LLM Diagnostic Performance in Complex Critical Illness In ICU Wed, 11 Jun 2025 Large language models (LLMs) are increasingly used in healthcare for education, research, and clinical care. They have shown promise by passing all stages of the US Medical Licensing Exam and generating accurate, empathetic responses to patient queries, suggesting the potential to assist physicians in complex clinical decision-making, including differential diagnosis.  ...

Comment Infections in long-term care: burden affirmed, action needed Philipp Kohler, Allison McGeer Lancet Infect Dis Available online 16 June 2025 https://doi.org/10.1016/S1473-3099(25)00287-7 In The Lancet Infectious Diseases, Enrico Ricchizzi and colleagues report the results of a year-long study of the incidence of health-care-associated infections (HAIs) in long-term care facilities (LTCFs) in nine European countries.1 Using prospective surve...

Atrial Fibrillation in Critical Illness In ICU Wed, 11 Jun 2025 Atrial fibrillation (AF) presents significant management challenges in the ICU. Pre-existing AF affects 10–20% of ICU patients, while new-onset AF (NOAF) occurs in 5–15% of critically ill individuals and up to 46% in those with septic shock. NOAF may be transient or indicate an underlying predisposition, complicating treatment decisions.  AF in critical illness is linked to worse o...

Electronic Sepsis Screening and Mortality  In Sepsis Wed, 12 Mar 2025 Early recognition and treatment of sepsis are crucial for improving patient outcomes, leading to clinical guidelines recommending sepsis screening programmes. However, evidence supporting these programmes is limited. Observational studies suggest screening improves care processes, such as timely lactate measurement and antibiotic administration, and may reduce mortality. However...

Industry Payments and Prescription of Inhaled Medications In ICU Tue, 3 Jun 2025 The Physician Payments Sunshine Act mandates public disclosure of payments from pharmaceutical and medical device companies to clinicians. While previous research shows these payments can influence prescribing habits, less is known about their impact on drug-device combinations like inhalers. These products involve both medication and a delivery device, often requiring cli...

Intravenous Tenecteplase Before Endovascular Thrombectomy In ICU Tue, 3 Jun 2025 Intravenous thrombolysis before endovascular thrombectomy (EVT) in stroke patients has potential benefits for improving reperfusion but also carries a risk of increased intracranial haemorrhage. Since 2018, six randomised trials have found no significant difference in outcomes between combining thrombolysis (mainly with alteplase) and EVT versus EVT alone. Tenecteplase, a ...

OPTPRESS: Targeting High Mean Arterial Pressure for Patients With Septic Shock  In Sepsis Tue, 3 Jun 2025 Sepsis is a serious global health issue, with septic shock carrying a high mortality rate (~38.5%). The optimal blood pressure target for managing septic shock remains unclear. Recent trials show that maintaining a mean arterial pressure (MAP) above 65 mmHg isn’t always beneficial, but higher targets (80–85 mmHg) may help patients with chronic...

Editor's Note  What if Readmission Prevents Death?—The Challenge of Composite Outcomes Deborah Grady, Raegan W. Durant, Timothy S. Anderson JAMA Intern Med Published Online: August 11, 2025 doi: 10.1001/jamainternmed.2025.3709 Composite outcomes, which combine several different events into a single outcome, are frequently used in clinical trials. Clinical trials testing transition of care interventions often measure distinct outcomes such as readmissio...

#EA25: Managing the Bloody AirwayIn ICUMon, 26 May 2025 Difficult airway management is a core competency for any anaesthesiologist and can often mean the difference between life and death. Among the most complex and high-risk scenarios is the bloody airway, where active bleeding significantly impairs visibility and complicates even standard difficult airway techniques. Failure to control bleeding in the airway is a major contributor to airway-related mortality. ...

Invited Commentary  Antibiotic Prophylaxis in Variceal Hemorrhage—Time to Stop? Catherine Mezzacappa, Guadalupe Garcia-Tsao JAMA Intern Med Published Online: August 11, 2025 doi: 10.1001/jamainternmed.2025.3841 In their systematic review and bayesian meta-analysis published in this issue of JAMA Internal Medicine, Prosty et al1 assess the evidence supporting the universally recommended practice of administering prophylactic broad-spectrum ant...