EDITORIAL Early Mobilization of Critical Care Patients — Still More to Learn Marc Moss N Engl J Med October 26, 2022DOI: 10.1056/NEJMe2212360 Each year, intensive care unit (ICU)–acquired weakness occurs in approximately 1 million critically ill patients who are undergoing mechanical ventilation worldwide.1 ICU-acquired weakness begins early in the course of critical illness and is related to multiple mechanisms, including deconditioning, myopathy, and ne...

COVID-19 Vaccines Prevented 20 Million Deaths Worldwide Findings from the first modelling study to quantify the impact of COVID-19 vaccines show that nearly 19.9 million out of a potential 31.4 million deaths were prevented in the first year (December 2020-December 2021) after the introduction of the vaccine. The findings are based on data from 185 countries using COVID-19 death records and total excess deaths from each country.  It is not possible to measu...

Early Deep Sedation in Mechanically Ventilated COVID-19 Patients Sedation management is a critical component when managing mechanically ventilated patients. It is important to use a protocol-driven approach, which favours paired spontaneous awakening (SAT) and breathing (SBT) trials, along with light levels of sedation. The initial period of respiratory failure in the emergency department and the first 48 hours in the ICU are critical to ensure reduced overall time...

ORIGINAL ARTICLE Oxygen-Saturation Targets for Critically Ill Adults Receiving Mechanical Ventilation Matthew W. Semler, Jonathan D. Casey, Bradley D. Lloyd, et al N Engl J Med October 24, 2022DOI: 10.1056/NEJMoa2208415 Abstract BACKGROUND Invasive mechanical ventilation in critically ill adults involves adjusting the fraction of inspired oxygen to maintain arterial oxygen saturation. The oxygen-saturation target that will optimize clinical outcomes in t...

ORIGINAL ARTICLE Early Active Mobilization during Mechanical Ventilation in the ICU The TEAM Study Investigators and the ANZICS Clinical Trials Group N Engl J Med October 26, 2022DOI: 10.1056/NEJMoa2209083 Abstract BACKGROUND Intensive care unit (ICU)–acquired weakness often develops in patients who are undergoing invasive mechanical ventilation. Early active mobilization may mitigate ICU-acquired weakness, increase survival, and reduce disability. ME...

Research Waning of vaccine effectiveness against moderate and severe covid-19 among adults in the US from the VISION network: test negative, case-control study Jill M Ferdinands, Suchitra Rao, Brian E Dixon, et al BMJ 2022; 379 doi: https://doi.org/10.1136/bmj-2022-072141 (Published 03 October 2022)Cite this as: BMJ 2022;379:e072141 Abstract Objective To estimate the effectiveness of mRNA vaccines against moderate and severe covid-19 in adults by time ...

ORIGINAL ARTICLE Spontaneous-Breathing Trials with Pressure-Support Ventilation or a T-Piece Arnaud W. Thille, Arnaud Gacouin, Rémi Coudroy, et al N Engl J Med October 26, 2022DOI: 10.1056/NEJMoa2209041 BACKGROUND Spontaneous-breathing trials can be performed with the use of either pressure-support ventilation (PSV) or a T-piece. Whether PSV trials may result in a shorter time to tracheal extubation than T-piece trials, without resulting in a higher risk of...

Research External validation of a prediction model for estimating fat mass in children and adolescents in 19 countries: individual participant data meta-analysis Mohammed T Hudda, Jonathan C K Wells,  Linda S Adair, et al BMJ 2022; 378 doi: https://doi.org/10.1136/bmj-2022-071185 (Published 21 September 2022)Cite this as: BMJ 2022;378:e071185 Abstract Objective To evaluate the performance of a UK based prediction model for estimating fat-free mass (and...

Renal Replacement Therapy in Patients With Sepsis-Associated AKI Acute kidney injury (AKI) is a serious complication of sepsis. According to data from several clinical studies, AKI can occur in nearly 50% of patients with sepsis and has a mortality rate of approximately 60% at three months.  Renal replacement therapy (RRT) is used to treat AKI, but some data show that it exerts only a limited effect in patients with sepsis-associated AKI (SA-AKI). ...

Research Effectiveness of a behavioural intervention delivered by text messages (safetxt) on sexually transmitted reinfections in people aged 16-24 years: randomised controlled trial Caroline Free, Melissa J Palmer, Ona L McCarthy, et al BMJ 2022; 378 doi: https://doi.org/10.1136/bmj-2022-070351 (Published 28 September 2022)Cite this as: BMJ 2022;378:e070351 Abstract Objective To quantify the effects of a series of text messages (safetxt) delivered in ...