ORIGINAL ARTICLE Closed-Loop Insulin Delivery for Glycemic Control in Noncritical Care Lia Bally, Hood Thabit, Sara Hartnell, et al N Engl J Med 2018; 379:547-556 DOI: 10.1056/NEJMoa1805233 Abstract BACKGROUND 背景 In patients with diabetes, hospitalization can complicate the achievement of recommended glycemic targets. There is increasing evidence that a closed-loop delivery system (artificial pancreas) can improve glucose control in patients with type 1 diabetes. We want...

Articles Plasma-first resuscitation to treat haemorrhagic shock during emergency ground transportation in an urban area: a randomised trial Hunter B Moore, Ernest E Moore, Michael P Chapman, et al Lancet 2018; 392: 283-291 Summary Background 背景 Plasma is integral to haemostatic resuscitation after injury, but the timing of administration remains controversial. Anticipating approval of lyophilised plasma by the US Food and Drug Administration, the US Department of Defe...

ORIGINAL ARTICLE A Copeptin-Based Approach in the Diagnosis of Diabetes Insipidus Wiebke Fenske, Julie Refardt, Irina Chifu, et al N Engl J Med 2018; 379:428-439 DOI: 10.1056/NEJMoa1803760 Abstract BACKGROUND 背景 The indirect water-deprivation test is the current reference standard for the diagnosis of diabetes insipidus. However, it is technically cumbersome to administer, and the results are often inaccurate. The current study compared the indirect water-deprivation tes...

CORRESPONDENCE Mobile Automated External Defibrillator Response System during Road Races Tomoya Kinoshi, Shota Tanaka, Ryo Sagisaka, et al N Engl J Med 2018; 379:488-489 DOI: 10.1056/NEJMc1803218 TO THE EDITOR: The number of marathon races and other road races has rapidly increased in Japan,1 as have the number of sudden cardiac arrests during these races.2 We developed a rapid mobile automated external defibrillator (AED) system to provide early cardiopulmonary resuscitat...

ORIGINAL ARTICLE Prehospital Plasma during Air Medical Transport in Trauma Patients at Risk for Hemorrhagic Shock Jason L. Sperry, Francis X. Guyette, Joshua B. Brown, et al N Engl J Med 2018; 379:315-326 DOI: 10.1056/NEJMoa1802345 Abstract BACKGROUND 背景 After a person has been injured, prehospital administration of plasma in addition to the initiation of standard resuscitation procedures in the prehospital environment may reduce the risk of downstream complications from...

Original Investigation July 24/31, 2018 Association Between the New York Sepsis Care Mandate and In-Hospital Mortality for Pediatric Sepsis Idris V. R. Evans, Gary S. Phillips, Elizabeth R. Alpern, et al JAMA. 2018;320(4):358-367. doi:10.1001/jama.2018.9071 Abstract Importance 背景 The death of a pediatric patient with sepsis motivated New York to mandate statewide sepsis treatment in 2013. The mandate included a 1-hour bundle of blood cultures, broad-spectrum antibi...

Perspective > Medscape Pharmacists > Ask the Pharmacists Tight Blood Glucose Control in Cardiac Surgery Patients Alyson P. Lozicki, PharmD July 20, 2018 Question: Does intensive, perioperative glucose control benefit patients with or without diabetes undergoing cardiac surgery? Response from Expert Alyson P. Lozicki, PharmD Drug Information Research Fellow Perioperative hyperglycemia (occurring intraoperatively or in the immediate postoperative period) develops in...

ORIGINAL ARTICLE A Randomized Trial of Epinephrine in Out-of-Hospital Cardiac Arrest Gavin D. Perkins, Chen Ji, Charles D. Deakin, et al N Engl J Med July 18, 2018 DOI: 10.1056/NEJMoa1806842 BACKGROUND 背景 Concern about the use of epinephrine as a treatment for out-of-hospital cardiac arrest led the International Liaison Committee on Resuscitation to call for a placebo-controlled trial to determine whether the use of epinephrine is safe and effective in such patients. 人...

Causes and incidence of community-acquired serious infections among young children in south Asia (ANISA): an observational cohort study Samir K Saha, Stephanie J Schrag, Shams El Arifeen, et al. Lancet 2018; 392: 145-159 Summary Background 背景 More than 500 000 neonatal deaths per year result from possible serious bacterial infections (pSBIs), but the causes are largely unknown. We investigated the incidence of community-acquired infections caused by specific orga...

Intensive Care Medicine ONLINE FIRST THIS WEEK (FREE ACCESS) Editorial ~ Martin J. Tobin. Conflicts of interest and the patient–doctor covenant. Letter ~ Lama H. Nazer - Critical care research in the World Health Organisation Eastern Mediterranean Region over two decades: where do we stand? Editorial Debate ~ John A. Myburgh. Intracranial pressure thresholds in severe traumatic brain injury: Pro. Editorial Debate ~ Raimund Helbok et al. Intracranial pressure thresholds in ...