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JAMA Clinical Reviews
JAMA Research at Critical Care Reviews 2024 (CCR Down Under)
Dec 11, 2024
Derek Angus, Chair of Critical Care Medicine at UPMC, joins the discussion alongside JAMA Editor in Chief Kirsten Bibbins-Domingo. They delve into four pivotal critical care trials recently presented in Melbourne. Topics include the effectiveness of sepsis alert systems that significantly lower hospital mortality, evolving oxygen strategies, and the comparison of high-flow nasal oxygen against non-invasive ventilation. They also explore the impact of biomarker-guided protocols in reducing unnecessary antibiotic use among sepsis patients, emphasizing personalized patient care.
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- The effectiveness of electronic sepsis alerts in reducing in-hospital mortality was confirmed, but their practical implementation remains challenging.
- The ADAPT-Sepsis trial highlighted procalcitonin's role in safely shortening antibiotic duration for suspected sepsis patients, improving antibiotic stewardship.
Deep dives
Impact of Electronic Sepsis Alerts
The study on electronic sepsis alerts aimed to assess their effectiveness in reducing in-hospital mortality. Conducted as a large-scale randomized trial, it involved over 60,000 patients across multiple hospitals. The trial demonstrated a significant improvement in hospital mortality when the alerts were activated, with a risk ratio of 0.85. While this indicates the alerts can enhance patient care, questions remain about their operational impact and efficiency in clinical practice.
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