Most ICU survivors could drive months before anyone told them so

The edition in brief

A UK prospective cohort put 33 intensive care survivors — all ventilated for at least 72 hours or supported with extracorporeal membrane oxygenation — through a full licensing-authority driving assessment at a median 12.5 weeks after discharge. Twenty-six (79%) were judged capable of driving a standard vehicle, but only 15 (45%) had actually resumed. Of the seven found unfit, four had physical and two psychological impairment, and most resumed within the year after adaptation or retraining. Driving confidence rose from a median of 7 to 9 and 97% rated the assessment very good or excellent. A retrospective cohort of 269 critically ill children with acute cardiorespiratory failure and hyperglycaemia showed that a three-marker rapid immunoassay classifier using interleukin-6, interleukin-8 and soluble tumour necrosis factor receptor 1 reproduced latent-class subphenotypes with an area under the curve of 0.90 and 89.6% agreement, preserving the mortality difference (33.3% versus 11.8%) and the differential response to intensive insulin. A systematic evidence map of 1,116 studies of novel acute kidney injury biomarkers found 944 on prediction and only 12 on management. Across 5.37 million weighted US paediatric mental health emergency visits, the odds of presenting to a high-volume paediatric emergency department differed by ethnicity and by diagnosis. A pearl covers the handover of a patient still in the department. The edition closes with a Hong Kong randomised trial in which a brief telephone intervention plus six months of weekly messaging after emergency discharge raised abstinence from a health-risk behaviour from 19.9% to 30.1% at six months, with the effect fading once the messages stopped.