Risk Factors for Subsyndromal Delirium Progression and Mortality In ICU Tue, 25 Mar 2025 Delirium is common in critically ill patients and is linked to poor outcomes like prolonged hospital stays and cognitive impairment. Subsyndromal delirium (SSD) is an intermediate state between no delirium and full delirium, involving cognitive and behavioural abnormalities without meeting DSM-5 criteria for delirium. SSD affects about one-third of ICU patients and...

Editorial  Beyond Obstruction—A Milestone in COPD Diagnosis Francesca Polverino JAMA 2025;333;(24):2151-2153 doi:10.1001/jama.2025.6653 The landscape of chronic obstructive pulmonary disease (COPD) is changing rapidly. Thanks to long-term studies tracking lung function and the integration of advanced imaging and analytic tools, we now have a much deeper understanding of how COPD presents in different patients. The emergence of multiomic technologies ha...

Ventilation-Induced AKI in Acute Respiratory Failure In ICU Tue, 25 Mar 2025 Mechanical ventilation increases the risk of acute kidney injury (AKI) in critically ill patients, with studies indicating a three-fold higher risk compared to non-ventilated patients. The lung-kidney cross-talk during mechanical ventilation occurs through three primary mechanisms: (1) gas exchange abnormalities (hypoxaemia and hypercapnia) impair renal blood flow, (2) inflamm...

Editorial Is a “Fine Tuning” of the Flow Rate During High Flow Oxygen Therapy Clinically Relevant?: The Optimal Setting of High Flow Nasal Cannula Should Be Explored Further Alessandro Galazzi, Giacomo Grasselli Chest 2025; 167: 1257-1258 The clinical effects of high flow nasal cannula (HFNC) include improvement of oxygenation, reduction of respiratory rate, inspiratory effort and dyspnea, amelioration of ventilation homogeneity and preservation of mucociliary...

Severe Sepsis and Septic Shock Management Bundle Compliance and Mortality In Sepsis Tue, 25 Mar 2025 Sepsis is a major cause of death and disability. The Centers for Medicare & Medicaid Services (CMS) aims to improve sepsis outcomes through the Severe Sepsis and Septic Shock Management Bundle (SEP-1), which hospitals must report compliance with. SEP-1, based on the Surviving Sepsis Campaign bundle, is linked to lower mortality rates.  CMS i...

Invited Commentary  April 10, 2025 Olfactory Impairment and Mortality—The Crossroads of Neurodegeneration, Frailty, and Aging Nicholas R. Rowan JAMA Otolaryngol Head Neck Surg. Published online April 10, 2025. doi:10.1001/jamaoto.2025.0161 Ruane and colleagues1 address a pressing and timely issue: the intersection of olfactory impairment (OI) and aging-related outcomes. While their focus is on OI and its association with mortality, this ...

What is the MINUTES Bundle?  In ICU Thu, 20 Mar 2025 The MINUTES bundle was discussed in one of the sessions @ISICEM in Brussels. The MINUTES bundle is a structured approach designed to guide healthcare professionals in the initial 30-minute management of patients presenting with undifferentiated circulatory shock. The acronym stands for Maintain ABCs, INfuse vasopressors and/or fluids, INvestigate, Ultrasound, Treat ...

Editor's Note  Less Is More March 17, 2025 Nudging Toward Effective and Scalable Palliative Care Interventions in Intensive Care Nathan M. Stall, Tracy Y. Wang, Sharon K. Inouye JAMA Intern Med. 2025;185(5):521. doi:10.1001/jamainternmed.2025.0100 More than 5 million patients are admitted to intensive care units (ICUs) across the US every year, and mortality rates average between 10% and 29% for ICU stays.1 Intensive care is characterized by th...

End-Tidal to Arterial PCO2 Ratio as Guide to Weaning from VV-ECMO In ICU Thu, 20 Mar 2025 A presentation on "End-Tidal to Arterial Pco₂ Ratio as Guide to Weaning from Venovenous Extracorporeal Membrane Oxygenation" @ISICEM explored the potential of the end-tidal to arterial carbon dioxide pressure ratio (PetCO₂/PaCO₂) as a predictor for successful weaning from venovenous extracorporeal membrane oxygenation (VV-ECMO) in patients suffering from severe ac...

Editorial  May 12, 2025 Morning or Nighttime Medication Dosing—Does It Matter in the Treatment of Hypertension? Sandra J. Taler JAMA. Published online May 12, 2025. doi:10.1001/jama.2025.7286 Normal circadian rhythm of blood pressure (BP), defined as a BP decline of 10% to 20% at night, is an important predictor of cardiovascular health and an indicator of cardiovascular disease (CVD) risk when absent. For treatment of hypertension, it has be...