ARTICLES|ONLINE FIRST Perioperative covert stroke in patients undergoing non-cardiac surgery (NeuroVISION): a prospective cohort study The NeuroVISION Investigators Lancet epub August 15, 2019 DOI:https://doi.org/10.1016/S0140-6736(19)31795-7 Summary Background 背景 In non-surgical settings, covert stroke is more common than overt stroke and is associated with cognitive decline. Although overt stroke occurs in less than 1% of adults after non-cardiac sur...

Monocyte Distribution Width as Biomarker for Early Sepsis Detection Existing biomarkers provide limited use for rapid detection of sepsis since they cannot accurately distinguish sepsis from other common conditions encountered in the emergency department (ED). Now a U.S. clinical trial suggests that the monocyte distribution width (MDW) can be a useful indicator of Sepsis-2 and Sepsis-3 in high-risk ED patients. "Changes in the volume of peripheral blood monocyt...

ARTICLES|ONLINE FIRST An artificial intelligence-enabled ECG algorithm for the identification of patients with atrial fibrillation during sinus rhythm: a retrospective analysis of outcome prediction Zachi I Attia, Peter A Noseworthy, Francisco Lopez-Jimenez, et al Lancet Published:August 01, 2019 DOI:https://doi.org/10.1016/S0140-6736(19)31721-0 Summary Background 背景 Atrial fibrillation is frequently asymptomatic and thus underdetected but is asso...

ICU Diaries Not Useful in Preventing PTSD Symptoms Results of a randomised clinical trial in France indicate that the use of ICU diaries was not helpful in preventing post-traumatic stress disorder symptoms (PTSD) after ICU hospitalisation. In this multicentre study, investigators compared the use of patients' ICU diaries – filled out by clinicians and family members during the ICU stay – with usual care.Previous studies exploring the usefulness of ICU diaries in p...

Letter | Published: 31 July 2019 A clinically applicable approach to continuous prediction of future acute kidney injury Nenad Tomašev, Xavier Glorot, Jack W. Rae, et al Nature  572, pages116–119 (2019) Abstract The early prediction of deterioration could have an important role in supporting healthcare professionals, as an estimated 11% of deaths in hospital follow a failure to promptly recognize and treat deteri...

Vitamin C Drug Cocktail for Sepsis The combination of intravenous vitamin C, corticosteroids and thiamine has been made famous by Dr. Paul Marik, M.D. for the treatment of sepsis in critically ill patients. The ‘Marik protocol’, also termed HAT (Hydrocortisone, Ascorbic acid, Thiamine), has however come under criticism regarding the lack of evidence. Dr. Marik of Sentara Norfolk General Hospital, Virginia, has been using the Marik protocol to treat sepsis in his...

ORIGINAL ARTICLE Transfusion Volume for Children with Severe Anemia in Africa Kathryn Maitland, Peter Olupot-Olupot, Sarah Kiguli, et al N Engl J Med 2019; 381:420-431DOI: 10.1056/NEJMoa1900100 Abstract BACKGROUND 背景 Severe anemia (hemoglobin level, <6 g per deciliter) is a leading cause of hospital admission and death in children in sub-Saharan Africa. The World Health Organization recommends transfusion of 20 ml of whole-blood equivalent per ...

Review August 13, 2019 Extracorporeal Life Support for Adults With Respiratory Failure and Related Indications: A Review Daniel Brodie, Arthur S. Slutsky, Alain Combes JAMA. 2019;322(6):557-568. doi:10.1001/jama.2019.9302

ORIGINAL ARTICLE Immediate Transfusion in African Children with Uncomplicated Severe Anemia Kathryn Maitland, Sarah Kiguli, Peter Olupot-Olupot, et al. N Engl J Med 2019; 381:407-419DOI: 10.1056/NEJMoa1900105 Abstract BACKGROUND 背景 The World Health Organization recommends not performing transfusions in African children hospitalized for uncomplicated severe anemia (hemoglobin level of 4 to 6 g per deciliter and no signs of clinical severity). Howev...

Research Diagnosis of elevated intracranial pressure in critically ill adults: systematic review and meta-analysis Shannon M Fernando, Alexandre Tran, Wei Cheng, et al BMJ 2019;366:l4225 Abstract Objectives 背景 To summarise and compare the accuracy of physical examination, computed tomography (CT), sonography of the optic nerve sheath diameter (ONSD), and transcranial Doppler pulsatility index (TCD-PI) for the diagnosis of elevated intracranial pressure...