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Antibiotic decisions in the ICU: a dragon’s tale Pieter Depuydt, MD, PhD Head of Clinic - Department of Intensive Care Ghent University Hospital Ghent, Belgium Associate Professor - Department of Internal Medicine Faculty of Medicine Ghent University consider the clinical problem of suspected infection in your ICU patient as a ‘monster’ … with a ‘head’, a ‘body’ and a ‘tail’ Medical decision-making about antibiotic use in critically ill patients is challenging and comple...
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The Burden of Viruses in Pneumonia Associated With Acute Respiratory Failure: An Underappreciated Issue Andrew F. Shorr, Kristen Fisher, Scott T. Micek, et al Chest 2018; 154: 84-90 Background 背景 Pneumonia associated with mechanical ventilation (MV) results in substantial mortality and represents a leading reason for the use of antibiotics. The role of viruses in this setting is unclear. Identifying a viral cause in such instances could facilitate antibiotic stewardsh...
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Algorithm for early diagnosis and treatment of thrombocytopaenia in ICU Patients in the intensive care unit (ICU) have a range of clinical problems, including multi-organ failure, sepsis, and shock, and early diagnosis and management are crucial to optimise outcomes. A report in the journal Critical Care proposes a new algorithm to help intensivists make a rapid diagnosis so that they can initiate early appropriate management for ICU patients with thrombocytopaenia. The...
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JAMA Clinical Guidelines Synopsis July 3, 2018 Management of Patients With Acute Lower Gastrointestinal Tract Bleeding Neil Sengupta, Adam S. Cifu JAMA. 2018;320(1):86-87. doi:10.1001/jama.2018.5684 Guideline title 指南题目 ACG Clinical Guideline: Management of Patients With Acute Lower Gastrointestinal Bleeding ACG临床指南:急性下消化道出血患者的诊治 Release date 发布日期 March 1, 2016 2016年3月1日 Funding source 资助来源 American College of Gastroenterology (ACG), Na...
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Does Size Matter When Calculating the “Correct” Tidal Volume for Pediatric Mechanical Ventilation?: A Hypothesis Based on FVC Gina J. Kim, Christopher J.L. Newth, Robinder G. Khemani, et al Chest 2018; 154: 77-83 Background 背景 Tidal volumes standardized to predicted body weight are recommended for adult mechanical ventilation, but children are frequently ventilated by using measured body weight. The goal of this study was to examine the difference in FVC (in milliliter...
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Intensive Care Medicine ONLINE FIRST (FREE ACCESS) From the Inside ~ Nicola Petrucci et al. Beyond bleeps and alarms: live music by the bedside in the ICU. Systematic Review ~ Sarah Vollam et al. Out-of-hours discharge from intensive care, in-hospital mortality and intensive care readmission rates: a systematic review and meta-analysis. Understanding the Disease ~ Pierre Tattevin et al. Understanding central nervous system efficacy of antimicrobials. Original ~ Daniel E. F...
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Perspective > Medscape Critical Care > Critical Issues COMMENTARY A Negative APRV Trial in ARDS Aaron B. Holley, MD June 29, 2018 Recently, I reviewed a randomized, controlled trial (RCT)[1] comparing acute respiratory distress syndrome (ARDS) management with protocolized airway pressure release ventilation (APRV) with low-tidal-volume (LTV) ventilation. APRV showed superiority for the primary outcome, ventilator-free days, and a number of secondary outcomes. Mo...
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Terlipressin versus norepinephrine as infusion in patients with septic shock: a multicentre, randomised, double-blinded trial Zi-Meng Liu, Juan Chen, Qiuye Kou, et al Intensive Care Med 2018 DOI: https://doi.org/10.1007/s00134-018-5267-9 Purpose 目的 Recent clinical data suggest that terlipressin, a vasopressin analogue, may be more beneficial in septic shock patients than catecholamines. However, terlipressin’s effect on mortality is unknown. We set out to ascertain the ...
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Long-term albumin administration in decompensated cirrhosis (ANSWER): an open-label randomised trial Paolo Caraceni, Oliviero Riggio, Paolo Angeli, et al Lancet 2018; 391: 2417-2429 Summary Background 背景 Evidence is scarce on the efficacy of long-term human albumin (HA) administration in patients with decompensated cirrhosis. The human Albumin for the treatmeNt of aScites in patients With hEpatic ciRrhosis (ANSWER) study was designed to clarify this issue. 长期应用人...
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Perspective > Medscape > Trending Clinical Topics Trending Clinical Topics for June 2018 Ryan Syrek June 29, 2018 Each week, we identify one top search term, speculate as to what caused its popularity, and provide an infographic on a related condition. If you have thoughts about what's trending and why, feel free to share them with us on Twitter or Facebook! Trending Clinical Topic of the Week (June 23-29): Cannabis News about the largest developed country to end ...
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