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ORIGINAL ARTICLE Extracorporeal Membrane Oxygenation for Severe Acute Respiratory Distress Syndrome Alain Combes, David Hajage, Gilles Capellier, et al N Engl J Med 2018; 378:1965-1975 DOI: 10.1056/NEJMoa1800385 Abstract BACKGROUND 背景 The efficacy of venovenous extracorporeal membrane oxygenation (ECMO) in patients with severe acute respiratory distress syndrome (ARDS) remains controversial. vvECMO对严重ARDS患者的疗效仍存在争议。 METHODS 方法 In an international clinical...
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Intensive Care Medicine ONLINE FIRST THIS WEEK (FREE ACCESS) The Surviving Sepsis Campaign (SSC) has released a new updated Hour-1 Bundle to reflect the latest evidence from the International Guidelines for Management of Sepsis and Septic Shock 2016. In this revision of the SSC bundles, the 3-hour and 6-hour bundles have been combined into a single “Hour-1 Bundle” with the explicit intention of beginning resuscitation and management immediately. This new sepsis “Hour-1 Bun...
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邀请您参加MOSAICS II研究   您还记得MOSAICS研究吗? 2009年7月,亚洲16个国家150个ICU参加了为期一个月的MOSAICS研究。研究旨在了解亚洲国家ICU中全身性感染集束化治疗的依从性及其对临床预后的影响。研究最终纳入1285名严重全身性感染/感染性休克患者,住院病死率44.5%,6小时及24小时集束化治疗措施的依从性分别为7.6%与3.5%。 该研究结果发表在BMJ 2011; 342: d3245 MOSAICS II研究的目的 Sepsis 3.0定义系根据西方高收入国家临床资料提出。而世界其他地区全身性感染流行病学特点知之甚少。 本研究主要...
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Intravenous Immune Globulin to Prevent Heparin-Induced Thrombocytopenia Theodore E. Warkentin, Troy H. Climans, Pierre-Aurèle Morin N Engl J Med 2018; 378:1845-1848 DOI: 10.1056/NEJMc1801799 TO THE EDITOR: Heparin-induced thrombocytopenia is a prothrombotic drug reaction caused by anti–platelet factor 4 (PF4)–heparin antibodies of the IgG class that activate platelets through platelet Fcγ receptors.1 Although treatment with nonheparin anticoagulation is emphasized, recent ...
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Early corticosteroids for Pneumocystis pneumonia in adults without HIV are not associated with better outcome Patrick M. Wieruszewski, Jason N. Barreto, Erin Frazee, et al Chest 2018 DOI: 10.1016/j.chest.2018.04.026 ABSTRACT Background: 背景 Evidence supporting adjunctive corticosteroids during the treatment of Pneumocystis pneumonia (PcP) in adults without human immunodeficiency virus (HIV) is minimal and controversial. 对于HIV阴性成年PcP患者而言,支持皮质激素辅助治疗的证...
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SeptiCyte LAB: new test aims to make sepsis molecular Sepsis is a life-threatening condition and early detection is critical to ensure that the patient receives timely and appropriate treatment. For almost 25 years, clinicians have used the systemic inflammatory response syndrome (SIRS) criteria, a measure of the clinical expression of the host response to inflammation, as a marker of sepsis. A new approach to the diagnosis of sepsis has been proposed by Miller et al., ba...
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Intensive Care Medicine ONLINE FIRST THIS WEEK (FREE ACCESS) Letter ~ Thomas Marian et al. Are intensive care physicians aware of dysphagia? The MADICU survey results. Correspondence ~ Shunsuke Taito et al. Do change of care and rehabilitation for patients with mechanical ventilation increase chances of return to work? Editorial Debate ~ Laurent Papazian et al. Should all ICU clinicians regularly be tested for burnout? Yes. Editorial Debate ~ Bara Ricou et al. Should all I...
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Restrictive versus Liberal Fluid Therapy for Major Abdominal Surgery Myles PS, Bellomo R, Corcoran T, et al N Engl J Med published on May 10, 2018 DOI: 10.1056/NEJMoa1801601 BACKGROUND 背景 Guidelines to promote the early recovery of patients undergoing major surgery recommend a restrictive intravenous-fluid strategy for abdominal surgery. However, the supporting evidence is limited, and there is concern about impaired organ perfusion. 旨在促进大手术患者早期康复的指南推荐...
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Research Age and sex of surgeons and mortality of older surgical patients: observational study Yusuke Tsugawa, Anupam B Jena, E John Orav, et al. BMJ 2018; 361: k1343 doi: https://doi.org/10.1136/bmj.k1343 (Published 25 April 2018) Abstract Objective 目的 To investigate whether patients’ mortality differs according to the age and sex of surgeons. 研究患者病死率是否受到外科医生年龄与性别的影响。 Design 设计 Observational study. 观察性研究 Setting 场景 US acute care hos...
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CORRESPONDENCE Long-Term Outcomes of the ADRENAL Trial Balasubramanian Venkatesh, Simon Finfer, John Myburgh, et al N Engl J Med April 25, 2018 DOI: 10.1056/NEJMc1803563 TO THE EDITOR: We recently reported the primary results of the Adjunctive Corticosteroid Treatment in Critically Ill Patients with Septic Shock (ADRENAL) trial, which tested the hypothesis that hydrocortisone would result in lower mortality than placebo among patients with septic shock.1 Further analysis o...
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