Timing of Antibiotic Therapy in the Intensive Care Unit Severe infections are common among patients in the ICU. According to findings from the Extended Study on Prevalence of Infection in Intensive Care III (EPIC III), 54% of the study patients had at least one suspected or proven infection on the study day, and 24% of these patients had more than one suspected or proven infection. These infections are generally either bacterial or fungal in origin and...

Original Investigation December 21, 2021 Effect of Therapeutic Drug Monitoring vs Standard Therapy During Maintenance Infliximab Therapy on Disease Control in Patients With Immune-Mediated Inflammatory Diseases: A Randomized Clinical Trial Silje Watterdal Syversen, Kristin Kaasen Jørgensen, Guro Løvik Goll, et al JAMA. 2021;326(23):2375-2384. doi:10.1001/jama.2021.21316 Abstract Importance  Proactive therapeutic drug monitoring (TDM...

Outcomes of Mechanically Ventilated COVID-19 Patients Millions of people worldwide have been infected with COVID-19, with many requiring hospitalisation. Approximately 30% of hospitalisaed patients with COVID-19 are started on invasive ventilation for several pneumonia. Invasive ventilation portend a poor prognosis as approximately 40% of these patients do not survive hospitalisation. Even those who survive usually have a prolonged duration of ventilatory support. ...

ARTICLES|ONLINE FIRST Rivaroxaban versus no anticoagulation for post-discharge thromboprophylaxis after hospitalisation for COVID-19 (MICHELLE): an open-label, multicentre, randomised, controlled trial Eduardo Ramacciotti, Leandro Barile Agati, Daniela Calderaro, et al Lancet Published:December 15, 2021 DOI:https://doi.org/10.1016/S0140-6736(21)02392-8 Summary Background Patients hospitalised with COVID-19 are at risk for thrombotic events after disch...

Omicron Puts Scientists on Alert There is panic around the globe as news of a new variant of coronavirus circulated this week. The variant is believed to harbour a large number of mutations and is spreading quickly across the world. The World Health Organization (WHO) has identified it as a variant of concern and named it Omicron. Omicron is the latest in line of SARS-CoV-2 variants and joins Delta, Alpha, Beta and Gamma. The variant has sparked the interest of ...

ARTICLES| VOLUME 399, ISSUE 10321, P237-248, JANUARY 15, 2022 Final efficacy analysis, interim safety analysis, and immunogenicity of a single dose of recombinant novel coronavirus vaccine (adenovirus type 5 vector) in adults 18 years and older: an international, multicentre, randomised, double-blinded, placebo-controlled phase 3 trial Scott A Halperin, Lingyun Ye, Donna MacKinnon-Cameron, et al Lancet 2022; 399: 237-248 Summary Background ...

ICU Management & Practice, Volume 21 - Issue 5, 2021 Management of Acute Arrhythmias in Patients With Cardiac Dysfunction - Update of ESC Guidelines In 2020, the ultra-short acting beta-blocker landiolol was first included in the ESC guidelines with a class I recommendation. The recommendations were based on study results demonstrating the rapid response, efficacy, and safety of this drug. At a recent symposium, during 2021 Heart Failure World Congress, car...

Original Investigation December 20, 2021 Effect of Regional vs General Anesthesia on Incidence of Postoperative Delirium in Older Patients Undergoing Hip Fracture Surgery: The RAGA Randomized Trial Ting Li, Jun Li, Liyong Yuan, et al JAMA. Published online December 20, 2021. doi:10.1001/jama.2021.22647 Abstract Importance  In adults undergoing hip fracture surgery, regional anesthesia may reduce postoperative delirium, but there is ...

ICU Management & Practice, Volume 21 - Issue 5, 2021 Microbiome and Pneumonia in Children A significant research gap exists in the field of the lung microbiome and pneumonia development in paediatric population. Its study may improve nosocomial pneumonia prevention and help to achieve zero pneumonia rates. Most frequent hospital acquired infections (HAI) in Paediatric Intensive Care Units (PICU), are ventilator associated pneumonia (VAP), catheter-relate...

COMMENT|ONLINE FIRST Mixing mRNA, adenoviral, and spike-adjuvant vaccines for protection against COVID-19 Christopher D Richardson Lancet Published:December 06, 2021 DOI:https://doi.org/10.1016/S0140-6736(21)02757-4 Supply and availability issues for government-approved vaccines, together with worries about rare side-effects (such as thrombotic thrombocytopenia), have necessitated the switch to heterologous COVID-19 vaccination schedules—an approach commonl...