Antibiotic Delay Intervals, Mortality Among Patients With Suspected Sepsis Timely delivery of antibiotics is a major cornerstone of sepsis therapy. Clinical evidence suggests that every one-hour delay in antibiotics after emergency department (ED) triage or the onset of organ dysfunction or shock could result in a 3-7% increase in the odds of a poor outcome. The Surviving Sepsis Campaign (SSC) guidelines recommend antibiotic initiation within one hour of ED triage,...

Original Investigation June 3, 2021 Effect of Bamlanivimab vs Placebo on Incidence of COVID-19 Among Residents and Staff of Skilled Nursing and Assisted Living Facilities: A Randomized Clinical Trial Myron S. Cohen, Ajay Nirula, Mark J. Mulligan, et al JAMA. Published online June 3, 2021. doi:10.1001/jama.2021.8828 Abstract Importance Preventive interventions are needed to protect residents and staff of s...

5G-Powered Robot-Assisted Teleultrasound Diagnostic System In situations where there are limited medical resources and a lack of expertise, and where the risk of infection is also high, teleultrasound can provide an effective solution.  A study was conducted to explore the feasibility of the application of a 5G-powered robot-assisted teleultrasound diagnostic system in an ICU. Robot-assisted ultrasound diagnostic systems allow dynamic observation ...

Original Investigation June 1, 2021 Effect of Reduced-Dose vs High-Dose Glucocorticoids Added to Rituximab on Remission Induction in ANCA-Associated Vasculitis: A Randomized Clinical Trial Shunsuke Furuta, Daiki Nakagomi, Yoshihisa Kobayashi, et al JAMA. 2021;325(21):2178-2187. doi:10.1001/jama.2021.6615 Abstract Importance The current standard induction therapy for antineutrophil cytoplasm antibody (ANCA...

Anticoagulation Therapy in Patients With COVID-19 No therapy is currently recommended for COVID-19. Some data from registries and autopsies suggest a potential role for coagulopathy in influencing outcome in patients with COVID-19. In COVID-19 patients with respiratory insufficiency, a combination of disseminated intravascular coagulation and localised pulmonary thrombotic microangiopathy may be present. Hence, anticoagulation therapy could be used in some COVID-19...

Original Investigation January 13, 2021 Postdischarge Virtual Visits for Low-risk Surgeries: A Randomized Noninferiority Clinical Trial Kristen Harkey, Nicole Kaiser, Jing Zhao, et al JAMA Surg. 2021;156(3):221-228. doi:10.1001/jamasurg.2020.6265 Abstract Importance Postdischarge video-based virtual visits are a growing aspect of surgical care and have dramatically increased in the setting of the coronavirus disease 2019 (COVID-19) pandemic. Obje...

Delayed Initiation Strategy for Renal Replacement Therapy Delaying renal replacement therapy (RRT) in critically ill patients with severe kidney injury and no severe complication is safe and can allow optimisation of the use of medical devices. However, uncertainty still remains regarding the duration for which RRT can be delayed without risk to the patient. In this study, the researchers evaluate a more-delayed initiation strategy and whether it would result in mo...

Original Investigation February 17, 2021 Association of Cryoprecipitate Use With Survival After Major Trauma in Children Receiving Massive Transfusion Maria A. Tama, Melvin E. Stone Jr, Stephen M. Blumberg, et al JAMA Surg. 2021;156(5):453-460. doi:10.1001/jamasurg.2020.7199 Abstract Importance Although most massive transfusion protocols incorporate cryoprecipitate in the treatment of hemorrhaging injured patients, minimal data exist on its use in c...

ICU Management & Practice, Volume 21 - Issue 1, 2021 Nutrition Management of COVID-19 Patients in the ICU and Post-ICU This article is a summary of a webinar series where three nutritional experts discussed a practical approach on how to feed and how to provide high-quality nutritional therapy to critically ill patients during hospitalisation. Prof Elizabeth De Waele, Dr Arthur Van Zanten and Prof Paul Wischmeyer in the webinar series discuss nutrition supp...

Original Investigation March 17, 2021 Association Between Anesthesiologist Volume and Short-term Outcomes in Complex Gastrointestinal Cancer Surgery Julie Hallet, Angela Jerath, Alexis F. Turgeon, MD, et al JAMA Surg. 2021;156(5):479-487. doi:10.1001/jamasurg.2021.0135 Abstract Importance Intraoperative anesthesiology care is crucial to high-quality surgical care. The clinical expertise and experience of anesthesiologists may decrease the risk of ad...