ICU Management & Practice, Volume 23 - Issue 3, 2023 Medical Errors in the Preanalytical Phase of Blood Gases Test The preanalytical phase of the blood gases study is the most susceptible to errors, causing increased time and costs for patients and hospitals. Knowledge and training of the involved health personnel must be constant to improve results. Introduction Arterial or venous blood gases test is a frequent tool in the Intensive Care Unit (ICU) c...

Direct assessment of microcirculation in shock: a randomized-controlled multicenter study Raphael Romano Bruno, Jakob Wollborn, Karl Fengler, et al Intensive Care Medicine volume 49, pages 645–655 (2023) Abstract Purpose Shock is a life-threatening condition characterized by substantial alterations in the microcirculation. This study tests the hypothesis that considering sublingual microcirculatory perfusion variables in the therapeutic management reduces 3...

ARTICLES| VOLUME 5, ISSUE 6, E370-E379, JUNE 2023 Identifying subtypes of heart failure from three electronic health record sources with machine learning: an external, prognostic, and genetic validation study Amitava Banerjee, Ashkan Dashtban, Suliang Chen, et al. Lancet Digit Health Published: June, 2023 DOI:https://doi.org/10.1016/S2589-7500(23)00065-1 Summary Background Machine learning has been used to analyse heart failure subtypes...

Editorial  July 10, 2023 Intensive Care Unit Transfer Decisions—Science or Art? Tracy Y. Wang, Tyrone A. Johnson, Mitchell H. Katz JAMA Intern Med. Published online July 10, 2023. doi:10.1001/jamainternmed.2023.2636 For many hospital-based clinicians, one of the most consequential triage decisions is whether to transfer a high-risk patient from a regular medical-surgical bed to the intensive care unit (ICU). Despite its importance and frequen...

Prediction of Favourable Outcome After Cardiac Arrest Hypoxic-ischaemic brain injury following cardiac arrest (CA) is associated with significant morbidity and mortality. Withdrawal of life-sustaining therapy (WLST) is a common cause of death in these cases. Prognostication plays a crucial role. Current guidelines, such as those from ESICM,  propose a multimodal approach combining clinical examination, electrophysiology, brain imaging and biomarkers. However, ...

Research Therapeutic value of first versus supplemental indications of drugs in US and Europe (2011-20): retrospective cohort study Kerstin N Vokinger, Camille E G Glaus, Aaron S Kesselheim, et al BMJ 2023; 382 doi: https://doi.org/10.1136/bmj-2022-074166 (Published 05 July 2023)Cite this as: BMJ 2023;382:e074166 Abstract Objective To analyze the therapeutic value of supplemental indications compared with first indications for drugs approved in the US ...

ONLINE FIRST (FREE ACCESS) LATEST ARTICLES OPEN ACCESS ~ Conference Reports and Expert PanelESICM guidelines on acute respiratory distress syndrome: definition, phenotyping and respiratory support strategiesGrasselli G. et al. OPEN ACCESS ~ OriginalDirect assessment of microcirculation in shock: a randomized-controlled multicenter studyBruno R.R. et al.  OriginalRelationship between COVID-19 and ICU-acquired colonization and infection related to mult...

Original Investigation  July 10, 2023 A Statewide Quality Initiative to Reduce Unnecessary Antibiotic Treatment of Asymptomatic Bacteriuria Valerie M. Vaughn, Ashwin Gupta, Lindsay A. Petty, et al JAMA Intern Med. Published online July 10, 2023. doi:10.1001/jamainternmed.2023.2749 Key Points Question  Is stewardship focused on diagnostic testing or antibiotic treatment associated with reduced asymptomatic bacteriuria (ASB) treatm...

ICU Management & Practice, Volume 23 - Issue 3, 2023 Intravenous Fluids in Critically Ill Patients: When Less is Better While intravenous fluids have traditionally been a routine treatment for most critically ill patients, many severe pathologies now suggest a preference for conservative fluid therapy over liberal fluid administration. Introduction Intravenous fluid resuscitation began in 1832 during the cholera pandemic, improving intravascular volum...

Original Investigation  July 10, 2023 Temporal Clustering of Critical Illness Events on Medical Wards Samik Doshi, Saeha Shin, Lauren Lapointe-Shaw, et al JAMA Intern Med. Published online July 10, 2023. doi:10.1001/jamainternmed.2023.2629 Key Points Question  Is a critical illness event (death or intensive care unit transfer) associated with an increase in the near-term risk of critical illness in other patients on the same medi...