Original Investigation  Critical Care Medicine February 5, 2025 Neurodevelopmental Outcomes After Nitric Oxide During Cardiopulmonary Bypass for Open Heart Surgery: A Randomized Clinical Trial Debbie A. Long, Kristen S. Gibbons, Stephen B. Horton, et al JAMA Netw Open. 2025;8(2):e2458040. doi:10.1001/jamanetworkopen.2024.58040 Key Points Question  Does nitric oxide (NO) administered via cardi...

Timing of Invasive Mechanical Ventilation in Patients With Sepsis In Sepsis Mon, 16 Sep 2024 Mechanical ventilation (MV) can be both beneficial and harmful for critically ill patients. It improves gas exchange, reduces the work of breathing, and lowers self-inflicted lung injury risk. MV, often accompanied by sedatives and neuromuscular blockers, can also reduce oxygen consumption and carbon dioxide production, and in patients with cardiac issues, it m...

Consensus Statement  Critical Care Medicine February 3, 2025 Extracorporeal Blood Purification in European Pediatric Intensive Care Units: A Consensus Statement Gabriella Bottari, Emanuele Buccione, Benan Bayrakci, et al JAMA Netw Open. 2025;8(2):e2457657. doi:10.1001/jamanetworkopen.2024.57657 Abstract Importance  Important advances have been made in extracorporeal blood purification ther...

Editorial Extubation Failure Among Patients With Obesity Amit Kansal, Maurizio Cecconi Chest 2025; 167: 11-13 https://doi.org/10.1016/j.chest.2024.08.021 Up to 10% of the adult patients who are being mechanically ventilated in ICUs suffer from extubation failure after planned extubation.1 The risk may increase to 20% among the high-risk patients2; those older than 65 years; and those with underlying cardiac disease, chronic respiratory disord...

ABYSS Trial: Cardiovascular Safety of Interrupting Beta-Blockers In ICU Fri, 30 Aug 2024 New research shows that discontinuing beta-blockers in patients with a history of myocardial infarction (MI) did not demonstrate cardiovascular safety compared to continuation and provided no improvement in patients' quality of life. Advancements in MI management and findings from observational studies have led to questions about the necessity of continuing beta...

Critical Care: Original Research Prophylactic Antibiotics in Adults With Acute Brain Injury Who Are Invasively Ventilated in the ICU: A Systematic Review and Meta-Analysis Kathryn Hadley-Brown, Laura Hailstone, Roisin Devane, et al Chest Available online 28 October 2024 https://doi.org/10.1016/j.chest.2024.10.031 Background Lower respiratory tract infections are common in patients receiving invasive mechanical ventilation in an ICU after an acute brain i...

Editorial Beta Blockers and Septic Shock: More Work to Do Tony Whitehouse, Mervyn Singer Chest 2025; 167: 9-10 https://doi.org/10.1016/j.chest.2024.09.007 Despite over 40 years of research, the search for an intervention that can alter clinical outcomes from septic shock remains elusive. Survival has improved, in part because of earlier recognition and treatment and in part because of reduced iatrogenic harm. However, mortality rates remain unacceptably hig...

Critical Care: Original Research Comparative Effectiveness of Albumin vs No Albumin on Renal Replacement Therapy and Mortality in Patients With Septic Shock and Renal Impairment Asad E. Patanwala, Alexander H. Flannery, Hemalkumar B. Meht, et al Chest Available online 18 October 2024 https://doi.org/10.1016/j.chest.2024.10.012 Background Albumin infusions may be renally protective or harmful in patients with septic shock who have kidney impairment. This ...

The Hazards of Monitoring – Alarm Fatigue in the ICU In ICU Fri, 17 May 2024 Alarm fatigue is a pressing clinical problem in our post-pandemic ICUs and can adversely impact patient outcomes. Its root causes can be classified by patient, device and organisation related. We believe it can be mitigated and we propose interventions through attention to policy, education and the creation of a meaningful culture of safety. "There are more things to alarm us t...

Critical Care: Original Research Lower or Higher Oxygenation Targets in Patients With COVID-19 in the ICU: A Secondary Bayesian Analysis of the Handling Oxygenation Targets in COVID-19 Trial Frederik Mølgaard Nielsen, Thomas Lass Klitgaard, Anders Granholm, et al Chest Available online 18 September 2024 https://doi.org/10.1016/j.chest.2024.08.055 Background In the Handling Oxygenation Targets in COVID-19 (HOT-COVID) trial, a Pao2 target of 60 mm&n...