Reversing Sepsis-Induced Hypotension Sepsis is characterised by hypovolaemia and vasodilation. It is also characterised by organ dysfunction secondary to a dysregulated immune response of the host to the microbial pathogen. Prompt identification, early treatment with appropriate antibiotics, and fluid resuscitation can improve patient outcomes. Patients with cirrhosis and sepsis are a distinct group. The haemodynamic alterations are more profound in these patients ...

Editor's Note  November 28, 2022 The Uncertain Effects of Surveillance Screening for COVID-19 for Individuals Entering Health Care Facilities Eric Ward, Mitchell H. Katz JAMA Intern Med. Published online November 28, 2022. doi:10.1001/jamainternmed.2022.5429 Entrance surveillance screenings have been widely implemented in health care settings during the COVID-19 pandemic. These measures, which are required by the US Department of Labor,1 ...

ICU Management & Practice, Volume 22 - Issue 3, 2022 Pain Management in Paediatric Critical Care An overview of the main treatment options currently available in paediatric critical care setting. Critically ill paediatric patients often suffer from pain secondary to trauma, complex medical procedures, invasive testing monitoring devices and illness-induced discomfort. Although the gold standard for assessing patient comfort is self-report, in paediatrics...

ICU Management & Practice, Volume 22 - Issue 3, 2022 Perioperative Haemodynamic Optimisation of the High-Risk Surgical Patient An overview of evidence supporting perioperative haemodynamic optimisation in high-risk surgery patients and strategies to facilitate its implementation and adoption to improve patient outcomes. A million surgical procedures performed every year worldwide are at risk of complications that can be attributed to the nature of the su...

Editorials Oxygen administration during general anaesthesia for surgery Michele Samaja, Davide Chiumello BMJ 2022; 379 doi: https://doi.org/10.1136/bmj.o2823 (Published 30 November 2022)Cite this as: BMJ 2022;379:o2823 Oxygen can be a double edged sword Oxygen is routinely administered to almost all patients undergoing general anaesthesia,1 to ensure adequate oxygenation from intubation until awakening—the period when complications due to hypoxaemia ar...

ICU Management & Practice, Volume 22 - Issue 3, 2022 Analgesia, Sedation and Neuromuscular Blockade in Critically Ill Patients A Practical Approach for Intensivists A practical approach to analgesia, sedation and neuromuscular blockade of critically ill patients and a discussion on potential benefits, adverse effects and current professional international recommendations. Introduction Patients hospitalised in the Intensive Care Unit (ICU) are natur...

The Influence of COVID-19 on Intensivist Wellbeing The COVID-19 pandemic has been challenging for healthcare systems around the world. In particular, the pandemic has resulted in critical care staffing shortages and has affected the quality of care.  In this review, the researchers examine the emergency response of hospitals to the pandemic and how it influenced the well-being of frontline intensivists. They also discuss potential strategies to improve inte...

Endotypes of Traumatic Brain Injury Traumatic brain injury (TBI) is a heterogeneous disease. It has various injury mechanisms and tissue pathologies. It is a leading cause of mortality and morbidity in young individuals globally. In addition, the incidence of TBI in older patients is an area of concern with an increase in an ageing population that is more likely to be multi-morbid and fall-prone.  Mortality from TBI has decreased over the years. How...

Prehospital Lyophilised Plasma Transfusion for Trauma-Induced Coagulopathy Trauma-induced coagulopathy affects approximately 20 to 50% of patients with severe trauma. Its occurrence increases transfusion requirements, multi-visceral failure, and mortality. Blood transfusion is the primary therapy for trauma-induced coagulopathy. However, optimal modalities for plasma transfusion in a prehospital setting remain undefined. Findings from the COMBAT (Control of...

Feature Christmas 2022: The Scientist On the 12th Day of Christmas, a Statistician Sent to Me . . . Richard D Riley, Tim J Cole, Jon Deeks, et al BMJ 2022; 379 doi: https://doi.org/10.1136/bmj-2022-072883 (Published 20 December 2022)Cite this as: BMJ 2022;379:e072883 The BMJ’s statistical editors relish a quiet Christmas, so make their wish come true and pay attention to the list of common statistical faux pas presented here by Riley and colleagues ...