Inflammatory Subphenotype and Brain Dysfunction in Mechanically Ventilated Patients In ICU Wed, 3 Jul 2024 Up to 80% of mechanically ventilated ICU patients experience acute brain dysfunction, commonly manifesting as delirium or coma. Both conditions are linked to increased mortality and long-term cognitive impairment in survivors. The underlying pathophysiology of acute brain dysfunction during respiratory failure is poorly understood.  Previo...

Novel Lipopeptide Effective Against Staphylococcus Aureus In ICU Fri, 7 Jun 2024 A novel antibacterial lipopeptide produced by the bacterium Serratia marcescens is highly effective in killing Staphylococcus aureus, one of the most significant pathogens in humans. Staphylococcus aureus is among the five most common causes of hospital-acquired infections, often leading to life-threatening infections following surgery. Since the int...

Sex Differences in SOFA Score of Sepsis Patients In Sepsis Tue, 2 Jul 2024 Sepsis is a life-threatening condition caused by a dysregulated host response to infection. The Sepsis-related Organ Failure Assessment (SOFA) score, developed in 1996, quantifies organ dysfunction across six systems: neurological, cardiovascular, respiratory, renal, liver, and coagulation. Initially specific to sepsis, the SOFA score is widely used in ICUs for daily patient mon...

Nirmatrelvir-Ritonavir for Long-COVID In ICU Sun, 9 Jun 2024 In a recent clinical trial, a 15-day course of nirmatrelvir-ritonavir targeting SARS-CoV-2 was found to be safe as an extended-duration treatment. However, it did not alleviate specific symptoms of long COVID. These findings are published in JAMA Internal Medicine. The combination of nirmatrelvir-ritonavir is approved by the FDA for treating acute COVID-19 in newly infected adults, with mi...

VV-ECMO, Prone Position and Supine MV for Hypoxaemic ARDS In ICU Tue, 11 Jun 2024 Severe acute respiratory distress syndrome (ARDS) with PaO2/FiO2 < 80 mmHg is life-threatening, and its optimal management strategy is unclear. This meta-analysis aimed to compare the effects of low tidal volumes (Vt), moderate Vt, prone ventilation, and venovenous extracorporeal membrane oxygenation (VV-ECMO) on mortality in severe ARDS. Study researchers conducted...

LLM Capabilities in Perioperative Risk Prediction, Prognostication In ICU Tue, 11 Jun 2024 General-domain large language models may perform risk stratification and predict postoperative outcome measures using procedure descriptions and a patient's electronic health record notes. A recent study examined the predictive performance of a model on eight tasks: prediction of American Society of Anesthesiologists Physical Status (ASA-PS), hospital admissio...

Effectiveness of Alternative Spontaneous Breathing Trial Techniques In ICU Tue, 11 Jun 2024 For intubated critically ill adults and children, minimising invasive mechanical ventilation to reduce complications is crucial. Early identification of when patients can safely transition to spontaneous breathing aims to shorten ventilation duration. However, clinicians must balance this with the risk of reintubation, which occurs in about 10% of cases, particu...

Ethical, Religious Barriers to Providing Medical Aid in Dying In ICU Sun, 2 Jun 2024 Recently published research by the University of Colorado Anschutz Medical Campus examines the prevalence and impact of physicians’ ethical or religious barriers to involvement in medical aid in dying (MAiD). MAiD is a multi-step process where a physician provides a terminally ill adult with decision-making capacity a lethal dose of medication to end their life. The re...

Incidence of Traumatic Brain Injury in Older Adults In ICU Sun, 2 Jun 2024 According to a study by UC San Francisco and the San Francisco VA Health Care System, approximately 13% of older adults are diagnosed with traumatic brain injury (TBI), typically caused by ground-level falls. The findings are published in JAMA. Researchers tracked around 9,200 Medicare enrollees, with an average age of 75 at the study’s outset. The study aimed to identify fac...

Invited Commentary  May 8, 2024 Surgical Competency Assessment Using Entrustable Professional Activities Stephanie L. Nitzschke, Stanley W. Ashley, Gilbert R. Upchurch Jr JAMA Surg. 2024;159(7):809. doi:10.1001/jamasurg.2024.0815 This year the American Board of Surgery (ABS) endorsed the use of entrustable professional activities (EPAs), a competency-based assessment tool, in all general surgery residencies.1 This represents the next step in a vis...