Impact of Fatigue on Anaesthesia Providers Fatigue is being recognised as a workplace hazard of increasing concern. It is a significant problem for anaesthesiologists who have long working hours and irregular schedules. Fatigue negatively impacts vigilance, communication, and teamwork and shows decreased performance during psychomotor testing. However, its impact on real-life performance is uncertain. Fatigue is a complex issue with many definitions proposed in ...

COMMENT|ONLINE FIRST Real-world effectiveness of nirmatrelvir–ritonavir against BA.4 and BA.5 omicron SARS-CoV-2 variants Carlos K H Wong, Kristy T K Lau, Gabriel M Leung Lancet Infect Dis Published: February 10, 2023 DOI:https://doi.org/10.1016/S1473-3099(23)00056-7 Over the past year of the COVID-19 pandemic, populations worldwide have been facing the constant threat of the SARS-CoV-2 omicron variant and its sublineages, and the high transmissibility and ...

Shifting Sepsis Quality Measures From Processes to Outcomes Sepsis is a significant health issue that leads to high rates of death and disability, with over 250,000 adult deaths annually in the U.S. alone. Healthcare providers, patients, regulatory agencies, and advocates for quality improvement acknowledge the importance of preventing sepsis and improving its outcomes.  The Severe Sepsis/Septic Shock Early Management Bundle (SEP-1) from the Centers for Med...

COMMENT|ONLINE FIRST SARS-CoV-2 rebound with and without antivirals Nicola Petrosillo Lancet Infect Dis Published: February 13, 2023 DOI:https://doi.org/10.1016/S1473-3099(23)00063-4 As the COVID-19 pandemic continues, interventions for preventing SARS-CoV-2 transmission and progression to severe disease remain priorities. Vaccines against COVID-19 have an important role in preventing symptomatic infections that would otherwise lead to hospitalisation and d...

World Sepsis Day The Global Sepsis Alliance (GSA) and the Sepsis Stiftung joined together to celebrate 10 years of World Sepsis Day on 16 September 2022 in Berlin, under the theme of " Making Sepsis a National and Global Health Priority”. The event aimed to engage with high-level policy makers, representatives of health authorities, patient organizations, health care providers, science, industry, and civil society, to learn from each other through networking a...

New Paradigm of Personalised Sedation Lung-protective ventilation (LPV) limits lung injury (VILI). However, deep sedation is required to tolerate LPV, and patient self-induced lung injury (P-SILI) can occur during spontaneous breathing along with high respiratory efforts, lung stress and strain. Prevention of P-SILI may require further sedation. In addition, patient-ventilator dyssynchrony can worsen outcomes, resulting in increased sedation.  Ventilation t...

Editor's Note  February 20, 2023 At a Higher Dose and Longer Duration, Ivermectin Still Not Effective Against COVID-19 Kirsten Bibbins-Domingo, Preeti N. Malani JAMA. Published online February 20, 2023. doi:10.1001/jama.2023.1922 ACochrane meta-analysis of 11 eligible trials examining the efficacy of ivermectin for the treatment of COVID-19 published through April 2022 concluded that ivermectin has no beneficial effect for people with COVID-1...

Speed of Cooling After Cardiac Arrest: Sub-study from TTM-2 Trial Out-of-hospital cardiac arrest (OHCA) typically has a poor prognosis. Less than 50% of patients admitted to ICU survive to hospital discharge. Animal models suggest that therapeutic hypothermia is neuroprotective and decreases neuronal injury.  Targeted temperature management (TTM 33–36 °C) is part of international guidelines when managing post-OHCA patients. Evidence suggests that better neu...

Editorial  February 20, 2023 The Ethics of Clinical Research: Managing Persistent Uncertainty Alex John London, Christopher W. Seymour JAMA. Published online February 20, 2023. doi:10.1001/jama.2023.1675 In the face of novel pathogens, incomplete knowledge, and disagreement about the merits of medical treatments, translating the duty to care into concrete benefits for patients depends on our ability to quickly act on the duty to learn.1 ...

ICU Management & Practice, Volume 22 - Issue 4, 2022 Reducing Antibiotic Resistance in the ICU This article reviews practices currently available to reduce the spread of antimicrobial resistance and novel therapies that are presently being developed. Introduction Among healthcare providers, and especially among those working with intensive care unit (ICU) patients, one of the greatest concerns that has emerged in recent decades has been a steady escal...