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...

Original Investigation  June 26, 2023 Evidence for Anchoring Bias During Physician Decision-Making Dan P. Ly, Paul G. Shekelle, Zirui Song JAMA Intern Med. Published online June 26, 2023. doi:10.1001/jamainternmed.2023.2366 Key Points Question  Do emergency department physicians anchor on information found in the patient visit reason section documented before a physician sees the patient? Findings  In this cross-sect...

JAMA Insights  June 26, 2023 Prophylaxis Against Pneumocystis jirovecii Pneumonia in Adults Shiwei Zhou, Samuel L. Aitken JAMA. Published online June 26, 2023. doi:10.1001/jama.2023.9844 Pneumocystis jirovecii is an opportunistic fungal pathogen that causes life-threatening pneumonia in immunocompromised patients. Patients with Pneumocystis pneumonia (PCP) typically present with fever, nonproductive cough, dyspnea, an...

Original Investigation  June 26, 2023 Use of Mechanical Ventilation Across 3 Countries Naheed K. Jivraj, Andrea D. Hill, Meng-Shiou Shieh, et al JAMA Intern Med. Published online June 26, 2023. doi:10.1001/jamainternmed.2023.2371 Key Points Question  Do population-level rates of invasive mechanical ventilation differ among countries? Findings  In this cohort study of 59 873 hospital admissions in England, 70 250 in C...

ICU Without Borders Critical illness is characterised by various phases and outcomes, including deterioration, organ dysfunction, and recovery or death. Patient care is often fragmented, with different groups of healthcare providers managing different aspects of the patient's journey. Communication and collaboration gaps between these groups can lead to breakdowns in care and potentially impact patient outcomes. A study reported that delays in transferring patients...