ONLINE FIRST (FREE ACCESS) LATEST ARTICLES OPEN ACCESS ~ OriginalRole of total lung stress on the progression of early COVID-19 pneumoniaCoppola S. et al. Conference Reports and Expert PanelCritically ill cancer patient’s resuscitation: a Belgian/French societies’ consensus conferenceMeert A-P. et al.  EditorialThe goal of personalized glucose control in the critically ill remains elusiveKrinsley J.S., Deane A.M. and Gunst J. Imaging in Intensive Care Medic...

Ethics in Extracorporeal Life Support Extracorporeal life support has had a significant impact on modern medicine. However, the use of this technology has significant ethical challenges. In this review, the authors identify three ethical discourses: trials and evidence accompanying the use of ECLS, the ECLS allocation, decision-making and limiting care and death on ECLS and ECLS in organ donation. They then provide a narrative synthesis of all major arguments ex...

Original Investigation Caring for the Critically Ill PatientOctober 4, 2021 Effect of Convalescent Plasma on Organ Support–Free Days in Critically Ill Patients With COVID-19: A Randomized Clinical Trial Writing Committee for the REMAP-CAP Investigators JAMA. Published online October 4, 2021. doi:10.1001/jama.2021.18178 Abstract Importance  The evidence for benefit of convalescent plasma for critically ill patients with COVID-19 is i...

Trends in Sepsis-Related Mortality in the U.S. Sepsis is a life-threatening organ dysfunction. It is the leading cause of death in the U.S. It is also one of the most expensive conditions to treat. However, the burden of sepsis-related mortality in the U.S. in recent years is not well-characterised. Previous studies utilise hospital databases and electronic health records to determine trends, but these have been limited to only a few hospital systems and geogr...

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。 ...