- Original ArticleAug 27, 202210.1056/NEJMoa2208686
In comatose patients after out-of-hospital cardiac arrest, the incidence of death or severe disability was similar regardless of whether a restrictive or a liberal oxygenation strategy was used.
- Original ArticleAug 27, 202210.1056/NEJMoa2208687
This trial showed no significant difference in the percentage of patients who died or had severe disability or coma when higher or lower blood-pressure targets were used after an out-of-hospital cardiac arrest.
- N Engl J Med 2022; 386:2518-2519
…soon the sharpened features, and sunken eye, and fallen jaw, pale and cold, bearing the manifest impress of death’s signet, began to glow with returning animation…. During the British cholera epidemic of 1831, William O’Shaughnessy reported that the blood of victims “has lost a large portion of its water…a great...
- N Engl J Med 2022; 386:2459-2470
In this trial, a restrictive approach to intravenous fluid administration in critically ill patients with septic shock did not reduce deaths at 90 days.
- N Engl J Med 2022; 386:2387-2398
In this trial of intravenous vitamin C in adult patients with sepsis, those who received a vitamin C infusion had a higher risk of death or persistent organ dysfunction at 28 days than those who received placebo.
- N Engl J Med 2022; 386:1627-1637
In this randomized, controlled trial involving neonates in two Australian tertiary neonatal intensive care units, nasal high-flow therapy during neonatal endotracheal intubation increased the likelihood of successful intubation on the first attempt without physiological instability.
- N Engl J Med 2022; 386:e34
Prone positioning improves oxygenation and decreases mortality in patients with acute respiratory distress syndrome. This video demonstrates how to place an intubated patient in the prone position, with an emphasis on patients who have a body-mass index of more than 30 and for whom the prone position is necessary for...
- N Engl J Med 2022; 386:1187-1188
Little is known regarding appropriate patient selection for and clinical outcomes with lung transplantation for respiratory failure due to Covid-19. This study analyzes lung transplantations reported in the United Network for Organ Sharing registry from August 2020 through September 2021.
- N Engl J Med 2022; 386:964-975
Acute kidney injury can be accompanied by life-threatening electrolyte and metabolic abnormalities. Kidney-replacement therapy may be urgently needed to prevent death from uremia. This review considers treatment approaches, indications, and intensity in critically ill patients with AKI.
- N Engl J Med 2022; 386:888-889
Acute kidney injury often complicates critical illness and is associated with high morbidity, with patients not infrequently receiving renal replacement therapy, and with increased mortality.1 Patients with acute kidney injury have an elevated risk of chronic kidney disease, cardiovascular disease, and premature death, even when kidney function has...
- N Engl J Med 2022; 386:879-879
A 79-year-old man was admitted to the intensive care unit for septic shock. Placement of a hemodialysis catheter ultimately led to the finding of an isolated persistent left superior vena cava.
- N Engl J Med 2022; 386:815-826
This randomized, double-blind trial involving critically ill patients compared balanced multielectrolyte solution with saline as fluid therapy in the ICU. There was no evidence that the risk of death or acute kidney injury was lower with the use of BMES than with saline.
- N Engl J Med 2022; 386:861-868
Four cases of non–travel-associated melioidosis (caused by Burkholderia pseudomallei) that were identified across the United States were associated with the use of a contaminated aromatherapy room spray.
- N Engl J Med 2022; 386:791-792
The introduction of electroencephalography (EEG) into hospital practice generated interest in monitoring patients with severe brain injury after cardiac arrest. As early as 1964, a study involving 50 comatose patients who had been resuscitated after cardiac arrest showed “bursts of very large amplitude spikes, sharp waves, or complex wave forms...
- N Engl J Med 2022; 386:780-780
A 50-year-old man underwent intubation for hypercarbic respiratory failure. Multiple pale, rubbery, branching casts were removed by means of bronchoscopy, and the patient ultimately received a diagnosis of plastic bronchitis.
- N Engl J Med 2022; 386:e19
A 36-year-old man presented with daily expectoration of large, branching bronchial casts. Magnetic resonance lymphangiography revealed occlusion of the thoracic duct, and lymphatic plastic bronchitis was diagnosed.
- N Engl J Med 2022; 386:724-734
A trial involving comatose survivors of cardiac arrest tested whether aggressively treating rhythmic and periodic EEG activity would improve neurologic outcomes. Despite suppression of abnormal EEG activity, the incidence of a poor neurologic outcome did not differ significantly from that with standard care, and mortality was high in both groups.
- N Engl J Med 2022; 386:391-393
This interactive feature about infants born very prematurely offers a case vignette accompanied by two essays supporting resuscitation in all neonates born at 22 weeks’ gestation or selective resuscitation. Vote and comment at NEJM.org.
- N Engl J Med 2021; 385:2464-2474
A 26-year-old woman was transferred to this hospital because of respiratory failure and altered mental status. Three days earlier, she had undergone elective liposuction. CT of the chest showed diffuse opacities involving all lung lobes; CT of the head showed cerebral edema and a hypodensity in the globus pallidus. A...