ORIGINAL ARTICLE Tranexamic Acid in Patients Undergoing Noncardiac Surgery P.J. Devereaux, Maura Marcucci, Thomas W. Painter, et al N Engl J Med April 2, 2022DOI: 10.1056/NEJMoa2201171 Abstract BACKGROUND Perioperative bleeding is common in patients undergoing noncardiac surgery. Tranexamic acid is an antifibrinolytic drug that may safely decrease such bleeding. METHODS We conducted a trial involving patients undergoing noncardiac surgery. Patients...

ORIGINAL ARTICLE Effectiveness of the BNT162b2 Vaccine after Recovery from Covid-19 Ariel Hammerman, Ruslan Sergienko, Michael Friger, et al N Engl J Med 2022; 386:1221-1229DOI: 10.1056/NEJMoa2119497 Abstract BACKGROUND The risk of infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) decreases substantially among patients who have recovered from coronavirus disease 2019 (Covid-19). However, it is unknown how long protective immunit...

Prone Positioning in Patients Receiving vvECMO for ARDS Several studies have supported the efficacy of venovenous extracorporeal membrane oxygenation (vvECMO) to improve survival in severe acute respiratory distress syndrome (ARDS). ARDS is one of the primary causes of admission to the ICU. The use of an effective approach to support respiratory function in patients with severe respiratory failure is thus an important goal when managing these patients. This has bec...

ARTICLES|ONLINE FIRST Heterologous versus homologous COVID-19 booster vaccination in previous recipients of two doses of CoronaVac COVID-19 vaccine in Brazil (RHH-001): a phase 4, non-inferiority, single blind, randomised study Sue Ann Costa Clemens, Lily Weckx, Ralf Clemens, et al Lancet Published:January 21, 2022 DOI:https://doi.org/10.1016/S0140-6736(22)00094-0 Summary Introduction The inactivated whole-virion SARS-CoV-2 vaccine (CoronaVac, Sinovac...

ORIGINAL ARTICLE Protection against SARS-CoV-2 after Covid-19 Vaccination and Previous Infection Victoria Hall, Sarah Foulkes, Ferdinando Insalata, et al N Engl J Med 2022; 386:1207-1220DOI: 10.1056/NEJMoa2118691 Abstract BACKGROUND The duration and effectiveness of immunity from infection with and vaccination against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are relevant to pandemic policy interventions, including the timing of vaccin...

ARDS Subphenotypes Using Machine Learning An observational, multicohort, retrospective study was conducted to validate two machine-learning clinical classifier models for assigning acute respiratory distress syndrome (ARDS) subphenotypes. Two ARDS subphenotypes with distinct biological and clinical features and differential treatment responses have been identified in seven individual cohorts. In addition, clinical classifier models to facilitate bedside identi...

ORIGINAL ARTICLE Homologous and Heterologous Covid-19 Booster Vaccinations Robert L. Atmar, Kirsten E. Lyke, Meagan E. Deming, et al N Engl J Med January 26, 2022DOI: 10.1056/NEJMoa2116414 Abstract BACKGROUND Although the three vaccines against coronavirus disease 2019 (Covid-19) that have received emergency use authorization in the United States are highly effective, breakthrough infections are occurring. Data are needed on the serial use of homologous ...

Post-hoc Analysis of the NONSEDA Trial In recent years, there has been an increase in awareness of minimising sedation in the ICU. Several benefits of avoiding heavy sedation have been reported in clinical studies, and clinical guidelines also encourage less sedation. Findings from the NONSEDA trial were published in 2020. In this trial, 700 critically ill patients were randomised to receive light sedation or non-sedation during mechanical ventilation. Findings ...

Editorials Awake prone positioning for patients with covid-19 Joseph Barker, David Koeckerling, Nadeesha Lakmal Mudalige, et al BMJ 2022; 376 doi: https://doi.org/10.1136/bmj.o632 (Published 23 March 2022)Cite this as: BMJ 2022;376:o632 It’s a matter of time Awake prone positioning is thought to improve clinical outcomes in patients with covid-19 by modulating lung mechanics during progressive hypoxaemic respiratory failure.12 The intervention is attra...

CORRESPONDENCE Efficacy of Antibodies and Antiviral Drugs against Covid-19 Omicron Variant Emi Takashita, Noriko Kinoshita, Seiya Yamayoshi, et al N Engl J Med January 26, 2022DOI: 10.1056/NEJMc2119407 TO THE EDITOR: In November 2021, the B.1.1.529 (omicron) variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was detected in South Africa.1 Since then, omicron has rapidly spread around the world. On November 26, 2021, the World Healt...