Genetically Predicted Insomnia and Risk of Sepsis Insomnia, a common sleep disorder, has been linked to various adverse health outcomes, including altered immune function and elevated systemic levels of inflammatory markers, which may affect women more than men. Dysregulated immune responses can lead to conditions like sepsis, which has high morbidity and mortality. A study was conducted to determine if insomnia is associated with risk of sepsis. Researchers als...

ICU Management & Practice, Volume 23 - Issue 2, 2023 Sustainability and Extracorporeal Organ Support Extracorporeal organ support (ECOS) involves an extensive use of healthcare resources and clinical problem-solving challenges. The feasibility of applying known ecological analysis and sustainability strategies in healthcare need to be started in this setting. Introduction As with any other species, human activity modifies the environment at multiple l...

Deaths From Neonatal Sepsis and the Need to Improve Treatment A global observational study jointly led by University College London (UCL) has revealed a concerning trend in the effectiveness of antibiotics to treat sepsis in newborn babies. The study, conducted across 19 hospitals in 11 countries and involving over 3,200 infants with sepsis, found a high mortality rate among infants with culture-positive sepsis (nearly 1 in 5 infants). The study is published i...

Editorial  December 1, 2023 Prone Positioning During Venovenous ECMO for Severe ARDS Ricardo Teijeiro-Paradis, Niall D. Ferguson JAMA. Published online December 1, 2023. doi:10.1001/jama.2023.22456 Care of patients with severe hypoxemic respiratory failure receiving mechanical ventilation has advanced significantly in the last 25 years due to a focus on minimization of iatrogenic injury, largely ventilator-induced lung injury. In addition to ...

Research Christmas 2023: Workforce Crisis Effect of a doctor working during the festive period on population health: natural experiment using 60 years of Doctor Who episodes (the TARDIS study) Richard D Riley BMJ 2023; 383 doi: https://doi.org/10.1136/bmj-2023-077143 (Published 18 December 2023)Cite this as: BMJ 2023;383:e077143 Abstract Objective To examine the effect of a (fictional) doctor working during the festive period on populati...

Using PMX-HA in Patients With Sepsis Endotoxin can trigger immune responses and organ failure in sepsis patients. Polymyxin B hemadsorption (PMX-HA) is an extracorporeal blood purification technique to remove circulating endotoxin and prevent organ failure. While some studies have suggested that PMX-HA improves outcomes in sepsis patients, conflicting results have been observed in randomised controlled trials (RCTs). The EUPHRATES trial, which enrolled septic sh...

Feature Covid-19 Is convalescent plasma still useful as a covid treatment? Katharine Lang BMJ 2023; 383 doi: https://doi.org/10.1136/bmj.p2185 (Published 08 November 2023)Cite this as: BMJ 2023;383:p2185 Enthusiasm for one of the earliest promising treatments for covid-19 has waned. Katharine Lang finds that convalescent plasma for covid may still have a place, particularly in immunocompromised people What is convalescent plasma? It’s a fo...

Human-Centred Visualisation Technologies for Patient Monitoring Information technology has become integral to perioperative and intensive care medicine, revolutionising patient care. Patient monitoring, crucial for ensuring safe anaesthesia practices and optimising patient ventilation, haemodynamics, and metabolism in critical care, is now widely recognised as a standard practice. Adopting monitoring technologies has greatly improved patient outcomes in these medic...

EDITORIAL| VOLUME 164, ISSUE 4, P816-817, OCTOBER 2023 The Emulated Targeted Trial: A Causal, But Never Casual, Surrogate for Randomized Clinical Trials Pedro D. Wendel-Garcia, Lieuwe D.J. Bos Chest 2023; 164: 816-817 DOI: https://doi.org/10.1016/j.chest.2023.06.016 Randomization properly carried out […] relieves the experimenter from the anxiety of considering and estimating the magnitude of the innumerable causes by which his data may be disturbed.R. A. ...

Time Definition of Reintubation Mechanical ventilation is crucial for supporting critically ill patients, and a timely extubation strategy is essential for improved patient outcomes. Despite standard weaning procedures, a significant percentage of patients (3-20%) require reintubation. Post-extubation respiratory failure can cause respiratory fatigue, requiring additional mechanical ventilation. This results in prolonged ICU stay, increased costs, and increased in-...