Research Association between physician US News & World Report medical school ranking and patient outcomes and costs of care: observational study Yusuke Tsugawa, Daniel M Blumenthal, Ashish K Jha, et al. Cite this as: BMJ 2018;362:k3640 Abstract Objective 目的 To investigate whether the US News & World Report (USNWR) ranking of the medical school a physician attended is associated with patient outcomes and healthcare spending. 研究医生毕业的医学院美...

Research Laparoscopic cholecystectomy versus percutaneous catheter drainage for acute cholecystitis in high risk patients (CHOCOLATE): multicentre randomised clinical trial Charlotte S Loozen, Hjalmar C van Santvoort, Peter van Duijvendijk, et al BMJ 2018; 363 doi: https://doi.org/10.1136/bmj.k3965 (Published 08 October 2018)Cite this as: BMJ 2018;363:k3965 Abstract Objective 目的 To assess whether laparoscopic cholecystectomy is superior to percutaneous catheter draina...

Original Investigation October 16, 2018 Effect of Theophylline as Adjunct to Inhaled Corticosteroids on Exacerbations in Patients With COPD: A Randomized Clinical Trial Graham Devereux, Seonaidh Cotton, Shona Fielding, et al JAMA. 2018;320(15):1548-1559. doi:10.1001/jama.2018.14432 Abstract Importance 背景 Chronic obstructive pulmonary disease (COPD) is a major global health issue and theophylline is used extensively. Preclinical investigations have demonstrated ...

ORIGINAL ARTICLE A Candida auris Outbreak and Its Control in an Intensive Care Setting David W. Eyre, Anna E. Sheppard, Hilary Madder, et al N Engl J Med 2018; 379:1322-1331 DOI: 10.1056/NEJMoa1714373 Abstract BACKGROUND 背景 Candida auris is an emerging and multidrug-resistant pathogen. Here we report the epidemiology of a hospital outbreak of C. auris colonization and infection. 耳念珠菌是一种新出现的多重耐药致病菌。我们报告了医院内爆发耳念珠菌定植与感染的流行病学。 METH...

Original Investigation Caring for the Critically Ill Patient October 9, 2018 Effect of Targeted Polymyxin B Hemoperfusion on 28-Day Mortality in Patients With Septic Shock and Elevated Endotoxin Level: The EUPHRATES Randomized Clinical Trial R. Phillip Dellinger, Sean M. Bagshaw, Massimo Antonelli, et al. JAMA. 2018;320(14):1455-1463. doi:10.1001/jama.2018.14618 Abstract Importance 背景 Polymyxin B hemoperfusion reduces blood endotoxin levels in sepsis. Endotoxin...

ORIGINAL ARTICLE Six-Month Outcomes after Restrictive or Liberal Transfusion for Cardiac Surgery C. David Mazer, Richard P. Whitlock, Dean A. Fergusson, et al N Engl J Med 2018; 379:1224-1233 DOI: 10.1056/NEJMoa1808561 Abstract BACKGROUND 背景 We reported previously that, in patients undergoing cardiac surgery who were at moderate-to-high risk for death, a restrictive transfusion strategy was noninferior to a liberal strategy with respect to the composite outcome of death ...

ORIGINAL ARTICLE Wearable Cardioverter–Defibrillator after Myocardial Infarction Jeffrey E. Olgin, Mark J. Pletcher, Eric Vittinghoff, et al. N Engl J Med 2018; 379:1205-1215 DOI: 10.1056/NEJMoa1800781 Abstract BACKGROUND 背景 Despite the high rate of sudden death after myocardial infarction among patients with a low ejection fraction, implantable cardioverter–defibrillators are contraindicated until 40 to 90 days after myocardial infarction. Whether a wearable cardioverte...

Original Investigation September 25, 2018 Effect of Algorithm-Based Therapy vs Usual Care on Clinical Success and Serious Adverse Events in Patients with Staphylococcal Bacteremia: A Randomized Clinical Trial Thomas L. Holland, Issam Raad, Helen W. Boucher, et al JAMA. 2018;320(12):1249-1258. doi:10.1001/jama.2018.13155 Abstract Importance 背景 The appropriate duration of antibiotics for staphylococcal bacteremia is unknown. 葡萄球菌菌血症的适当抗生素疗程并不明确。 O...

“Simulate, or not to simulate?” Evolution in medicine and the anaesthesia context. A brief discussion about the importance and the state of the art of simulation in anaesthesia and intensive care medicine. Training in simulation plays a key role in complex systems such as aviation and the nuclear industry, to investigate predictable errors that lead to adverse outcomes. The advancement made by aviation integrating simulation in training over the past years is relevant, wh...

INTENSIVE CARE MEDICINE ONLINE FIRST THIS WEEK (FREE ACCESS) Image ~ Zhuxiao Ren et al. Congenital haemangioma causing heart failure. Letter ~ Morgan Benaïs et al. Socioeconomic status features of ICU patients: the PRECAREA pilot study. Image ~ Zhongheng Zhang et al. Effectiveness of sodium bicarbonate infusion on mortality in septic patients with metabolic acidosis. Original ~ L. E. M. Haas et al. Healthcare-related costs in very elderly intensive care patients. Original ...