Editorial  Prone Positioning in Viral Bronchiolitis—Back to the Back? Joseph G. Kohne, Susan R. Conway, Steven L. Shein JAMA Published Online: June 17, 2026 doi: 10.1001/jama.2026.11742 Acute viral bronchiolitis is the most common diagnosis in US children’s hospitals, and respiratory failure is the costliest diagnosis across all pediatric acute care.1 Despite the prevalence of this condition and its impact on children, families, and health systems, evi...

Stepwise Clinical and Diagnostic Strategy for Coma In ICU Thu, 14 May 2026 A narrative review presents a structured, physiology-based diagnostic strategy for patients with coma of unknown origin. Coma is defined as a state of unarousable unresponsiveness characterised by the complete absence of both arousal and awareness. It represents one of the most urgent and diagnostically challenging conditions in acute care, particularly when there is no obvious ...

Extracorporeal Life Support and Modification of Haemostasis In ICU Thu, 14 May 2026 The ELMOH (ExtracorporeaL life support and Modification Of Hemostasis) trial investigated how coagulation changes during the first 48 hours of extracorporeal membrane oxygenation (ECMO) and whether these changes differ between venovenous (VV) and venoarterial (VA) ECMO. ECMO is increasingly used in critically ill patients with severe respiratory or circulatory failure, ...

Invited Commentary  To Tube or Not to Tube—A Case for Early Enteral Nutrition Yuqi Zhang, Krista Haines, Suresh Agarwal JAMA Surg 2026;161;(6):583. doi:10.1001/jamasurg.2026.1058 The early introduction of enteral feeding after surgery is well recognized as a cornerstone of Enhanced Recovery After Surgery (ERAS) protocols, consistently shown to reduce postoperative infections and mortality across multiple surgical domains. Although prior studies have compa...

Definition of Refractory Septic Shock: Consensus from SCCM and ESICM In Sepsis Wed, 25 Mar 2026 A consensus process conducted by the Society of Critical Care Medicine (SCCM) and the European Society of Intensive Care Medicine (ESICM) to establish clinical criteria for defining refractory septic shock, a severe and poorly standardised subset of septic shock, was presented at the SCCM Congress this week. Sepsis is defined as life-threatening organ dys...

Early Vasopressin Administration in Septic Shock In Sepsis Thu, 14 May 2026 A recent study examined whether starting vasopressin earlier in the course of septic shock improves patient outcomes. Septic shock is a severe form of sepsis characterised by profound circulatory failure and high mortality. Norepinephrine is the recommended first-line vasopressor, but escalating doses can cause adverse effects such as arrhythmias and myocardial injury. Vasopres...

EDITORIAL Sodium Bicarbonate in Critical Illness — A New Chapter for the Book Marlies Ostermann, Deborah J. Cook N Engl J Med 2026;395:1124-1127 DOI: 10.1056/NEJMe2610218 Acute metabolic acidosis is common in hospitalized patients owing to conditions such as shock, kidney disease, and diabetic ketoacidosis. While the underlying cause is being treated, it may be tempting to use buffer solutions concurrently to try to raise extracellular pH, particularly in c...

Invited Commentary  Exchange Transfusion for Severe Babesiosis—Insights From a Multicenter Retrospective Analysis Eric A. Meyerowitz, Johanna P. Daily JAMA Intern Med Published Online: March 30, 2026 doi: 10.1001/jamainternmed.2026.0252 Babesia microti is a tickborne intraerythrocytic parasite reported in at least 24 states across the US, with 1827 cases reported in 2020.1 Rising cases have been attributed to climate and weather changes across the coun...

Six Phases of Prolonged Veno-Venous Extracorporeal Membrane Oxygenator Support In ICU Wed, 6 May 2026 A new article proposes a novel conceptual framework to guide the management of patients undergoing prolonged veno-venous extracorporeal membrane oxygenation (V-V ECMO) for severe respiratory failure. V-V ECMO is an invasive, resource-intensive therapy used in cases of refractory hypoxaemic respiratory failure, particularly acute respiratory distress sy...

Comment Kidney xenotransplantation—bridge to allotransplantation or destination treatment? Alexandre Loupy, Aurélie Sannier, Gabriel C Oniscu Lancet 2026; 408: 976-978 https://doi.org/10.1016/S0140-6736(26)01479-0 The shortage of human kidneys remains a central problem in transplantation, and many candidates die or are removed from the waiting list before an organ becomes available.1Genetically engineered porcine kidneys have long been proposed to expand th...