ARTICLES|ONLINE FIRST Cyclophosphamide added to glucocorticoids in acute exacerbation of idiopathic pulmonary fibrosis (EXAFIP): a randomised, double-blind, placebo-controlled, phase 3 trial Jean-Marc Naccache, Stéphane Jouneau, Morgane Didier, et al Lancet Respir Med Published:September 07, 2021 DOI:https://doi.org/10.1016/S2213-2600(21)00354-4 Summary Background The use of cyclophosphamide in patients with acute exacerbation of idiopathic pulmonary ...

Sex, Illness Severity and Mortality in ICU Patients Women account for only about 35-45% of patients in the ICU. This is surprising since half of the world’s population are women. This highlights a very pertinent question: do men and women have equitable access to the ICU? There have been several clinical studies that have tried to determine sex differences in illness severity and survival. However, there have been no consistent results. Some studies show no diff...

ARTICLES|ONLINE FIRST Awake prone positioning for COVID-19 acute hypoxaemic respiratory failure: a randomised, controlled, multinational, open-label meta-trial Stephan Ehrmann, Jie Li, Miguel Ibarra-Estrada, et al Lancet Respir Med Published:August 20, 2021 DOI:https://doi.org/10.1016/S2213-2600(21)00356-8 Summary Background Awake prone positioning has been reported to improve oxygenation for patients with COVID-19 in retrospective and observational s...

Application of Artificial Intelligence in the ICU Artificial Intelligence (AI) holds great promise in critical care. Vast amounts of data are regularly collected in intensive care units, making ICUs the perfect environment for deploying machine-learning techniques. AI in ICUs can have several applications. For example, when determining the short and long-term outcomes of different interventions, a well-designed ICU system could provide significant support in the...

ARTICLES | ONLINE FIRST Inhaled isoflurane via the anaesthetic conserving device versus propofol for sedation of invasively ventilated patients in intensive care units in Germany and Slovenia: an open-label, phase 3, randomised controlled, non-inferiority trial Andreas Meiser, Thomas Volk, Jan Wallenborn, et al Lancet Respir Med Published:August 26, 2021 DOI:https://doi.org/10.1016/S2213-2600(21)00323-4 Summary Background Previous studies indicate tha...

Association of Volume of Sepsis Cases and Mortality Sepsis is a leading cause of death worldwide and is also associated with a high burden of patient mortality.  This burden is expected to increase as populations age. Patients with sepsis typically require high-cost interventions in ICUs. Even with urgent treatment, the probability of death still remains high. However, ICUs that have more experience treating such patients may be associated with lower mortality...

ARTICLES|ONLINE FIRST Daily testing for contacts of individuals with SARS-CoV-2 infection and attendance and SARS-CoV-2 transmission in English secondary schools and colleges: an open-label, cluster-randomised trial Bernadette C Young, David W Eyre, Saroj Kendrick, et al Lancet Published:September 14, 2021 DOI:https://doi.org/10.1016/S0140-6736(21)01908-5 Summary Background School-based COVID-19 contacts in England have been asked to self-isolate at home...

Original Investigation September 21, 2021 Effect of Probiotics on Incident Ventilator-Associated Pneumonia in Critically Ill Patients: A Randomized Clinical Trial Jennie Johnstone, Maureen Meade, François Lauzier, et al JAMA. 2021;326(11):1024-1033. doi:10.1001/jama.2021.13355 Abstract Importance  Growing interest in microbial dysbiosis during critical illness has raised questions about the therapeutic potential of microbiome modifi...

Safe Liberation During Weaning from VV-ECMO The use of venovenous extracorporeal membrane oxygenation (VV-ECMO) in patients with severe acute respiratory distress syndrome (ARDS) has increased substantially over the last few years. However, conclusive evidence supporting its use is still lacking, and mortality of patients treated with VV-ECMO for ARDS is still high. Optimal strategies of mechanical ventilation (MV) during VV-ECMO have been reported, but there is...

ONLINE FIRST (FREE ACCESS) OriginalsManagement of arterial partial pressure of carbon dioxide in the first week after traumatic brain injury: results from the CENTER-TBI studyCiterio G. et al.Occurrence and timing of withdrawal of life-sustaining measures in traumatic brain injury patients: a CENTER-TBI studyvan Veen E. et al. Correspondances“L’histoire se répète”, one size does not fit allKuindersma M. and Spronk P.E.“L'histoire se répète”, one size does not fi...