Editor's Note  March 4, 2024 Judicious Use of Rapid Viral Tests in Emergency Departments Lona Mody JAMA Intern Med. Published online March 4, 2024. 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, ...

Hydrocortisone Plus Fludrocortisone for CAP-Related Septic Shock In a subgroup analysis of the Activated Protein C and Corticosteroids for Human Septic Shock (APROCCHSS) trial, researchers aimed to explore the effects of hydrocortisone plus fludrocortisone on patients with community-acquired pneumonia (CAP) compared to those with non-CAP-related septic shock. The goal was to determine whether glucocorticoids would improve outcomes in these patients.  The AP...

qSOFA With suPAR for Risk Detection, Antibiotic Treatment Guidance Early recognition and initiation of antibiotics are crucial in managing sepsis. Various warning scores, including qSOFA (quick Sequential Organ Failure Assessment), have been introduced to aid early detection. Patients with suspected infection and at least two of the qSOFA clinical signs are at a significantly higher risk of death after 28 days. However, managing patients with only one qSOFA point r...

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. Published online March 4, 2024. doi:10.1001/jamainternmed.2023.8243 Central venous catheters (CVCs) are widely used in US critical care settings, providing essential functions such as medication administration, hemodynamic monitoring, and rel...

Cell-Based Therapies for ARDS  Cell-based therapies, particularly mesenchymal stromal cells (MSCs), hold significant promise for treating acute respiratory distress syndrome (ARDS). MSCs exhibit therapeutic effects such as reducing inflammation, improving lung function, and promoting tissue repair. These cells can be sourced from different tissues, affecting their ease of harvest and potential effects. Over 1,000 clinical trials involving MSCs are registered, wi...

Editorials Reasons to avoid ultra-processed foods Carlos A Monteiro, Eurídice Martínez-Steele, Geoffrey Cannon BMJ 2024; 384 doi: https://doi.org/10.1136/bmj.q439 (Published 28 February 2024)Cite this as: BMJ 2024;384:q439 Ultra-processed foods damage health and shorten life Hundreds of epidemiological studies and meta-analyses have reported associations between ultra-processed food consumption and adverse health outcomes. In a linked paper (doi:10.1136/bmj...

Machine Learning for Predicting Unscheduled Returns to ED Hospitals utilise unscheduled return visit (URV) rates in emergency departments (EDs) to determine care quality. Higher rates lead to increased costs and longer wait times for patients who need immediate care. Frequent ED visits also contribute to overcrowding, causing treatment delays and higher mortality rates.  Developing predictive models is essential for early intervention to reduce ED revisits....

Environmental Sustainability and Antimicrobials Healthcare's environmental sustainability has become a pressing concern, with hospitals, clinical services, and the pharmaceutical industry identified as key contributors to environmental impact. Hospitals, in particular, are responsible for most greenhouse gas emissions, with the ICU being a significant consumer of resources like electricity, disposables, and pharmaceuticals. While most studies concentrate on these b...

Acute Mesenteric Ischaemia: Incidence, Diagnosis, Management, Outcomes Acute mesenteric ischaemia (AMI) is a rare condition with challenging diagnosis due to nonspecific symptoms and lack of established diagnostic biomarkers. Existing evidence suggests high mortality rates with limited improvement in outcomes over time. Recent estimates indicate an incidence of approximately 5–7 cases per 10,000 hospital admissions, likely underestimated due to poor recognition. Di...

ICU Management & Practice, Volume 23 - Issue 5, 2023 Long-Term Home Ventilation in Children: Facing the Challenge Discharging ventilated children home is a difficult challenge in which the training of families is essential. We present our hospital's transition programme for ventilated children going home, which is based on a family-centred model. Introduction  The progressive improvement of neonatal intensive care (NICU) and paediatric intensive ...