Original Investigation Caring for the Critically Ill Patient September 13, 2017 Incidence and Trends of Sepsis in US Hospitals Using Clinical vs Claims Data, 2009-2014 Chanu Rhee, Raymund Dantes, Lauren Epstein, et al. JAMA. Published online September 13, 2017. doi:10.1001/jama.2017.13836 Abstract Importance 背景 Estimates from claims-based analyses suggest that the incidence of sepsis is increasing and mortality rates from sepsis are decreasing. However, estimates...

Severity of Hypoxemia and Effect of High-Frequency Oscillatory Ventilation in Acute Respiratory Distress Syndrome  Maureen O. Meade, Duncan Young, Steven Hanna, et al. Am J Respir Crit Care Med 2017; 196: 727-733 Abstract Rationale: 背景 High-frequency oscillatory ventilation (HFOV) is theoretically beneficial for lung protection, but the results of clinical trials are inconsistent, with study-level meta-analyses suggesting no significant effect on mortality. 高...

News H7N9 Avian Flu Continues to Spread, Worsen in China Janis C. Kelly September 12, 2017 The latest epidemic of Asian lineage avian influenza A (Asian H7N9) in China infected almost as many patients as the four previous outbreaks combined and gave rise to a variant less susceptible to available treatments and vaccines, researchers report in an article  published in the September 8 issue of the Morbidity and Mortality Weekly Report. 研究人员在Morbidity and Mortality ...

A fatal outbreak of ST11 carbapenem-resistant hypervirulent Klebsiella pneumoniae in a Chinese hospital: a molecular epidemiological study. Gu D, Dong N, Zheng Z, et al. Lancet Infect Dis. 2017 Aug 29. pii: S1473-3099(17)30489-9. doi: 10.1016/S1473-3099(17)30489-9. [Epub ahead of print] Abstract BACKGROUND: 背景 Hypervirulent Klebsiella pneumoniae strains often cause life-threatening community-acquired infections in young and healthy hosts, but are usually sensitive to an...

ORIGINAL ARTICLE Oxygen Therapy in Suspected Acute Myocardial Infarction Robin Hofmann, M.D., Stefan K. James, M.D., Ph.D., Tomas Jernberg, M.D., Ph.D., Bertil Lindahl, M.D., Ph.D., David Erlinge, M.D., Ph.D., Nils Witt, M.D., Ph.D., Gabriel Arefalk, M.D., Mats Frick, M.D., Ph.D., Joakim Alfredsson, M.D., Ph.D., Lennart Nilsson, M.D., Ph.D., Annica Ravn-Fischer, M.D., Ph.D., Elmir Omerovic, M.D., Ph.D., Thomas Kellerth, M.D., David Sparv, B.Sc., Ulf Ekelund, M.D., Ph.D., R...

Special Article Collection Sepsis Awareness Month We are pleased to present a new Special Article Collection focused on sepsis, drawing together a selection of recently published articles from CHEST in recognition of Sepsis Awareness Month. Selected articles are freely available to access throughout the month of September. Hydrocortisone and Ascorbic Acid Synergistically Prevent and Repair Lipopolysaccharide-Induced Pulmonary Endothelial Barrier Dysfunc...

Preliminary Communication August 22/29, 2017 Effect of Ganciclovir on IL-6 Levels Among Cytomegalovirus-Seropositive Adults With Critical Illness: A Randomized Clinical Trial Ajit P. Limaye, Renee D. Stapleton, Lili Peng, et al. JAMA. 2017;318(8):731-740. doi:10.1001/jama.2017.10569 Abstract Importance 背景 The role of cytomegalovirus (CMV) reactivation in mediating adverse clinical outcomes in nonimmunosuppressed adults with critical illness is unknown. 对于无免疫功...

Original Investigation August 22/29, 2017 Effect of Natriuretic Peptide–Guided Therapy on Hospitalization or Cardiovascular Mortality in High-Risk Patients With Heart Failure and Reduced Ejection Fraction: A Randomized Clinical Trial G. Michael Felker, Kevin J. Anstrom, Kirkwood F. Adams, et al. JAMA. 2017;318(8):713-720. doi:10.1001/jama.2017.10565 Abstract Importance 背景 The natriuretic peptides are biochemical markers of heart failure (HF) severity and predictors ...

Original Investigation July 2017 Comparison of Appendectomy Outcomes Between Senior General Surgeons and General Surgery Residents Baha Siam, Abbas Al-Kurd, Natalia Simanovsky, et al JAMA Surg. 2017;152(7):679-685. doi:10.1001/jamasurg.2017.0578 Abstract Importance 背景 In some centers, the presence of a senior general surgeon (SGS) is obligatory in every procedure, including appendectomy, while in others it is not. There is a relative paucity in the literature of re...

News & Perspective Mayo, Cleveland Clinic Lead US News Top Hospitals List Megan Brooks August 08, 2017 For the second consecutive year, the Mayo Clinic in Rochester, Minnesota, claimed the number one spot in the annual honor roll of best hospitals published by US News and World Report. The Cleveland Clinic in Ohio holds the number two spot in the annual honor roll, which highlights hospitals delivering "exceptional treatment across multiple areas of care," the maga...