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Medscape Critical Care > Critical Issues Ultrasound to Assess Volume Status--Why Bother? Aaron B. Holley, MD November 14, 2016 Volume Assessment by Bedside Debate 床旁评估容量的争论 Indulge me and imagine that you are on intensive care unit rounds at an academic hospital. You are discussing a patient who is mechanically ventilated, hypotensive, and on vasopressors. Your team is sure that the patient is septic, but he has already had aggressive resuscitation with fluids...
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Immediate total-body CT scanning versus conventional imaging and selective CT scanning in patients with severe trauma (REACT-2): a randomised controlled trial. ICM Index Number: 23/064 Authors: Sierink JC, Treskes K, Edwards MJ et al. Reference: Lancet 2016;388:673-683. Trial registration number: NCT01523626. © Elsevier Ltd. ICM ABSTRACT Objective To assess the effect of total-body CT scanning compared with the standard work-up on in-hospital mortality in trauma patien...
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Intensive blood-pressure lowering in patients with acute cerebral hemorrhage. ICM Index Number: 23/056 Authors: Qureshi AI, Palesch YY, Barsan WG et al. Reference: N Engl J Med 2016;375:1033-1043. Trial registration number: NCT01176565. © Massachusetts Medical Society. ICM ABSTRACT Objective To investigate whether reducing systolic (BP) earlier than in previous trials would show greater therapeutic benefit in patients with intracerebral haemorrhage (ICH). Introduction ...
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Medscape Critical Care > Critical Issues COMMENTARY Transfusion Thresholds in the ICU: Is the Pendulum Swinging Back? Aaron B. Holley, MD November 03, 2016 Transfusion Thresholds 输血阈值 For many years, the findings of the Transfusion Requirements in Critical Care (TRICC) trial guided packed red blood cell (pRBC) administration in the intensive care unit (ICU).[1] This multicenter, randomized controlled trial (RCT) compared a conservative transfusion threshold (7.0 g/...
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Medscape Medical News > Oncology Old vs New: End of Debate on Blood Transfusion Storage Pam Harrison October 25, 2016 The most definitive evidence to date again confirms that in-hospital mortality rates do not differ for patients who receive the freshest blood during a transfusion compared to those who receive the oldest blood, leaving no room for further debate over the effect that storage length has on clinical outcomes, new research shows. 迄今为止最确切的证据证实,...
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Medscape Neurology > Viewpoints COMMENTARY Benefits and Risks of Craniectomy for Traumatic Intracranial Hypertension Laurie L. Barclay, MD October 06, 2016 Trial of Decompressive Craniectomy for Traumatic Intracranial Hypertension Hutchinson PJ, Kolias AG, Timofeev IS, et al N Engl J Med. 2016;375:1119-1130 Summary 总结 For patients with refractory traumatic intracranial hypertension, the impact of decompressive craniectomy on clinical outcomes is still a matter of deb...
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EDITORIAL IMPROVING FUNCTIONAL OUTCOMES FOLLOWING CRITICAL ILLNESS? The profound effects of critical illness on muscle strength, physical function and health related quality of life are well acknowledged [1,2]. Muscle weakness has been shown to occur early and rapidly in critical illness, and more rapidly still in those with multi-organ failure [3]. Similarly, follow-up studies have shown that the early weakness has prolonged and significant effects including reduced f...
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Editorial | October 05, 2016 Empirical Antifungal Therapy in Critically Ill Patients With Sepsis: Another Case of Less Is More in the ICU Trishul Siddharthan, Petros C. Karakousis, William Checkley JAMA. Published online October 05, 2016. doi:10.1001/jama.2016.13801 Candida species are the most common cause of invasive fungal infections, accounting for 70% to 90% of hospital cases.1,2 Although the overall US incidence of candidemia is low among nonneutropenic, criticall...
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Editorial | October 05, 2016 Oxygen in the ICU: Too Much of a Good Thing? Niall D. Ferguson JAMA. Published online October 05, 2016. doi:10.1001/jama.2016.13800 Oxygen gas was discovered and described in the 1770s by Scheele, Priestley, and Lavoisier and shortly thereafter its therapeutic potential for patients with respiratory illness was appreciated.1 Oxygen has become a mainstay of treatment for acutely ill patients, with emphasis frequently placed on the importance ...
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Editorial | October 03, 2016 Evaluating Glucocorticoids for Sepsis: Time to Change Course Sachin Yende, B. Taylor Thompson JAMA. Published online October 03, 2016. doi:10.1001/jama.2016.13904 For decades, researchers have tested glucocorticoids such as hydrocortisone, methylprednisolone, prednisolone, and dexamethasone, in varying doses, for the related conditions of pneumonia, sepsis, septic shock, and acute respiratory distress syndrome.1- 4 The overarching rationale ...
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