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ORIGINAL ARTICLE Early, Goal-Directed Therapy for Septic Shock — A Patient-Level Meta-Analysis The PRISM Investigators March 21, 2017 DOI: 10.1056/NEJMoa1701380 BACKGROUND 背景 After a single-center trial and observational studies suggesting that early, goal-directed therapy (EGDT) reduced mortality from septic shock, three multicenter trials (ProCESS, ARISE, and ProMISe) showed no benefit. This meta-analysis of individual patient data from the three recent trials was desi...
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Sevoflurane for Sedation in Acute Respiratory Distress Syndrome. A Randomized Controlled Pilot Study Matthieu Jabaudon, Pierre Boucher, Etienne Imhoff, et al. Am J Respir Crit Care Med 2017; 195: 792-800 Rationale: 背景 Sevoflurane improves gas exchange, and reduces alveolar edema and inflammation in preclinical studies of lung injury, but its therapeutic effects have never been investigated in acute respiratory distress syndrome (ARDS). 有关肺损伤的临床前研究显示,七...
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Epidemiology of Weaning Outcome according to a New Definition. The WIND Study Gaëtan Béduneau, Tài Pham, Frédérique Schortgen, et al. Am J Respir Crit Care Med 2017; 195: 772-783 Rationale: 背景 The weaning process concerns all patients receiving mechanical ventilation. A previous classification into simple, prolonged, and difficult weaning ignored weaning failure and presupposed the use of spontaneous breathing trials. 脱机过程涉及所有接受机械通气的患者。既往分类方法将患...
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Recovery after Acute Kidney Injury John A. Kellum, Florentina E. Sileanu, Azra Bihorac, et al Am J Respir Crit Care Med 2017; 195: 784-791 Rationale: 背景 Little is known about how acute kidney injury (AKI) resolves, and whether patterns of reversal of renal dysfunction differ among patients with respect to ultimate recovery. 有关急性肾损伤(AKI)的恢复过程,以及不同患者肾脏功能障碍的逆转模式知之甚少。 Objectives: 目的 We sought to examine different patterns for AKI revers...
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EMPIRICAL MICAFUNGIN TREATMENT AND SURVIVAL WITHOUT INVASIVE FUNGAL INFECTION IN ADULTS WITH ICU-ACQUIRED SEPSIS, CANDIDA COLONIZATION, AND MULTIPLE ORGAN FAILURE: 
THE EMPIRICUS RANDOMIZED CLINICAL TRIAL. Authors: Timsit JF, Azoulay E, Schwebel C, et al. Reference: JAMA 2016;316:1555–1564. © American Medical Association. Level of evidence: 2 ICM ABSTRACT Objective To determine the effect of empirical micafungin treatment on survival without an invasive fungal infection i...
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FDA Approvals > Medscape Medical News FDA Expands Use of Procalcitonin Test to Help Guide ABX Use Megan Brooks February 24, 2017 The US Food and Drug Administration (FDA) has cleared the expanded use of the Vidas Brahms procalcitonin (PCT) test to help clinicians determine whether antibiotic treatment should be initiated or stopped in patients with lower respiratory tract infections and stopped in patients with sepsis. The Vidas Brahms PCT assay, manufactured by bioMér...
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Medscape Critical Care > Critical Issues How to Interpret a Diffusion Capacity of the Lung for Carbon Monoxide Aaron B. Holley, MD March 07, 2017 Background The diffusion capacity of the lung for carbon monoxide (DLCO) is used to measure the body's ability to transfer oxygen across the alveolar-capillary membrane. [1] Internists use this test to identify interstitial lung disease, oncologists order it to assess the effects of chemotherapy, and pulmonologists use it f...
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High-flow warm humidified oxygen versus standard low-flow nasal cannula oxygen for moderate bronchiolitis (HFWHO RCT): an open, phase 4, randomised controlled trial Elizabeth Kepreotes, Bruce Whitehead, John Attia, et al Lancet 2017; 389: 930-939 Summary Background 背景 Bronchiolitis is the most common lung infection in infants and treatment focuses on management of respiratory distress and hypoxia. High-flow warm humidified oxygen (HFWHO) is increasingly used, but has...
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Reuters Health Information Early High Protein Intake May Decrease Mortality in ICU Patients With Low Muscle Mass By Rob Goodier March 01, 2017 NEW YORK (Reuters Health) – Delivering high protein nutrition shortly after admission to intensive care may reduce the mortality risk for patients with low muscle mass, a retrospective study suggests. 一项回顾性研究提示,收入ICU后尽快给予高蛋白质营养可能降低肌肉减少患者的死亡风险。 “We found protein intake over days 2 to 4 to be si...
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EPIDEMIOLOGY OF ACUTE KIDNEY INJURY IN CRITICALLY ILL CHILDREN AND YOUNG ADULTS. Authors: Kaddourah A, Basu RK, Bagshaw SM, Goldstein SL for the AWARE Investigators. Reference: N Engl J Med, 2017; 376: 11-20 © Massachusetts Medical Society. Level of evidence: 4 ICM ABSTRACT Objective To define the incremental risk of death and complications associated with severe acute kidney injury (AKI) in critically ill children and young adults. Introduction In adult patients, AKI is ...
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