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High-Flow Oxygen through Nasal Cannula in Acute Hypoxemic Respiratory Failure Jean-Pierre Frat, M.D., Arnaud W. Thille, M.D., Ph.D., Alain Mercat, M.D., Ph.D., et al. N Engl J Med 2015 DOI: 10.1056/NEJMoa1503326 BACKGROUND (背景) Whether noninvasive ventilation should be administered in patients with acute hypoxemic respiratory failure is debated. Therapy with high-flow oxygen through a nasal cannula may offer an alternative in patients with hypoxemia. 无创通气能否用于治...
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Animals and Healthcare Facilities: A Healthy Match? Laura A. Stokowski, RN, MS; Reviewers: Rekha Murthy, MD; David J. Weber, MD, MPH May 14, 2015 房间中的动物(Animals in the House) Although teeming with unseen disease-causing pathogens, the hospital has traditionally been viewed as a clean, even sterile environment—no place for animals. With increasing recognition of the strength of the human/animal bond and research showing the benefits of animal-assisted therapy, howeve...
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Automated, electronic alerts for acute kidney injury: a single-blind, parallel-group, randomised controlled trial F. Perry Wilson, Michael Shashaty, Jeffrey Testani, Iram Aqeel, Yuliy Borovskiy, Susan S. Ellenberg, Harold I. Feldman, Hilda Fernandez, Yevgeniy Gitelman, Jennie Lin, Dan Negoianu, Chirag R. Parikh, Peter P. Reese, Richard Urbani, Barry Fuchs Lancet 2015; 385: 1966-1974 摘要(Summary) 背景(Background) Acute kidney injury often goes unrecognised in its early st...
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ARTICLES OF THE MONTH REVIEW ~ Highly resistant bacteria: Prevention and management in the most severe patients  Bassetti et al. Preventive and therapeutic strategies in critically ill patients with highly resistant bacteria. This concise review focuses on diagnostic and therapeutic approaches to preventing and managing nosocomial infections in ICU patients. ORIGINAL ~ High flow oxygen therapy after cardiac surgery in patients with a BMI ≥30 Corley et al. Direct extub...
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Fecal Transplant Effective for Recurrent C diff, Review Shows Janis C. Kelly May 06, 2015 Fecal microbiota transplantation (FMT) appears effective and relatively safe for recurrent Clostridium difficile infection (CDI), but there is too little evidence to draw reliable conclusions about use of the procedure for refractory or initial CDI, a new systematic review suggests. Dimitri Drekonja, MD, from the Minneapolis Veterans Affairs Health Care System, Minnesota, and colleag...
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评论 早期目标指导治疗再次遭受打击? Early Goal-Directed Therapy Takes Another Hit? Aaron B. Holley, MD May 04, 2015 步入新千年的早期全身性感染临床试验 Early Sepsis Trials in the New Millennium 新千年的第一个十年间,有数项大样本、看似设计良好的全身性感染临床试验显示,通过采取特异性干预措施,临床预后显著改善。 2003年某月我在ICU中应用活化蛋白C[1] 治疗一名因脑膜炎导致全身性感染的年轻女性患者(患者最初对药物治疗反应良好,但随后发生了上消化道出血,我们被迫停药)。我还对所有全身...
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Ten tips on how to win the war against resistance to antibiotics 解决抗生素耐药问题的十个建议 Jean Carlet (Foundation Hospital St Joseph, Paris, France) Intensive Care Med DOI 10.1007/s00134-014-3594-z   Antibiotic resistance has increased dramatically in the past few years and nowadays represents a serious threat to public health [1–3]. Reasons are multiple, the excess in antibiotic consumption being the most important one. Therefore, antibiotic prescription must be ...
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Ten big mistakes in intensive care medicine 重症医学领域的十大谬误 Jean-Louis Vincent, Jesse B. Hall, Arthur S. Slutsky Intensive Care Med (2015) 41:505–507 DOI 10.1007/s00134-014-3570-7 罗竞超译 “Experience is simply the name we give our mistakes.” – Oscar Wilde “错误是经验的别称”——奥斯卡·王尔德 Very good clinicians often use a form of self-doubt to avoid the dangers of overconfidence in the diagnosis and management of disease. Asking the questions ‘‘What does not fit w...
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[编者按]:随着循证医学的日益普及,各种临床指南应运而生。我们或热衷制定指南,或积极执行指南。学会网站曾多次刊出对指南的各种反思,希望借此引起临床医生的重视。近日,Intensive Care Medicine杂志在线发表述评,讨论了临床医生对临床指南应当关注的十个重点问题。其中,编者认为最重要的一句话是:“CPG的作者应当清楚地表明他们并不期望所有医生对所有患者均采用同一治疗方案,而是提供背景信息与更多的判断以便做出决定...毕竟,制定指南的目的是指导,而不是强求统一。” 笃信临床指南前需要慎重考虑的十...
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The attributable mortality of delirium in critically ill patients: prospective cohort study. ICM Index Number: 22/020 Authors: Klein Klouwenberg PMC, Zaal IJ, Spitoni C et al. Reference: BMJ 2014; 349: g6652 doi: 10.1136/bmj.g6652. Trial registration number: NCT01905033. © British Medical Association. ICM ABSTRACT Objective To determine the attributable mortality caused by delirium in critically ill patients. Introduction Up to two thirds of patients admitted to the ICU w...
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