ORIGINAL ARTICLE Randomized Trial of BCG Vaccine to Protect against Covid-19 in Health Care Workers Laure F. Pittet, Nicole L. Messina, Francesca Orsini, et al N Engl J Med 2023; 388:1582-1596DOI: 10.1056/NEJMoa2212616 Abstract BACKGROUND The bacille Calmette–Guérin (BCG) vaccine has immunomodulatory “off-target” effects that have been hypothesized to protect against coronavirus disease 2019 (Covid-19). METHODS In this international, double-blind, ...

ICU Diaries and Post-ICU Distress Symptoms In recent years, health diaries have become an important tool for patients and providers to manage personal health. A health diary is a record of a patient's overall health and wellness, which the patient writes to keep track of different aspects of their health. Studies show that greater self-care behaviours, such as the use of symptom diaries, improve survival for patients with heart failure. Health diaries, either in wr...

Original Investigation  April 20, 2023 Piperacillin-Tazobactam Compared With Cefoxitin as Antimicrobial Prophylaxis for Pancreatoduodenectomy: A Randomized Clinical Trial Michael I. D’Angelica, Ryan J. Ellis, Jason B. Liu, et al JAMA. Published online April 20, 2023. doi:10.1001/jama.2023.5728 Key Points Question  Does use of perioperative broad-spectrum antibiotics reduce postoperative surgical site infection after open pancreat...

ARTICLES|ONLINE FIRST Intravenous ravulizumab in mechanically ventilated patients hospitalised with severe COVID-19: a phase 3, multicentre, open-label, randomised controlled trial Djillali Annane, Sean J Pittock, Hrishikesh S Kulkarni, et al Lancet Respir Med Published:March 20, 2023 DOI:https://doi.org/10.1016/S2213-2600(23)00082-6 Summary Background The complement pathway is a potential target for the treatment of severe COVID-19. We evaluated the ...

Socioeconomic Status and Outcomes in Critical Care Socioeconomic status is a known determinant of health inequalities. However, previous studies on the impact of socioeconomic status on outcomes in critical care have produced inconsistent findings.  A new review analyses available evidence on the relationship between socioeconomic status and outcomes in critical care. The analysis included observational cohort studies of adults that examined the association...

ARTICLES|ONLINE FIRST Low versus standard calorie and protein feeding in ventilated adults with shock: a randomised, controlled, multicentre, open-label, parallel-group trial (NUTRIREA-3) Jean Reignier, Gaetan Plantefeve, Jean-Paul Mira, et al Lancet Respir Med Published:March 20, 2023 DOI:https://doi.org/10.1016/S2213-2600(23)00092-9 Summary Background The optimal calorie and protein intakes at the acute phase of severe critical illness remain unknow...

Antioxidant, Anti-inflammatory Therapy in Sepsis Sepsis is associated with long-term cognitive impairment and poor psychological and functional outcomes. Potential mechanisms for this include intracerebral oxidative stress and inflammation. However, there is limited knowledge about the effects of early antioxidant and anti-inflammatory therapy on cognitive, psychological, and functional outcomes in sepsis survivors. The Vitamin C, Thiamine, and Steroids in Sepsi...

ORIGINAL ARTICLE Platelet Transfusion before CVC Placement in Patients with Thrombocytopenia Floor L.F. van Baarle, Emma K. van de Weerdt, Walter J.F.M. van der Velden, et al N Engl J Med 2023; 388:1956-1965DOI: 10.1056/NEJMoa2214322 Abstract BACKGROUND Transfusion guidelines regarding platelet-count thresholds before the placement of a central venous catheter (CVC) offer conflicting recommendations because of a lack of good-quality evidence. The routine...

ARTICLES|ONLINE FIRST Measuring the global response to antimicrobial resistance, 2020–21: a systematic governance analysis of 114 countries Jay Patel, Anne Harant, Genevie Fernandes, et al Lancet Infect Dis Published:January 16, 2023 DOI:https://doi.org/10.1016/S1473-3099(22)00796-4 Summary Background Understanding strategic commitments and policy responses to overcome antimicrobial resistance at the national, regional, and global levels is required t...

COMMENT|ONLINE FIRST Too many antibiotics for patients with COVID-19 despite low bacterial infections Daniele Roberto Giacobbe, Matteo Bassetti Lancet Infect Dis Published:January 27, 2023 DOI:https://doi.org/10.1016/S1473-3099(22)00866-0 Although low rates of bacterial infections have frequently been reported in patients hospitalised with COVID-19, excessive use of antibiotics has also been described in this population since the beginning of the COVID-19 p...