Preliminary Communication | February 19, 2019 Effect of Intravenous Acetaminophen vs Placebo Combined With Propofol or Dexmedetomidine on Postoperative Delirium Among Older Patients Following Cardiac Surgery: The DEXACET Randomized Clinical Trial Balachundhar Subramaniam, Puja Shankar, Shahzad Shaefi, et al JAMA. 2019;321(7):686-696. doi:10.1001/jama.2019.0234 Abstract Importance 背景 Postoperative d...

Diagnostic approaches for hospital-acquired pneumonia A new study suggests that a comprehensive approach might be undertaken for microbiological diagnosis in critically ill non-ventilated hospital-acquired pneumonia (HAP). Sputum sampling determined one third of microbiological diagnosis in HAP patients who were not subsequently intubated. In contrast, invasive methods were associated with higher rates of microbiological diagnosis.  Hospital-acquired pneumo...

ORIGINAL ARTICLE Decolonization to Reduce Postdischarge Infection Risk among MRSA Carriers Susan S. Huang, Raveena Singh, James A. McKinnell, et al N Engl J Med 2019; 380:638-650DOI: 10.1056/NEJMoa1716771 BACKGROUND Hospitalized patients who are colonized with methicillin-resistant Staphylococcus aureus(MRSA) are at high risk for infection after discharge. METHODS We conducted a multicenter, randomized, controlled trial of postdischarge hygiene e...

PUBLIC RELEASE: 14-FEB-2019 Antidepressant could stop deadly sepsis, study suggests Previous FDA approval could fast-track new treatment UNIVERSITY OF VIRGINIA HEALTH SYSTEM An antidepressant drug used to treat obsessive-compulsive disorder could save people from deadly sepsis, new research from the University of Virginia School of Medicine suggests. Sepsis is a significant cause of death around the world. The federal Centers for Disease Control an...

Mortality, morbidity, and hospitalisations due to influenza lower respiratory tract infections, 2017: an analysis for the Global Burden of Disease Study 2017 GBD 2017 Influenza Collaborators Lancet Respir Med 2019; 7: 69-89 Background 背景 Although the burden of influenza is often discussed in the context of historical pandemics and the threat of future pandemics, every year a substantial burden of lower respiratory tract infections (LRTIs) and other respirato...

Intensive Care Medicine ONLINE FIRST THIS WEEK(FREE ACCESS) Seven-Day Profile Publication ~ Alain Combes - Feasibility and safety of extracorporeal CO2 removal to enhance protective ventilation in Acute Respiratory Distress Syndrome: the SUPERNOVA study  Review ~ G. A. Schmidt - Ultrasound-guided vascular access in critical illness  Original ~ Gerald Chi - Extended-duration Betrixaban versus shorter-duration Enoxaparin for Venous Thromboembolism Prophylaxis in criti...

Original Investigation Effect of Electroencephalography-Guided Anesthetic Administration on Postoperative Delirium Among Older Adults Undergoing Major Surgery: The ENGAGES Randomized Clinical Trial Troy S. Wildes, Angela M. Mickle, Arbi Ben Abdallah, et al JAMA. 2019;321(5):473-483. doi:10.1001/jama.2018.22005Key Points Abstract Importance 背景 Intraoperative electroencephalogram (EEG) waveform suppression, often suggesting excessive general anesthesia, ...

Intensive blood pressure reduction with intravenous thrombolysis therapy for acute ischaemic stroke (ENCHANTED): an international, randomised, open-label, blinded-endpoint, phase 3 trial Craig S Anderson, Yining Huang, Richard I Lindley, et al Lancet Published:February 07, 2019 DOI:https://doi.org/10.1016/S0140-6736(19)30038-8 Summary Background 背景 Systolic blood pressure of more than 185 mm Hg is a contraindication to thrombolytic treatment with intraven...

Efficacy and safety of minimally invasive surgery with thrombolysis in intracerebral haemorrhage evacuation (MISTIE III): a randomised, controlled, open-label, blinded endpoint phase 3 trial Daniel F Hanley, Richard E Thompson, Michael Rosenblum, et al Lancet Published:February 07, 2019 DOI:https://doi.org/10.1016/S0140-6736(19)30195-3 Summary Background 背景 Acute stroke due to supratentorial intracerebral haemorrhage is associated with high morbidity and ...

Venovenous extracorporeal membrane oxygenation for acute respiratory distress syndrome: a systematic review and meta-analysis Laveena Munshi, Allan Walkey, Ewan Goligher, et al Lancet Respir Med 2019; 7: 163-172 Background 背景 Use of extracorporeal membrane oxygenation (ECMO) in adults with severe acute respiratory distress syndrome has increased in the past 10 years. However, the efficacy of venovenous ECMO in people with acute respiratory distress synd...