Optimal Respiratory Support for COVID-19 Patients Non-invasive respiratory support is an essential part of critical care. Non-invasive ventilation and high-flow nasal oxygen (HFNO) are commonly used in patients with acute hypoxaemic respiratory failure. Non-invasive respiratory support can alleviate respiratory distress, improve oxygenation and reduce the need for invasive mechanical ventilation. It can also help reduce mortality by reducing the need for trachea...

ARTICLES| VOLUME 22, ISSUE 2, P274-283, FEBRUARY 01, 2022 Narrow-spectrum antibiotics for community-acquired pneumonia in Dutch adults (CAP-PACT): a cross-sectional, stepped-wedge, cluster-randomised, non-inferiority, antimicrobial stewardship intervention trial Valentijn A Schweitzer, Inger van Heijl, Wim G Boersma, et al Lancet Infect Dis 2022; 22: 274-283 Summary Background Adults hospitalised to a non-intensive care unit (ICU) ward wit...

ORIGINAL ARTICLE Rilzabrutinib, an Oral BTK Inhibitor, in Immune Thrombocytopenia David J. Kuter, Merlin Efraim, Jiri Mayer, et al N Engl J Med 2022; 386:1421-1431DOI: 10.1056/NEJMoa2110297 Abstract BACKGROUND Rilzabrutinib, an oral, reversible covalent inhibitor of Bruton’s tyrosine kinase, may increase platelet counts in patients with immune thrombocytopenia by means of dual mechanisms of action: decreased macrophage (Fcγ receptor)–mediated platelet de...

ORIGINAL ARTICLE Early Outpatient Treatment for Covid-19 with Convalescent Plasma David J. Sullivan, Kelly A. Gebo, Shmuel Shoham, et al N Engl J Med March 30, 2022DOI: 10.1056/NEJMoa2119657 Abstract BACKGROUND Polyclonal convalescent plasma may be obtained from donors who have recovered from coronavirus disease 2019 (Covid-19). The efficacy of this plasma in preventing serious complications in outpatients with recent-onset Covid-19 is uncertain. ...

Diagnosing Non-Convulsive Seizures in the ICU: Tackling the Top Challenges One clinical factor complicating the work of ICU physicians and nurses is the difficulty of diagnosing nonconvulsive status epilepticus (NCSE)—an invisible condition that must be managed aggressively to prevent lasting damage to the brain. Because the prevalence of NCSE among neurological patients can reach up to 60%, and because it becomes increasingly hard to manage the longer it goes untreate...

ARTICLES|ONLINE FIRST Proteomic biomarkers of progressive fibrosing interstitial lung disease: a multicentre cohort analysis Willis S Bowman, Chad A Newton, Angela L Linderholm, et al Lancet Respir Med Published:January 18, 2022 DOI:https://doi.org/10.1016/S2213-2600(21)00503-8 Summary Background Progressive fibrosing interstitial lung disease (ILD) is characterised by parenchymal scar formation, leading to high morbidity and mortality. The ability to...

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...