EDITORIAL Traumatic Acute Subdural Hematoma — Should the Bone Flap Be Removed or Replaced? Shankar Gopinath N Engl J Med April 23, 2023DOI: 10.1056/NEJMe2302936 Traumatic acute subdural hematomas often warrant emergency evacuation of the blood clot to avoid further cerebral compression and its sequelae. Once the subdural clot is removed, the million-dollar question in the mind of the neurosurgeon is to whether to replace the bone flap (craniotomy) or not (deco...

Safety Outcomes of Direct Discharge From ICU Patients discharged from ICUs are traditionally transferred to a hospital ward to facilitate recovery and rehabilitation and to organise discharge planning. However,  direct discharge home (DDH) from ICUs is becoming more common due to high hospital ward censuses and transfer delays. This increase is mainly due to strained ward capacity and high costs. Prior research shows an inverse correlation between DDH and ICU ...

COMMENT|ONLINE FIRST Guidelines adherence as a major protective aspect to increase survival rate in patients with candidaemia in Europe Mohammad Sadegh Rezai, Fatemeh Ahangarkani Lancet Infect Dis Published:February 15, 2023 DOI:https://doi.org/10.1016/S1473-3099(23)00046-4 Despite improvements in medical interventions and new antifungal drugs, candidaemiais widely recognised as a major cause of morbidity and mortality worldwide.1, 2 Not...

ICU Diaries and Post-ICU Distress Symptoms In recent years, health diaries have become an important tool for patients and providers to manage personal health. A health diary is a record of a patient's overall health and wellness, which the patient writes to keep track of different aspects of their health. Studies show that greater self-care behaviours, such as the use of symptom diaries, improve survival for patients with heart failure. Health diaries, either in wr...

Socioeconomic Status and Outcomes in Critical Care Socioeconomic status is a known determinant of health inequalities. However, previous studies on the impact of socioeconomic status on outcomes in critical care have produced inconsistent findings.  A new review analyses available evidence on the relationship between socioeconomic status and outcomes in critical care. The analysis included observational cohort studies of adults that examined the association...

Antioxidant, Anti-inflammatory Therapy in Sepsis Sepsis is associated with long-term cognitive impairment and poor psychological and functional outcomes. Potential mechanisms for this include intracerebral oxidative stress and inflammation. However, there is limited knowledge about the effects of early antioxidant and anti-inflammatory therapy on cognitive, psychological, and functional outcomes in sepsis survivors. The Vitamin C, Thiamine, and Steroids in Sepsi...

COMMENT|ONLINE FIRST Too many antibiotics for patients with COVID-19 despite low bacterial infections Daniele Roberto Giacobbe, Matteo Bassetti Lancet Infect Dis Published:January 27, 2023 DOI:https://doi.org/10.1016/S1473-3099(22)00866-0 Although low rates of bacterial infections have frequently been reported in patients hospitalised with COVID-19, excessive use of antibiotics has also been described in this population since the beginning of the COVID-19 p...

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...

Prehospital Physician Presence During Paediatric OHCA A study was conducted to investigate whether the presence of prehospital physicians affected the neurological outcomes of paediatric patients who experienced an out-of-hospital cardiac arrest (OHCA). The study included paediatric patients who were 17 years old or younger and were registered in a database between June 2014 and December 2019.  The researchers used logistic regression models and stabil...

Early Tracheostomy vs Late Tracheostomy in Traumatic Brain Injury, Stroke A recent review aimed to determine whether early tracheostomy benefits patients with severe traumatic brain injury (TBI) and stroke and whether these benefits persist across different underlying conditions. The included studies in the review were those written in English, French, Spanish, or Portuguese and with a formulated question that compared outcomes between early and late tracheostom...