ARTICLES| VOLUME 22, ISSUE 2, P209-221, FEBRUARY 01, 2022 Remdesivir plus standard of care versus standard of care alone for the treatment of patients admitted to hospital with COVID-19 (DisCoVeRy): a phase 3, randomised, controlled, open-label trial Florence Ader, Maude Bouscambert-Duchamp, Maya Hites, et al Lancet Infect Dis 2022; 22: 209-221 Summary Background The antiviral efficacy of remdesivir against SARS-CoV-2 is still controversia...

ICU Management & Practice, Volume 21 - Issue 6, 2021 Reversal of Direct Oral Anticoagulants This review focuses on different techniques to reverse direct oral anticoagulants, either with specific or non-specific agents. Direct oral anticoagulants (DOACs) are now standing for Vitamin K antagonists in many clinical settings. They are recognised as a major step forward for our patients. Their efficacy has been confirmed in venous thromboembolism prophy...

ORIGINAL ARTICLEFREE PREVIEW High-Sensitivity Troponin I after Cardiac Surgery and 30-Day Mortality P.J. Devereaux, Andre Lamy, Matthew T.V. Chan, et al N Engl J Med 2022; 386:827-836DOI: 10.1056/NEJMoa2000803 Abstract BACKGROUND Consensus recommendations regarding the threshold levels of cardiac troponin elevations for the definition of perioperative myocardial infarction and clinically important periprocedural myocardial injury in patients undergo...

ORIGINAL ARTICLEFREE PREVIEW Balanced Multielectrolyte Solution versus Saline in Critically Ill Adults Simon Finfer, Sharon Micallef, Naomi Hammond, et al N Engl J Med January 18, 2022DOI: 10.1056/NEJMoa2114464 Abstract BACKGROUND Whether the use of balanced multielectrolyte solution (BMES) in preference to 0.9% sodium chloride solution (saline) in critically ill patients reduces the risk of acute kidney injury or death is uncertain. METH...

ARTICLES| VOLUME 22, ISSUE 2, P183-195, FEBRUARY 01, 2022 Community transmission and viral load kinetics of the SARS-CoV-2 delta (B.1.617.2) variant in vaccinated and unvaccinated individuals in the UK: a prospective, longitudinal, cohort study Anika Singanayagam, Seran Hakki, Jake Dunning, et al Lancet Infect Dis 2022; 22: 183-195 Summary Background The SARS-CoV-2 delta (B.1.617.2) variant is highly transmissible and spreading globally, i...

What Does ARDS Mean During COVID-19? Acute Respiratory Distress Syndrome (ARDS) was described as a syndrome in 1967. At that time, it was defined as a condition characterised by severe hypoxaemia and diffuse bilateral opacities. Diagnosis of ARDS has always been context-dependent, but overall, achievements in traumatic and medical resuscitation and the use of invasive mechanical ventilation have allowed patients with ARDS to live longer. ARDS was always consider...

Research Letter December 3, 2021 Immunogenicity of Extended mRNA SARS-CoV-2 Vaccine Dosing Intervals Brian Grunau, David M. Goldfarb, Michael Asamoah-Boaheng, et al JAMA. 2022;327(3):279-281. doi:10.1001/jama.2021.21921 Standard dosing intervals for BNT162b2 and mRNA-1273 SARS-CoV-2 vaccines are 21 and 28 days, respectively.1 Data suggest improved effectiveness of ChAdOx1 adenoviral2 and other nonreplicating va...

ORIGINAL ARTICLE Effectiveness of BNT162b2 Vaccine against Critical Covid-19 in Adolescents Samantha M. Olson, Margaret M. Newhams, Natasha B. Halasa, et al N Engl J Med 2022; 386:713-723DOI: 10.1056/NEJMoa2117995 Abstract BACKGROUND The increasing incidence of pediatric hospitalizations associated with coronavirus disease 2019 (Covid-19) caused by the B.1.617.2 (delta) variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the United...

Surviving Sepsis Campaign Guidelines and Individualised Care Sepsis is a major cause of death in the ICU. It is a complex disease, and treatment is typically guided by evidence-based guidelines. However, it is important to remember that guidelines provide a systematic approach to patient evaluation and treatment decisions, but they are not a compilation of truth. The Surviving Sepsis Campaign (SSC) Guidelines are the most reliable guidelines used by the intensiv...

Original Investigation November 17, 2021 Inhaled Pulmonary Vasodilator Therapy in Adult Lung Transplant: A Randomized Clinical Trial Kamrouz Ghadimi, Jhaymie Cappiello, Mary Cooter-Wright, et al JAMA Surg. 2022;157(1):e215856. doi:10.1001/jamasurg.2021.5856 Abstract Importance  Inhaled nitric oxide (iNO) is commonly administered for selectively inhaled pulmonary vasodilation and prevention of oxidative injury after lung transplant (LT). Inhal...