Anti-influenza Immune Plasma for the Treatment of Patients With Severe Influenza A: A Randomised, Double-Blind, Phase 3 Trial John H Beigel, Evgenia Aga, Marie-Carmelle Elie-Turenne, et al Lancet Respir Med 2019; 7: 941-950 Background 背景 Infection with influenza virus causes substantial morbidity and mortality globally, although antiviral treatments are available. Previous studies have suggested that anti-influenza immune plasma could be beneficial...

ICU Management & Practice, Volume 19 - Issue 3, 2019 Virtual Reality in the Intensive Care Unit: State of Play and Future Prospects An overview of the practical uses of virtual reality in the ICU and the benefits it can provide. One way of defining virtual reality (VR) is as the set of techniques and systems required for human beings to enter computer-generated synthetic worlds. VR techniques are based on real-time interaction with an artificial immersiv...

Original Investigation November 5, 2019 Effect of Caspofungin vs Fluconazole Prophylaxis on Invasive Fungal Disease Among Children and Young Adults With Acute Myeloid Leukemia: A Randomized Clinical Trial Brian T. Fisher, Theoklis Zaoutis, Christopher C. Dvorak, et al JAMA. 2019;322(17):1673-1681. doi:10.1001/jama.2019.15702 Importance 背景 Children, adolescents, and young adults with acute myeloid leukemia ...

Original Investigation December 10, 2019 Effect of Fresh vs Standard-issue Red Blood Cell Transfusions on Multiple Organ Dysfunction Syndrome in Critically Ill Pediatric Patients: A Randomized Clinical Trial Philip C. Spinella, Marisa Tucci, Dean A. Fergusson, et al JAMA. 2019;322(22):2179-2190. doi:10.1001/jama.2019.17478 Importance 背景 The clinical consequences of red blood cell storage age for criti...

SPECIAL ARTICLE FREE PREVIEW Discrimination, Abuse, Harassment, and Burnout in Surgical Residency Training Yue-Yung Hu, Ryan J. Ellis, D. Brock Hewitt, et al. N Engl J Med 2019; 381:1741-1752DOI: 10.1056/NEJMsa1903759 BACKGROUND Physicians, particularly trainees and those in surgical subspecialties, are at risk for burnout. Mistreatment (i.e., discrimination, verbal or physical abuse, and sexual harassment) may contribute to burnout and suicidal thoughts. ...

ICU Management & Practice, Volume 19 - Issue 3, 2019 Pre-packed Critical Care Drug Pouch for Acute Patient Care Human factors are significant contributors to drug error. To overcome some of these human factors, we propose standardisation and consolidation of agreed drugs and equipment into a compact pre-packed critical care drug pouch (CCP) for use in non-theatre environments. Introduction  Emergency and sedation drugs availability and preparation rep...

ORIGINAL ARTICLE FREE PREVIEW Early Surgery or Conservative Care for Asymptomatic Aortic Stenosis Duk-Hyun Kang, Sung-Ji Park, Seung-Ah Lee, et al N Engl J Med November 16, 2019DOI: 10.1056/NEJMoa1912846 BACKGROUND 背景 The timing and indications for surgical intervention in asymptomatic patients with severe aortic stenosis remain controversial. 无症状的严重主动脉瓣狭窄患者手术干预的时机及适应症存在争议。 METHODS 方法 In a multicenter trial, we ran...

Myocardial Ischaemia During Ventilator Weaning Weaning is a critical process for patients in intensive care. Weaning failure can result in poor outcomes and prolonged weaning which in turn can increase the risk of death. One of the main mechanisms of weaning failure is weaning-induced cardiac pulmonary oedema (WiPO). While advances in diagnosis have been made using tools such as bedside echocardiography or biomarkers, the underlying mechanisms of WiPO still remain uncl...

ORIGINAL ARTICLE Prevention of Early Ventilator-Associated Pneumonia after Cardiac Arrest Bruno François, Alain Cariou, Raphaël Clere-Jehl, et al N Engl J Med 2019; 381:1831-1842DOI: 10.1056/NEJMoa1812379 BACKGROUND 背景 Patients who are treated with targeted temperature management after out-of-hospital cardiac arrest with shockable rhythm are at increased risk for ventilator-associated pneumonia. The benefit of preventive short-term antibiotic therapy...

ICU Management & Practice, Volume 19 - Issue 3, 2019 New ESPEN Guidelines for Nutrition in the Critically Ill: Help, What Happened!? ESPEN guidelines for nutrition in critical illness have shifted from optimistic anticipative nutritional pharmacotherapy towards cautious and balanced metabolic support. This important new orientation in ICU nutrition management is a consequence of recent strong RCT-based evidence. Introduction Recently, the new ESPEN gu...