Prothrombin complex concentrates for rapid anticoagulation reversal before surgery Current guidelines for rapid anticoagulation reversal for emergency surgery recommend four-factor prothrombin complex concentrate (PCC) and vitamin K co-administration. A team of experts from the U.S., Canada and Germany reviewed the current evidence on PPC treatment for vitamin K antagonist reversal in the perioperative setting. Overall, the studies identified in this review support curren...

ORIGINAL ARTICLE Intravenous Iron in Patients Undergoing Maintenance Hemodialysis Iain C. Macdougall, Claire White, Stefan D. Anker, et al N Engl J Med October 26, 2018 DOI: 10.1056/NEJMoa1810742 Abstract BACKGROUND Intravenous iron is a standard treatment for patients undergoing hemodialysis, but comparative data regarding clinically effective regimens are limited. METHODS In a multicenter, open-label trial with blinded end-point evaluation, we randomly assigned adults un...

ORIGINAL ARTICLE Randomized Trial of Platelet-Transfusion Thresholds in Neonates Anna Curley, Simon J. Stanworth, Karen Willoughby, et al N Engl J Med November 2, 2018 DOI: 10.1056/NEJMoa1807320 Abstract BACKGROUND Platelet transfusions are commonly used to prevent bleeding in preterm infants with thrombocytopenia. Data are lacking to provide guidance regarding thresholds for prophylactic platelet transfusions in preterm neonates with severe thrombocytopenia. METHODS In th...

Intensive Care Medicine本周免费阅读 ONLINE FIRST THIS WEEK (FREE ACCESS) Original ~ Emily A. Vail. Relationship between height and outcomes among critically ill adults: a cohort study. Original ~ Sean M. Bagshaw. Timing of onset of persistent critical illness: a multi-centre retrospective cohort study. Review ~ Djillali Annane. Academic conflict of interest. Imaging in Intensive Care Medicine ~ Gustavo Nobre de Jesus. Post-intubation tracheal laceration. Imaging in Intensi...

ORIGINAL ARTICLE Effect of Genetic Diagnosis on Patients with Previously Undiagnosed Disease Kimberly Splinter, David R. Adams, Carlos A. Bacino, et al N Engl J Med October 10, 2018 DOI: 10.1056/NEJMoa1714458 Abstract BACKGROUND 背景 Many patients remain without a diagnosis despite extensive medical evaluation. The Undiagnosed Diseases Network (UDN) was established to apply a multidisciplinary model in the evaluation of the most challenging cases and to identify the biolog...

ORIGINAL ARTICLE Changes in Prevalence of Health Care–Associated Infections in U.S. Hospitals Shelley S. Magill, Erin O’Leary, Sarah J. Janelle, et al N Engl J Med 2018; 379:1732-1744 DOI: 10.1056/NEJMoa1801550 Abstract BACKGROUND 背景 A point-prevalence survey that was conducted in the United States in 2011 showed that 4% of hospitalized patients had a health care–associated infection. We repeated the survey in 2015 to assess changes in the prevalence of health care–assoc...

Original Investigation Caring for the Critically Ill Patient October 24, 2018 Effect of Early Sustained Prophylactic Hypothermia on Neurologic Outcomes Among Patients With Severe Traumatic Brain Injury: The POLAR Randomized Clinical Trial D. James Cooper, Alistair D. Nichol, Michael Bailey, et al JAMA. Published online October 24, 2018. doi:10.1001/jama.2018.17075 Abstract Importance 背景 After severe traumatic brain injury, induction of prophylactic hypothermia ...

Original Investigation Caring for the Critically Ill Patient October 24, 2018 Effect of Human Recombinant Alkaline Phosphatase on 7-Day Creatinine Clearance in Patients With Sepsis-Associated Acute Kidney Injury: A Randomized Clinical Trial Peter Pickkers, Ravindra L. Mehta, Patrick T. Murray, et al JAMA. Published online October 24, 2018. doi:10.1001/jama.2018.14283 Abstract Importance 背景 Sepsis-associated acute kidney injury (AKI) adversely affects long-term ...

Original Investigation Caring for the Critically Ill Patient October 24, 2018 Effect of High-Flow Nasal Oxygen vs Standard Oxygen on 28-Day Mortality in Immunocompromised Patients With Acute Respiratory Failure: The HIGH Randomized Clinical Trial Elie Azoulay, Virginie Lemiale, Djamel Mokart, et al JAMA. Published online October 24, 2018. doi:10.1001/jama.2018.14282 Abstract Importance 背景 High-flow nasal oxygen therapy is increasingly used for acute hypoxemic r...

Original Investigation Caring for the Critically Ill Patient October 24, 2018 Effect of a Low vs Intermediate Tidal Volume Strategy on Ventilator-Free Days in Intensive Care Unit Patients Without ARDS: A Randomized Clinical Trial Writing Group for the PReVENT Investigators JAMA. Published online October 24, 2018. doi:10.1001/jama.2018.14280 Abstract Importance 背景 It remains uncertain whether invasive ventilation should use low tidal volumes in critically ill pa...