 4, P814-815, OCTOBER 2023 Lung-Protective Concept and Noninvasive Respiratory Support Masaaki Sakuraya Chest 2023; 164: 814-815 DOI:https://doi.org/10.1016/j.chest.2023.05.014 Noninvasive respiratory support (NIRS), which includes high-flow nasal cannula (HFNC) and noninvasive ventilation (NIV), has been used for initial respiratory treatment in patients with respiratory failure. However, conclusive evidence is insufficient for ...

Awake Prone Position in Acute Hypoxaemic Respiratory Failure A study aimed to improve understanding of the impact of the awake prone position on the breathing patterns of patients with low oxygen levels. The researchers carried out a crossover trial examining how awake prone position use in patients with acute hypoxaemic respiratory failure affected their physiological responses. The study involved 15 patients with acute hypoxaemic respiratory failure and PaO2/F...

PULMONARY VASCULAR: ORIGINAL RESEARCH| VOLUME 164, ISSUE 4, P981-991 The Effects of Exercise Training in Patients With Persistent Dyspnea Following Pulmonary Embolism: A Randomized Controlled Trial Øyvind Jervan, Stacey Haukeland-Parker, Jostein Gleditsch, et al Chest 2023; 164: 981-991 Open Access Published: May 04, 2023 DOI:https://doi.org/10.1016/j.chest.2023.04.042 Background Persistent dyspnea, functional limitations, and reduced quality of life (QoL) ...

CRITICAL CARE: ORIGINAL RESEARCH| VOLUME 164, ISSUE 4, P885-891, OCTOBER 2023 Emulating Target Trials Comparing Early and Delayed Intubation Strategies Kerollos Nashat Wanis, Arin L. Madenci, Sicheng Hao, et al Chest 2023; 164: 885-891 Published: May 05, 2023 DOI: https://doi.org/10.1016/j.chest.2023.04.048 Background Whether intubation should be initiated early in the clinical course of critically ill patients remains a matter of debate. Results from pr...

CRITICAL CARE: ORIGINAL RESEARCH| VOLUME 164, ISSUE 4, P913-928, OCTOBER 2023 Noninvasive Oxygenation Strategies in Adult Patients With Acute Hypoxemic Respiratory Failure: A Systematic Review and Network Meta-Analysis Tyler Pitre, Dena Zeraatkar, George V. Kachkovski, et al Chest 2023; 164: 913-928 Published: April 19, 2023 DOI:https://doi.org/10.1016/j.chest.2023.04.022 Background Several recently published randomized controlled trials have evaluated v...

Ultra-Low Tidal Volume Ventilation for COVID-19-ARDS A new study aimed to evaluate the effectiveness of ventilation with ultra-low tidal volume (ULTV) compared to low tidal volume (LTV) in patients suffering from COVID-19-related acute respiratory distress syndrome (ARDS). COVID-19-related ARDS is associated with a high mortality rate and extended mechanical ventilation duration.  The study was conducted in ten ICUs in France and included patients who were ...

CRITICAL CARE: ORIGINAL RESEARCH| VOLUME 164, ISSUE 4, P892-912, OCTOBER 2023 Lower vs Higher Fluid Volumes in Adult Patients With Sepsis: An Updated Systematic Review With Meta-Analysis and Trial Sequential Analysis Praleene Sivapalan, Karen L. Ellekjaer, Marie K. Jessen, et al Chest 2023; 164: 892-912 Open Access Published:May 02, 2023 DOI:https://doi.org/10.1016/j.chest.2023.04.036 Background IV fluids are recommended for adults with sepsis. However, ...