Prehospital Cricothyrotomy in Emergency Airway Management In ICU Thu, 3 Jul 2025 Cricothyrotomy, an emergency airway procedure through the cricoid membrane, has been used in emergency and prehospital settings since the 1980s. Due to its rarity and high risk of error, it is considered a high-risk, low-occurrence procedure. Understanding when EMS performs cricothyrotomy is crucial to improving training and prehospital airway care. Several studies have...

Environmental Sustainability in Intensive Care Medicine In ICU Thu, 3 Jul 2025 The climate crisis requires decarbonisation across all major emission sectors, including healthcare, which contributes 4–5% of global emissions due to its complex supply chains, high energy use, and waste. Ninety-three countries have committed under a WHO initiative to develop environmentally responsible health systems. Addressing healthcare emissions needs a multi-faceted e...

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...

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...

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...

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...

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...

EDITORIAL A Less Invasive Approach to Intensive Care Hayley B. Gershengorn N Engl J Med Published October 29, 2025 DOI: 10.1056/NEJMe2512006 The intensive care unit (ICU) conjures images of unconscious patients surrounded by machines and penetrated by devices — endotracheal tubes, surgical drains, and urinary, venous, and arterial catheters. Although this scenario may be necessary for some patients, for many, high-quality studies have shown benefits of a di...

EDITORIAL Glucocorticoids for Pneumonia in Africa — Old Therapy, New Context Arthur Kwizera, Martin W. Dünser Published October 29, 2025 DOI: 10.1056/NEJMe2514533 The African continent is home to 1.55 billion people, one fifth of the world’s population, spread over an area larger than the United States, China, and India combined. The disease burden is enormous,1 and health care resources are severely constrained. In one multinational survey, one i...

Machine Learning vs Humans: Identifying Trauma Patients in Need of Haemorrhage Control Resuscitation In ICU Mon, 16 Jun 2025 Timely identification of haemorrhage control resuscitation (HCR) needs in trauma patients is challenging due to inconsistent recognition and decision-making, which delay treatment and harm outcomes. Traditional clinical tools like scores and flowcharts are easy to use but often lack predictive accuracy and are poorly integrated i...