Research Electronic health record alerts for acute kidney injury: multicenter, randomized clinical trial F Perry Wilson, Melissa Martin, Yu Yamamoto, et al BMJ 2021; 372: m4786 doi: https://doi.org/10.1136/bmj.m4786 (Published 18 January 2021) Abstract Objective To determine whether electronic health record alerts for acute kidney injury would improve patient outcomes of mortality, dialysis, and progression of acute kidney injury. Design Double bli...

Lower or Higher Oxygenation Targets for Acute Hypoxemic Respiratory Failure Olav L. Schjørring, Thomas L. Klitgaard, Anders Perner, et al N Engl J Med January 20, 2021DOI: 10.1056/NEJMoa2032510 Abstract BACKGROUND Patients with acute hypoxemic respiratory failure in the intensive care unit (ICU) are treated with supplemental oxygen, but the benefits and harms of different oxygenation targets are unclear. We hypothesized that using a lower target for partial...

ORIGINAL ARTICLE Baricitinib plus Remdesivir for Hospitalized Adults with Covid-19 Andre C. Kalil, Thomas F. Patterson, Aneesh K. Mehta, et al N Engl J Med December 11, 2020DOI: 10.1056/NEJMoa2031994 Abstract BACKGROUND Severe coronavirus disease 2019 (Covid-19) is associated with dysregulated inflammation. The effects of combination treatment with baricitinib, a Janus kinase inhibitor, plus remdesivir are not known. METHODS We conducted a dou...

CORRESPONDENCE|ONLINE FIRST Infectivity of asymptomatic versus symptomatic COVID-19 Andrew A Sayampanathan, Cheryl S Heng, Phua Hwee Pin, et al Lancet Published:December 18, 2020 DOI:https://doi.org/10.1016/S0140-6736(20)32651-9 Asymptomatic cases of COVID-19 are a potential source of substantial spread within the community setting.1 However, little information is available about the infectivity and epidemiological significance of people with asymptomatic...

ARTICLES|ONLINE FIRST Ultra-early tranexamic acid after subarachnoid haemorrhage (ULTRA): a randomised controlled trial René Post, Menno R Germans, Maud A Tjerkstra, et al. Lancet Published:December 21, 2020 DOI:https://doi.org/10.1016/S0140-6736(20)32518-6 Summary Background In patients with aneurysmal subarachnoid haemorrhage, short-term antifibrinolytic therapy with tranexamic acid has been shown to reduce the risk of rebleeding. However, whether this...

ORIGINAL ARTICLE Efficacy and Safety of the mRNA-1273 SARS-CoV-2 Vaccine Lindsey R. Baden, Hana M. El Sahly, Brandon Essink, et al N Engl J Med 2021; 384:403-416DOI: 10.1056/NEJMoa2035389 Abstract BACKGROUND Vaccines are needed to prevent coronavirus disease 2019 (Covid-19) and to protect persons who are at high risk for complications. The mRNA-1273 vaccine is a lipid nanoparticle–encapsulated mRNA-based vaccine that encodes the prefusion stabilized full...

Nebulised Heparin for Patients with ARDS Mechanical ventilation in the ICU for 48 hours or longer is known to be associated with ARDS, which could be present either when ventilatory support is initiated or develop afterwards, typically during the first five days. ARDS affects approximately 23% of mechanically ventilated, critically ill patients and has a mortality of nearly 46%. Patients on prolonged mechanical ventilation and ARDS are at risk of impaired physical func...

CORRESPONDENCE Duration of Culturable SARS-CoV-2 in Hospitalized Patients with Covid-19 Min-Chul Kim, Chunguang Cui, Kyeong-Ryeol Shin, et al N Engl J Med January 27, 2021DOI: 10.1056/NEJMc2027040 TO THE EDITOR: The duration of transmissibility of coronavirus disease 2019 (Covid-19) and the associated level of contagion have been uncertain. We cultured severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in serial respiratory samples obtained from h...

Nebulised heparin for patients with or at risk of acute respiratory distress syndrome: a multicentre, randomised, double-blind, placebo-controlled phase 3 trial Barry Dixon, Roger J Smith, Duncan J Campbell, et al Lancet Respir Med Published:January 22, 2021 DOI:https://doi.org/10.1016/S2213-2600(20)30470-7 Summary Background Mechanical ventilation in intensive care for 48 h or longer is associated with the acute respiratory distress syndrome (ARDS), which ...

Global variation in postoperative mortality and complications after cancer surgery: a multicentre, prospective cohort study in 82 countries GlobalSurg Collaborative and National Institute for Health Research Global Health Research Unit on Global Surgery Lancet 2021; 397: 387–97 Summary Background 80% of individuals with cancer will require a surgical procedure, yet little comparative data exist on early outcomes in low-income and middle-income countries (LM...