Prehospital transdermal glyceryl trinitrate in patients with ultra-acute presumed stroke (RIGHT-2): an ambulance-based, randomised, sham-controlled, blinded, phase 3 trial The RIGHT-2 Investigators Lancet Published:February 06, 2019 DOI:https://doi.org/10.1016/S0140-6736(19)30194-1 Summary Background 背景 High blood pressure is common in acute stroke and is a predictor of poor outcome; however, large trials of lowering blood pressure have given variable res...

Intensive Care Medicine ONLINE FIRST (FREE ACCESS)  ORIGINAL ~ The SIC (Simple Intensive Care) Studies-I - cardiac index - diagnostic accuracyHiemstra B, Koster G, Wiersema R, Hummel YM, van der Harst P, Snieder H, Eck RJ, Kaufmann T, Scheeren TWL, Perner A, Wetterslev J, de Smet AMGA, Keus F, van der Horst ICC; SICS Study Group.The diagnostic accuracy of clinical examination for estimating cardiac index in critically ill patients: the Simple Inte...

Original Investigation | February 18, 2019 Effect of a Nurse-Led Preventive Psychological Intervention on Symptoms of Posttraumatic Stress Disorder Among Critically Ill Patients: A Randomized Clinical Trial Dorothy M. Wade, Paul R. Mouncey, Alvin Richards-Belle, et al JAMA. 2019;321(7):665-675. doi:10.1001/jama.2019.0073 Abstract Importance 背景 A meta-analysis of outcomes during the 6 months after intens...

ORIGINAL ARTICLE Bag-Mask Ventilation during Tracheal Intubation of Critically Ill Adults Jonathan D. Casey, David R. Janz, Derek W. Russell, et al  N Engl J Med February 18, 2019DOI: 10.1056/NEJMoa1812405 BACKGROUND 背景 Hypoxemia is the most common complication during tracheal intubation of critically ill adults and may increase the risk of cardiac arrest and death. Whether positive-pressure ventilation with a bag-mask device (bag-mask ventilation) during...

ORIGINAL ARTICLE Adjunctive Intermittent Pneumatic Compression for Venous Thromboprophylaxis Yaseen M. Arabi, Fahad Al-Hameed, Karen E.A. Burns, et al N Engl J Med February 18, 2019DOI: 10.1056/NEJMoa1816150 BACKGROUND 背景 Whether adjunctive intermittent pneumatic compression in critically ill patients receiving pharmacologic thromboprophylaxis would result in a lower incidence of deep-vein thrombosis than pharmacologic thromboprophylaxis alone is uncertai...

Original Investigation February 18, 2019 Effect of Titrating Positive End-Expiratory Pressure (PEEP) With an Esophageal Pressure–Guided Strategy vs an Empirical High PEEP-Fio2 Strategy on Death and Days Free From Mechanical Ventilation Among Patients With Acute Respiratory Distress Syndrome: A Randomized Clinical Trial Jeremy R. Beitler, Todd Sarge, Valerie M. Banner-Goodspeed, et al; for the EPVent-2 Study Group JAMA. Published online February 18, 2019. doi:10.1...

Original Investigation Effect of a Resuscitation Strategy Targeting Peripheral Perfusion Status vs Serum Lactate Levels on 28-Day Mortality Among Patients With Septic Shock： The ANDROMEDA-SHOCK Randomized Clinical Trial Glenn Hernández, Gustavo A. Ospina-Tascón, Lucas Petri Damiani, et al JAMA. Published online February 17, 2019. doi:10.1001/jama.2019.0071 Abstract Importance  背景 Abnormal peripheral perfusion after septic shock resuscitation has been ...

Long-term developmental effects of withholding parenteral nutrition for 1 week in the paediatric intensive care unit: a 2-year follow-up of the PEPaNIC international, randomised, controlled trial Sören Verstraete, Sascha C Verbruggen, José A Hordijk, et al Lancet Respir Med 2019; 7: 141-153 Background 背景 The paediatric early versus late parenteral nutrition in critical illness (PEPaNIC) multicentre, randomised, controlled trial showed that, compared wit...

Hour-1 Bundle Updated The Surviving Sepsis Campaign has updated the Hour-1 bundle emphasizing time of recognition and element completion guidance. The Hour-1 bundle* should be viewed as a quality improvement opportunity moving toward an ideal state. For critically ill patients with sepsis or septic shock, time is of the essence. Although the starting time for the Hour-1 bundle is recognition of sepsis, both sepsis and septic shock should be viewed asmedical ...

A new ICU equipment diagram…but is it Art? Design for Southmead ICU  It is well established that the Arts have a clear contribution to make in the delivery of an improved healthcare experience for patients, service users and staff. ‘Arts and health are, and should be firmly recognised as being, integral to health, healthcare provision and healthcare environments, including supporting staff.' (Department of Health Working Group on Arts and Health 2006) Southm...