Should We Wean Patients off Vasopressors before Weaning Them off Ventilation? Xavier Monnet Am J Respir Crit Care Med 2022; 205: 980-981 Failed extubation and subsequent reintubation are independently associated with mortality and morbidity of patients under mechanical ventilation (1). This is the reason why, before starting the weaning process, one carefully waits until the patient has reached a sufficient degree of autonomy (2). Among the criteria used to ensur...

Original Published: 13 May 2022 Comparison of 8 versus 15 days of antibiotic therapy for Pseudomonas aeruginosa ventilator-associated pneumonia in adults: a randomized, controlled, open-label trial Adrien Bouglé, Sophie Tuffet, Laura Federici, et al Intensive Care Med 13 May 2022 https://doi.org/10.1007/s00134-022-06690-5 Abstract Purpose Compared to long duration of antibiotic therapy, a short duration has a comparable clinical efficac...

ARTICLES|ONLINE FIRST Baricitinib versus dexamethasone for adults hospitalised with COVID-19 (ACTT-4): a randomised, double-blind, double placebo-controlled trial Cameron R Wolfe, Kay M Tomashek, Thomas F Patterson, et al Lancet Respir Med Published:May 23, 2022 DOI:https://doi.org/10.1016/S2213-2600(22)00088-1 Summary Background Baricitinib and dexamethasone have randomised trials supporting their use for the treatment of patients with COVID-19. We a...

The Job Crisis for Emergency Physicians Emergency physicians have always been guaranteed a good job after residency and have been able to find work wherever they wanted and whenever they wanted.  However, in recent years there has been a shift in the demand. According to data from the American College of Emergency Physicians (ACEP), in 2019, approximately 20% of emergency medicine residents reported that they had difficulty finding a job in their preferred ...

Randomized Clinical Study of Temporary Transvenous Phrenic Nerve Stimulation in Difficult-to-Wean Patients Martin Dres,  Marcelo Gama de Abreu,  Hamid Merdji, et al Am J Respir Crit Care Med Vol 205, Iss 10, pp 1169–1178, May 15, 2022 Abstract Rationale: Diaphragm dysfunction is frequently observed in critically ill patients with difficult weaning from mechanical ventilation. Objectives: To evaluate the effects of temporary transvenous diaphragm n...

Research Letter May 13, 2022 Risk of Infection and Hospitalization Among Vaccinated and Unvaccinated Children and Adolescents in New York After the Emergence of the Omicron Variant Vajeera Dorabawila, Dina Hoefer, Ursula E. Bauer, et al JAMA. Published online May 13, 2022. doi:10.1001/jama.2022.7319 In the US, 12.3 million youth aged 18 years and younger were diagnosed with COVID-19 by April 7, 2022.1 Studies conducted before the Omicron variant...

COMMENT|ONLINE FIRST What a second booster dose of mRNA COVID-19 vaccines tells us Paul Loubet, Odile Launay Lancet Infect Dis May 09, 2022 DOI:https://doi.org/10.1016/S1473-3099(22)00282-1 Real-world studies have shown waning vaccine effectiveness against both SARS-CoV-2 infection and COVID-19-related hospitalisation within 2·5 months after a first booster dose of COVID-19 mRNA vaccine, especially for the SARS-CoV-2 omicron (B.1.1.529) variant. 1Several...

ARTICLES|ONLINE FIRST Measuring the availability of human resources for health and its relationship to universal health coverage for 204 countries and territories from 1990 to 2019: a systematic analysis for the Global Burden of Disease Study 2019 GBD 2019 Human Resources for Health Collaborators Lancet 2022 Published: May 23, 2022 DOI:https://doi.org/10.1016/S0140-6736(22)00532-3 Summary Background Human resources for health (HRH) include a range of ...

ICU Capacity Transfers and Mortality Transfers from one ICU to another ICU are associated with an increased length of stay in the ICU and the hospital. Inter-hospital ICU transfers occur for three main reasons: clinical transfers, capacity transfers and repatriations.  A study was conducted to show that different ICU transfers differ in risk-adjusted mortality rate. The primary endpoint of the study was survival to 30 days. The secondary endpoint included s...

Original Investigation May 13, 2022 Association of Prior BNT162b2 COVID-19 Vaccination With Symptomatic SARS-CoV-2 Infection in Children and Adolescents During Omicron Predominance Katherine E. Fleming-Dutra, Amadea Britton, Nong Shang, et al JAMA. Published online May 13, 2022. doi:10.1001/jama.2022.7493 Key Points Question  Does the estimated effectiveness of 2 doses of the BNT162b2 COVID-19 vaccine against symptomatic SARS-CoV-2 ...