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...

Editorial  March 21, 2023 Toward Personalizing Care: Assessing Heterogeneity of Treatment Effects in Randomized Trials Issa J. Dahabreh, Dhruv S. Kazi JAMA. 2023;329(13):1063-1065. doi:10.1001/jama.2023.3576 Clinicians know that individual patients may respond differently to a given treatment and that the overall treatment effect reported in a randomized trial of the treatment may not be directly applicable to all patients in clinical practice.1 D...

Original Investigation  February 20, 2023 Prevalence of Chronic Kidney Disease in China: Results From the Sixth China Chronic Disease and Risk Factor Surveillance Limin Wang, Xin Xu, Mei Zhang, et al JAMA Intern Med. Published online February 20, 2023. doi:10.1001/jamainternmed.2022.6817 Key Points Question  What is the prevalence of chronic kidney disease (CKD) in China? Findings  In this nationally representative c...

Strategies to Optimise Extubation Extubation failure refers to the inability to sustain spontaneous breathing after the removal of an artificial airway. The need for reintubation with 24 to 72 hours or up to seven days can lead to high morbidity, mortality and disability. The incidence of extubation failure in ICUs remains high (10-15%) and has two main causes: weaning failure and airway failure.  In this paper, the authors aim to update strategies for opti...

Original Investigation  Caring for the Critically Ill Patient March 21, 2023 Heterogeneous Treatment Effects of Therapeutic-Dose Heparin in Patients Hospitalized for COVID-19 Ewan C. Goligher, Patrick R. Lawler, Thomas P. Jensen, et al JAMA. 2023;329(13):1066-1077. doi:10.1001/jama.2023.3651 Key Points Question  What patient characteristics are associated with benefit or harm of therapeutic-dose heparin in patients hospitalized for mode...