Mechanical Ventilation Across Countries Invasive mechanical ventilation (IMV) is a crucial component of intensive care in modern healthcare. However, it remains uncertain whether the rates of IMV usage differ between countries. A recent study analysed data from 2018, focusing on patients aged 20 years and above who underwent IMV in England, Canada, and the United States. The study aimed to determine the per capita rates of IMV in adults within these three high-i...

Avoiding Harm When Feeding Critically Ill Patients Nutrition in critical illness has become a significant area of focus in recent decades. Initially, early and adequate feeding was believed to enhance outcomes by promptly ensuring the patient reaches full energy target. However, this perspective was challenged after the release of the EPaNIC trial in 2011. The EPaNIC trial observed worse outcomes in patients who received early supplemental parenteral nutrition (...

Influence of Gender on Age-Associated Mortality in Sepsis Despite advancements in medical care, sepsis remains a significant global health issue and a leading cause of hospital mortality worldwide. Numerous epidemiological studies have been conducted on sepsis, but its epidemiology remains unclear due to its heterogeneous nature. Sepsis is characterised by an imbalanced immune response to infection. Most studies on mortality risk factors in sepsis primarily focu...

Invited Commentary  August 7, 2023 The Penicillin Allergy Decision Rule—Something New for Penicillin Allergy Allison Ramsey, S. Shahzad Mustafa JAMA Intern Med. Published online August 7, 2023. doi:10.1001/jamainternmed.2023.3936 For the birth of something new, there has to be a happening. Newton saw an apple fall; James Watt watched a kettle boil; Roentgen fogged some photographic plates. And these people knew enough to translate ordinary h...

EDITORIAL Glucose Control in the ICU Guillermo E. Umpierrez N Engl J Med 2023; 389:1234-1237DOI: 10.1056/NEJMe2309442 Randomized, controlled trials aiming for near-normal glycemic targets (80 to 110 mg per deciliter [4.4 to 6.1 mmol per liter]) in critically ill patients have shown conflicting data regarding the benefits of intensive glycemic control (Table 1). In 2001, Van den Berghe et al. reported a dramatic 42% lower mortality among patients in the surgica...

Editorial  August 22/29, 2023 Extracranial-Intracranial Bypass Surgery for Stroke Prevention Seemant Chaturvedi, J. Marc Simard JAMA. 2023;330(8):697-698. doi:10.1001/jama.2023.11166 The concept of performing an extracranial-intracranial (EC-IC) arterial bypass operation for a patient with an internal carotid artery (ICA) or middle cerebral artery (MCA) occlusion is intuitively appealing. In these patients, it is believed that areas of hypope...

Understanding Medication Errors in the ICU Medication use is a fundamental aspect of healthcare. The process of administering medication involves numerous steps. Within a single medication administration sequence, there can be a range of 80 to 200 individual steps. Each of these steps represents a potential opportunity for a medication error, thus highlighting the importance of thorough and vigilant medication management practices. Medication errors remain a pre...

Mechanical Ventilation in Patients With Acute Brain Injury Acute brain injury (BI) affects millions of patients each year, with high mortality rates and significant disability. Invasive mechanical ventilation is often required for the most severe cases of BI. These patients frequently experience respiratory complications, such as ventilator-associated pneumonia and acute respiratory distress syndrome, which can result in longer ventilator times and poor outcomes. ...

Invited Commentary  August 16, 2023 Lung Transplant for Acute Respiratory Distress Syndrome Emily Cerier, Ankit Bharat JAMA Surg. Published online August 16, 2023. doi:10.1001/jamasurg.2023.3474 Accumulating evidence using data from individual centers,1 as well as national registries,2,3 substantiating the advantages of lung transplant for patients who experience irreversible lung damage due to COVID-19 infection, finds an essential...

ICU Management & Practice, Volume 23 - Issue 3, 2023 Current Airway Management During Anaesthesia - The STARGATE Study An overview of the International obServational sTudy on AiRway manaGement in operAting room and non-operaTing room anaEsthesia (STARGATE study) that will collect information on peri-intubation adverse events and airway management procedures in adult patients undergoing general anaesthesia to receive surgery or other diagnostic/therapeutic p...