Original Investigation October 5, 2021 Effect of a Pulmonary Embolism Diagnostic Strategy on Clinical Outcomes in Patients Hospitalized for COPD Exacerbation: A Randomized Clinical Trial David Jiménez, Alvar Agustí, Eva Tabernero, et al JAMA. 2021;326(13):1277-1285. doi:10.1001/jama.2021.14846 Abstract Importance  Active search for pulmonary embolism (PE) may improve outcomes in patients hospitalized for exacerbations of chronic obs...

Mental Disorders and Risk of Severe COVID-19 Over the last few months, several risk factors have been identified for severe COVID-19 illness and mortality. These include age, male sex, obesity and cardiovascular disease. Recent evidence from a meta-analysis also demonstrates an increased risk of severe or fatal COVID-19 among patients with a pre-existing mental disorder.  Since then, several studies have found that patients with psychiatric disorders are also ...

Original Investigation Caring for the Critically Ill PatientOctober 5, 2021 Effect of Prophylactic Subcutaneous Scopolamine Butylbromide on Death Rattle in Patients at the End of Life: The SILENCE Randomized Clinical Trial Harriëtte J. van Esch, Lia van Zuylen, Eric C. T. Geijteman, et al JAMA. 2021;326(13):1268-1276. doi:10.1001/jama.2021.14785 Abstract Importance  Death rattle, defined as noisy breathing caused by the presence of ...

Association of Higher vs Lower PEEP on Mortality Mechanical ventilation is a life-saving strategy for critically ill patients. However, it can promote and/or exacerbate lung injury through several mechanisms, including alveolar overdistension and repetitive opening and closing of the alveoli and small airways. Positive end-expiratory pressure (PEEP) has been employed to prevent end-expiratory alveolar collapse and counteract mechanical strain. However, excessive PE...

Editorial September 29, 2021 Vasopressin and Steroids as Adjunctive Treatment for In-Hospital Cardiac Arrest Jason Haukoos, Ivor S. Douglas, Comilla Sasson JAMA. Published online September 29, 2021. doi:10.1001/jama.2021.15460 Cardiopulmonary arrest occurs in approximately 290 000 hospitalized patients annually in the United States, representing nearly 1% of all admissions and with survival estimated at 20%.1 To date, most research on cardi...

Medical News & Perspectives October 21, 2021 The Flawed Science of Antibody Testing for SARS-CoV-2 Immunity Jennifer Abbasi JAMA. Published online October 21, 2021. doi:10.1001/jama.2021.18919 在新冠肺炎疫情大流行早期，开发商设计了新冠病毒抗体检测，以确定人们是否受到感染。一些专家认为，血液检测最终将有助于解除封锁。一种观点认为，那些带有抗体的人至少在短期内不会发生再次感染，因此他们可以回归社会，而不会使自己或他人置于危险之中。 ...

ditorial October 21, 2021 Glucocorticoid Dose in COVID-19: Lessons for Clinical Trials During a Pandemic Steven A. Webb, Alisa M. Higgins, Colin J. McArthur JAMA. Published online October 21, 2021. doi:10.1001/jama.2021.16438 The ongoing COVID-19 pandemic necessitates an urgent need for rapid and yet methodologically rigorous clinical trials to identify the optimal combination of safe and effective treatments as well as rapid identification of c...

Original Investigation September 29, 2021 Effect of Vasopressin and Methylprednisolone vs Placebo on Return of Spontaneous Circulation in Patients With In-Hospital Cardiac Arrest: A Randomized Clinical Trial Lars W. Andersen, Dan Isbye, Jesper Kjærgaard, et al JAMA. Published online September 29, 2021. doi:10.1001/jama.2021.16628 Abstract Importance  Previous trials have suggested that vasopressin and methylprednisolone administered...

#LIVES2021 Begins: Intensive Care is All About the Team ESICM President Maurizio Cecconi, President-Elect Elie Azoulay and Congress Chair Armand Girbes officially opened the LIVES Digital 2021 Congress with a welcome address, an update on ESICM’s activities and initiatives and an overview of the Congress programme.  The COVID-19 crisis has put intensive care medicine at the heart of all concerns within the medical community on a governmental and state level...

Original Investigation Caring for the Critically Ill PatientOctober 21, 2021 Effect of 12 mg vs 6 mg of Dexamethasone on the Number of Days Alive Without Life Support in Adults With COVID-19 and Severe Hypoxemia: The COVID STEROID 2 Randomized Trial The COVID STEROID 2 Trial Group JAMA. Published online October 21, 2021. doi:10.1001/jama.2021.18295 Abstract Importance  A daily dose with 6 mg of dexamethasone is recommended for up to...