Recommended Reading from the Vrije Universiteit Amsterdam Medical Center Critical Care Medicine Fellows Mirjam Kop, Nicolas F. Schroten, Sharon Soe-Loek-Mooi, et al Am J Respir Crit Care Med Published on 18-October-2017 as 10.1164/rccm.201701-0245RR Keh D, et al. Effect of Hydrocortisone on Development of Shock Among Patients With Severe Sepsis. The HYPRESS randomized clinical trial. JAMA (1) Reviewed by Mirjam Kop Corticosteroids have been used for the treatment of patien...

Perspective > Critical Issues COMMENTARY The Pros and Cons of Extracorporeal Membrane Oxygenation for ARDS Aaron B. Holley, MD January 16, 2018 Using Extracorporeal Membrane Oxygenation for ARDS 采用ECMO治疗ARDS Critical Care Medicine just published a pro-con debate. One side argued for extracorporeal membrane oxygenation (ECMO) as first-line therapy for acute respiratory distress syndrome (ARDS); the other side argued against it.[1,2] I've spent the past 18 months w...

News > Reuters Health Information Steroid Therapy Speeds Recovery From Septic Shock, but With No Survival Benefit By Gene Emery January 22, 2018 (Reuters Health) - A hydrocortisone infusion does not reduce mortality among septic shock patients undergoing mechanical ventilation, but it does speed recovery when the condition is not fatal, according to an international study of 3,658 patients treated over four years. 根据一项历时4年入选了3658名患者的国际研究结果，接受...

Adjunctive Glucocorticoid Therapy in Patients with Septic Shock Comment Kathrin Jähne, MD | Jan 25, 2018 Interesting but once again negative septic shock trial 有趣的但结果再次阴性的感染性休克试验 Steroid use in septic shock has multiple targets: Supplement the stress hormone cortisol to overcome TEMPORARY insufficiency. Faster reversal of shock may relate to this. Shock reversal is less likely to influence the primary end-point (90day mortality) and rather a very short te...

Can we improve the reliability of ARDS diagnosis? Failure to reliably diagnose ARDS, or acute respiratory distress syndrome, could lead to underrecognition and undertreatment in clinical practice. New research shows the reliability of the Berlin ARDS definition is "moderate," driven primarily by differences in chest imaging interpretation. The study is in press in the journal CHEST. The 2012 revision to the ARDS definition sought to improve the validity and reliability of...

We don’t appreciate SALT Jean-Louis Vincent and Daniel De Backer Am J Respir Crit Care Med. 2017 Dec 18. doi: 10.1164/rccm.201709-1874LE To the Editor: 致编辑 In this era of personalized medicine (1, 2), it is quite surprising to see counterexamples like the Isotonic Solution Administration Logistical Testing (SALT) trial (3), a perfect illustration of the wrong use of a randomized, controlled trail (RCT). The same is true for the Plasma-Lyte 148 versUS Saline (PLUS) study...

Perspective > Viewpoints COMMENTARY What We Can Learn From Treating Sepsis in Low-Resource Settings Gregory S. Martin, MD, MSc December 08, 2017 Effect of an Early Resuscitation Protocol on In-hospital Mortality Among Adults With Sepsis and Hypotension: A Randomized Clinical Trial Andrews B, Semler MW, Muchemwa L, et al JAMA. 2017;318:1233-1240 Study Summary Early and targeted sepsis resuscitation[1] has become the cornerstone of effective sepsis therapy,[2,3] yet ...

Perspective > Viewpoints COMMENTARY What We Can Learn From Treating Sepsis in Low-Resource Settings Gregory S. Martin, MD, MSc December 08, 2017 Effect of an Early Resuscitation Protocol on In-hospital Mortality Among Adults With Sepsis and Hypotension: A Randomized Clinical Trial Andrews B, Semler MW, Muchemwa L, et al JAMA. 2017;318:1233-1240 Study Summary Early and targeted sepsis resuscitation[1] has become the cornerstone of effective sepsis therapy,[2,3] yet...

News > Reuters Health Information Prolonged Beta-lactam Infusion Better for Patients With Sepsis By Will Boggs MD December 04, 2017 NEW YORK (Reuters Health) - Mortality in patients with sepsis is lower for those who receive prolonged intravenous infusions of antipseudomonal beta-lactams than for those who receive short-term infusions, according to a systematic review and meta-analysis of randomized trials. "In a previous meta-analysis published in 2013 in Clinica...

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...