ORIGINAL ARTICLE Large-Scale Assessment of a Smartwatch to Identify Atrial Fibrillation Marco V. Perez, Kenneth W. Mahaffey, Haley Hedlin, et al. N Engl J Med 2019; 381:1909-1917DOI: 10.1056/NEJMoa1901183 BACKGROUND Optical sensors on wearable devices can detect irregular pulses. The ability of a smartwatch application (app) to identify atrial fibrillation during typical use is unknown. METHODS Participants without atrial fibrillation (as reported by ...

JAMA Clinical Guidelines Synopsis September 23, 2019 Prevention and Management of Venous Thromboembolism Jonathan D. Paul, Adam S. Cifu JAMA. Published online September 23, 2019. doi:10.1001/jama.2019.13853 Guideline title 指南题目 2018 Guidelines for Management of Venous Thromboembolism 2018静脉血栓栓塞治疗指南 Developers 制定者 American Society of Hematology (ASH) and McMaster University GRADE Centre 美国血液病学会(ASH)及McM...

Mechanical Ventilation Effects on Neurocognitive Functions The hypothesis that mechanical ventilation (MV) can cause neurotoxicity in critically ill patients has long been debated. First reported in 1999, MV is thought to trigger chronic cognitive disorders. Brain damage induced by MV can be caused by alveolar stretching, abnormalities in PaO2/PaCO2, biotrauma and MV causing direct brain inflammation. Alveolar stretching, induced by MV, goes on to produce system...

ARTICLES|ONLINE FIRST Ceftolozane–tazobactam versus meropenem for treatment of nosocomial pneumonia (ASPECT-NP): a randomised, controlled, double-blind, phase 3, non-inferiority trial Marin H Kollef, Martin Nováček, Ülo Kivistik, et al Lancet Infect Dis September 25, 2019 DOI:https://doi.org/10.1016/S1473-3099(19)30403-7 Summary Background 背景 Nosocomial pneumonia due to antimicrobial-resistant pathogens is associated with high mortality. We assessed th...

Nighttime Intensivist Staffing The work hours and sleep schedules of physicians who have completed training have seldom been studied. But there is ample evidence that suggests that sleep deprivation can cause errors in decision-making even in easy and familiar circumstances. Keeping in mind that the critical care setting is usually quite stressful, long working hours and sleep deprivation can increase the likelihood of errors. The fact is that critical care pati...

Viewpoint July 19, 2019 Evidence vs Consensus in Clinical Practice Guidelines Benjamin Djulbegovic, Gordon Guyatt JAMA. 2019;322(8):725-726. doi:10.1001/jama.2019.9751 Clinical practice guidelines have become increasingly prominent in clinical medicine over the last 4 decades, and represent one of the most important tools for potentially improving clinical decision-making and, in turn, potentially improving patients’ outcomes.1 Historically, many organ...

ICU Management & Practice, Volume 18 - Issue 1, 2018 Immune dysfunction in sepsis An overview of the recent advances in the diagnosis and treatment of immune system dysfunction in sepsis. Sepsis is defined as life-threatening organ dysfunction caused by a dysregulated host response to infection (Singer et al. 2016). Sepsis-induced immune system dysfunction is an important sequelae of sepsis. The persistence of immune system dysfunction in the later stage...

Original Investigation August 28, 2019 Effect of Low-Dose Supplementation of Arginine Vasopressin on Need for Blood Product Transfusions in Patients With Trauma and Hemorrhagic Shock: A Randomized Clinical Trial Carrie A. Sims, Daniel Holena, Patrick Kim, et al JAMA Surg. Published online August 28, 2019. doi:10.1001/jamasurg.2019.2884 Importance 背景 Current therapies for traumatic blood loss focus on hemor...

Blood Cultures Before Sepsis Treatment Severe bacterial infections pose a significant threat to public health, with 1.7 million people in the U.S. infected with sepsis every year. There has been a constant debate within medicine as to when treatment should be administered. Current guidelines state that blood cultures should be taken before antimicrobial treatment is initiated, as is the common course of action for internal medicine physicians. However, common pr...

Original Investigation Critical Care MedicineAugust 7, 2019 Long-term Host Immune Response Trajectories Among Hospitalized Patients With Sepsis Sachin Yende, John A. Kellum, Victor B. Talisa, et al JAMA Netw Open. 2019;2(8):e198686. doi:10.1001/jamanetworkopen.2019.8686 Importance 背景 Long-term immune sequelae after sepsis are poorly understood. 脓毒症后长期免疫后遗症尚未明确。 Objective 目的 To as...