PICU Patients At-Risk for PARDS Approximately 2-4% of patients admitted to PICUs suffer from paediatric acute respiratory distress syndrome (PARDS). PARDS has a mortality rate of nearly 20% and has no specific treatment. Identifying children at risk of developing PARDS could potentially result in more targeted therapies to prevent disease progression and improve patient outcomes.  Children At Risk for PARDS (ARF-PARDS) are identified using criteria establis...

Original Investigation March 8, 2022 Association of Tropical Cyclones With County-Level Mortality in the US Robbie M. Parks, Jaime Benavides, G. Brooke Anderson, et al JAMA. 2022;327(10):946-955. doi:10.1001/jama.2022.1682 Key Points Question  In the US from 1988-2018, were tropical cyclones associated with increases in county-level cause-specific death rates in subsequent months? Findings  In this retrospective observa...

ORIGINAL ARTICLEFREE PREVIEW Calorie Restriction with or without Time-Restricted Eating in Weight Loss Deying Liu, Yan Huang, Chensihan Huang, et al N Engl J Med 2022; 386:1495-1504DOI: 10.1056/NEJMoa2114833 Abstract BACKGROUND The long-term efficacy and safety of time-restricted eating for weight loss are not clear. METHODS We randomly assigned 139 patients with obesity to time-restricted eating (eating only between 8:00 a.m. and 4:00 p.m.) with c...

CORRESPONDENCE Pulse Oximetry for Monitoring Patients with Covid-19 at Home — A Pragmatic, Randomized Trial Kathleen C. Lee, Anna U. Morgan, Krisda H. Chaiyachati, et al N Engl J Med April 6, 2022DOI: 10.1056/NEJMc2201541 TO THE EDITOR: Reports of silent hypoxia in patients with coronavirus disease 2019 (Covid-19) have raised the question of whether patients should use pulse oximeters at home to measure oxygen saturation rather than relying on subjective dy...

Physical Rehabilitation in the ICU Approximately 65% of patients who survive critical illness suffer clinically detectable weakness due to muscle mass loss, myopathy and polyneuropathy. These changes occur early in ICU admission and are associated with prolonged weaning from mechanical ventilation and increased ICU and hospital length of stay. Clinical weakness is also associated with increased mortality both in the hospital and in the ICU and over the first year a...

CHEST INFECTIONS: ORIGINAL RESEARCH| VOLUME 161, ISSUE 2, P345-355, FEBRUARY 01, 2022 Risk Factors for Invasive Candida Infection in Critically Ill Patients: A Systematic Review and Meta-analysis Daniel O. Thomas-Rüddel, Peter Schlattmann, Mathias Pletz, et al Chest 2022; 161: 345-355 Background Current guidelines recommend empirical antifungal therapy in patients with sepsis with high risk of invasive Candida infection. However, ma...

ORIGINAL ARTICLE Protection by a Fourth Dose of BNT162b2 against Omicron in Israel Yinon M. Bar-On, Yair Goldberg, Micha Mandel, et al N Engl J Med April 5, 2022DOI: 10.1056/NEJMoa2201570 Abstract BACKGROUND On January 2, 2022, Israel began administering a fourth dose of BNT162b2 vaccine to persons 60 years of age or older. Data are needed regarding the effect of the fourth dose on rates of confirmed severe acute respiratory syndrome coronavirus 2 (SARS-...

Medium-Term and Long-Term Impact of COVID-19 As countries around the world become more accustomed to living with COVID-19, an important topic of discussion has been the medium-term and long-term impact of COVID-19 on respiratory function and health-related quality of life.  Most published studies on COVID-19 include patients with varying degrees of severity and evaluate patients up to six months after a COVID-19 episode. None of these studies specifically f...

ORIGINAL ARTICLE Intramuscular AZD7442 (Tixagevimab–Cilgavimab) for Prevention of Covid-19 Myron J. Levin, Andrew Ustianowski, Stéphane De Wit, et al N Engl J Med April 20, 2022DOI: 10.1056/NEJMoa2116620 Abstract BACKGROUND The monoclonal-antibody combination AZD7442 is composed of tixagevimab and cilgavimab, two neutralizing antibodies against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that have an extended half-life and have been show...

EDITORIAL| VOLUME 161, ISSUE 2, P303-304, FEBRUARY 01, 2022 The Value of SEP-1 Richard Beale Chest 2022; 161: 303-304 Twenty years ago, the concept of sepsis as the host response to infection1 was still largely the obsession of intensivists and infectious diseases specialists. Deteriorating patients were recognized late,2 often presenting in a state of collapse, and the lack of a systematic approach to treatment resulted in variable clinical car...