ICU Management & Practice, Volume 23 - Issue 4, 2023 Transforming a PICU in the Digital Age Digitalisation is ultimately the driving force behind digital transformation. It will take us from a reactive healthcare system to a proactive one that focuses on prediction and prevention. Introduction The digital transformation has left a few things untouched in recent years, radically changing healthcare management for citizens, professionals, and public hea...

CHEST COMMENTARY| VOLUME 165, ISSUE 1, P16-18, JANUARY 2024Download Full Issue Upcoming Clinical Trials in Critical Care, Diffuse Lung Disease, Pulmonary Vascular Disease, and Thoracic Oncology in 2024 Adam Edward Lang, Michael N. Kammer, Aravind Menon, et al Chest 2024; 165: 16-18 DOI:https://doi.org/10.1016/j.chest.2023.07.029 Abbreviations:  CTEPH (chronic thromboembolic pulmonary hypertension), IPF(idiopathic pulmonary f...

American Thoracic Society Guideline Update for Patients with ARDS ARDS is a life-threatening respiratory failure characterised by acute hypoxaemia and bilateral radiographic infiltrates. The definition of ARDS has evolved over 50 years, with recent suggestions to include intubated and non-intubated patients. Management remains largely supportive, focusing on strategies to limit lung injury, but high mortality rates persist, and survivors often face long-term impair...

Editorial  January 21, 2024 Transitioning From SIRS to Phoenix With the Updated Pediatric Sepsis Criteria: The Difficult Task of Simplifying the Complex Roberto Jabornisky, Nathan Kuppermann, Sebastián González-Dambrauskas JAMA. Published online January 21, 2024. doi:10.1001/jama.2023.27988 Everyone must acknowledge the difficulty of distinguishing diseases…whoever denies this may as well deny that there is such a thing as medical art. Wi...

Invited Commentary  December 13, 2023 Fertility, Family, and a Career in Surgery—Time to Change the Narrative J. Elaine Tang, Melina C. Vassiliou, Liane S. Feldman JAMA Surg. Published online December 13, 2023. doi:10.1001/jamasurg.2023.6397 Medical training usually falls within the window of optimal fertility for most trainees.1 Operating within the rigid confines of residency programs, the perceived realities of family planning can str...

Editorial  January 21, 2024 Context and Implications of the New Pediatric Sepsis Criteria Erin F. Carlton, Mallory A. Perry-Eaddy, Hallie C. Prescott JAMA. Published online January 21, 2024. doi:10.1001/jama.2023.27979 Sepsis has been recognized as an important cause of morbidity and mortality for more than 2800 years.1 Derived from the Greek word sepo (σηπω, translated as “I rot,”), sepsis appears in writings of Homer, Hippocr...

Invited Commentary  December 13, 2023 Surgery, Anesthesia, and TBI Outcomes—Unraveling the Complex Interplay Caitlin R. Collins, Andre Campbell JAMA Surg. Published online December 13, 2023. doi:10.1001/jamasurg.2023.6371 In their study “Extracranial Surgery and Functional and Cognitive Outcomes After Traumatic Brain Injury: A TRACK-TBI Study,”1 Roberts et al shed crucial light on the potential risks associated with e...

Sleep and Circadian Disruption in the ICU Sleep measurement in critically ill patients remains a barrier for large studies on ICU sleep and circadian disruption (SCD). The gold standard, polysomnography, is difficult to interpret due to factors like medications and complex illnesses. While portable, wearable devices have improved sleep and circadian function measures, challenges persist for bedside utility, including cost, feasibility, tolerance, and interpretabili...

Invited Commentary  December 18, 2023 Daily Toothbrushing to Prevent Hospital-Acquired Pneumonia—Brushing Away the Risk Rupak Datta JAMA Intern Med. Published online December 18, 2023. doi:10.1001/jamainternmed.2023.6807 Often overlooked and understudied, oral care is critical to health, quality of life, and prevention of infection such as hospital-acquired pneumonia (HAP). HAP is classified into ventilator-associated pneumonia (VAP) and ...

Association of Active Renin Content With Mortality Sepsis affects 1.7 million patients annually, with a mortality rate of 10–50%. Current biomarkers like WBC count, lactate, and blood cultures have variable impacts on prognosis. Recent evidence suggests that circulating renin is proposed as a more predictive biomarker for septic shock outcomes than lactate.  The Vitamin C, Thiamine, and Steroids in Sepsis (VICTAS) trial is a randomised, double-blind, adapti...