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邀请您参加有关拯救脓毒症临床指南的在线调查 脓毒症及其各种并发症是危及人类健康的重要临床综合征,同时给社会带来了严重的经济负担。根据高收入国家和地区的流行病学数据预计,全球脓毒症的年发病率约为437例/10万人口,年发病人数超过3150万。专家估计,中低收入国家脓毒症的发病率可能更高。我国脓毒症发病率约为461例/10万人口,年发病人数约500万,死亡人数超过100万。 因此,增进医务人员对脓毒症的理解,是改善脓毒症患者临床预后的重要手段。 由加拿大McMaster大学Waleed Alhazzani医生负责的全球问卷调...
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High-risk ECMO - heroic rescue or futile care? Over the past decade, extracorporeal membrane oxygenation (ECMO) has become mainstream therapy in adult intensive care. Although the list of contraindications to ECMO has shrunk considerably, a few of these remain absolute, notes Dr. Graeme MacLaren in an editorial article published in the journal Critical Care. "There are a number of circumstances outside of this list of contraindications to which ECMO could be applied ...
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Medical News & Perspectives September 19, 2018 Unproven but Profitable: The Boom in US Stem Cell Clinics Rita Rubin JAMA. Published online September 19, 2018. doi:10.1001/jama.2018.13861 Stanford orthopedic surgeon Jason Dragoo, MD, is conducting 4 randomized clinical trials of the use of autologous stem cells to treat knee osteoarthritis. Interest in the trials seems high—nearly 100 people inquire about them daily, Dragoo says—but he recognizes that some patient...
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ORIGINAL ARTICLE Energy-Dense versus Routine Enteral Nutrition in the Critically Ill The TARGET Investigators, for the ANZICS Clinical Trials Group N Engl J Med October 22, 2018 DOI: 10.1056/NEJMoa1811687 Abstract BACKGROUND 背景 The effect of delivering nutrition at different calorie levels during critical illness is uncertain, and patients typically receive less than the recommended amount. 危重病阶段给予不同热卡水平营养的效果尚不明确,患者接受的热卡通常低于推荐目标。 ME...
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Special Communication October 22, 2018 Extracorporeal Membrane Oxygenation for Severe Acute Respiratory Distress Syndrome and Posterior Probability of Mortality Benefit in a Post Hoc Bayesian Analysis of a Randomized Clinical Trial Ewan C. Goligher, George Tomlinson, David Hajage, et al JAMA. Published online October 22, 2018. doi:10.1001/jama.2018.14276 Abstract Importance 背景 Bayesian analysis of clinical trial data may provide useful information to aid in study i...
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ORIGINAL ARTICLE Haloperidol and Ziprasidone for Treatment of Delirium in Critical Illness Timothy D. Girard, Matthew C. Exline, Shannon S. Carson, et al. N Engl J Med October 22, 2018 DOI: 10.1056/NEJMoa1808217 Abstract BACKGROUND 背景 There are conflicting data on the effects of antipsychotic medications on delirium in patients in the intensive care unit (ICU). 抗精神病药物对ICU患者谵妄的疗效数据相互矛盾。 METHODS 方法 In a randomized, double-blind, placebo-controlled tr...
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ORIGINAL ARTICLE Pantoprazole in Patients at Risk for Gastrointestinal Bleeding in the ICU Mette Krag, Søren Marker, Anders Perner, et al N Engl J Med October 24, 2018 DOI: 10.1056/NEJMoa1714919 Abstract BACKGROUND 背景 Prophylaxis for gastrointestinal stress ulceration is frequently given to patients in the intensive care unit (ICU), but its risks and benefits are unclear. ICU患者常常接受胃肠道应激性溃疡的预防,但其风险及获益并不清楚。 METHODS 方法 In this European, multi...
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Original Investigation October 22, 2018 Decontamination Strategies and Bloodstream Infections With Antibiotic-Resistant Microorganisms in Ventilated Patients: A Randomized Clinical Trial Bastiaan H. Wittekamp, Nienke L. Plantinga, Ben S. Cooper, et al JAMA. Published online October 22, 2018. doi:10.1001/jama.2018.13765 Abstract Importance 背景 The effects of chlorhexidine (CHX) mouthwash, selective oropharyngeal decontamination (SOD), and selective digestive tract de...
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Original Investigation October 22, 2018 Effect of Protocolized Weaning With Early Extubation to Noninvasive Ventilation vs Invasive Weaning on Time to Liberation From Mechanical Ventilation Among Patients With Respiratory Failure: The Breathe Randomized Clinical Trial Gavin D. Perkins, Dipesh Mistry, Simon Gates, et al JAMA. Published online October 22, 2018. doi:10.1001/jama.2018.13763 Abstract Importance 背景 In adults in whom weaning from invasive mechanical v...
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ORIGINAL ARTICLE Timing of Renal-Replacement Therapy in Patients with Acute Kidney Injury and Sepsis Saber D. Barbar, Raphaël Clere-Jehl, Abderrahmane Bourredjem, et al N Engl J Med 2018; 379:1431-1442 DOI: 10.1056/NEJMoa1803213 Abstract BACKGROUND 背景 Acute kidney injury is the most frequent complication in patients with septic shock and is an independent risk factor for death. Although renal-replacement therapy is the standard of care for severe acute kidney injury, the...
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