Sex Differences in Treatment of ICU Patients Sex imbalance in the ICU has been consistently reported. Worldwide, fewer women are admitted to the ICU than men. Several studies have reported systematic differences in the treatment men and women receive in ICUs. Studies from Europe, North America, and Asia all show women are less likely to receive invasive mechanical ventilation than men. Studies also show that women have lower mean Therapeutic Intervention Scoring Sy...

ARTICLES|ONLINE FIRST Effect of non-invasive ventilation after extubation in critically ill patients with obesity in France: a multicentre, unblinded, pragmatic randomised clinical trial Audrey De Jong, Anne Bignon, François Stephan, et al. Lancet Respir Med Published:January 21, 2023 DOI:https://doi.org/10.1016/S2213-2600(22)00529-X Summary Background Non-invasive ventilation (NIV) and oxygen therapy (high-flow nasal oxygen [HFNO] or standard oxygen)...

ARTICLES|ONLINE FIRST Continued enteral nutrition until extubation compared with fasting before extubation in patients in the intensive care unit: an open-label, cluster-randomised, parallel-group, non-inferiority trial Mickaël Landais, Mai-Anh Nay, Johann Auchabie, et al. Lancet Respir Med Published:January 21, 2023 DOI:https://doi.org/10.1016/S2213-2600(22)00413-1 Summary Background Fasting is frequently imposed before extubation in patients in inte...

COMMENT|ONLINE FIRST Six pills less: no benefit for bicarbonate supplementation in renal allograft recipients Klemens Budde, Fabian Halleck Lancet Published:January 25, 2023 DOI:https://doi.org/10.1016/S0140-6736(22)02630-7 Metabolic acidosis (defined as serum bicarbonate <22 mmol/L) is frequent in patients with chronic kidney disease and is associated with disease progression.1Several prospective trials and meta-analyses2, 3, 4, 5, 6...

Nutrition Therapy and Clinical Outcomes in Critically Ill Patients Nutrition therapy is an important component of care for critically ill patients. The European Society for Clinical Nutrition and Metabolism (ESPEN) critical care guidelines recommend a progressive ramp-up of medical nutrition therapy, providing < 70% of measured energy expenditure or estimated needs during the early phase of acute illness and up to 80–100% after day three.  The clinical o...

ARTICLES|ONLINE FIRST Weaning from mechanical ventilation in intensive care units across 50 countries (WEAN SAFE): a multicentre, prospective, observational cohort study Tài Pham, Leo Heunks, Giacomo Bellani, et al. Lancet Respir Med Published:January 21, 2023 DOI:https://doi.org/10.1016/S2213-2600(22)00449-0 Summary Background Current management practices and outcomes in weaning from invasive mechanical ventilation are poorly understood. We aimed to ...

Research Association between healthy lifestyle and memory decline in older adults: 10 year, population based, prospective cohort study Jianping Jia, Tan Zhao, Zhaojun Liu, et al BMJ 2023; 380 doi: https://doi.org/10.1136/bmj-2022-072691 (Published 25 January 2023)Cite this as: BMJ 2023;380:e072691 Abstract Objective To identify an optimal lifestyle profile to protect against memory loss in older individuals. D...

Source Control and Sepsis Management Source control is important in the treatment of sepsis and septic shock. Lack or delay of source control can result in worse outcomes for patients.   The 2021 Surviving Sepsis Campaign guidelines recommend identifying the anatomical source of infection that requires source control and implementing it as soon as possible. However, adequate source control is difficult to define, and its optimal timing is difficult to ...

ARTICLES|ONLINE FIRST Sodium bicarbonate for kidney transplant recipients with metabolic acidosis in Switzerland: a multicentre, randomised, single-blind, placebo-controlled, phase 3 trial Nilufar Mohebbi, Alexander Ritter, Anna Wiegand, et al. Lancet Published:January 25, 2023 DOI:https://doi.org/10.1016/S0140-6736(22)02606-X Summary Background Metabolic acidosis is common in kidney transplant recipients and is associated with declining graft functi...

Closed-Loop Oxygen Control in Patients With AHRF High flow nasal oxygen (HFNO) has many physiological benefits in patients with acute hypoxaemic respiratory failure (AHRF). It can also help reduce the need for intubation. However, optimal flow settings are unknown and are generally based on expert recommendations.  Maintaining oxygenation within a given target range requires intensive patient monitoring and frequent manual adjustment of the fraction of insp...