Timing of anticoagulation after ischaemic stroke and atrial fibrillation: better swift than sorry Wendy C Ziai, Georgios Tsivgoulis Lancet Available online 23 June 2025 https://doi.org/10.1016/S0140-6736(25)00676-2 Non-valvular atrial fibrillation accounts for 13–26% of acute ischaemic strokes.1 Direct oral anticoagulants (DOACs) are highly effective in reducing the risk of ischaemic stroke with significantly lower rates of intracranial haemorrhage compar...

Burden of Brain Tissue Hypoxia, Metabolic Dysfunction in SAH  In ICU Mon, 28 Apr 2025 Non-traumatic subarachnoid haemorrhage (SAH) is a significant cause of death and disability globally, with an incidence of around 6 per 100,000 person-years. The initial treatment focuses on early aneurysm repair to prevent re-bleeding and reduce early brain injury risk. Management also addresses secondary brain injuries, including hydrocephalus, elevated intracr...

Non-Burn Dermatological Emergencies in Critical Care In ICU Tue, 22 Apr 2025 Non-burn dermatologic emergencies, although less common than burn injuries, are associated with high morbidity and mortality due to the extensive loss of the skin barrier. These conditions often mimic burn-related pathophysiology and demand urgent, multidisciplinary care. Optimal outcomes are typically achieved at specialised burn centres, but limited availability means that i...

Peri-Intubation Adverse Events and Clinical Outcomes In ICU Tue, 22 Apr 2025 Tracheal intubation (TI) is a critical procedure used in emergency departments (EDs) and ICUs worldwide, though it carries significant risks, especially in resource-limited settings. Major adverse events (MAEs) like haemodynamic instability, severe hypoxaemia, and cardiac arrest are common during the peri-intubation period and are associated with worse patient outcomes. Critic...

WHO Bacterial Priority Pathogens List In ICU Tue, 22 Apr 2025 Antimicrobial resistance (AMR) poses a significant global health threat, hindering the prevention and treatment of infections caused by bacteria, parasites, viruses, and fungi. Antibiotic-resistant pathogens are particularly problematic, leading to increased mortality and healthcare costs. In 2019, antibiotic-resistant infections caused an estimated 1.27 million deaths globally, with the gre...

Invited Commentary  Infectious Diseases April 15, 2025 Optimizing Personal Protective Equipment for a Sustainable Future Meghana A. Gadgil, Preeti Mehrotra JAMA Netw Open. 2025;8(4):e255269. doi:10.1001/jamanetworkopen.2025.5269 The important study by Sutjipto et al1 shows that deescalating personal protective equipment (PPE) requirements for COVID-19 can reduce cost and carbon impacts without compromising safety. This 24-month compar...

The Puzzle of Cognitive Impairment After ICU In ICU Tue, 15 Apr 2025 Critically ill patients, particularly those who experience delirium or require invasive mechanical ventilation, are at high risk for long-term cognitive impairments. Ventilator-associated brain injury is an emerging area of research, with experts emphasising the need for improved assessment tools and advanced statistical methods to evaluate brain dysfunction in conditions like acute r...

Editorial  Coagulopathy Treatment in Cardiac Surgery—Pharmacy or Blood Bank? Faisal G. Bakaeen, Mariya A. Geube JAMA Surg Published Online: June 11, 2025 doi: 10.1001/jamasurg.2025.1669 Cardiac surgery is the largest consumer of blood and blood derivatives in all surgical specialties, and it accounts for 15% of the nation’s allocated blood.1 This creates pressure on hospital resources and blood availability to meet transfusion requirements. In add...

Epinephrine vs Norepinephrine in Children With Septic Shock In Sepsis Tue, 15 Apr 2025 Sepsis remains a major cause of illness and death among children worldwide. Although mortality has decreased due to quality improvement initiatives and clinical guidelines, 4–10% of paediatric sepsis cases still result in death, often due to refractory shock or multiorgan dysfunction. For children with persistent shock despite fluid resuscitation, vasoactive agent...

Monitoring of Patients With Acute Respiratory Failure During Non-Invasive Respiratory Support In ICU Tue, 15 Apr 2025 Acute respiratory failure (ARF) is characterised by hypoaxemia, which may be accompanied by hypoventilation, hypercapnia, or isolated acute hypoxaemic respiratory failure (AHRF). This condition results in an inability to deliver adequate oxygen to organs and remove CO2, leading to acid-base imbalances. Although supplemental oxygen can s...