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Perspective > Critical Issues COMMENTARY Protocolized APRV Versus Assist Control for ARDS Aaron B. Holley, MD November 27, 2017 Settling the APRV in ARDS Debate The 2017 American Thoracic Society/European Respiratory Society guidelines on mechanical ventilation for acute respiratory distress syndrome (ARDS)[1]failed to address airway-pressure release ventilation (APRV). Although many consider APRV to be a "rescue mode" for refractory hypoxemia,[2] others argue that...
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Perspective > Viewpoints COMMENTARY Angiotensin II: New Hope for Treating Septic Shock? Greg Martin, MD October 27, 2017 Angiotensin II for the Treatment of Vasodilatory Shock Khanna A, English SW, Wang XS, et al; ATHOS-3 Investigators N Engl J Med. 2017; 377:419-430 Background 背景 Septic shock occurs in the United States in approximately 200,000 people each year and leads to approximately 50,000 deaths,[1] and sepsis overall leads to approximately 1 in every 2-3 h...
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Perspective > Viewpoints COMMENTARY In COPD, Are Sepsis Outcomes Better When a Bronchodilator Doubles as an Anti-inflammatory? Nicholas Gross, MD, PhD October 26, 2017 Association of Pre-hospital Theophylline Use and Mortality in Chronic Obstructive Pulmonary Disease Patients With Sepsis Shih YN, Chen YT, Chu H, et al Respir Med. 2017;125:33-38 Introduction 背景 Sepsis is a life-threatening disorder, and data show that its incidence doubled from 2000 through 200...
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Perspective > Viewpoints COMMENTARY Can Ganciclovir Thwart CMV Reactivation in Critical Illness? Greg Martin, MD October 30, 2017 CMV Reactivation: Can It Be Reduced? CMV复燃:能否减少? Cytomegalovirus (CMV) is a widely prevalent human herpes virus found in most healthy adults and causes lifelong latent infection in many organs, such as the lung. Latent CMV commonly reactivates during immunosuppression or critical illness, and research shows an association of CMV...
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ICM RESEARCH AGENDA (FREE ACCESS) Michael A. Gillies et al. Current research priorities in perioperative intensive care medicine. Alain Combes et al. The ICM research agenda on extracorporeal life support. Hans Flaatten et al. The status of intensive care medicine research and a future agenda for very old patients in the ICU. Pratik P. Pandharipande et al. The intensive care delirium research agenda: a multinational, interprofessional perspective. Marin H. Kollef et al. Th...
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News Age of Transfused Blood Does Not Affect Mortality Nicola M. Parry, DVM September 29, 2017 Transfusing critically ill patients with the freshest available red cells, rather than with standard-issue (oldest available) red cells, provides no clinically meaningful benefits, a new study suggests. 一项新的研究提示,危重病患者输注最新鲜的红细胞而非标准规程(最陈旧的)红细胞并无临床获益。 D. James Cooper, MD, Monash University, Melbourne, Victoria, Australia, and colleague...
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Editorial September 13, 2017 Counting Sepsis, an Imprecise but Improving Science Kristina E. Rudd, Anthony Delaney, Simon Finfer AMA. 2017;318(13):1228-1229. doi:10.1001/jama.2017.13697 Sepsis, most succinctly defined as organ dysfunction due to infection, is estimated to account for more than 5 million deaths around the world each year and to cause or contribute to approximately half of all deaths occurring in hospitals in the United States.1,2 A 2016 report from the...
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High-Frequency Oscillation in Acute Respiratory Distress Syndrome: The End of the Story? Vincent JL. Am J Respir Crit Care Med 2017; 196: 670-671 Acute respiratory distress syndrome (ARDS) is still associated with considerable morbidity and mortality (1). It is characterized by acute onset of diffuse inflammatory lung injury, which causes increased pulmonary vascular permeability, leading to increased lung weight, loss of aerated lung tissue, decreased lung compliance, and...
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CORRESPONDENCE Early, Goal-Directed Therapy for Septic Shock — A Patient-Level Meta-Analysis N Engl J Med 2017; 377:994-995 DOI: 10.1056/NEJMc1708979 The authors reply: In response to Saleh: we do not have specific information on monitoring in the usual-care (control) groups. However, all three original trials1-3 were conducted at sites that did not systematically apply any protocolized approach to resuscitation of patients with sepsis as part of usual care and, by definit...
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News > Reuters Health Information Hypervirulent Carbapenem-resistant Klebsiella Pneumoniae Emerges By Will Boggs MD September 08, 2017 NEW YORK (Reuters Health) - An ST11 carbapenem-resistant hypervirulent Klebsiella pneumoniae caused a fatal outbreak in a Chinese hospital and could pose a threat elsewhere, researchers report. 研究人员报告,一种ST11耐碳青霉烯高毒力肺炎克雷白杆菌在一家中国医院内导致致死性暴发流行,且可能对其他地区造成危害。 “This new type of superbug...
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