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...

Original Investigation May 26, 2021 Effect of 2 Inactivated SARS-CoV-2 Vaccines on Symptomatic COVID-19 Infection in Adults: A Randomized Clinical Trial Nawal Al Kaabi, Yuntao Zhang, Shengli Xia, et al JAMA. Published online May 26, 2021. doi:10.1001/jama.2021.8565 Abstract Importance Although effective vaccines against COVID-19 have been developed, additional vaccines are still needed. Objective To evaluate the efficacy and adverse ...

ORIGINAL ARTICLE Dexamethasone and Surgical-Site Infection Tomás B. Corcoran, Paul S. Myles, Andrew B. Forbes, et al N Engl J Med 2021; 384:1731-1741DOI: 10.1056/NEJMoa2028982 Abstract BACKGROUND The glucocorticoid dexamethasone prevents nausea and vomiting after surgery, but there is concern that it may increase the risk of surgical-site infection. METHODS In this pragmatic, international, noninferiority trial, we randomly assigned 8880 adult pati...

#EA20: Wellbeing of Healthcare Providers During COVID-19 In a three-part session on burnout and depression of healthcare providers during COVID-19: diagnosis and approach at Euroanaesthesia 2020, Dr. Miodrag Milenovic of University of Belgrade and Clinical Center of Serbia, Emergency Center, talked about the occupational wellbeing in healthcare providers during the pandemic.  Dr. Milenovic highlighted the fact that the field of anaesthesiology is already quite ...

Original Investigation May 4, 2021 Effect of Half-Dose vs Stable-Dose Conventional Synthetic Disease-Modifying Antirheumatic Drugs on Disease Flares in Patients With Rheumatoid Arthritis in Remission: The ARCTIC REWIND Randomized Clinical Trial Siri Lillegraven, Nina Paulshus Sundlisæter, Anna-Birgitte Aga, et al JAMA. 2021;325(17):1755-1764. doi:10.1001/jama.2021.4542 Abstract Importance Sustained remission has become an achievable goal f...

#EA20: Is Technology the Answer for Perioperative Patient Safety? One of the most enjoyable sessions at Euroanaesthesia 2020 this year was the pro-con debate. The debate this time was on the topic: is technology the final answer for perioperative patient safety? Two experts, Dr. Daniel Arnal from the  Hospital Universitario Fundación Alcorcón, Madrid, Spain, delivered the pro argument, while Prof. William Harrop-Griffiths from Imperial College, London, UK, deli...

ORIGINAL ARTICLE Tranexamic Acid for the Prevention of Blood Loss after Cesarean Delivery Loïc Sentilhes, Marie V. Sénat, Maëla Le Lous, et al N Engl J Med 2021; 384:1623-1634DOI: 10.1056/NEJMoa2028788 Abstract BACKGROUND Prophylactic administration of tranexamic acid has been associated with reduced postpartum blood loss after cesarean delivery in several small trials, but evidence of its benefit in this clinical context remains inconclusive. METHODS...

ICU Management & Practice, Volume 20 - Issue 4, 2020 Treatment of Catecholamine Refractory Hypotension in Septic Shock: Beyond First Line Vasopressor Hypotension during septic shock is a strong indicator of patient outcome and mortality. Arginine vasopressin is a naturally produced human hormone with vasoconstriction effect via V1 receptor activation and a short 5-20 minutes half-life and is recommended by the Surviving Sepsis Campaign guidelines to be adde...

ORIGINAL ARTICLE Interleukin-6 Receptor Antagonists in Critically Ill Patients with Covid-19 The REMAP-CAP Investigators N Engl J Med 2021; 384:1491-1502DOI: 10.1056/NEJMoa2100433 Abstract BACKGROUND The efficacy of interleukin-6 receptor antagonists in critically ill patients with coronavirus disease 2019 (Covid-19) is unclear. METHODS We evaluated tocilizumab and sarilumab in an ongoing international, multifactorial, adaptive platform trial. Adul...