Rethinking Septic Shock Management: Potential of Early Vasopressin Use to Enhance Patient Outcomes In ICU Thu, 28 Nov 2024 ICU Management & Practice, Volume 24 - Issue 5, 2024 Vasopressin timing, patient selection, optimal vasopressin use in septic shock, and potential mortality benefits in selected patient populations. Septic Shock Overview and Current Treatments Septic shock is a severe, life-threatening response to infection, character...

Invited Commentary  Medical Education January 9, 2025 Another Resident Survey—Useful to Whom? Julie L. Oyler, Jason T. Alexande JAMA Netw Open. 2025;8(1):e2454054. doi:10.1001/jamanetworkopen.2024.54054 Grbic and colleagues1 performed a cross-sectional study examining whether program director (PD) assessments of postgraduate year 1 (PGY-1) resident performance during the transition to residency differed by specialt...

Hypotension and Adverse Outcomes in Traumatic Brain Injury In ICU Mon, 18 Nov 2024 Traumatic brain injury (TBI) is a major cause of death and disability, with 60 million cases annually and 8.1 million years of disability worldwide. Hypotension, a common secondary injury in TBI, often results from blood loss or neurogenic causes like myocardial depression or brainstem herniation disrupting autonomic control. Hypotension significantly worsens outcomes, i...

Invited Commentary  January 2, 2025 Silent Cost of Private Equity Hospitals Aaron R. Dezube, Virginia R. Litle JAMA Surg. Published online January 2, 2025. doi:10.1001/jamasurg.2024.5983 As private equity acquisition of acute care hospitals increases across the US,1,2 it is time we examine not only the finance differentials of hospital ownership, but also the cost for patient surgical outcomes. Quality of care has appropriately become a ...

D-PRISM: Diagnostic and Treatment Approaches in Pneumonia In ICU Tue, 26 Nov 2024 Pneumonia is a major global health issue, particularly for critically ill patients in ICUs. It encompasses various types, such as community-acquired pneumonia (CAP), hospital-acquired pneumonia (HAP), and ventilator-associated pneumonia (VAP), each with distinct diagnostic and treatment challenges. Annually, pneumonia contributes to over 2.5 million deaths and costs appro...

Weaning Success Rate With High-Intensity and Sham Inspiratory Muscle Training In ICU Tue, 26 Nov 2024 Failure to wean from mechanical ventilation is common, affecting up to 35% of critically ill patients undergoing the weaning process and significantly worsening outcomes, including prolonged ICU stays, longer hospitalisations, and higher mortality risk. Respiratory muscle weakness, present in over 60% of mechanically ventilated patients, is a major con...

Invited Commentary  Pulmonary Medicine January 3, 2025 Evidence-Based Anticoagulation Choice for Acute Pulmonary Embolism Brandon C. Maughan, Christopher Kabrhel, Angela F. Jarman JAMA Netw Open. 2025;8(1):e2452850. doi:10.1001/jamanetworkopen.2024.52850 Systemic anticoagulation is the foundation of treatment for most patients with pulmonary embolism (PE). Guidelines recommend that most patients hospitalized for acute PE who are treated wi...

Adjunctive Vasopressin Initiation for Septic Shock Patients In Sepsis Tue, 26 Nov 2024 Vasoactive drugs are commonly prescribed to critically ill adult patients in ICUs, with noradrenaline being the first-line treatment for septic shock. Vasopressin, a second-line vasopressor, is also widely used. However, there is uncertainty regarding the timing of vasopressin initiation.  The VASST and VANISH trials, which investigated vasopressin in septic ...

Humidified NIV vs High-Flow Therapy for Preventing Reintubation in Obese Patients In ICU Tue, 12 Nov 2024 Research on weaning obese patients from mechanical ventilation has shown mixed results. Early studies linked obesity to prolonged ventilation, while later research, after adjusting for BMI and other biases, found a protective effect, such as faster extubation with no increase in reintubation rates. A recent meta-analysis, however, excluded BMI as a...

Fibre-Supplemented Enteral Nutrition in Critically Ill Patients In ICU Tue, 12 Nov 2024 Critical illness often disrupts gut function, metabolism, and immune function, leading to malnutrition. Enteral nutrition (EN) is preferred for critically ill patients, but up to 75% face feeding intolerance, resulting in poor nutrient delivery and GI symptoms. Dietary fibre (DF) has health benefits, including supporting gut integrity and immune responses, which may...