张少雷译 感染控制: 对于在COVID-19患者身上进行有可能产生气溶胶操作的医护人员，COVID-19治疗指南小组(the Panel)建议使用合适的呼吸面罩(N-95呼吸面罩)或动力空气净化呼吸面罩，而不是外科口罩，此外还应使用其他个人防护装备，即手套、防护服及面屏、护目镜等护眼用具(AIII)。 建议对于COVID-19患者，如果可能，由具有丰富气道管理经验的医务人员进行气管内插管(AIII)。 建议如果可能的话，可以通过可视喉镜进行插管(CIII)。 血流动力学支持: 建议去甲肾上腺素作为首选的升压药物(AII)。 ...

ESPEN expert statements and practical guidance for nutritional management of individuals with sars-cov-2 infection. Clinical Nutrition , https://doi.org/10.1016/j.clnu.2020.03.022 新冠肺炎不良预后与高病死率与免疫功能低下、高龄、合并基础疾病、肥胖以及营养不良密切相关，炎症反应与并发的全身感染（sepsis）使病情进一步加重。 ICU住院时间延长本身就可导致病人获得性营养不良与严重的骨骼肌丧失。最近，ESPEN（European Society for Clinical Nutrition and Metabolism，）为COVID-...

Persons at Risk for Infection with SARS-CoV-2 Pre-Exposure Prophylaxis The COVID-19 Treatment Guidelines Panel (the Panel) does not recommend the use of any agents for SARS-CoV-2 pre-exposure prophylaxis (PrEP) outside the setting of a clinical trial(AIII). Post-Exposure Prophylaxis The Panel does not recommend the use of any agents for SARS-CoV-2 post-exposure prophylaxis (PEP) outside the setting of a clinical trial (AIII). Management of Persons...

COVID-19: The Surviving Sepsis Campaign Guidelines The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is causing rapidly spreading illness, and COVID-19 has now affected thousands of people around the world. Clinicians are in urgent need of guidance to deal with this crisis. A panel of 36 experts from 12 countries proposed 53 questions, reviewed literature for direct and indirect evidence on the management of COVID-19 in critically ill patients in the ...

JAMA Clinical Guidelines Synopsis March 26, 2020 Management of Critically Ill Adults With COVID-19 Jason T. Poston, Bhakti K. Patel, Andrew M. Davis JAMA. Published online March 26, 2020. doi:10.1001/jama.2020.4914 Guideline title Surviving Sepsis Campaign: Guidelines on the Management of Critically Ill Adults With COVID-19 Developer Surviving Sepsis Campaign (SSC) Release date March 23, 2020 Target population Critic...

Management of Adult Acute and Acute-on-Chronic Liver Failure in the ICU Both acute liver failure (ALF) and acute on chronic liver failure (ACLF) are associated with high morbidity and mortality. Even today, medical treatment of these two disorders has limited benefits and for those who fail to respond, the only viable treatment is a liver transplant. Both ALF and ACLF rarely occur in isolation and in most cases there is multiple organ involvement. As with many critical...

Practice | Rapid Recommendations Gastrointestinal bleeding prophylaxis for critically ill patients: a clinical practice guideline Zhikang Ye, Annika Reintam Blaser, Lyubov Lytvyn, et al BMJ 2020; 368:l6722 doi: https://doi.org/10.1136/bmj.l6722 Abstract Clinical question 临床问题 What is the role of gastrointestinal bleeding prophylaxis (stress ulcer prophylaxis) in critically ill patients? This guideline was prompted by the publication of a new large ra...

ICU Management & Practice, Volume 19 - Issue 3, 2019 New ESPEN Guidelines for Nutrition in the Critically Ill: Help, What Happened!? ESPEN guidelines for nutrition in critical illness have shifted from optimistic anticipative nutritional pharmacotherapy towards cautious and balanced metabolic support. This important new orientation in ICU nutrition management is a consequence of recent strong RCT-based evidence. Introduction Recently, the new ESPEN gu...

JAMA Clinical Guidelines Synopsis September 23, 2019 Prevention and Management of Venous Thromboembolism Jonathan D. Paul, Adam S. Cifu JAMA. Published online September 23, 2019. doi:10.1001/jama.2019.13853 Guideline title 指南题目 2018 Guidelines for Management of Venous Thromboembolism 2018静脉血栓栓塞治疗指南 Developers 制定者 American Society of Hematology (ASH) and McMaster University GRADE Centre 美国血液病学会(ASH)及McM...

Viewpoint July 19, 2019 Evidence vs Consensus in Clinical Practice Guidelines Benjamin Djulbegovic, Gordon Guyatt JAMA. 2019;322(8):725-726. doi:10.1001/jama.2019.9751 Clinical practice guidelines have become increasingly prominent in clinical medicine over the last 4 decades, and represent one of the most important tools for potentially improving clinical decision-making and, in turn, potentially improving patients’ outcomes.1 Historically, many organ...