Editorial  October 12, 2023 Precision in Transfusion Medicine Matthew D. Neal, Beverley J. Hunt JAMA. Published online October 12, 2023. doi:10.1001/jama.2023.16134 Blood transfusion management has come a long way since the introduction of blood banks in the 1930s, leading to the widespread use of plasma and blood in the Second World War. The gradual introduction of blood components, such as platelets and cryoprecipitate, occurred in the foll...

Original Investigation  Caring for the Critically Ill Patient October 12, 2023 Red Blood Cell Transfusion in the Intensive Care Unit Senta Jorinde Raasveld, Sanne de Bruin, Merijn C. Reuland, et al JAMA. Published online October 12, 2023. doi:10.1001/jama.2023.20737 Key Points Question  What were transfusion practices worldwide among patients admitted to the intensive care unit (ICU)? Findings  In this internation...

Editorial  September 5, 2023 Blood Pressure Management After Successful Thrombectomy Amrou Sarraj JAMA. 2023;330(9):811-812. doi:10.1001/jama.2023.14588 Despite the success of endovascular therapy (EVT) in acute ischemic stroke due to large vessel occlusion,1-3opportunities to further optimize clinical outcomes remain. One such avenue is to reduce hemorrhagic transformation in the infarcted tissue bed after successful reperfusion, which has b...

ORIGINAL ARTICLE Adjunctive Dexamethasone for Tuberculous Meningitis in HIV-Positive Adults Joseph Donovan, Nguyen D. Bang, Darma Imran, et al N Engl J Med 2023; 389:1357-1367DOI: 10.1056/NEJMoa2216218 Abstract BACKGROUND Adjunctive glucocorticoids are widely used to treat human immunodeficiency virus (HIV)–associated tuberculous meningitis despite limited data supporting their safety and efficacy. METHODS We conducted a double-blind, randomized, p...

Mechanical Ventilation Across Countries Invasive mechanical ventilation (IMV) is a crucial component of intensive care in modern healthcare. However, it remains uncertain whether the rates of IMV usage differ between countries. A recent study analysed data from 2018, focusing on patients aged 20 years and above who underwent IMV in England, Canada, and the United States. The study aimed to determine the per capita rates of IMV in adults within these three high-i...

Original Investigation  September 5, 2023 Intensive vs Conventional Blood Pressure Lowering After Endovascular Thrombectomy in Acute Ischemic Stroke: The OPTIMAL-BP Randomized Clinical Trial Hyo Suk Nam, Young Dae Kim, JoonNyung Heo, et al JAMA. 2023;330(9):832-842. doi:10.1001/jama.2023.14590 Key Points Question  Does early intensive blood pressure management improve outcomes after successful reperfusion with endovascular thromb...

Original Investigation  Caring for the Critically Ill Patient October 10, 2023 Nasal Iodophor Antiseptic vs Nasal Mupirocin Antibiotic in the Setting of Chlorhexidine Bathing to Prevent Infections in Adult ICUs: A Randomized Clinical Trial Susan S. Huang, Edward J. Septimus, Ken Kleinman, et al JAMA. 2023;330(14):1337-1347. doi:10.1001/jama.2023.17219 Key Points Question  Does nasal iodophor ...

Original Investigation  September 5, 2023 Blood Pressure Management After Endovascular Therapy for Acute Ischemic Stroke: The BEST-II Randomized Clinical Trial Eva A. Mistry, Kimberly W. Hart, Larry T. Davis, et al JAMA. 2023;330(9):821-831. doi:10.1001/jama.2023.14330 Key Points Question  Are moderately low systolic blood pressure (SBP) targets (<140 and <160 mm Hg) after successful endovascular stroke treatment harmful? ...

Original Investigation  September 5, 2023 Defining Usual Oral Temperature Ranges in Outpatients Using an Unsupervised Learning Algorithm Catherine Ley, Frederik Heath, Trevor Hastie, et al JAMA Intern Med. Published online September 5, 2023. doi:10.1001/jamainternmed.2023.4291 Key Points Question  Can personalized temperature norms be defined to improve the clinical utility of oral temperature measur...

Avoiding Harm When Feeding Critically Ill Patients Nutrition in critical illness has become a significant area of focus in recent decades. Initially, early and adequate feeding was believed to enhance outcomes by promptly ensuring the patient reaches full energy target. However, this perspective was challenged after the release of the EPaNIC trial in 2011. The EPaNIC trial observed worse outcomes in patients who received early supplemental parenteral nutrition (...