New Paradigm of Personalised Sedation Lung-protective ventilation (LPV) limits lung injury (VILI). However, deep sedation is required to tolerate LPV, and patient self-induced lung injury (P-SILI) can occur during spontaneous breathing along with high respiratory efforts, lung stress and strain. Prevention of P-SILI may require further sedation. In addition, patient-ventilator dyssynchrony can worsen outcomes, resulting in increased sedation.  Ventilation t...

ARTICLES|ONLINE FIRST Guideline adherence and survival of patients with candidaemia in Europe: results from the ECMM Candida III multinational European observational cohort study Martin Hoenigl, Jon Salmanton-García, Matthias Egger, et al Lancet Infect Dis Published: February 15, 2023 DOI:https://doi.org/10.1016/S1473-3099(22)00872-6 Summary Background The European Confederation of Medical Mycology (ECMM) collected data on epidemiology, risk factors, ...

Editor's Note  February 20, 2023 At a Higher Dose and Longer Duration, Ivermectin Still Not Effective Against COVID-19 Kirsten Bibbins-Domingo, Preeti N. Malani JAMA. Published online February 20, 2023. doi:10.1001/jama.2023.1922 ACochrane meta-analysis of 11 eligible trials examining the efficacy of ivermectin for the treatment of COVID-19 published through April 2022 concluded that ivermectin has no beneficial effect for people with COVID-1...

CORRESPONDENCE|ONLINE FIRST Infection rate in Guangzhou after easing the zero-COVID policy: seroprevalence results to ORF8 antigen Junyuan Huang, Shi Zhao, Ka Chun Chong, et al. Lancet Infect Dis Published: February 17, 2023 DOI:https://doi.org/10.1016/S1473-3099(23)00112-3 On Dec 7, 2022, the Chinese government announced ten measures indicating the end of the zero-COVID policy, which was in effect for more than 2 years.1 Most of the stringent preventive me...

Speed of Cooling After Cardiac Arrest: Sub-study from TTM-2 Trial Out-of-hospital cardiac arrest (OHCA) typically has a poor prognosis. Less than 50% of patients admitted to ICU survive to hospital discharge. Animal models suggest that therapeutic hypothermia is neuroprotective and decreases neuronal injury.  Targeted temperature management (TTM 33–36 °C) is part of international guidelines when managing post-OHCA patients. Evidence suggests that better neu...

於服用口服抗病毒藥的新冠病毒住院患者中，病毒量反彈的風險因素及相關臨床結果: 一項 回顧性隊列研究 ARTICLES|ONLINE FIRST Viral burden rebound in hospitalised patients with COVID-19 receiving oral antivirals in Hong Kong: a population-wide retrospective cohort study Carlos K H Wong, Kristy T K Lau, Ivan C H Au, et al. Lancet Infect Dis Published: February 13, 2023 DOI:https://doi.org/10.1016/S1473-3099(22)00873-8 Summary Background Viral rebound after ...

Editorial  February 20, 2023 The Ethics of Clinical Research: Managing Persistent Uncertainty Alex John London, Christopher W. Seymour JAMA. Published online February 20, 2023. doi:10.1001/jama.2023.1675 In the face of novel pathogens, incomplete knowledge, and disagreement about the merits of medical treatments, translating the duty to care into concrete benefits for patients depends on our ability to quickly act on the duty to learn.1 ...

ICU Management & Practice, Volume 22 - Issue 4, 2022 Reducing Antibiotic Resistance in the ICU This article reviews practices currently available to reduce the spread of antimicrobial resistance and novel therapies that are presently being developed. Introduction Among healthcare providers, and especially among those working with intensive care unit (ICU) patients, one of the greatest concerns that has emerged in recent decades has been a steady escal...

ORIGINAL ARTICLE Hydrocortisone in Severe Community-Acquired Pneumonia Pierre-François Dequin, Ferhat Meziani, Jean-Pierre Quenot, et al N Engl J Med March 21, 2023DOI: 10.1056/NEJMoa2215145 Abstract BACKGROUND Whether the antiinflammatory and immunomodulatory effects of glucocorticoids may decrease mortality among patients with severe community-acquired pneumonia is unclear. METHODS In this phase 3, multicenter, double-blind, randomized, controlle...

Editorials Poorly substantiated health claims on infant formula Nigel Rollins BMJ 2023; 380 doi: https://doi.org/10.1136/bmj.p310 (Published 15 February 2023)Cite this as: BMJ 2023;380:p310 Authorities should move to protect infants and parents from commercial interests Early infant feeding is critically important for the survival, development, and lifelong health of children. It is also a big business. In 2019, global sales of infant formula milks exceeded...