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Late parenteral nutrition beneficial to undernourished critically ill children In undernourished critically ill children, withholding parenteral nutrition (PN) for one week was clinically superior to early PN, according to a subanalysis of the Pediatric Early vs. Late Parenteral Nutrition in Intensive Care Unit (PEPaNIC) randomised clinical trial. "In this subanalysis of 289 undernourished critically ill children with insufficient enteral nutritional intake, withholding...
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Original Investigation September 25, 2018 Effect of Algorithm-Based Therapy vs Usual Care on Clinical Success and Serious Adverse Events in Patients with Staphylococcal Bacteremia: A Randomized Clinical Trial Thomas L. Holland, Issam Raad, Helen W. Boucher, et al JAMA. 2018;320(12):1249-1258. doi:10.1001/jama.2018.13155 Abstract Importance 背景 The appropriate duration of antibiotics for staphylococcal bacteremia is unknown. 葡萄球菌菌血症的适当抗生素疗程并不明确。 O...
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"Fluid overload" - a poorly-defined term that should be avoided Clinicians examining an oedematous patient are wont to say that the patient has “fluid overload” or “hypervolemia” or both and propose fluid restriction and/or diuretics as the logical strategy, when often during the acute phases of resuscitation from circulatory shock this approach may be inappropriate, says an editorial published in the journal Critical Care. A fundamental determinant of cardiac output an...
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“Simulate, or not to simulate?” Evolution in medicine and the anaesthesia context. A brief discussion about the importance and the state of the art of simulation in anaesthesia and intensive care medicine. Training in simulation plays a key role in complex systems such as aviation and the nuclear industry, to investigate predictable errors that lead to adverse outcomes. The advancement made by aviation integrating simulation in training over the past years is relevant, wh...
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INTENSIVE CARE MEDICINE ONLINE FIRST THIS WEEK (FREE ACCESS) Image ~ Zhuxiao Ren et al. Congenital haemangioma causing heart failure. Letter ~ Morgan Benaïs et al. Socioeconomic status features of ICU patients: the PRECAREA pilot study. Image ~ Zhongheng Zhang et al. Effectiveness of sodium bicarbonate infusion on mortality in septic patients with metabolic acidosis. Original ~ L. E. M. Haas et al. Healthcare-related costs in very elderly intensive care patients. Original ...
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Intramuscular versus intravenous oxytocin to prevent postpartum haemorrhage at vaginal delivery: randomised controlled trial Nita Adnan, Rebecca Conlan-Trant, Ciara McCormick, et al BMJ 2018; 362 doi: https://doi.org/10.1136/bmj.k3546 (Published 04 September 2018) Cite this as: BMJ 2018;362:k3546 Abstract Objective 目的 To determine whether intravenous oxytocin is more effective than intramuscular oxytocin at preventing postpartum haemorrhage at vaginal delivery. 确定...
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Assessment of the Safety of Discharging Select Patients Directly Home From the Intensive Care Unit: A Multicenter Population-Based Cohort Study. Stelfox HT, Soo A, Niven DJ, et al JAMA Intern Med. 2018 Aug 20. doi: 10.1001/jamainternmed.2018.3675. [Epub ahead of print] IMPORTANCE: 背景 The safety of discharging adult patients recovering from critical illness directly home from the intensive care unit (ICU) is unknown. 病情恢复的危重病成年患者从ICU直接出院回家的安全性尚不...
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JAMA Clinical Guidelines Synopsis August 27, 2018 Diagnosis and Treatment of Clostridium difficile Infection Arjun Gupta, Adam S. Cifu, Sahil Khanna JAMA. Published online August 27, 2018. doi:10.1001/jama.2018.12194 Guideline title: Diagnosis and Treatment of Clostridium difficile Infections in Adults and Children Release date: February 15, 2018 (online); April 1, 2018 (print) Prior version: 2010 Developer: Infectious Diseases Society of America (IDSA) and Society fo...
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News > Medscape Medical News > Neurology News New AI Platform Diagnoses Brain Disease in Seconds George W. Citroner August 15, 2018 An artificial intelligence (AI) platform accurately identifies acute neurologic events, such as stroke, from CT scans in as little as 1.2 seconds, new research suggests. If the findings are confirmed, this technology would radically speed the triage process by immediately alerting physicians to critical findings that may otherwise hav...
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PCT-guided antibiotic treatment improves outcomes in sepsis patients Procalcitonin (PCT)-guided antibiotic treatment in ICU patients with infection and sepsis patients results in improved survival and reduced antibiotic treatment duration, according to results of a new meta-analysis published in the journal Critical Care. Early identification of sepsis and appropriate initial management including the start of antibiotic treatment and fluid resuscitation improves outcomes....
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