Immunotherapy effects on sepsis A randomised controlled multicentre trial assessed for the first time the safety and pharmacokinetics of an antiprogrammed cell death-ligand 1 (anti–PD-L1) immune checkpoint inhibitor (BMS-936559; Bristol-Myers Squibb, Princeton, NJ) and its effect on immune biomarkers in participants with sepsis-associated immunosuppression. Results show that BMS-936559 was well tolerated, with no evidence of drug-induced hypercytokinaemia or cyt...

Effect of adhesive tape versus endotracheal tube fastener in critically ill adults The securement method of endotracheal tubes should ideally prevent dislodgement and minimise complications. Endotracheal tube fastener can reduce complications among critically ill patients who are undergoing endotracheal intubation.  You might also like:UK study: extubating ventilated patients on vasoactive infusions 'safe' A study was conducted with critically ill adults who ...

Resuscitation in septic shock: is less better? On Day 2 of the Euroanaesthesia Congress 2019 (#EA19), there was a session on Resuscitation in septic shock: is less better? Three key speakers Gernot Marx (Aachen, Germany), Claude Martin (Marseille, France) and Jean-Louis Vincent (Brussels, Belgium), spoke about less fluid, less vasopressors and less inotropes in septic shock. The central message of this session was simple: less is more in sepsis.  The session was...

Acute pain in the ICU: management beyond the usual therapeutic strategies At this year’s Euroanaesthesia 2019 in Vienna, Austria, Prof. Caterina Aurilio (Naples, Italy), talked about acute pain management in the ICU. She started her presentation with the definition of pain as outlined by the International Association for the Study of Pain (IASP). Pain is an "unnecessary sensory and emotional experience associated with actual or potential tissue damage, or desc...

Highlights from the pro-con debate on guidelines At this year’s Euroanaesthesia Congress #EA19, there was a short debate on the topic of guidelines. Talking about the pros was Edoardo De Robertis, Past-Chair, ESA Guidelines Committee, University of Perugia, Italy, and talking about the cons was Arash Afshari, Chair, ESA Guidelines Committee, Rigshospitalet, Copenhagen, Denmark  Here are some highlights from both sides of the debate! Dr. Arash Afshari“I think tha...

小剂量阿奇霉素可能减少COPD急性加重住院患者的治疗失败。这是American Journal of Respiratory and Critical Care Medicine杂志在线发表的一项多中心随机对照试验的结果。 既往研究表明，阿奇霉素能够预防COPD的急性加重。然而，尚不清楚这种抗生素如何能够COPD急性加重的住院患者强化治疗的需求，或者在上述患者出院后为何能够减少急性加重的风险。 在新的研究中，即比利时阿奇霉素治疗COPD加重住院患者研究(BACE)，除住院期间的其他用药外，患者使用小剂量阿奇霉素，并在出院后继续使用小剂量阿奇霉...

Azithromycin may reduce treatment failure in acute COPD exacerbations Low‐dose azithromycin may reduce treatment failure in patients hospitalised for acute exacerbations of chronic obstructive pulmonary disease (COPD). This finding is from a multicentre, randomised controlled trial published online in the American Journal of Respiratory and Critical Care Medicine. The antibiotic azithromycin prevents acute exacerbations in COPD as shown in previous studies. It w...

Editorial June 3, 2019 Setting Positive End-Expiratory Pressure in Mechanically Ventilated Patients Undergoing Surgery Thomas Godet, Emmanuel Futier JAMA. 2019;321(23):2285-2287. doi:10.1001/jama.2019.7540 What is the optimal level of positive end-expiratory pressure (PEEP) for patients receiving mechanical ventilation? Despite decades of investigations, this question continues to be discussed among researchers and clinicians with no clear answer, leaving...

Reasonable Doubt Don't Be Fooled by New Study Tamiflu Still Pretty Worthless for H1N1 Runde, Dan, MD Emergency Medicine News: April 2019 - Volume 41 - Issue 4 - p 6 doi: 10.1097/01.EEM.0000554842.09002.7c It's possible that the Tamiflu pandemonium may be peaking for most emergency and primary care physicians because the dubious benefits of oseltamivir have now been well documented, discussed, and disseminated. (See box.) But there's also a new kid on the...

Editorial June 11, 2019 Revisiting, Reframing, and Casting a New Light on Liberation From Mechanical Ventilation Timothy D. Girard, Karen E. A. Burns JAMA. 2019;321(22):2167-2169. doi:10.1001/jama.2019.7364 Every year, more than 1 million patients throughout the world receive mechanical ventilation for acute respiratory failure. One of the most important decisions clinicians make in managing these critically ill patients is how to liberate them ...