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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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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 To the Editor: 致编辑 In reporting the results of their meta-analysis of individual patient data from three trials, the Protocolized Resuscitation in Sepsis Meta-Analysis (PRISM) investigators (June 8 issue)1 conclude that early, goal-directed therapy (EGDT) did not result in better outcomes than usual care in the resuscit...
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Fluid Challenge: Its Impact on Fluid Responsiveness The fluid challenge is considered the gold standard for diagnosis of fluid responsiveness. A new systematic review finds that the duration of the fluid infusion in a fluid challenge has a significant influence on fluid responsiveness – i.e., a rapid infusion increases the proportion of patients with a positive response. However, the type and volume of fluid or the time of assessment does not appear to have any effect o...
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[编者按]:2017年4月8日,我们在网站上介绍了JAMA在线发表的RCT结果:肺保护性通气基础上肺复张对术后肺部并发症的影响。近日,JAMA刊登了两封读者来信,对该研究结果提出了自己的看法。 Comment & Response August 15, 2017 Alveolar Recruitment Strategies After Cardiac Surgery—Reply Marcelo B. P. Amato, Marcia S. Volpe, Ludhmila A. Hajjar JAMA. 2017;318(7):668-669. doi:10.1001/jama.2017.8697 In Reply Drs Li and Shi raised concerns about which of our study groups actually provided...
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Global Study: Most ICU Patients Underfed A large international multicentre cohort study shows that most of the patients are underfed during their ICU stay. In their findings published in the journal Clinical Nutrition, researchers say most of the patients in intensive care are receiving the same amount of calories regardless of their condition, patient's well-being is not satisfied, and delayed nutrition is more frequent. The findings show poor adherence to nutritional gu...
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[编者按]:2017年4月8日,我们在网站上介绍了JAMA在线发表的RCT结果:肺保护性通气基础上肺复张对术后肺部并发症的影响。近日,JAMA刊登了两封读者来信,对该研究结果提出了自己的看法。 Comment & Response August 15, 2017 Alveolar Recruitment Strategies After Cardiac Surgery Guohui Li, Xueyin Shi JAMA. 2017;318(7):667. doi:10.1001/jama.2017.8689 To the Editor Dr Costa Leme and colleagues1 reported that an intensive alveolar recruitment strategy resulted in less-severe pulmonary...
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[编者按]: 纵观国际医学领域,近年来也不乏各种运动造势,推出各种理念,最终只是空欢喜一场。相应的例证如他汀类药物的神奇疗效。肠道菌丛的无限应用范围以及与各种急性慢性疾病的普遍相关性,未来很有可能成为又一经典范例。精准医学也是近年的宠儿。事实上,在精准医学盛行其道的今天,仍然有部分专家保持了清醒的头脑(学会网址既往也转载JAMA述评介绍相应观点)。本文虽然并不直接与重症医学领域相关,但文中观点对我们可能仍有帮助。 From The JAMA Network August 1, 2017 Viral Testing for Pediatric ...
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Clinical trial research in focus: rethinking trials in sepsis David Grimaldi, Jean-Louis Vincent Lancet Respir Med 2017; 8: 610-611 Published: August 2017 DOI: http://dx.doi.org/10.1016/S2213-2600(17)30268-0 Sepsis is a frequent condition, defined as life-threatening organ dysfunction associated with a severe infection.1 Over the past three decades, progress in understanding of the pathophysiology of sepsis has led to the development of a large number of potential new the...
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