Editorial  July 10, 2023 Translating Clinical Trial Results to Clinical Practice During a Pandemic Andre C. Kalil, Angela Huttner, Carlos A. Gomez JAMA. Published online July 10, 2023. doi:10.1001/jama.2023.11260 In February 2020, the National Institutes of Health (NIH) launched a public-private partnership, the Adaptive COVID-19 Treatment Trial (ACTT) network,1,2 followed in April 2020 by the Accelerating COVID-19 Therapeutic Interventi...

Non-invasive Oxygenation Strategies for Acute Hypoxaemic Respiratory Failure Non-invasive oxygenation strategies such as high-flow nasal cannula, continuous positive airway pressure, and non-invasive bilevel ventilation can effectively avoid intubation in patients with acute hypoxaemic respiratory failure. These strategies can be delivered through interfaces like facemasks or helmets. Avoiding unnecessary intubation has become even more highlighted during the COVID...

COMMENT|ONLINE FIRST A negative trial for vasoactive intestinal peptide in COVID-19-associated acute hypoxaemic respiratory failure Warren L Lee, Arthur S Slutsky Lancet Respir Med Published:June 19, 2023DOI:https://doi.org/10.1016/S2213-2600(23)00218-7 In The Lancet Respiratory Medicine, Samuel M Brown and colleagues1 report the results of a multicentre, randomised controlled trial of aviptadil, the synthetic form of the 28-amino-acid neuropeptide vasoactive ...

Automated Antibiotic Dosing Sepsis is a major challenge in intensive care medicine with high morbidity and mortality. Early and proper use of antibiotics is crucial for effective treatment. Personalising antibiotic dosing is essential. However, maintaining adequate antibiotic exposure can be challenging, particularly for critically ill patients, as changes in organ function and fluid balance can affect the clearance and distribution of antibiotics. This results ...

ICU Management & Practice, Volume 23 - Issue 1, 2023 Sepsis Diagnosis: Pancreatic Stone Protein in Adults, Children, and Neonates Based on the concepts and the checklist criteria for an ideal sepsis biomarker presented in the article Sepsis Diagnosis: Clinical signs, Scores, and Biomarkers in this issue of ICU Management & Practice, we update and review the potential use of Pancreatic Stone Protein (PSP) in adults, children, and neonates....

ICU Management & Practice, Volume 23 - Issue 3, 2023 Medical Errors in the Preanalytical Phase of Blood Gases Test The preanalytical phase of the blood gases study is the most susceptible to errors, causing increased time and costs for patients and hospitals. Knowledge and training of the involved health personnel must be constant to improve results. Introduction Arterial or venous blood gases test is a frequent tool in the Intensive Care Unit (ICU) c...

Editorial  July 10, 2023 Intensive Care Unit Transfer Decisions—Science or Art? Tracy Y. Wang, Tyrone A. Johnson, Mitchell H. Katz JAMA Intern Med. Published online July 10, 2023. doi:10.1001/jamainternmed.2023.2636 For many hospital-based clinicians, one of the most consequential triage decisions is whether to transfer a high-risk patient from a regular medical-surgical bed to the intensive care unit (ICU). Despite its importance and frequen...

Prediction of Favourable Outcome After Cardiac Arrest Hypoxic-ischaemic brain injury following cardiac arrest (CA) is associated with significant morbidity and mortality. Withdrawal of life-sustaining therapy (WLST) is a common cause of death in these cases. Prognostication plays a crucial role. Current guidelines, such as those from ESICM,  propose a multimodal approach combining clinical examination, electrophysiology, brain imaging and biomarkers. However, ...

ICU Management & Practice, Volume 23 - Issue 3, 2023 Intravenous Fluids in Critically Ill Patients: When Less is Better While intravenous fluids have traditionally been a routine treatment for most critically ill patients, many severe pathologies now suggest a preference for conservative fluid therapy over liberal fluid administration. Introduction Intravenous fluid resuscitation began in 1832 during the cholera pandemic, improving intravascular volum...

ICU Without Borders Critical illness is characterised by various phases and outcomes, including deterioration, organ dysfunction, and recovery or death. Patient care is often fragmented, with different groups of healthcare providers managing different aspects of the patient's journey. Communication and collaboration gaps between these groups can lead to breakdowns in care and potentially impact patient outcomes. A study reported that delays in transferring patients...