COMMENT|ONLINE FIRST Nutrition in critical illness—research is worth the EFFORT Emma J Ridley, Lee-anne S Chapple Lancet Published:January 25, 2023 DOI:https://doi.org/10.1016/S0140-6736(23)00091-0 Multiple high-quality randomised controlled trials conducted over the past decade in critical care nutrition have shown no difference between interventions and routine care.1, 2, 3, 4 These findings have led to the assumption that nutrition in...

Continuous Cuff Pressure Control in Preventing Ventilator-Associated Pneumonia Patients in the ICU often require invasive mechanical ventilation support. This requires tracheal intubation, where an endotracheal cuff wrapped around the tip of the tube seals the extraluminal airway for positive pressure ventilation. Inappropriate cuff pressure control can contribute to ventilator-associated complications. Studies report that approximately 10–20% of long-term (≥ 48 hr...

EDITORIAL Extracorporeal CPR in Out-of-Hospital Cardiac Arrest — Still on Life Support? John F. Keaney, Jr., Thomas Münzel N Engl J Med 2023; 388:370-371DOI: 10.1056/NEJMe2214116 Despite many advances in the treatment of heart disease over the past four decades, up to one third of all patients with acute manifestations of heart disease do not reach the hospital after cardiac arrest. Only 8 to 10% of patients with out-of-hospital cardiac arrest survive; the eve...

Dexamethasone and Oxygen Support Strategies for COVID-19 Hypoxaemic Respiratory Failure Acute hypoxaemic respiratory failure (AHRF) is one of the main manifestations of severe COVID-19. The RECOVERY trial showed that dexamethasone 6 mg/d for ten days reduced 28-day mortality in patients with the most severe COVID-19. Another study described the benefit of high-dose dexamethasone in ARDS. However, Munch et al. found no difference between high-dose and low-dose dexam...

Remote Ischaemic Conditioning in Septic Shock Septic shock is one of the most severe complications of any infection. It affects millions of people each year. Studies show that in the U.S. and Europe, nearly 10% of patients admitted to the ICU have septic shock. Significant efforts have been made to recognise and treat septic shock early. Still, over 50% of patients die of septic shock within days or weeks after diagnosis. Thus, there is a need for new therapeutic a...

Surge Mechanical Ventilation During COVID-19 During the COVID-19 pandemic, many hospitals in the U.S. exceeded their mechanical ventilation capability. As COVID-19 spread to communities with limited immunity, challenges associated with providing surge mechanical ventilation were reported. Hospitals, healthcare systems, and jurisdictional authorities purchased more ventilators. But the fear that the supply would not be able to fulfill the demand conti...

Clinical Nutrition Issues in 2022 Critically ill patients are fed with amounts below the recommendations of international guidelines. To overcome large energy deficits, supplemental parenteral nutrition (SPN) to top up enteral nutrition (EN) has been proposed. This strategy is included in both the American (ASPEN) and European (ESPEN) clinical nutrition guidelines.  SPN has demonstrated clinical benefits and is included in the American and European guidelin...

Vitamin D Supplements and Risk of COVID-19 Findings from two large clinical trials show that increasing vitamin D levels in adults during the COVID-19 pandemic was not associated with protection against coronavirus or other respiratory tract infections.  Vitamin D has long been recognised to support innate immune responses to respiratory viruses and bacteria. Some studies show that vitamin D may protect against respiratory tract infections, particularly amo...

Editorial  December 16, 2022 Long-term Follow-up After Critical COVID-19: REMAP-CAP Revisited Michael L. Barnett, Paul E. Sax JAMA. Published online December 16, 2022. doi:10.1001/jama.2022.23700 The year 2020 was a grim and uncertain time for any clinician caring for inpatients with COVID-19, especially those with critical illness. In an era of modern medicine in which the range of options for many conditions can seem limitless, this novel v...

ICU Professionals’ Knowledge of End-of-Life Decision-Making Law There are laws regulating healthcare practice at the end of life. Most healthcare professionals rely on their clinical knowledge to inform treatment decisions during this time. However, the extent to which the law informants their decision-making at the end of life remains uncertain.  In this study, the researchers describe what healthcare professionals in the ICU and emergency departments know...