ORIGINAL ARTICLEFREE PREVIEW Hypothermia versus Normothermia after Out-of-Hospital Cardiac Arrest Josef Dankiewicz, Tobias Cronberg, Gisela Lilja, et al N Engl J Med 2021; 384:2283-2294DOI: 10.1056/NEJMoa2100591 Abstract BACKGROUND Targeted temperature management is recommended for patients after cardiac arrest, but the supporting evidence is of low certainty. METHODS In an open-label trial with blinded assessment of outcomes, we randomly assigned ...

Effects of Ventilatory Rescue Therapies in Mechanically Ventilated COVID-19 Patients Several publications have highlighted the features of COVID-19-associated acute respiratory distress syndrome (ARDS). Patients with COVID-19 ARDS have a form of injury that resembles ARDS unrelated to COVID-19. International guidelines recommend adherence to evidence-based management strategies, including lung-protective mechanical ventilation and positive end-expiratory pressure (...

ONLINE FIRST THIS WEEK(FREE ACCESS) Tanios M. et al. ~Fentanyl- and midazolam-induced coma each influence days of mechanical ventilation and 28-day mortality Kalbhenn J. et al. ~ “Do no further harm” – Why shall we sedate unresponsive patients? Vaara S.T. et al. ~Restrictive fluid management versus usual care in acute kidney injury (REVERSE-AKI): a pilot randomized controlled feasibility trial Patel B.V. et al. ~ Natural history, trajectory...

Biomarkers to Identify Acute Kidney Injury for Early Sepsis Detection Early recognition of sepsis is vital for improving patient outcomes. If detected on time, sepsis can be treated with antibiotics and source control, recognition and reversal of shock and organ support. The three most common organ dysfunctions in sepsis are cardiovascular, renal and respiratory. Cardiovascular and respiratory organ dysfunctions are easier to recognise. But detection of acute kidne...

ARTICLES| VOLUME 397, ISSUE 10288, P1885-1894, MAY 22, 2021 Patient care and clinical outcomes for patients with COVID-19 infection admitted to African high-care or intensive care units (ACCCOS): a multicentre, prospective, observational cohort study The African COVID-19 Critical Care Outcomes Study (ACCCOS) Investigators Lancet 2021; 397: 1885-1894 DOI:https://doi.org/10.1016/S0140-6736(21)00441-4 Summary Background There have been ins...

Cognitive Impairment, Brain Insult After Mechanical Ventilation Mechanical ventilation is an essential treatment strategy in the ICU. It is a life-support tool that is often needed in critically ill patients. However, mechanical ventilation is known to cause injury to distal organs such as the lungs, diaphragm and brain.  A systematic review was conducted to identify publications that assessed the link between mechanical ventilation and either cognitive imp...

CORRESPONDENCE PF4 Immunoassays in Vaccine-Induced Thrombotic Thrombocytopenia N Engl J Med May 19, 2021DOI: 10.1056/NEJMc2106383 TO THE EDITOR: In a recent study, Greinacher et al.1 reported thrombotic complications, mostly cerebral vein thrombosis, associated with thrombocytopenia in 11 patients after they had been vaccinated with ChAdOx1 nCoV-19 (AstraZeneca). Although none of these patients had received heparin, the authors detected high titers of anti–pla...

COMMENT| VOLUME 397, ISSUE 10291, P2226-2228, JUNE 12, 2021 Anticoagulation in COVID-19: reaction to the ACTION trial Jeffrey S Berger, Jean Marie Connors Lancet 2021; 379: 2226-2228 DOI:https://doi.org/10.1016/S0140-6736(21)01291-5 Early in the COVID-19 pandemic, it became clear that coagulopathy leading to macrovascular and microvascular thrombotic events was a considerable potential complication for patients with COVID-19.1Increased inflam...

ARTICLES|ONLINE FIRST Effects of nurse-to-patient ratio legislation on nurse staffing and patient mortality, readmissions, and length of stay: a prospective study in a panel of hospitals Matthew D McHugh, Linda H Aiken, Douglas M Sloane, et al Lancet Published: May 11, 2021 DOI:https://doi.org/10.1016/S0140-6736(21)00768-6 Summary Background Substantial evidence indicates that patient outcomes are more favourable in hospitals with better nurse staffin...

ARTICLES| VOLUME 397, ISSUE 10291, P2253-2263, JUNE 12, 2021 Therapeutic versus prophylactic anticoagulation for patients admitted to hospital with COVID-19 and elevated D-dimer concentration (ACTION): an open-label, multicentre, randomised, controlled trial Renato D Lopes, Pedro Gabriel Melo de Barros e Silva, Remo H M Furtado, et al Lancet 2021; 397: 2253-2263 DOI:https://doi.org/10.1016/S0140-6736(21)01203-4 Summary Background C...