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ORIGINAL ARTICLE A Randomized Trial of a Family-Support Intervention in Intensive Care Units Douglas B. White, Derek C. Angus, Anne-Marie Shields, et al N Engl J Med 2018; 378:2365-2375 DOI: 10.1056/NEJMoa1802637 Abstract BACKGROUND 背景 Surrogate decision makers for incapacitated, critically ill patients often struggle with decisions related to goals of care. Such decisions cause psychological distress in surrogates and may lead to treatment that does not align with patie...
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Perspective SHATTUCK LECTURE Innovation for Pandemics Bill Gates N Engl J Med 2018; 378:2057-2060 DOI: 10.1056/NEJMp1806283 Over recent decades, the world has seen incredible progress in reducing child mortality and tackling infectious diseases. Thanks to better vaccines and other interventions, child mortality has decreased by more than 50% since 1990. We are on the verge of eradicating polio. HIV is no longer a certain death sentence. And half the world is now malaria-fr...
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ORIGINAL ARTICLE Procalcitonin-Guided Use of Antibiotics for Lower Respiratory Tract Infection David T. Huang, Donald M. Yealy, Michael R. Filbin, et al Abstract BACKGROUND 背景 The effect of procalcitonin-guided use of antibiotics on treatment for suspected lower respiratory tract infection is unclear. 降钙素原指导抗生素治疗疑似下呼吸道感染的作用尚不清楚。 METHODS 方法 In 14 U.S. hospitals with high adherence to quality measures for the treatment of pneumonia, we provided...
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Correspondence The Magic Bullet in Sepsis or the Inflation of Chance Findings? Morten H. Møller, Jon H. Laake, John A. Myburgh, et al. Chest 2017; 152: 222-223 To the Editor: In the June 2017 issue of CHEST, Marik et al1 presented a single-center retrospective before and after study assessing the effects of treating patients with severe sepsis/septic shock with IV vitamin C, hydrocortisone, and thiamine. Forty-seven patients were treated with IV vitamin C, hydroc...
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EDITORIAL Finding the Right Balance Birgitte Brandstrup N Engl J Med 2018; 378:2335-2336 DOI: 10.1056/NEJMe1805615 When I was a young resident in the 1990s, surgical patients received so much intravenous saline on the day of surgery that they often gained 4 to 6 kg, and by postoperative day 2 or 3, pulmonary congestion and cardiac arrhythmias were commonplace. That was the basis for a 2003 trial of restrictive versus standard fluid therapy,1 which aimed to answer a simple ...
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Intensive Care Medicine ONLINE FIRST THIS WEEK (FREE ACCESS) Editorial debate ~ ​Jean-François Timsit and Matteo Bassett. Antipathy against SDD is justified: Yes. Editorial debate ~ Luciano Silvestri et al. Antipathy against SDD is justified: No. ​ Editorial debate ~ Michael Quintel et al. Antipathy against SDD is justified: We are not sure. Original ~ Elie Azoulay et al. Management and outcomes of acute respiratory distress syndrome patients with and without comorbid cond...
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News > WebMD Health News Vitamin Cocktail for Sepsis Getting Wider Test Matt Smith May 29, 2018 A simple vitamin cocktail to treat sepsis has shaken up the medical world, raising hopes of a more effective treatment for one of history's great killers. But will it stand up to tougher tests? 一种简单的维生素鸡尾酒疗法治疗全身性感染对医学界产生了震动,为治疗这种一个世纪以来危及生命的临床疾病带来了有效治疗的曙光。但是,这种疗法能否经受更加严苛的验证呢? Researchers at sev...
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Editorial May 20, 2018 qSOFA Score for Patients With Sepsis in Low- and Middle-Income Countries Neill K. J. Adhikari, Gordon D. Rubenfeld JAMA. Published online May 20, 2018. doi:10.1001/jama.2018.6413 In the past 2 years, sepsis has received considerable attention from the global community. In 2017, the World Health Assembly passed a resolution urging all 194 UN Member States to implement actions to reduce the burden of sepsis, and for the World Health Organization to...
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CORRESPONDENCE ICU Admissions for Sepsis or Pneumonia in Australia and New Zealand in 2017 Aidan Burrell, Sue Huckson, David V. Pilcher for the ANZICS N Engl J Med 2018; 378:2138-2139 DOI: 10.1056/NEJMc1717178 TO THE EDITOR: Seasonal patterns of presentations to intensive care units (ICUs) in the Southern Hemisphere can inform health care planning for critically ill patients worldwide, as was seen during the H1N1 influenza pandemic in 2009.1 During the late winter and earl...
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Original Investigation May 20, 2018 Association of the Quick Sequential (Sepsis-Related) Organ Failure Assessment (qSOFA) Score With Excess Hospital Mortality in Adults With Suspected Infection in Low- and Middle-Income Countries Kristina E. Rudd, Christopher W. Seymour, Adam R. Aluisio, et al JAMA. Published online May 20, 2018. doi:10.1001/jama.2018.6229 Abstract Importance 背景 The quick Sequential (Sepsis-Related) Organ Failure Assessment (qSOFA) score has not be...
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