Less is More in Shock Management In ICU Tue, 6 May 2025 Permissive hypotension, phenotyping shock, vasopressor selection and timing, and emerging interest in beta-blockade for septic patients. It is important to reconsider conventional aggressive approaches to shock management and explore the evolving concept of permissive hypotension. There is a need to avoid reflexively treating all hypotension with vasopressors or fluids and instead focus on patient-...

Research Letter  Initial Antibiotic Selection Strategy and Subsequent Antibiotic Use—Insights From the INSPIRE Trials Shruti K. Gohil, Edward Septimus, Ken Kleinman, et al JAMA Published Online: July 17, 2025 doi: 10.1001/jama.2025.11256 Four cluster-randomized trials have demonstrated that a stewardship bundle including real-time computerized provider order entry (CPOE) prompts safely reduced initial extend...

Critical Care: Research Letters Use of High-Dose Hydroxocobalamin for Septic Shock Jason R. Carr, Brian Locke, Jayshil J. Patel, et al Chest 2025; 168: 131-135 To the Editor: Septic shock, a global health burden with a case fatality rate exceeding 40%, is initiated and maintained by circulating nitric oxide and hydrogen sulfide that are emergent targets of therapeutic interest.1 High-dose (5-gm) hydroxocobalamin (vitamin B12) (HD-HOC) scavenges circula...

Original Investigation  Infectious Diseases Estimated Burden of Influenza and Direct and Indirect Benefits of Influenza Vaccination Mary G. Krauland, Alexis Mandell, Mark S. Roberts JAMA Netw Open 2025;8;(7):e2521324. doi:10.1001/jamanetworkopen.2025.21324 Key Points Question  What is the estimated influenza case burden, both direct and indirect, averted by vaccination? Findings  This decision ana...

Research Letter  Oncology “Me-Too” Drugs Compared With Original Drugs in Randomized Clinical Trials Timothée Olivier, Calvin Smith, Vinay Prasad, et al JAMA Intern Med Published Online: July 14, 2025 doi: 10.1001/jamainternmed.2025.2892 The development of “me-too” or “next-in-class” drugs in oncology may offer benefits including improved efficacy, better safety profiles, or economic competition.1,2 Addi...

Enteral Nutrition in Critically Ill Patients  In ICU Tue, 6 May 2025 Enteral nutrition delivers essential nutrients to treat or prevent disease-related malnutrition in critically ill patients. This malnutrition, influenced by poor intake and inflammation, can impact the effectiveness of nutrition therapy. Evidence from recent randomised trials in both critically ill and non-critically ill patients has shaped current practices.  A recent re...

Editorials Addressing the indirect health burden of covid-19 Zhihao Lei BMJ 2025; 390 doi: https://doi.org/10.1136/bmj.r1268 (Published 02 July 2025)Cite this as: BMJ 2025;390:r1268 Consider collateral impacts when planning for future crises The covid-19 pandemic’s impact extends far beyond the direct effects of infection and death, resulting in sharp increases in other causes of illness and death that demand attention. A new time-series analysis of the Glo...

Original Investigation  Public Health Body Mass Index in Children Before, During, and After the COVID-19 Pandemic Frederik Kirkemann Jensen, Sigrid Bjerge Gribsholt, Sara Schwartz, et al JAMA Netw Open 2025;8;(7):e2519528. doi:10.1001/jamanetworkopen.2025.19528 Key Points Question  Did prevalence of underweight, overweight, and obesity in schoolchildren change during and after the COVID-19 pandemic compared wi...

In-Hospital Mortality Using Admission CT Perfusion in Severe TBI  In ICU Tue, 6 May 2025 Traumatic brain injury (TBI) is classified into mild, moderate, and severe categories, with severe TBI (defined by a Glasgow Coma Scale ≤8) being the leading cause of hospitalisation, disability, and mortality worldwide. Globally, over 50 million people suffer from TBI annually, costing around $400 billion each year. Severe TBI is a clinical emergency that ...

Research Global, regional, and national characteristics of the main causes of increased disease burden due to the covid-19 pandemic: time-series modelling analysis of global burden of disease study 2021 Can Chen, Wenkai Zhou, Yifan Cui, et al BMJ 2025; 390 doi: https://doi.org/10.1136/bmj-2024-083868 (Published 02 July 2025)Cite this as: BMJ 2025;390:e083868 Abstract Objective To quantify and identify the main caus...