Reduced Plasma Volume Response to Crystalloid Fluid in Goal‑Directed Fluid Therapy In ICU Wed, 25 Jun 2025 Anaesthetists use fluids and drugs during surgery to maintain adequate tissue perfusion pressure and oxygenation. Goal-directed therapy (GDT) is a strategy aimed at optimising cardiovascular function and organ perfusion during the perioperative period by closely monitoring haemodynamic parameters such as cardiac output (CO), blood pressure, oxygen...

Original Investigation  Neurology Acute Surgery vs Conservative Treatment for Traumatic Acute Subdural Hematoma Thomas A. Van Essen, John K. Yue, Jason Barber, et al JAMA Netw Open 2025;8;(10):e2535200. doi:10.1001/jamanetworkopen.2025.35200 Key Points Question  Among US trauma centers, is a treatment strategy for traumatic acute subdural hematoma (ASDH) preferring acute surgery superior to one preferring conservative treatment? Finding...

Pulse Oximetry for Predicting Clinical Deterioration in Sepsis In Sepsis Wed, 25 Jun 2025 Sepsis is a life-threatening condition caused by a dysregulated response to infection, leading to organ dysfunction and high mortality—about 10% overall and over 40% in septic shock cases. Early detection of patients at risk of deterioration in the emergency department (ED) is critical for timely treatment and appropriate patient disposition. Existing tools like t...

Articles Acute pulmonary embolism in children and adolescents in the USA (2016 and 2019): a nationwide retrospective cohort study Simon Wolf, Luca Valerio, Nils Kucher, et al Lancet Respir Med 2025; 13: 393-402 https://doi.org/10.1016/S2213-2600(24)00412-0 Summary Background Epidemiological data on acute pulmonary embolism among children and adolescents are sparse and only date back to the 2000s. We aimed to establish annual estimates and ag...

Editorial  A Revision to Organ Failure Assessment in Critically Ill Patients Christopher W. Seymour JAMA Published Online: October 29, 2025 doi: 10.1001/jama.2025.20255 Modern intensive care of critically ill patients is evolving. Nearly 1 in 5 hospitalized patients receive intensive care, and there are new diseases, treatments, and approaches to organ support. Many intensive care unit (ICU) patients develop acute, vital organ failure—a nefarious and u...

Consensus Statement  Critical Care Medicine Rationale and Methodological Approach Underlying the Development of the Sequential Organ Failure Assessment (SOFA)–2 Score: A Consensus Statement Rui Moreno, Andrew Rhodes, Otavio Ranzani, et al JAMA Netw Open 2025;8;(10):e2545040. doi:10.1001/jamanetworkopen.2025.45040 Key Points Question  Can an update to the Sequential Organ Failure Assessment (SOFA) score that reflects current clinical practi...

Editorial  Sodium Bicarbonate in Severe Acidemia and Acute Kidney Injury—Turning the Tide or Chasing a Myth? Prit Kusirisin, Fernando G. Zampieri, Sean M. Bagshaw JAMA Published Online: October 29, 2025 doi: 10.1001/jama.2025.20457 Severe acidemia commonly complicates critical illness.1 If unresolved or untreated, acidemia may exacerbate multiorgan dysfunction, prompt escalation in life support, and portend greater risk of adverse outcomes. Intravenous...

Original Investigation  Caring for the Critically Ill Patient Development and Validation of the Sequential Organ Failure Assessment (SOFA)-2 Score Otavio T. Ranzani, Mervyn Singer, Jorge I. F. Salluh, et al JAMA Published Online: October 29, 2025 doi: 10.1001/jama.2025.20516 Key Points Question  Does an updated Sequential Organ Failure Assessment (SOFA)-2 score describe organ dysfunction in critically ill patients and its association wi...

Editorial  Capillary Refill Time in Sepsis—Searching for the Holy Grail Flavia R. Machado, Matthew W. Semler JAMA Published Online: October 29, 2025 doi: 10.1001/jama.2025.20518 Almost 25 years ago, a landmark trial of early goal-directed therapy (EGDT) by Rivers and colleagues reshaped the care of septic shock by introducing the concept that “early” management was crucial.1 Although implementation has varied across high- and low-resource settings, the...

Original Investigation  Caring for the Critically Ill Patient Sodium Bicarbonate for Severe Metabolic Acidemia and Acute Kidney Injury: The BICARICU-2 Randomized Clinical Trial Boris Jung, Mathieu Jabaudon, Audrey De Jong, et al JAMA Published Online: October 29, 2025 doi: 10.1001/jama.2025.20231 Key Points Question  For patients with severe metabolic acidosis and moderate to severe acute kidney injury, does sodium bicarbonate infusion ...