ARTICLES| VOLUME 4, ISSUE 5, E330-E339, MAY 2023 Infection and co-infection patterns of community-acquired pneumonia in patients of different ages in China from 2009 to 2020: a national surveillance study Yan-Ning Liu, Yun-Fa Zhang, Qiang Xu, et al Lancet Microbe 2023; 4: E330-E339 Published:March 28, 2023 DOI:https://doi.org/10.1016/S2666-5247(23)00031-9 Summary Background Severe community-acquired pneumonia (SCAP) is associated with ...

Prone Positioning for Acute Hypoxaemic Respiratory Failure Prone positioning is a medical intervention that was initially proposed over 50 years ago as a way to improve gas exchange. Multiple clinical trials have been conducted on its effectiveness, with the Proning Severe ARDS Patients landmark trial demonstrating a mortality benefit in patients with severe ARDS. As a result, expert consensus and societal guidelines now recommend using prone positioning for severe...

Invited Commentary  May 1, 2023 Xuebijing Injection for the Treatment of Sepsis: What Would a Path to FDA Approval Look Like? Ellis F. Unger, David B. Clissold JAMA Intern Med. Published online May 1, 2023. doi:10.1001/jamainternmed.2023.0788 Sepsis is a serious condition with high morbidity and mortality for which treatment advancements are desperately needed. In this issue of JAMA Internal Medicine, Liu et al1 describe the results...

Original Investigation  May 1, 2023 Effect of an Herbal-Based Injection on 28-Day Mortality in Patients With Sepsis: The EXIT-SEP Randomized Clinical Trial Songqiao Liu, Chen Yao, Jianfeng Xie, et al JAMA Intern Med. Published online May 1, 2023. doi:10.1001/jamainternmed.2023.0780 Key Points Question  Is Xuebijing injection (XBJ) effective in reducing mortality in patients with sepsis? Findings  In this randomized c...

Sequential Extracorporeal Therapy in Sepsis Sepsis and septic shock are significant causes of morbidity and mortality in critical care, with a complex and rapidly evolving clinical presentation. This involves microbial invasion, infection focus, immune response, circulating pathogen and pathogen products, immunodysregulation, organ damage, and multiple organ dysfunction. Extracorporeal therapies may be used to target specific molecules at different stages, includin...

Invited Commentary  March 27, 2023 Should We Add Fludrocortisone to Hydrocortisone for Treatment of Septic Shock? Michael A. Matthay, Issa J. Dahabreh, B. Taylor Thompson JAMA Intern Med. 2023;183(5):460-461. doi:10.1001/jamainternmed.2023.0257 Mortality for patients with septic shock is greater than 30% in most studies. The mechanisms that contribute to poor survival are primarily explained by the development of multiorgan failure from activ...

Research Letter  Physician Work Environment and Well-Being February 6, 2023 Excess Mortality Among US Physicians During the COVID-19 Pandemic Mathew V. Kiang, Lindsey E. Carlasare, Sonoo Thadaney Israni, et al JAMA Intern Med. 2023;183(4):374-376. doi:10.1001/jamainternmed.2022.6308 In the US, the COVID-19 pandemic has already resulted in over 1 million excess deaths,1 defined as the difference between the num...

Original Investigation  March 27, 2023 Comparative Effectiveness of Fludrocortisone and Hydrocortisone vs Hydrocortisone Alone Among Patients With Septic Shock Nicholas A. Bosch, Bijan Teja, Anica C. Law, et al JAMA Intern Med. 2023;183(5):451-459. doi:10.1001/jamainternmed.2023.0258 Key Points Question  What is the comparative effectiveness of fludrocortisone added to hydrocortisone vs hydrocortisone alone among patients with septic shock...

ICU Management & Practice, Volume 22 - Issue 5, 2022 Rapid Assessment of Fluid Responsiveness and Tolerance With Ultrasound of the Neck Vessels Ultrasonographic assessment of the neck vessels in critically ill patients contributes to rapid and non-invasive management of fluids to evaluate responsiveness and tolerance and blood volume status. Introduction There are multiple ways to evaluate the responsiveness and tolerance to IV fluids, as well as veno...

Research Letter  March 30, 2023 Comparison of Availability of Trial Results in ClinicalTrials.gov and PubMed by Data Source and Funder Type Julianne T. Nelson, Tony Tse, Yvonne Puplampu-Dove, et al JAMA. Published online March 30, 2023. doi:10.1001/jama.2023.2351 Timely dissemination of clinical trial results is essential for improving transparency and ensuring that findings are available to inform evidence-based medicine.1 Prior analyse...