ICU Management & Practice, Volume 23 - Issue 3, 2023 The Green Intensive Care: From Environmental Hotspot to Action Together we must reduce the impact of the healthcare sector and shift towards a circular economy. This paper describes the shift of three ICU environmental hotspots: gloves, gowns, and CRRT bags. Introduction The healthcare sector is one of the most carbon-intensive sectors, contributing to 4.4% of global net greenhouse gas emissions and...

ORIGINAL ARTICLE Mild Hypercapnia or Normocapnia after Out-of-Hospital Cardiac Arrest Glenn Eastwood, Alistair D. Nichol, Carol Hodgson, et al N Engl J Med June 15, 2023DOI: 10.1056/NEJMoa2214552 Abstract BACKGROUND Guidelines recommend normocapnia for adults with coma who are resuscitated after out-of-hospital cardiac arrest. However, mild hypercapnia increases cerebral blood flow and may improve neurologic outcomes. METHODS We randomly assig...

ORIGINAL ARTICLE Ultrasonography or Radiography for Suspected Pediatric Distal Forearm Fractures Peter J. Snelling, Philip Jones, David Bade, et al N Engl J Med 2023; 388:2049-2057DOI: 10.1056/NEJMoa2213883 Abstract BACKGROUND Data on whether ultrasonography for the initial diagnostic imaging of forearm fractures in children and adolescents is noninferior to radiography for subsequent physical function of the arm are limited. 背景 作为儿童和青...

Perioperative Management of Patients With Diabetes Mellitus Diabetes mellitus (DM) is a chronic disease that is becoming increasingly common in the general population. An estimated 537 million people worldwide have DM. Its prevalence is expected to increase to 700 million by 2045. Approximately 1 in 11 adults in Europe have DM, roughly 61 million individuals. Patients with diabetes account for 15% of all surgical procedures, which burdens healthcare systems sign...

Research Letter  June 15, 2023 Accuracy of a Generative Artificial Intelligence Model in a Complex Diagnostic Challenge Zahir Kanjee, Byron Crowe, Adam Rodman JAMA. Published online June 15, 2023. doi:10.1001/jama.2023.8288 Recent advances in artificial intelligence (AI) have led to generative models capable of accurate and detailed text-based responses to written prompts (“chats”). These models score highly on standardized medical examinatio...

Original Investigation  June 20, 2023 Recent Vitamin K Antagonist Use and Intracranial Hemorrhage After Endovascular Thrombectomy for Acute Ischemic Stroke Brian Mac Grory, DaJuanicia N. Holmes, Roland A. Matsouaka, et al JAMA. 2023;329(23):2038-2049. doi:10.1001/jama.2023.8073 Key Points Question  In patients with acute ischemic stroke due to large vessel occlusion selected to receive endovascular thrombectomy (EVT), does recent...

Research Race-free estimated glomerular filtration rate equation in kidney transplant recipients: development and validation study Marc Raynaud, Solaf Al-Awadhi, Ivana Juric, et al BMJ 2023; 381 doi: https://doi.org/10.1136/bmj-2022-073654 (Published 31 May 2023)Cite this as: BMJ 2023;381:e073654 Abstract Objective To compare the performance of a newly developed race-free kidney recipient specific glomerular filtration rate (GFR) equation with the thre...

Role of Nurse-to-Nurse Familiarity on Mortality Nursing teams play an important role in providing safe and adequate care to critically ill patients in the ICU. The patient-to-nurse ratio significantly impacts patient outcomes, and teamwork is also crucial. A recent study emphasises the need for effective communication, collaboration, and a shared sense of responsibility among the nursing team to ensure optimal patient care. The authors suggest that investing in ...

ORIGINAL ARTICLE Tirofiban for Stroke without Large or Medium-Sized Vessel Occlusion Wenjie Zi, Jiaxing Song, Weilin Kong, et al N Engl J Med 2023; 388:2025-2036DOI: 10.1056/NEJMoa2214299 Abstract BACKGROUND The effects of the glycoprotein IIb/IIIa receptor inhibitor tirofiban in patients with acute ischemic stroke but who have no evidence of complete occlusion of large or medium-sized vessels have not been extensively studied. 背景 糖蛋白Ⅱb/Ⅲa受体...

Critical Care in Conflict Zones Conflict zones often involve gunfights, bomb blasts, and mass casualty incidents. However, patients in conflict zones may also present with everyday medical problems unrelated to trauma. Despite the challenges of working in a conflict zone, healthcare professionals strive to provide care for all patients, including those with chronic medical conditions. In 2021, MSF, a medical humanitarian organisation, provided medical care to 7,...