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...

ED-Based ICU - An Effective Solution? Intensive care units (ICUs) have a considerable impact on the lives of the patients that are admitted there to their families and the society as a whole. The delivery of intensive care to these patients is considerably expensive and resource-intensive. With an ageing population and the rise in the volume and acuity of patients requiring critical care, the demand for intensive care continues to increase. This demand has made sig...

Predicting Mortality - The Simple Intensive Care Studies-I A clinical examination is usually made by caregivers as a way to detect signs of deterioration in critically ill patients. However, there have been some inconsistencies when it comes to the prognostic value of this exam. A recent prospective cohort study of 1075 patients assessed whether there was an independent association with the findings from clinical examinations and 90-day mortality for patients in th...

ARTICLES|ONLINE FIRST Effects of tranexamic acid on death, disability, vascular occlusive events and other morbidities in patients with acute traumatic brain injury (CRASH-3): a randomised, placebo-controlled trial The CRASH-3 trial collaborators Lancet Published:October 14, 2019 DOI:https://doi.org/10.1016/S0140-6736(19)32233-0 Background 背景 Tranexamic acid reduces surgical bleeding and decreases mortality in patients with traumatic extracranial bleeding...

Neonatal Early-Onset Sepsis Calculator In 2007, a study funded by the National Institutes of Health assessed the use of predictive models to calculate the risk of early-onset sepsis (EOS) in neonatal patients, accounting for multiple variables. The main objectives of the study were to assess the links between the risk factors and the infection outcomes; use patient data collected from electronic medical records; and, to generate a predictive model to accurately det...

ARTICLES|ONLINE FIRST Effect of remote ischaemic conditioning on clinical outcomes in patients with acute myocardial infarction (CONDI-2/ERIC-PPCI): a single-blind randomised controlled trial Derek J Hausenloy, Rajesh K Kharbanda, Ulla Kristine Møller, et al. Lancet Published:September 06, 2019 DOI:https://doi.org/10.1016/S0140-6736(19)32039-2 Summary Background 背景 Remote ischaemic conditioning with transient ischaemia and reperfusion applied to t...

Large Decreases in ICU-Acquired Infections - National Infection Campaign ICUs in the UK have seen an 80% drop in bloodstream infections according to NIHR Guy's and St Thomas' Biomedical Research Centre-funded research. In collaboration with Guy's and St Thomas' clinicians and researchers from ICNARC (Intensive Care National Audit & Research Centre), the study analysed 1 million adult patients from 276 NHS ICUs across the UK from 2007-2012. Published in ...

Energy Balance in Obese, Mechanically Ventilated Patients in ICU Clinical evidence shows that overfeeding critically ill patients is associated with poor outcomes. Obesity is a major challenge in ICU patients because of the comorbidities and anomalies associated with it. Determining an appropriate dose of enteral nutrition is difficult in this patient population and the risk of overfeeding quite high. An association between negative energy balance and increased inf...