ONLINE FIRST (FREE ACCESS) OriginalsPoor timing and failure of source control are risk factors for mortality in critically ill patients with secondary peritonitisDe Pascale G. et al. Development and validation of novel sepsis subphenotypes using trajectories of vital signsBhavani S.V. et al. OPEN ACCESSSmall wards in the ICU: a favorable measure for controlling the transmission of carbapenem-resistant Klebsiella pneumoniaeChi X. et al.High arterial oxygen levels ...

ORIGINAL ARTICLE FREE PREVIEW Percutaneous Revascularization for Ischemic Left Ventricular Dysfunction Divaka Perera, Tim Clayton, Peter D. O’Kane, et al N Engl J Med 2022; 387:1351-1360DOI: 10.1056/NEJMoa2206606 Abstract BACKGROUND Whether revascularization by percutaneous coronary intervention (PCI) can improve event-free survival and left ventricular function in patients with severe ischemic left ventricular systolic dysfunction, as compared with opti...

ORIGINAL ARTICLE FREE PREVIEW Trial of Endovascular Treatment of Acute Basilar-Artery Occlusion Chunrong Tao, Raul G. Nogueira, Yuyou Zhu, et al N Engl J Med 2022; 387:1361-1372DOI: 10.1056/NEJMoa2206317 Abstract BACKGROUND Data from trials investigating the effects and risks of endovascular thrombectomy for the treatment of stroke due to basilar-artery occlusion are limited. METHODS We conducted a multicenter, prospective, randomized, controlled t...

Gram Stain-Guided Antibiotic Therapy in Patients With VAP The increase of multidrug-resistant (MDR) organisms in ICUs is a well-recognised threat. Due to a lack of development of new pharmaceutical agents, there are now only a few antibiotics that are effective against these organisms. The World Health Organization (WHO) has also highlighted the need to develop a global action plan to address antimicrobial resistance and optimise the use of antibiotic age...

CHEST INFECTIONS: ORIGINAL RESEARCH| VOLUME 162, ISSUE 4, P782-791, OCTOBER 01, 2022 Smartphone-Guided Self-prone Positioning vs Usual Care in Nonintubated Hospital Ward Patients With COVID-19: A Pragmatic Randomized Clinical Trial Garrett Rampon, Shijing Jia, Ritwick Agrawal, et al Chest 2022; 162: 782-791 Background Safe, effective, and easily implementable treatments that reduce the progression of respiratory failure in COVID-19 are urgent...

Editorial  October 26, 2022 Early Oxygen Supplementation After Resuscitation From Cardiac Arrest Jonathan Elmer, Francis X. Guyette JAMA. Published online October 26, 2022. doi:10.1001/jama.2022.18620 Supplemental oxygen administration was first noted to correct signs and symptoms of hypoxic respiratory failure more than a century ago.1,2 Since that time, oxygen has become one of the most widely administered therapeutic interventions in ...

Response to PEEP in COVID-19 ARDS With & Without ECMO There have been conflicting results concerning lung recruitability of COVID-19 acute respiratory distress syndrome (ARDS) and the use of techniques derived from changes in respiratory mechanics and/or gas exchange in response to positive end-expiratory pressure (PEEP) increase. Various factors may explain the heterogeneity of reports regarding recruitability of COVID-19 ARDS. These include time from ARDS ons...

Original Investigation  October 26, 2022 Effect of Lower vs Higher Oxygen Saturation Targets on Survival to Hospital Discharge Among Patients Resuscitated After Out-of-Hospital Cardiac Arrest: The EXACT Randomized Clinical Trial Stephen A. Bernard, Janet E. Bray, Karen Smith, et al JAMA. Published online October 26, 2022. doi:10.1001/jama.2022.17701 Key Points Question  Among patients with return of spontaneous circulation after ...

Original Investigation  Caring for the Critically Ill Patient October 26, 2022 Association of Extracorporeal Membrane Oxygenation With New Mental Health Diagnoses in Adult Survivors of Critical Illness Shannon M. Fernando, Mary Scott, Robert Talarico, et al JAMA. Published online October 26, 2022. doi:10.1001/jama.2022.17714 Key Points Question  Is the use of extracorporeal membrane oxygenation (ECMO) associated with postdisch...

Noninvasive Respiratory Support in Intensive Care Most forms of ventilatory support in intensive care before the 1950s were noninvasive without direct access to the lower airways, using face mask for positive pressure or generating negative pressure around the chest. Ventilators stimulating negative pressure were designed in the late 19th century. The first application of positive end-expiratory pressure (PEEP) was first described in the 1930s.  After the i...