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[编者按]:近年来,ECMO已经成为重症医学界时尚的宠儿。诚然,对部分危重病患者而言,ECMO能够显著改善生理指标,甚至挽救患者生命。然而,我们是否也面临着滥用ECMO的问题?这里介绍的是Blue Journal一个很短篇幅的文章。作者发现,在ARDS患者接受ECMO治疗(价格昂贵且疗效并未证实)前,仅有31%使用过俯卧位通气(价格便宜且疗效确定)。但愿这样的文章不仅仅是为当前的ECMO热潮浇一点凉水,更能够促进我们的思考... Unproven and Expensive before Proven and Cheap – Extracorporeal Membrane Oxygenation vs....
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Airway Pressure Release Ventilation in Pediatric Acute Respiratory Distress Syndrome: a Randomized Controlled Trial Saptharishi Lalgudi Ganesan, Muralidharan Jayashree, Sunit Chandra Singhi, et al Am J Respir Crit Care Med 2018 Published Online: April 11, 2018 https://doi.org/10.1164/rccm.201705-0989OC PubMed: 29641221 Rationale: 背景 Though case series describe benefits of Airway pressure release ventilation (APRV), this mo...
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Multistate Outbreak of E. coli O157:H7 Infections Linked to Chopped Romaine Lettuce Posted April 13, 2018 2:00 PM EST 概要 病例数 35例 发病    11个州 死亡    0例 住院    22例 召回    无 Highlights Information collected to date indicates that chopped romaine lettuce from the Yuma, Arizona growing region could be contaminated with E. coli O157:H7 and could make people sick. At this time, no common grower, supplier, distributor, or brand has been identified. Adv...
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Intensive Care Medicine ONLINE FIRST THIS WEEK (FREE ACCESS) Original ~ Fabiana Madotto et al. Resolved versus confirmed ARDS after 24h: Insights from the LUNG SAFE study. Seven-Day Profile Publication ~ Tobias Welte et al. Efficacy and safety of trimodulin, a novel polyclonal antibody preparation, in patients with severe community-acquired pneumonia: a randomised, placebo-controlled, double-blind, multicentre, phase II trial (CIGMA study). What's New in Intensive Care ~ G...
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Viewpoint April 10, 2018 The Proposal to Lower P Value Thresholds to .005 John P. A. Ioannidis JAMA. 2018;319(14):1429-1430. doi:10.1001/jama.2018.1536 P values and accompanying methods of statistical significance testing are creating challenges in biomedical science and other disciplines. The vast majority (96%) of articles that report P values in the abstract, full text, or both include some values of .05 or less.1 However, many of the claims that these reports highl...
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ORIGINAL ARTICLE Two-Year Outcomes with a Magnetically Levitated Cardiac Pump in Heart Failure Mandeep R. Mehra, Daniel J. Goldstein, Nir Uriel, et al N Engl J Med 2018; 378:1386-1395 DOI: 10.1056/NEJMoa1800866 Abstract BACKGROUND 背景 In an early analysis of this trial, use of a magnetically levitated centrifugal continuous-flow circulatory pump was found to improve clinical outcomes, as compared with a mechanical-bearing axial continuous-flow pump, at 6 months in patient...
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Articles Prevalence and risk factors of chronic obstructive pulmonary disease in China (the China Pulmonary Health [CPH] study): a national cross-sectional study Chen Wang, Jianying Xu, Lan Yang, et al Lancet 2018 Available online 9 April 2018 Summary Background 背景 Although exposure to cigarette smoking and air pollution is common, the current prevalence of chronic obstructive pulmonary disease (COPD) is unknown in the Chinese adult population. We conducted the China Pul...
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News > Medscape Medical News > Conference News > HM 2018 Machine Predicts Inpatient Sepsis 5 Hours Sooner Marcia Frellick April 10, 2018 ORLANDO — Deep machine learning can help predict sepsis in hospitalized patients an average of 5 hours before they meet the clinical definition, new data show. 新的数据显示,深度机器学习能够在住院患者满足临床诊断标准前平均5小时预测全身性感染。 "Every hour delay in antibiotic therapy is associated with a 7% to 8% increase in ...
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Articles Chronic obstructive pulmonary disease in China: a nationwide prevalence study Liwen Fang, Pei Gao, Heling Bao, et al Lancet Respir Med Available online 9 April 2018 https://doi.org/10.1016/S2213-2600(18)30103-6 Summary Background 背景 Because of the rapid change in economic development and lifestyle in China, and the ageing population, concerns have grown that chronic obstructive pulmonary disease (COPD) could become epidemic. An up-to-date nationwide estimat...
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Comment Antibiotic strategies in critical care: back to square one? Philipp Schuetz, Robert Eric Beardmore Lancet Infect Dis 2018: 8: 360-361 https://doi.org/10.1016/S1473-3099(18)30057-4 The worth of antibiotics to human health is without bound, but antimicrobial resistance poses a serious threat to this treasured resource.1 Reduction of the selection pressure on pathogens through the rational use of antimicrobials, and discernment of which antibiotic treatment strat...
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