Effect of Higher Protein Dosing in Critically Ill Patients The international critical care nutrition guidelines recommend a wide range of protein doses that are based on low-quality evidence. The impact of high-dose protein in critically ill patients is unknown.  A study was conducted to test the hypothesis that a higher dose of protein improves clinical outcomes in critically ill patients. This was an international, registry-based, single-blinded, randomis...

Editorials Quality improvement in primary care Kath Checkland BMJ 2023; 380 doi: https://doi.org/10.1136/bmj.p582 (Published 22 March 2023)Cite this as: BMJ 2023;380:p582 Lessons from the end of QOF in Scotland The Quality and Outcomes Framework (QOF) pay-for-performance scheme began in the UK National Health Service in the early 2000s.1 Under a new contract, as much as 20% of general practices’ remuneration was initially tied to the achievement of per...

ORIGINAL ARTICLE Transcatheter Arterialization of Deep Veins in Chronic Limb-Threatening Ischemia Mehdi H. Shishehbor, Richard J. Powell, Miguel F. Montero-Baker, et al N Engl J Med 2023; 388:1171-1180DOI: 10.1056/NEJMoa2212754 Abstract BACKGROUND Approximately 20% of patients with chronic limb-threatening ischemia have no revascularization options, leading to above-ankle amputation. Transcatheter arterialization of the deep veins is a percutaneous appro...

Research Letter  March 28, 2023 Discontinuation of Conventional Synthetic Disease-Modifying Antirheumatic Drugs in Patients With Rheumatoid Arthritis and Excellent Disease Control Siri Lillegraven, Nina Paulshus Sundlisæter, Anna-Birgitte Aga, et al JAMA. 2023;329(12):1024-1026. doi:10.1001/jama.2023.0492 With advances in rheumatoid arthritis (RA) therapy, more patients achieve sustained remission. Treatment recommendations suggest considerin...

ICU Management & Practice, Volume 22 - Issue 5, 2022 Point of Care Ultrasound: The Critical Imaging Tool for the Critically Unwell This article aims to discuss the specific role of point of care ultrasound (POCUS) in the diagnosis and management of pathology in the critical care setting, as well as a specific tool to aid in invasive procedures. We discuss the ABCDE assessment of patients within critical care using POCUS. Introduction Since its introdu...

Original Investigation  February 24, 2023 Effect of Tight Glycemic Control on Pancreatic Beta Cell Function in Newly Diagnosed Pediatric Type 1 Diabetes: A Randomized Clinical Trial Jennifer McVean, Gregory P. Forlenza, Roy W. Beck, et al JAMA. 2023;329(12):980-989. doi:10.1001/jama.2023.2063 Key Points Question  Does near normalization of glucose levels preserve pancreatic beta cell function in youth with newly diagnosed type 1 diabetes? ...

Research Comparative effectiveness and safety of analgesic medicines for adults with acute non-specific low back pain: systematic review and network meta-analysis Michael A Wewege, Matthew K Bagg, Matthew D Jones, et al BMJ 2023; 380 doi: https://doi.org/10.1136/bmj-2022-072962 (Published 22 March 2023)Cite this as: BMJ 2023;380:e072962 Abstract Objective To evaluate the comparative effectiveness and safety of analgesic medicines for acute non-specific...

ONLINE FIRST (FREE ACCESS) LATEST ARTICLES GuidelinesERS/ESICM/ESCMID/ALAT guidelines for the management of severe community-acquired pneumoniaMartin-Loeches I. et al. OPEN ACCESS ~  OriginalArgumentation in end-of-life conversations with families in Dutch intensive care units: a qualitative observational studyAkkermans A. et al. OriginalsHospital factors that influence ICU admission decision-making: a qualitative study of eight hospitalsValley T.S. et al...

Research Estimated impact from the withdrawal of primary care financial incentives on selected indicators of quality of care in Scotland: controlled interrupted time series analysis Daniel R Morales, Mark Minchin, Evangelos Kontopantelis, et al BMJ 2023; 380 doi: https://doi.org/10.1136/bmj-2022-072098 (Published 22 March 2023)Cite this as: BMJ 2023;380:e072098 Abstract Objective To determine whether the withdrawal of the Quality and Outcomes Framework...

ICU Management & Practice, Volume 22 - Issue 5, 2022 The Role of Lung Imaging to Personalise Lung Ventilation in ARDS Patients Computed tomography (CT) remains an invaluable technique to evaluate lung morphology and response to ventilatory strategy and to understand the pathophysiology of Acute Respiratory Distress Syndrome (ARDS) patients. The first report of Acute Respiratory Distress Syndrome (ARDS) in 1967 described patients with severe hypoxaemia an...