Viewpoint  January 20, 2023 The Importance of Shifting Sepsis Quality Measures From Processes to Outcomes Michael Klompas, Chanu Rhee, Mervyn Singer JAMA. Published online January 20, 2023. doi:10.1001/jama.2023.0340 Sepsis continues to be a leading cause of death and disability worldwide. In the US alone, more than a quarter million adults hospitalized with sepsis die each year. Clinicians, patients, regulators, and quality improvement advoc...

ONLINE FIRST (FREE ACCESS) LATEST ARTICLES EditorialIntensive Care Medicine facing the futureCiterio G. OriginalCircular material flow in the intensive care unit—environmental effects and identification of hotspotsHunfeld N. et al. Association between acute disease severity and one-year quality of life among post-hospitalisation COVID-19 patients: Coalition VII prospective cohort studyRosa R.G. et al. Relationship between immunosuppression and intensive car...

Ten Areas to Help Retain Critical Care Nurses The shortage of nurses in the ICU has been a problem for several years. However, the issue has become an even bigger problem because of the COVID-19 pandemic. Some of the most common reasons driving critical care nurses to leave include excessive workload, distress, and burnout. A shortage of nurses will likely impact the quality of patient care and quality-of-work life for all ICU staff. Hospital managers, nurse leader...

EDITORIAL Thromboprophylaxis after Extremity Fracture — Time for Aspirin? Matthew Costa N Engl J Med 2023; 388:274-275DOI: 10.1056/NEJMe2214045 Hospital-acquired venous thromboembolism remains a common and preventable cause of death, so many health care systems around the world mandate that all patients who are admitted to the hospital undergo a risk assessment for venous thromboembolism.1,2 Patients who have had traumatic injuries are at particular risk ...

ARTICLES|ONLINE FIRST Pregnancy outcomes and vaccine effectiveness during the period of omicron as the variant of concern, INTERCOVID-2022: a multinational, observational study Jose Villar, Constanza P Soto Conti, Robert B Gunier, et al Lancet Published:January 17, 2023 DOI:https://doi.org/10.1016/S0140-6736(22)02467-9 Summary Background In 2021, we showed an increased risk associated with COVID-19 in pregnancy. Since then, the SARS-CoV-2 virus has un...

ORIGINAL ARTICLE Aspirin or Low-Molecular-Weight Heparin for Thromboprophylaxis after a Fracture Major Extremity Trauma Research Consortium (METRC) N Engl J Med 2023; 388:203-213DOI: 10.1056/NEJMoa2205973 Abstract BACKGROUND Clinical guidelines recommend low-molecular-weight heparin for thromboprophylaxis in patients with fractures, but trials of its effectiveness as compared with aspirin are lacking. METHODS In this pragmatic, multicenter, randomi...

Management of the Acutely Unwell Child Nearly one-quarter of the world’s population are children aged 0–14 years, with this proportion rising to almost 50% in some countries. Children account for nearly one-fifth of all emergency department visits in the USA and U.K., with an increasing trend of emergency admissions requiring intensive care. Data from emergency departments in England and the U.S. report that approximately 20% of individuals are aged 14 y and u...

Medical News & Perspectives  Quick Uptakes January 11, 2023 Swab the Throat as Well as the Nose? The Debate Over the Best Way to Test for SARS-CoV-2 Rita Rubin JAMA. Published online January 11, 2023. doi:10.1001/jama.2022.23311 Three times over 5 days. That’s the most recent advice from the US Food and Drug Administration (FDA), posted in December 2022, about how often asymptomatic people should take rapid antigen tests to make sur...

Editorial  January 12, 2023 Lack of Benefit of Fluvoxamine for COVID-19 Adarsh Bhimraj, Jason C. Gallagher JAMA. Published online January 12, 2023. doi:10.1001/jama.2022.23954 The COVID-19 pandemic caught society unprepared. The lack of therapeutic agents for coronaviruses led to a scramble to investigate approved medications for repurposing against SARS-CoV-2.1 Successes were achieved with immunomodulatory agents for the inflammatory di...

Original Investigation  January 12, 2023 Effect of Fluvoxamine vs Placebo on Time to Sustained Recovery in Outpatients With Mild to Moderate COVID-19: A Randomized Clinical Trial Matthew W. McCarthy, Susanna Naggie, David R. Boulware, et al JAMA. Published online January 12, 2023. doi:10.1001/jama.2022.24100 Key Points Question  Does 50 mg of fluvoxamine twice daily for 10 days, compared with placebo, shorten symptom duration amo...