Practice | Rapid Recommendations Oxygen therapy for acutely ill medical patients: a clinical practice guideline Reed A C Siemieniuk, Derek K Chu, Lisa Ha-Yeon Kim, et al BMJ 2018; 363 doi: https://doi.org/10.1136/bmj.k4169 (Published 24 October 2018) Cite this as: BMJ 2018;363:k4169

GUIDELINES Renal replacement therapy: summary of NICE guidance James Gilbert, Kate Lovibond, Andrew Mooney, et al BMJ 2018;363:k4303 doi: 10.1136/bmj.k4303 Indications for starting renal replacement therapy • Consider starting dialysis when indicated by the impact of symptoms of uraemia on daily living, or biochemical measures, or uncontrollable fluid overload, or at an eGFR of around 5-7 mL/min/1.73 m2 if there are no symptoms. [Based on low quality eviden...

Use sepsis bundles, or you’re breaking the (New York) law Sep 28, 2017 In 2013, New York's state government began regulating the care of sepsis. The state has since required its hospitals (and thus its doctors) to adhere to some version of a sepsis protocol that included a "bundle" to be delivered within 3 hours after sepsis recognition: blood cultures before antibiotics; lactate measurement; broad-spectrum antibiotics The Empire State legislature and health departmen...

July 13, 2018 SEP-1 Guidelines May Be Too Restrictive Daniel M. Lindberg, MD reviewing Rhee C et al. Crit Care Med 2018 Jun 28 Most bundle failures had no effect on mortality. Hospitals are required to report compliance with the SEP-1 quality bundle as a core sepsis measure. Components of SEP-1 include blood cultures (within 3 hours), initial (3 hours) and repeat (6 hours) lactate measurement, early antibiotics and fluid resuscitation (3 hours), and vasopressors for p...

SCCM and ACEP Release Joint Statement About the SSC Hour-1 Bundle 摘自http://www.survivingsepsis.org/News/Pages/SCCM-and-ACEP-Release-Joint-Statement-About-the-Surviving-Sepsis-Campaign-Hour-1-Bundle.aspx The Society of Critical Care Medicine (SCCM) and the American College of Emergency Physicians (ACEP) acknowledge concerns expressed about the recently released Surviving Sepsis Campaign (SSC) Hour-1 Bundle and the appropriateness of implementation in the United Stat...

Perspective > Medscape > Clinical Practice Guidelines Care of Adult Patients in the ICU Clinical Practice Guidelines (2018) Society of Critical Care Medicine Reviewed and summarized by Medscape editors October 04, 2018 Clinical practice guidelines for the Prevention and Management of Pain, Agitation/Sedation, Delirium, Immobility, and Sleep Disruption in Adult Patients in the ICU were released in September 2018 by the Society for Critical Care Medicine.[1] Pain Use ...

Practice Guidelines Chronic heart failure in adults: summary of updated NICE guidance Jacqui Real, Emma Cowles, Anthony S Wierzbicki BMJ 2018; 362 doi: https://doi.org/10.1136/bmj.k3646 (Published 24 September 2018) Cite this as: BMJ 2018;362:k3646 What’s new in this guidance Clearer advice on managing the care of people with heart failure, including a greater emphasis on multidisciplinary working, shared decision making, care planning, lifestyle advice and interventions...

JAMA Clinical Guidelines Synopsis August 27, 2018 Diagnosis and Treatment of Clostridium difficile Infection Arjun Gupta, Adam S. Cifu, Sahil Khanna JAMA. Published online August 27, 2018. doi:10.1001/jama.2018.12194 Guideline title: Diagnosis and Treatment of Clostridium difficile Infections in Adults and Children Release date: February 15, 2018 (online); April 1, 2018 (print) Prior version: 2010 Developer: Infectious Diseases Society of America (IDSA) and Society fo...

Viewpoint August 28, 2018 Clinical Practice Guidelines: What’s Next? Paul G. Shekelle JAMA. 2018;320(8):757-758. doi:10.1001/jama.2018.9660 Clinical practice guidelines are a key component of medicine, as they provide evidence-based recommendations for physicians and other health care professionals about the management of care for patients with diseases or other clinical conditions. A number of important developments involving clinical practice guidelines have eme...

Inspiratory muscle training for ICU patients: first practical guide Inspiratory muscle weakness is a known consequence of prolonged mechanical ventilation, and there is emerging evidence that specific inspiratory muscle training (IMT) can ameliorate this weakness. Australian researchers recommend a multidisciplinary approach to IMT for patients in the intensive care unit (ICU).    "Effective IMT requires a multidisciplinary approach to maximise feasibility, with doctors, ...