Ceftriaxone to Prevent Early VAP in Patients With Acute Brain Injury Patients with acute brain injury are at high risk of ventilator-associated pneumonia (VAP). The debate surrounding the benefit of short-term antibiotic prophylaxis in this population is a key aspect of the investigation. The objective of this study was to determine the impact of a single early dose of the antibiotic ceftriaxone on the incidence of early VAP in patients with severe brain injury ...

Editorial  May 13, 2024 Can Cardiovascular Risk Assessment Be Improved in the 21st Century? Thomas A. Gaziano, J. Michael Gaziano JAMA. Published online May 13, 2024. doi:10.1001/jama.2024.7644 Cardiovascular risk assessment has become an essential part of preventive strategies designed to target risk factor interventions and has contributed to dramatic reductions in cardiovascular disease mortality during the past 60 years in the US and othe...

Artificial Intelligence in Critical Care: Opportunities and Obstacles In ICU Wed, 17 Apr 2024 The increasing availability of complex health data, coupled with advancing computational capabilities, offers an opportunity to define health and disease states with greater clarity and efficiency. This potential extends to real-time diagnosis and patient management. Due to its time-critical nature, the ICU presents unique challenges in creating effective mode...

Modification in ICU Design May Affect Delirium In ICU Tue, 9 Apr 2024 Delirium is a common psychiatric syndrome in critically ill patients, associated with high mortality rates and long-term cognitive decline. Recent trials on medication-based treatments have not shown significant benefits, leading to a shift towards nonpharmacologic approaches.  The Society of Critical Care Medicine recommends comprehensive interventions, including reorientati...

Invited Commentary  January 24, 2024 Guideline Implementation Is Improving Trauma Care in the Wild, Wild West Jeffrey K. Jopling, Lisa M. Kodadek, Elliott R. Haut JAMA Surg. 2024;159(4):372-373. doi:10.1001/jamasurg.2023.7154 Acore tenet in the care of patients with brain injury is prevention of secondary brain injury. In the immediate postinjury period, the patient’s physiology must be carefully managed to adequately perfuse and oxygenate the brain. M...

Early Systemic Insults Following Traumatic Brain Injury In ICU Tue, 9 Apr 2024 Traumatic brain injury (TBI) is a major cause of death and disability globally, with outcomes heavily influenced by both the severity of the initial injury and subsequent secondary injury mechanisms. Systemic insults (SIs), such as hypoxaemia and hypotension, can worsen outcomes by exacerbating the cascade of events following the initial damage. Previous studies have high...

Editor's Note  March 4, 2024 Judicious Use of Rapid Viral Tests in Emergency Departments Lona Mody JAMA Intern Med. 2024;184(5):537. doi:10.1001/jamainternmed.2024.0044 Acute viral illnesses are common, pervasive, and burdensome to patients, families, and health care systems.1Patients often present to emergency departments (EDs), which is followed by extensive diagnostic investigations, such as blood tests, cultures, chest radiography, and computed tom...

Molecular Phenotypes to Advance Precision Care in ARDS In ICU Tue, 9 Apr 2024 The heterogeneity of acute respiratory distress syndrome (ARDS) has played a role in hindering successful pharmacotherapy in clinical trials. To address this, researchers have identified two molecular phenotypes of ARDS - hypoinflammatory and hyperinflammatory - through latent class analysis (LCA) applied to protein biomarkers and clinical data across various cohorts. These p...

Invited Commentary  March 4, 2024 Enhancing Quality and Safety in Critical Care—Challenges and Strategies for Central Venous Catheters Elie A. Saade, Francis T. Lytle, Peter J. Pronovost JAMA Intern Med. 2024;184(5):482-483. doi:10.1001/jamainternmed.2023.8243 related articles icon  Related  Articles Central venous catheters (CVCs) are widely used in US critical care settings, providing essential functions such as medication ad...

Editor's Note  June 17, 2024 Skin Antisepsis to Prevent Surgical Site Infections: Implications for Global Surgery Anthony Charles, Preeti N. Malani JAMA. Published online June 17, 2024. doi:10.1001/jama.2024.9622 Surgical site infections (SSIs) are the most common health care–associated infection. Often preventable, SSIs are associated with substantial morbidity and mortality as well as prolonged hospitalizations and readmissions, and these i...