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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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News > Medscape Medical News > Neurology News Glasgow Coma Scale Gets an Eye-Opening Update Damian McNamara April 19, 2018 Working with a developer of the original Glasgow Coma Scale (GCS), researchers have found that adding pupil response to the GCS more accurately predicts prognosis after traumatic brain injury, including the likelihood of death, than either measure alone. Because previous research suggested that the GCS score and pupil reaction independently ...
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Novel Method for Noninvasive Sampling of the Distal Airspace in Acute Respiratory Distress Syndrome J. Brennan McNeil , Ciara M. Shaver , V. Eric Kerchberger , et al Am J Respir Crit Care Med 2018; 197: 1027-1035 Rationale: 背景 A major barrier to a more complete understanding of acute respiratory distress syndrome (ARDS) pathophysiology is the inability to sample the distal airspace of patients with ARDS. The heat moisture exchanger (HME) filter is an inline bacterios...
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Hyperchloraemia in sepsis: saline vs. balanced crystalloids Chloride, as the major anion of the extracellular fluid, constitutes an important element in the homeostasis of the human organism. Hyperchloraemia, whether a result of the sepsis process or a consequence of its treatment with supraphysiologic chloride fluids, appears to have a negative impact on the clinical outcome of septic patients, according to an article published in Annals of Intensive Care. Acidosis is a f...
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