Original Investigation May 11, 2021 Effect of a Digital Intervention on Depressive Symptoms in Patients With Comorbid Hypertension or Diabetes in Brazil and Peru: Two Randomized Clinical Trials Ricardo Araya, Paulo Rossi Menezes, Heloísa Garcia Claro, et al JAMA. 2021;325(18):1852-1862. doi:10.1001/jama.2021.4348 Abstract Importance  Depression is a leading contributor to disease burden globally. Digital mental health interventions ...

Choosing Wisely: The Next Five Recommendations In 2010, Howard Brody, a medical ethicist and family physician, authored "Medicine's Ethical Responsibility for Healthcare Reform - The Top Five List". His list challenged medical societies to identify five interventions in healthcare that were overused, and that did not provide patient benefit. Following the same logic, the American Board of Internal Medicine (ABIM) soon launched its "Choosing Wisely" campaign that also c...

Original Investigation May 11, 2021 Effect of Antimicrobial Therapy on Respiratory Hospitalization or Death in Adults With Idiopathic Pulmonary Fibrosis: The CleanUP-IPF Randomized Clinical Trial Fernando J. Martinez, Eric Yow, Kevin R. Flaherty, et al JAMA. 2021;325(18):1841-1851. doi:10.1001/jama.2021.4956 Abstract Importance Alteration in lung microbes is associated with disease progression in idiopathic pulmonary fibrosis. Objective...

Dyspnoea, Psychological Trauma and PTSD In a recent review, the authors hypothesise that some patients suffer unnecessary psychological sequelae such as depression, anxiety and post-traumatic stress disorder (PTSD) from dyspnoea that persists despite pharmacologic sedation during severe acute respiratory failure. The authors point out that the primary cause of dyspnoea is not the contraction of respiratory muscles. Air hunger arises from an increase in respiratory...

Research Prophylaxis against covid-19: living systematic review and network meta-analysis Jessica J Bartoszko, Reed A C Siemieniuk,  Elena Kum, et al BMJ 2021; 373 doi: https://doi.org/10.1136/bmj.n949 (Published 26 April 2021)Cite this as: BMJ 2021;373:n949 Abstract Objective To determine and compare the effects of drug prophylaxis on SARS-CoV-2 infection and covid-19. Design Living systematic review and network meta-analysis. Data sources W...

Use of Opioids After Intensive Care A study was conducted to evaluate opioid use in the ICU and identify factors associated with chronic opioid use after critical care. It also aimed to determine if chronic opioid use was associated with an increased risk of death.  Over the last few years, opioid misuse has become a major public health issue in many countries. Pharmaceutical companies have been marketing and promoting the use of liberal opioid prescribing for ...

Original Investigation May 25, 2021 Effect of Continuous Infusion of Hypertonic Saline vs Standard Care on 6-Month Neurological Outcomes in Patients With Traumatic Brain Injury: The COBI Randomized Clinical Trial Antoine Roquilly, Jean Denis Moyer, Olivier Huet, et al JAMA. 2021;325(20):2056-2066. doi:10.1001/jama.2021.5561 Abstract Importance Fluid therapy is an important component of care for patients with traumatic brain injury, but whe...

Genetic Clues to COVID-19 Pneumonia Researchers at Vanderbilt University Medical Center and colleagues have identified genetic factors that increase the risk for developing pneumonia and its severe, life-threatening consequences. Findings are published in the American Journal of Human Genetics. Information about these genetic clues may aid efforts to identify patients with COVID-19 at greatest risk for pneumonia, and enable earlier interventions to prevent se...

Research Suicide and self-harm in adult survivors of critical illness: population based cohort study Shannon M Fernando, Danial Qureshi, Manish M Sood, et al BMJ 2021; 373: n973 doi: https://doi.org/10.1136/bmj.n973 Abstract Objective To analyse the association between survival from critical illness and suicide or self-harm after hospital discharge. Design Population based cohort study using linked and validated provincial databases. Setting ...

ICU Management & Practice, Volume 20 - Issue 4, 2020 Continuous Monitoring Beyond the ICU - The Rise of Mobile Solutions Post-ICU patients are at high-risk of clinical deterioration. Continuous and mobile monitoring on hospital wards is useful to detect clinical deterioration at an early stage. It may help to prevent serious adverse events and ICU readmission. Most patients discharged from ICUs are old and have co-morbidities. Even when they are young an...