Optimised Prediction of All-Cause Mortality of ICU Patients Outcomes research on ICU patients requires accurate measures of comorbidity to predict mortality. The Simplified Acute Physiology Score (SAPS3) is widely used and provides some information on comorbidity. The Charlson comorbidity index (CCI) uses general comorbidity measures and may not be sufficiently discriminative. These risk scores use the presence of comorbidity as binary variables but disregard quant...

Original Investigation  February 7, 2023 Association Between Drug Characteristics and Manufacturer Spending on Direct-to-Consumer Advertising Michael J. DiStefano, Jenny M. Markell, Caroline C. Doherty, et al JAMA. 2023;329(5):386-392. doi:10.1001/jama.2022.23968 Key Points Question  What drug characteristics are associated with larger proportions of promotional spending allocated to direct-to-consumer advertising? Findings&nb...

ICU Management & Practice, Volume 22 - Issue 4, 2022 Antibiotic Stewardship in Critical and Emergency Care An overview of antimicrobial stewardship in critical care units and emergency departments, highlighting aspects to reduce multidrug resistance focusing on antibiotic optimisation in respiratory infections and sepsis. Introduction Infections caused by resistant bacteria are associated with higher treatment costs and increased morbidity and mortali...

Home High-Flow Nasal Cannula Oxygen Therapy for Stable Hypercapnic COPD: A Randomized Clinical Trial Kazuma Nagata, Takeo Horie, Naohiko Chohnabayashi, et al Am J Respir Crit Care Med 2022 Dec 1;206(11):1326-1335 DOI: 10.1164/rccm.202201-0199OC Abstract Rationale: The long-term effects of using a high-flow nasal cannula for chronic hypercapnic respiratory failure caused by chronic obstructive pulmonary disease remain unclear. Object...

Original Investigation  November 23, 2022 Safety and Efficacy of Robotic vs Open Liver Resection for Hepatocellular Carcinoma Fabrizio Di Benedetto, Paolo Magistri, Stefano Di Sandro, et al JAMA Surg. Published online November 23, 2022. doi:10.1001/jamasurg.2022.5697 Key Points Question  Is the robotic approach a safe strategy for hepatocellular carcinoma (HCC) resection with good long-term outcomes? Findings  In thi...

ICU Management & Practice, Volume 22 - Issue 4, 2022 Pancreatic Stone Protein Biomarker for Sepsis, Antimicrobial Resistance and Nosocomial Infections The problem of antimicrobial resistance and the use of a clinical decision score and point-of-care testing biomarkers, such as CRP and PSP, to help solve this problem.  Introduction  Infectious diseases are a public health issue around the world, with bacterial, viral, parasitic, or fungal-rel...

ARTICLES|ONLINE FIRST Effectiveness and durability of BNT162b2 vaccine against hospital and emergency department admissions due to SARS-CoV-2 omicron sub-lineages BA.1 and BA.2 in a large health system in the USA: a test-negative, case-control study Sara Y Tartof, Jeff M Slezak, Laura Puzniak, et al Lancet Respir Med Published:October 07, 2022 DOI:https://doi.org/10.1016/S2213-2600(22)00354-X Summary Background The SARS-CoV-2 omicron (B.1.1.529 BA.1) ...

ICU Management & Practice, Volume 22 - Issue 4, 2022 Pharmacokinetic/Pharmacodynamic Principles to Combat Antimicrobial Resistance Pharmacodynamic and pharmacokinetic principles play a central role in antimicrobial dose-optimisation to combat antimicrobial resistance. In the future, research focused on the integration of preclinical and clinical data is paramount. Antimicrobial Resistance in the ICU The use of antimicrobial drugs in the hospital is ve...

ARTICLES|ONLINE FIRST Transfusion practice in patients receiving VV ECMO (PROTECMO): a prospective, multicentre, observational study Gennaro Martucci, Matthieu Schmidt, Cara Agerstrand, et al. Lancet Respir Med Published:October 11, 2022 DOI:https://doi.org/10.1016/S2213-2600(22)00353-8 Summary Background In patients receiving venovenous (VV) extracorporeal membrane oxygenation (ECMO) packed red blood cell (PRBC) transfusion thresholds are usually hig...

Quality of Life, Costs, Economic Evaluation in ECMO Extracorporeal membrane oxygenation (ECMO) refers to mechanical support in patients for heart or lung function during cardiopulmonary failure. ECMO is used when conventional treatments have failed. As per the international guideline of the Extracorporeal Life Support Organization (ELSO), ECMO should be considered when the estimated mortality risk is about 50% and is mostly indicated when the mortality risk approac...