Editorial  April 20, 2023 Informing a Rational Approach to Antimicrobial Prophylaxis in Open Pancreatoduodenectomy Anthony Charles, Preeti N. Malani JAMA. 2023;329(18):1556-1557. doi:10.1001/jama.2023.6275 Despite numerous advances in perioperative care, surgical site infection (SSI) remains a frequent complication after major abdominal surgery, with gastrointestinal procedures among the highest risk for infection.1Besides the increased length of stay ...

ICU Management & Practice, Volume 23 - Issue 1, 2023 Tachycardia in Sepsis: Friend or Foe? An overview of tachycardia in sepsis, the importance of rate control and the beneficial effects of beta-blockers. Sepsis and Tachycardia – Aetiologic Factors During sepsis, the sympathetic nervous system plays a key role in maintaining cardiac output and blood pressure. This is achieved through changes in heart rate, contractility, and vascular tone. The proper ...

Editorial  May 9, 2023 The Role of Prophylactic Antibiotics for Patients With Severe Alcohol-Related Hepatitis Ewan Forrest, William Bernal JAMA. 2023;329(18):1552-1553. doi:10.1001/jama.2023.1729 Few effective pharmacologic therapies are available for alcohol-related hepatitis. In patients diagnosed with alcohol-related hepatitis, greater severity of liver injury and systemic inflammation are associated independently with early mortality.1&n...

ICU Management & Practice, Volume 23 - Issue 1, 2023 Sepsis Diagnosis: Clinical Signs, Scores, and Biomarkers Abstract Sepsis and antimicrobial resistance are two major public health problems. Sepsis is defined as a dysregulated response of the body to a bacterial infection with organ dysfunction. The 2021 Surviving Sepsis Campaign SSC guidelines proposed characterising the infection based on clinical assessment an...

Invited Commentary  May 1, 2023 The Disappointing Impact of Interventions to Prevent Hospital Readmissions Robert M. Wachter JAMA Intern Med. Published online May 1, 2023. doi:10.1001/jamainternmed.2023.0804 When it comes to intervention trials in health services research, we are often left with the challenge of interpreting the generalizability of a positive study, particularly when the intervention involved humans interacting with other hum...

European Guidelines: Management of Bleeding, Coagulopathy Following Trauma According to the Global Burden of Diseases, Injuries, and Risk Factors Study, trauma accounted for 8% of total deaths annually. Among adolescents aged 10-24 years, road injuries, self-harm, and interpersonal violence are the top causes of disability-adjusted life-years, and road injuries are ranked first in the 25-49 year age group. Post-traumatic bleeding and associated traumatic coagulopat...

Sepsis Through the Lens of Complexity Theory Sepsis is a complex and dysregulated state involving various factors, including pathogens, host response, organ failure, and medical interventions. Despite this complexity, the necessary concepts, approaches, and methods to understand sepsis are underappreciated. In a recent review, the authors highlight the need to understand sepsis through the lens of complexity theory. Complex systems science aims to understand sys...

Family-Centred Care at End of Life in the ICU Recent research on end-of-life (EOL) care in the ICU has focused on the importance of communication between ICU clinicians and patients' families. This research has highlighted the impact of such communication on family symptoms in the months following a patient's death. During the COVID-19 pandemic, restricted visiting policies in ICUs have undermined the quality of communication between clinicians and families, whi...

Invited Commentary  April 28, 2023 How Chatbots and Large Language Model Artificial Intelligence Systems Will Reshape Modern Medicine: Fountain of Creativity or Pandora’s Box? Ron Li, Andre Kumar, Jonathan H. Chen JAMA Intern Med. Published online April 28, 2023. doi:10.1001/jamainternmed.2023.1835 In an era of clinicians being burnt out by electronic medical records and documentation burdens, we might all dream of having a personal scribe to...

ICU Management & Practice, Volume 22 - Issue 5, 2022 Guiding Clinical Care Using Pancreatic Stone Protein The role of point-of-care testing in the early identification and management of sepsis, the need for better markers to identify sepsis, an overview of the Pancreatic Stone Protein (PSP) and clinical evidence highlighting its effectiveness as a biomarker. Pancreatic Stone Protein Infections are a leading cause of morbidity and mortality among criti...