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Nutritional Support in Malnourished Medical Inpatients Patients who are malnourished or at nutritional risk do tend to have poorer outcomes compared to patients who are relatively healthier when they undergo surgery or are sick. Poorly nourished patients do not have the reserves to fight off illness, and in many cases, are also immunosuppressed with delayed wound healing. Malnutrition is a major public health problem. Approximately 30% of patients who are admitted t...

Preliminary Communication Caring for the Critically Ill PatientJanuary 17, 2020 Effect of Vitamin C, Hydrocortisone, and Thiamine vs Hydrocortisone Alone on Time Alive and Free of Vasopressor Support Among Patients With Septic Shock: The VITAMINS Randomized Clinical Trial Tomoko Fujii, Nora Luethi, Paul J. Young, et al JAMA. Published online January 17, 2020. doi:10.1001/jama.2019.22176 Abstract Importance  It is unclear whether vitamin C,...

Original Investigation |Caring for the Critically Ill Patient | January 17, 2020 Effect of Stress Ulcer Prophylaxis With Proton Pump Inhibitors vs Histamine-2 Receptor Blockers on In-Hospital Mortality Among ICU Patients Receiving Invasive Mechanical Ventilation: The PEPTIC Randomized Clinical Trial The PEPTIC Investigators for the Australian and New Zealand Intensive Care Society Clinical Trials Group, Alberta Health Services Critical Care Strategic Clinical Networ...

The Epidemiology of Sepsis in Chinese ICUs: A National Cross-Sectional Survey Xie Jianfeng, Wang Hongliang, Kang Yan, et al  Crit Care Med: December 5, 2019 doi: 10.1097/CCM.0000000000004155 Abstract Objectives: 目的 We performed a national cross-sectional survey to determine the epidemiologic characteristics of patients with sepsis in ICU in China. 通过进行全国性横断面调查，以明确中国ICU内脓毒症的流行病学特征。 Design: ...

Original Investigation January 21, 2020 Effect of Hydroxyethyl Starch vs Saline for Volume Replacement Therapy on Death or Postoperative Complications Among High-Risk Patients Undergoing Major Abdominal Surgery: The FLASH Randomized Clinical Trial Emmanuel Futier, Matthias Garot, Thomas Godet, et al JAMA. 2020;323(3):225-236. doi:10.1001/jama.2019.20833 Importance  It is not known if use of colloid solu...

Practice | Rapid Recommendations Gastrointestinal bleeding prophylaxis for critically ill patients: a clinical practice guideline Zhikang Ye, Annika Reintam Blaser, Lyubov Lytvyn, et al BMJ 2020; 368:l6722 doi: https://doi.org/10.1136/bmj.l6722 Abstract Clinical question 临床问题 What is the role of gastrointestinal bleeding prophylaxis (stress ulcer prophylaxis) in critically ill patients? This guideline was prompted by the publication of a new large ra...

New Mode of Adaptive Ventilation For most patients who are admitted to the ICU and require mechanical ventilation, conventional modes of ventilation usually suffice. However, there are some patients who may require fine adjustments in ventilation so that the work of breathing is minimised, and the patient is still adequately ventilated and oxygenated. Over the years, many types of ventilatory approaches to protect the lung have been developed, but none has proven to...

Research Efficacy and safety of gastrointestinal bleeding prophylaxis in critically ill patients: systematic review and network meta-analysis Ying Wang, Zhikang Ye, Long Ge, et al BMJ 2020; 368 doi: https://doi.org/10.1136/bmj.l6744 (Published 06 January 2020) Cite this as: BMJ 2020;368:l6744 Abstract Objective 背景 To determine, in critically ill patients, the relative impact of proton pump inhibitors (PPIs), histamine...

ICU Management & Practice, Volume 19 - Issue 3, 2019 Knowledge Transfer to Improve Outcomes in Critically Ill Immunocompromised Patients An overview on sharing information, improving clinician skills, and transferring knowledge to ICU specialists about the care of immunocompromised patients. Background Studies have reported a volume-outcome relationship for cancer patients admitted to the ICU. In acute respiratory failure, mortality in ICUs managing m...