ORIGINAL ARTICLE Routine Functional Testing or Standard Care in High-Risk Patients after PCI Duk-Woo Park, Do-Yoon Kang, Jung-Min Ahn, et al N Engl J Med August 28, 2022DOI: 10.1056/NEJMoa2208335 Abstract BACKGROUND There are limited data from randomized trials to guide a specific follow-up surveillance approach after myocardial revascularization. Whether a follow-up strategy that includes routine functional testing improves clinical outcomes among high-...

ORIGINAL ARTICLE Dapagliflozin in Heart Failure with Mildly Reduced or Preserved Ejection Fraction Scott D. Solomon, John J.V. McMurray, Brian Claggett, et al N Engl J Med August 27, 2022DOI: 10.1056/NEJMoa2206286 Abstract BACKGROUND Sodium–glucose cotransporter 2 (SGLT2) inhibitors reduce the risk of hospitalization for heart failure and cardiovascular death among patients with chronic heart failure and a left ventricular ejection fraction of 40% or les...

ICU Management & Practice, Volume 22 - Issue 2, 2022 Sepsis Surveillance (Sepsis Sniffer): Where We Are Now and Where We Are Going Timely recognition of sepsis is the foundation of improved patient survival. This article discusses opportunities to improve this in multiple areas and the use of sepsis screening tools to improve surveillance and treatment of sepsis. Sepsis is a critical healthcare problem, associated with high mortality rates, and considera...

ORIGINAL ARTICLE Acetazolamide in Acute Decompensated Heart Failure with Volume Overload Wilfried Mullens, Jeroen Dauw, Pieter Martens, et al N Engl J Med August 27, 2022DOI: 10.1056/NEJMoa2203094 Abstract BACKGROUND Whether acetazolamide, a carbonic anhydrase inhibitor that reduces proximal tubular sodium reabsorption, can improve the efficiency of loop diuretics, potentially leading to more and faster decongestion in patients with acute decompensated h...

ORIGINAL ARTICLE Rivaroxaban in Rheumatic Heart Disease–Associated Atrial Fibrillation Stuart J. Connolly, Ganesan Karthikeyan, Mpiko Ntsekhe, et al N Engl J Med August 28, 2022DOI: 10.1056/NEJMoa2209051 Abstract BACKGROUND Testing of factor Xa inhibitors for the prevention of cardiovascular events in patients with rheumatic heart disease–associated atrial fibrillation has been limited. METHODS We enrolled patients with atrial fibrillation and echo...

ORIGINAL ARTICLE Percutaneous Revascularization for Ischemic Left Ventricular Dysfunction Divaka Perera, Tim Clayton, Peter D. O’Kane, et al N Engl J Med August 27, 2022DOI: 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 optimal medical thera...

ORIGINAL ARTICLE Oxygen Targets in Comatose Survivors of Cardiac Arrest Henrik Schmidt, Jesper Kjaergaard, Christian Hassager, et al N Engl J Med August 27, 2022DOI: 10.1056/NEJMoa2208686 Abstract BACKGROUND The appropriate oxygenation target for mechanical ventilation in comatose survivors of out-of-hospital cardiac arrest is unknown. METHODS In this randomized trial with a 2-by-2 factorial design, we randomly assigned comatose adults with out-of-...

ICU Management & Practice, Volume 22 - Issue 2, 2022 Challenges in the Haemodynamic Management of Septic Shock An overview of the haemodynamic management of patients in septic shock and strategies for detection of haemodynamic changes and appropriate therapeutic action to improve the prognosis of these patients. Introduction Sepsis is one of the main causes of admission to the Intensive Care Unit (ICU). It is defined as a life-threatening organ dysfun...

Invited Commentary  August 10, 2022 Expanding Options for Total Intravenous Anesthesia—The Etomidate vs Propofol for In-Hospital Complications Trial Jason M. Johanning JAMA Surg. Published online August 10, 2022. doi:10.1001/jamasurg.2022.3339 Using a randomized clinical trial design, the authors compared the ability of etomidate to provide total intravenous (IV) anesthesia with propofol.1 Propofol is the most common IV anesthesia medica...

ORIGINAL ARTICLE Blood-Pressure Targets in Comatose Survivors of Cardiac Arrest Jesper Kjaergaard, Jacob E. Møller, Henrik Schmidt, et al N Engl J Med August 27, 2022DOI: 10.1056/NEJMoa2208687 Abstract BACKGROUND Evidence to support the choice of blood-pressure targets for the treatment of comatose survivors of out-of-hospital cardiac arrest who are receiving intensive care is limited. METHODS In a double-blind, randomized trial with a 2-by-2 facto...