Serum Cardiac Troponin Elevation and Sepsis Mortality  In Sepsis Mon, 17 Feb 2025 Sepsis, as defined by Sepsis-3, is a life-threatening organ dysfunction caused by a dysregulated response to infection, with high mortality rates, especially in septic shock. Sepsis can cause acute myocardial injury, and high-sensitivity cardiac troponin (hs-cTn) assays are increasingly used to detect cardiac injury in these patients. While previous studies linked el...

Invited Commentary  Critical Care Medicine March 28, 2025 Active Prevention and Treatment of Post–Critical Illness Anemia—Is It Time for Large Effectiveness Trials? Timothy S. Walsh JAMA Netw Open. 2025;8(3):e252368. doi:10.1001/jamanetworkopen.2025.2368 Anemia is prevalent following critical illness and is associated with delayed recovery, functional impairments, and reduced quality of life.1 Evidence tells us that restrict...

Vasopressor Therapy and Intensive Care Patient Management In ICU Mon, 17 Feb 2025 Vasopressors are commonly used in critically ill patients to increase vascular tone in cases of severe hypotension with signs of altered tissue perfusion, such as poor skin perfusion, altered mental status, or decreased urine output—indicative of shock. Shock is associated with elevated lactate levels (>2 mmol/L) and can be classified into four types: hypovolaemic, car...

Editorial  May 19, 2025 The Case for Economic Analyses in Trials With a No Effect Primary Outcome Brian H. Cuthbertson, Gordon Rubenfeld JAMA Netw Open. 2025;8(5):e2517477. doi:10.1001/jamanetworkopen.2025.17477 In this edition of JAMA Network Open, the article “Cost-Effectiveness of α2-Agonists for Intravenous Sedation in Patients With Critical Illness”1 derives from an in-trial cost-utility analysis of a 3-drug regimen for...

Invited Commentary  Surgery March 25, 2025 Robotic-Assisted Cholecystectomy—for Whom? David R. Urbach JAMA Netw Open. 2025;8(3):e251711. doi:10.1001/jamanetworkopen.2025.1711 To assess whether robotic-assisted cholecystectomy is superior to laparoscopic cholecystectomy in the prevention of bile duct injury, Mullens and colleagues1 conducted a retrospective study of 737 908 Medicare beneficiaries, including 295 807 in an experimental c...

Editorial  May 19, 2025 The Search for the Single Best Sedative Edward T. Qian, Todd W. Rice JAMA. Published online May 19, 2025. doi:10.1001/jama.2025.7359 Critically ill patients receiving invasive mechanical ventilation often require continuous infusion of sedation to address pain and anxiety. The search for the single best sedative agent for critically ill patients has been the topic of investigations for decades. Propofol, a lipid-based ...

Propranolol to Reduce Sedatives for Patients Receiving Mechanical Ventilation In ICU Mon, 24 Feb 2025 Critically ill patients require sedation for mechanical ventilation, with dexmedetomidine and propofol being the first-line options. However, the COVID-19 pandemic led to global shortages of propofol, while dexmedetomidine is costly and not ideal for deep sedation. Benzodiazepines, another alternative, are linked to higher mortality in sepsis, increase...

Precision in Nutrition Therapy In ICU Mon, 24 Feb 2025 A recent review discusses the challenges of evaluating nutrition strategies in critically ill patients through multicenter randomised controlled trials (RCTs). While smaller observational studies showed promise, many large-scale RCTs have failed to demonstrate effectiveness and have even indicated potential harm from some interventions. This discrepancy may stem from individual differences in patie...

Balancing Risk and Benefit: The Role of CT in Sepsis Management In Sepsis Sun, 2 Feb 2025 Sepsis remains a leading cause of morbidity and mortality, requiring rapid and precise intervention to improve patient outcomes. Early detection and management are critical, as delayed treatment can significantly increase the risk of progression to septic shock and multiple organ failure. Computed tomography (CT) is widely used to identify infectious foci, providi...

Monitoring and ICP-Driven Therapies in TBI Using nICP Systems In ICU Tue, 4 Feb 2025 Intracranial hypertension after traumatic brain injury (TBI) leads to secondary brain damage, high mortality, and poor outcomes. Invasive intracranial pressure (ICP) monitoring using intraparenchymal or intraventricular systems is the gold standard for guiding TBI treatment. The Seattle International Severe Traumatic Brain Injury Consensus Conference (SIBICC) developed...