Original Investigation  April 11, 2023 Heterogeneity in Blood Pressure Response to 4 Antihypertensive Drugs: A Randomized Clinical Trial Johan Sundström, Lars Lind, Shamim Nowrouzi, et al JAMA. 2023;329(14):1160-1169. doi:10.1001/jama.2023.3322 Key Points Question  Is there a potential for personalized drug therapy in hypertension, and, if so, what is the magnitude of the benefit of personalization? Findings  In this...

ORIGINAL ARTICLE Tranexamic Acid to Prevent Obstetrical Hemorrhage after Cesarean Delivery Luis D. Pacheco, Rebecca G. Clifton, George R. Saade, et al N Engl J Med 2023; 388:1365-1375DOI: 10.1056/NEJMoa2207419 Abstract BACKGROUND Prophylactic use of tranexamic acid at the time of cesarean delivery has been shown to decrease the calculated blood loss, but the effect on the need for blood transfusions is unclear. METHODS We randomly assigned patients...

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...