Research Letter  Climate Change and Health September 21, 2023 Canadian Wildfire Smoke and Asthma Syndrome Emergency Department Visits in New York City Kai Chen, Yiqun Ma, Michelle L. Bell, et al JAMA. 2023;330(14):1385-1387. doi:10.1001/jama.2023.18768 The wildfires in Canada in 20231 deteriorated air quality locally and distantly. For example, the smoke of wildfires in Quebec drifted into New York City (NYC), hundreds of kilometers away, and c...

Critical Care Staffing in Pandemics The COVID-19 pandemic has had significant impact on healthcare, with millions of cases and deaths reported globally. Healthcare workers have been particularly affected, experiencing increased mental health issues, burnout, and moral distress. The pandemic has led to higher levels of anxiety, depression, stress reactions, sleep disturbances, and posttraumatic stress disorder among healthcare staff. Prolonged exposure to high-inten...

Teachable Moment  February 13, 2023 Time-Limited Trials of Intensive Care Unit Care John J. Popovich, Isadore Budnick, Thanh H. Neville JAMA Intern Med. 2023;183(4):360-361. doi:10.1001/jamainternmed.2022.6792 Story From the Front Lines Apatient in their 70s with pancreatic adenocarcinoma with known hepatic metastases and peritoneal carcinomatosis was admitted from the emergency department due to gastric outlet obstruction. Prior to admission, the p...

Artificial Intelligence-Generated Manuscripts The healthcare industry is seeing remarkable technological progress. Several new tools have emerged that could significantly influence scientific research. One notable tool is RTutor, which combines the R programming language with GPT-3. This integration allows users to create R code and conduct analyses using plain language explanations of data and desired procedures. This means that even without coding skills, users c...

Original Investigation  November 11, 2023 Effect of Dietary Sodium on Blood Pressure: A Crossover Trial Deepak K. Gupta, Cora E. Lewis, Krista A. Varady, et al JAMA. Published online November 11, 2023. doi:10.1001/jama.2023.23651 Key Points Question  What is the impact of dietary sodium intake on blood pressure in middle-aged to elderly individuals? Findings  In this prospectively allocated diet order crossover study...

ORIGINAL ARTICLE A Placebo-Controlled Trial of Percutaneous Coronary Intervention for Stable Angina Christopher A. Rajkumar, Michael J. Foley, Fiyyaz Ahmed-Jushuf, et al N Engl J Med November 11, 2023DOI: 10.1056/NEJMoa2310610 Abstract BACKGROUND Percutaneous coronary intervention (PCI) is frequently performed to reduce the symptoms of stable angina. Whether PCI relieves angina more than a placebo procedure in patients who are not receiving antianginal m...

EDITORIAL| VOLUME 164, ISSUE 4, P812-813, OCTOBER 2023 Fluid Therapy in Sepsis: Does It Matter How Much? Jonathan A. Silversides, Bram Rochwerg Chest 2023; 164: 812-813 DOI:https://doi.org/10.1016/j.chest.2023.05.027 Although IV fluid resuscitation is a fundamental element of sepsis management, debate regarding the ideal volume, type, timing, and physiologic targets is ongoing. A number of large randomized trials have been published addressing this importan...

Research Letter  October 9, 2023 Analysis of Devices Authorized by the FDA for Clinical Decision Support in Critical Care Jessica T. Lee, Alexander T. Moffett, George Maliha, et al JAMA Intern Med. Published online October 9, 2023. doi:10.1001/jamainternmed.2023.5002 The use of predictive clinical decision support (CDS) devices (ie, those that use machine learning [ML] or artificial intelligence [AI]) has the potential to improve outcomes in ...

Angiotensin II in Critically Ill Patients In December 2017, angiotensin II (ATII) intravenous infusion gained approval in the U.S. for treating septic or other distributive shock in adults. This approval was based on results from a phase II clinical trial which showed higher mean arterial pressure in septic shock patients on norepinephrine, who were randomly assigned to titrated ATII compared to placebo. However, the adoption and usage of ATII in clinical practice ...

ORIGINAL ARTICLE Restrictive or Liberal Transfusion Strategy in Myocardial Infarction and Anemia Jeffrey L. Carson, Maria Mori Brooks, Paul C. Hébert, et al N Engl J Med November 11, 2023DOI: 10.1056/NEJMoa2307983 Abstract BACKGROUND A strategy of administering a transfusion only when the hemoglobin level falls below 7 or 8 g per deciliter has been widely adopted. However, patients with acute myocardial infarction may benefit from a higher hemoglobin lev...