ICU Management & Practice, Volume 20 - Issue 4, 2020 Nutrition in the Post ICU Period: Where is the Evidence? This article summarises the current nutrition evidence in the phase of recovery that occurs following critical illness. Introduction It is plausible that the importance of nutrition may differ across different phases of illness. Reflecting this, the most recently updated clinical nutrition practice guidelines for critical care from the Europea...

CORRESPONDENCE|DECEMBER 19, 2020 Renal replacement therapy in acute kidney injury Vincenzo Sepe, Teresa Rampino, Carmelo Libetta Lancet 2020; 396: 1974 DOI:https://doi.org/10.1016/S0140-6736(20)32399-0 Stéphane Gaudry and colleagues1 found that early renal replacement therapy (RRT) in critically ill patients with acute kidney injury does not affect survival compared with a delayed RRT strategy. A major limitation of their meta-analysis is the clinical discreti...

Oxygen Therapy in Acute Care Medicine Oxygen therapy is a commonly used strategy in modern medicine. In most situations with declining oxygen saturations, clinicians are quick to use this technique. While effective in the setting of hypoxia, there are, however, some circumstances in which excess oxygen is indiscriminately administered for extended periods. In healthcare, there has been a significant shift from the concept of "more is better" to "less is more." There...

CORRESPONDENCE Racial Bias in Pulse Oximetry Measurement Michael W. Sjoding, Robert P. Dickson, Theodore J. Iwashyna, et al N Engl J Med 2020; 383:2477-2478DOI: 10.1056/NEJMc2029240 TO THE EDITOR: Oxygen is among the most frequently administered medical therapies, with a level that is commonly adjusted according to the reading on a pulse oximeter that measures patients’ oxygen saturation. Questions about pulse oximeter technology have been raised, given its...

ORIGINAL ARTICLE Tocilizumab in Patients Hospitalized with Covid-19 Pneumonia Carlos Salama, Jian Han, Linda Yau, et al N Engl J Med 2021; 384:20-30DOI: 10.1056/NEJMoa2030340 Abstract BACKGROUND Coronavirus disease 2019 (Covid-19) pneumonia is often associated with hyperinflammation. Despite the disproportionate incidence of Covid-19 among underserved and racial and ethnic minority populations, the safety and efficacy of the anti–interleukin-6 recep...

Research Letter December 14, 2020 Readmission and Death After Initial Hospital Discharge Among Patients With COVID-19 in a Large Multihospital System John P. Donnelly, Xiao Qing Wang, Theodore J. Iwashyna, et al JAMA. Published online December 14, 2020. doi:10.1001/jama.2020.21465 Although more patients are surviving severe coronavirus disease 2019 (COVID-19), there are limited data on outcomes after initial hospitalization. We therefore measure...

Research Christmas 2020: The Citadel Nonsensus in the treatment of proximal humerus fractures: uncontrolled, blinded, comparative behavioural analysis between Homo chirurgicus accidentus and Macaca sylvanus Sam Razaeian, Birgitt Wiese, Dafang Zhang, et al BMJ 2020; 371: m4429 doi: https://doi.org/10.1136/bmj.m4429 (Published 14 December 2020)  Abstract Objective To investigate the inter-rater reliability of Barbary macaques compared with an expert g...

From The Medical Letter on Drugs and Therapeutics An EUA for Bamlanivimab—A Monoclonal Antibody for COVID-19 JAMA. Published online December 11, 2020. doi:10.1001/jama.2020.24415 The investigational neutralizing IgG1 monoclonal antibody bamlanivimab (LY-CoV555; Lilly) has been granted an FDA Emergency Use Authorization (EUA) for treatment of recently diagnosed mild to moderate COVID-19 in patients who are ≥12 years old, weigh at least 40 kg, and are at high ...

Research Christmas 2020: Dr Strange Effectiveness of hospital clowns for symptom management in paediatrics: systematic review of randomised and non-randomised controlled trials Luís Carlos Lopes-Júnior, Emiliana Bomfim, Karin Olson, et al BMJ 2020; 371: m4290 doi: https://doi.org/10.1136/bmj.m4290 (Published 16 December 2020) Abstract Objective To evaluate evidence from randomised controlled trials and non-randomised controlled trials on the effecti...

Editorial December 9, 2020 Searching for the Optimal PEEP in Patients Without ARDS: High, Low, or in Between? Sarina K. Sahetya, Ewan C. Goligher, Arthur S. Slutsky JAMA. Published online December 9, 2020. doi:10.1001/jama.2020.23067 Positive pressure ventilation is lifesaving for patients with acute respiratory failure and has been the cornerstone of care for critically ill patients since the polio epidemic in the 1950s. Increasing end-expirato...