Personalised Mechanical Ventilation - The LIVE Study The effectiveness of personalised mechanical ventilation in patients with acute respiratory distress syndrome (ARDS) is still unclear. A new study was conducted in France to test whether a mechanical ventilation strategy personalised to an individual patient's lung morphology could improve survival compared with the standard of care. For the purpose of this study, 400 patients with moderate-to-severe ARDS were...

PERSONAL VIEW|ONLINE FIRST Improving the estimation of the global burden of antimicrobial resistant infections Direk Limmathurotsakul, Susanna Dunachie, Keiji Fukuda, et al. Lancet Infect Dis Published:August 16, 2019 DOI:https://doi.org/10.1016/S1473-3099(19)30276-2 Summary Estimating the global burden of disease from infections caused by pathogens that have acquired antimicrobial resistance (AMR) is essential for resource allocation and to inform AMR acti...

Global Survey of Management of Severe Paediatric Traumatic Brain Injury (TBI) in LMIC 近期，Pediatr Crit Care Med发表了有关严重颅脑外伤患儿诊疗的2019年国际共识(Management of Pediatric Severe Traumatic Brain Injury: 2019 Consensus and Guidelines-Based Algorithm for First and Second Tier Therapies)。为了解中低收入国家严重颅脑外伤患儿诊疗现状，来自加拿大温哥华的研究者进行了一项问卷调查，以期为今后的科研工作、指南制定提供更多依据。 支持组织：世界儿童重症医学联盟(World F...

Original Investigation September 3, 2019 Effect of Low-Intensity vs Standard-Intensity Warfarin Prophylaxis on Venous Thromboembolism or Death Among Patients Undergoing Hip or Knee Arthroplasty: A Randomized Clinical Trial Brian F. Gage, Anne R. Bass, Hannah Lin, et al JAMA. 2019;322(9):834-842. doi:10.1001/jama.2019.12085 Abstract Importance 背景 The optimal international normalized ratio (INR) to preven...

Stable/Unstable? Cardiovascular Dynamics in Critically Ill Patients There is currently doubt over the terms stable and unstable regarding cardiovascular dynamics in critically ill patients. Labelling a patient as haemodynamically stable or unstable can have different connotations depending on the practising physician. The term stable is originally defined as the condition of the patient being unchanged for a substantial amount of time. However, if this is the ca...

ARTICLES|ONLINE FIRST Personalised mechanical ventilation tailored to lung morphology versus low positive end-expiratory pressure for patients with acute respiratory distress syndrome in France (the LIVE study): a multicentre, single-blind, randomised controlled trial Jean-Michel Constantin, Matthieu Jabaudon, Jean-Yves Lefrant, et al Lancet Respir Med Published:August 06, 2019 DOI:https://doi.org/10.1016/S2213-2600(19)30138-9 Summary Background The effe...

ICU Management & Practice, Volume 19 - Issue 2, 2019 Big Data and hidden subtypes of sepsis Results of a study conducted by the University of Pittsburgh School of Medicine suggests that sepsis is not one condition, but many conditions that could benefit from different treatments. The findings are published in JAMA and were presented at the American Thoracic Society's Annual Meeting. Sepsis is the number one killer of hospitalised patients and is a life-t...

SPOTLIGHT|ONLINE FIRST When is the right time to discuss ECMO? William B Feldman, Steven P Keller Lancet Respir Med Published:August 12, 2019 DOI:https://doi.org/10.1016/S2213-2600(19)30278-4 The rise of extracorporeal membrane oxygenation (ECMO) over the past decade as a support modality provides clinicians with a powerful new therapy to care for patients with advanced cardiopulmonary disease. The growing use of this technology has required careful attention ...

Effects of Sedatives and Opioids on Patient Ventilator Asynchrony Patient-ventilator asynchrony is frequent during invasive mechanical ventilation. If patient-ventilator interaction is poor, it can prolong the duration of mechanical ventilation and can also result in longer ICU and hospital stay as well as increased mortality. It is thus important to optimise patient-ventilator interaction.  There are many factors that could affect patient-ventilator interaction...

COMMENT|ONLINE FIRST Simplified control measures for ESBL-producing Enterobacteriacae? Jean-Christophe Lucet, Jean-Ralph Zahar Lancet Infect Dis Published:August 23, 2019 DOI:https://doi.org/10.1016/S1473-3099(19)30412-8 Extended-spectrum β-lactamase (ESBL)-producing Enterobacteriacae have disseminated worldwide, with very high prevalence in countries of low and middle income1 and a roughly 10% prevalence in the community and at hospital admission in high-inco...