Extended Prone Positioning for COVID-19 ARDS COVID-19 has resulted in an estimated 270,000 hospitalisations in ICUs in Europe between May 2020 and March 2022. Nearly 80% of these patients have required tracheal intubation and invasive mechanical ventilation. While there is still an ongoing debate whether acute respiratory distress syndrome (ARDS) physiopathology is the same in COVID-19 and non-COVID-19 patients, there is consensus on the benefits of prone position....

ARTICLES| VOLUME 400, ISSUE 10363, P1597-1606, NOVEMBER 05, 2022 Helicobacter pylori eradication for primary prevention of peptic ulcer bleeding in older patients prescribed aspirin in primary care (HEAT): a randomised, double-blind, placebo-controlled trial Chris Hawkey, Anthony Avery, Carol A C Coupland, et al Lancet 2022; 400: 1597-1606 Summary Background Peptic ulcers in patients receiving aspirin are associated with Helicobacter pylori inf...

EDUCATION AND CLINICAL PRACTICE: ORIGINAL RESEARCH| VOLUME 162, ISSUE 4, P861-871, OCTOBER 01, 2022 High-Flow Nasal Cannula Reduces Effort of Breathing But Not Consistently via Positive End-Expiratory Pressure Robert D. Guglielmo, Justin C. Hotz, Patrick A. Ross, et al Chest 2022; 162: 861-871 Background High-flow nasal cannula (HFNC) therapy reduces the effort of breathing in patients with bronchiolitis, but the mechanisms are not understood...

ORIGINAL ARTICLE Early Amino Acids in Extremely Preterm Infants and Neurodisability at 2 Years Frank H. Bloomfield, Yannan Jiang, Jane E. Harding, et al N Engl J Med 2022; 387:1661-1672DOI: 10.1056/NEJMoa2204886 Abstract BACKGROUND Whether higher parenteral amino acid intake improves outcomes in infants with extremely low birth weight is unclear. METHODS In this multicenter, parallel-group, double-blind, randomized, placebo-controlled trial, we ass...

Prehospital Time and In-Hospital Trauma Mortality Time has always been considered an essential determinant of outcome in the early care of trauma patients, and the concept of trauma as a time-sensitive condition has been part of education and policy for decades. However, data on system performance from physician-staffed EMS are far less abundant than data from EMS systems. Physician-staffed EMS is believed to add complexity by performing more interventions that cou...

CRITICAL CARE: ORIGINAL RESEARCH| VOLUME 162, ISSUE 4, P796-803, OCTOBER 01, 2022 Comparison of Heart Rate After Phenylephrine vs Norepinephrine Initiation in Patients With Septic Shock and Atrial Fibrillation Anica C. Law, Nicholas A. Bosch, Daniel Peterson, et al Chest 2022; 162: 796-803 Background Atrial fibrillation (AF) is a common complication of sepsis. It is unclear whether norepinephrine, an α- and β-agonist, and phenylephrine, an α-...

ARTICLES| VOLUME 4, ISSUE 10, E668-E678, OCTOBER 01, 2022 Sex differences in clinical outcomes and biological profiles in systemic sclerosis-associated interstitial lung disease: a post-hoc analysis of two randomised controlled trials Elizabeth R Volkmann, Donald P Tashkin, Richard Silver, et al Lancet Rheumatol 2022; 4: E668-E678 Summary Background Observational studies have shown that men with systemic sclerosis have an increased risk of...

Preliminary Communication  October 11, 2022 Effect of Paroxetine or Quetiapine Combined With Oxycodone vs Oxycodone Alone on Ventilation During Hypercapnia: A Randomized Clinical Trial Jeffry Florian, Rutger van der Schrier, Victoria Gershuny, et al JAMA. 2022;328(14):1405-1414. doi:10.1001/jama.2022.17735 Key Points Question  Do specific psychotropic drug–opioid combinations further decrease the ventilatory response to hypercapn...

Ventilatory Settings and Outcomes in OHCA patients Protective ventilation strategies are commonly applied in patients after cardiac arrest. However, the optimal ventilatory settings in these patients and their association with patient outcomes remain unclear.  The goal of this study was to describe the ventilatory settings applied in the first 72 hours of mechanical ventilation in patients after out-of-hospital cardiac arrest (OHCA) and their association wi...

ARTICLES| VOLUME 3, ISSUE 10, E762-E771, OCTOBER 01, 2022 Efficacy of different preoperative skin antiseptics on the incidence of surgical site infections: a systematic review, GRADE assessment, and network meta-analysis Hasti Jalalzadeh, Hannah Groenen, Dennis R Buis, et al Lancet Microbe 2022; 3: E762-E771 Summary Background Surgical site infection (SSI) is the most common postoperative complication and substantially increases health-car...