ORIGINAL ARTICLE A Multicenter Trial of Vena Cava Filters in Severely Injured Patients Kwok M. Ho, Sudhakar Rao, Stephen Honeybul, et al N Engl J Med 2019; 381:328-337DOI: 10.1056/NEJMoa1806515 Abstract BACKGROUND 背景 Whether early placement of an inferior vena cava filter reduces the risk of pulmonary embolism or death in severely injured patients who have a contraindication to prophylactic anticoagulation is not known. 对于具有预防性抗凝禁忌的严重...

Original Investigation | July 23/30, 2019 Intensive vs Standard Treatment of Hyperglycemia and Functional Outcome in Patients With Acute Ischemic Stroke: The SHINE Randomized Clinical Trial Karen C. Johnston, Askiel Bruno, Qi Pauls, et al JAMA. 2019;322(4):326-335. doi:10.1001/jama.2019.9346 Abstract Importance 背景 Hyperglycemia during acute ischemic stroke is common and is associated with worse out...

Editor's Note July 16, 2019 Government Regulation of Sepsis Care Demetrios N. Kyriacou JAMA. 2019;322(3):250-251. doi:10.1001/jama.2019.9230 每年全球约有3000万脓毒症患者，且导致约600万患者死亡。尽管不断提出新的治疗手段，但是，过去数十年间脓毒症相关病死率的下降主要源于早期识别以及包括静脉抗生素和晶体液复苏在内的及时治疗。拯救脓毒症行动指南将重要治疗措施与其他重症治疗及实验室检查整合成集束化治疗进行推荐。然而，在医院环境下，根据这些指南推荐的...

ICU Management & Practice, Volume 18 - Issue 1, 2018 CO2 in the critically ill CO2 exerts potent effects on lung biology that could be clinically relevant in critically ill patients, in particular those with acute respiratory distress syndrome (ARDS). The impact of hypercapnia on outcome in these patients is yet to be determined. The physiological effects of hypercapnia are increasingly well understood, but the literature remains confusing. Importan...

Editor's Note July 16, 2019 Government Regulation of Sepsis Care Demetrios N. Kyriacou JAMA. 2019;322(3):250-251. doi:10.1001/jama.2019.9230 Sepsis is estimated to affect more than 30 million people and cause an estimated 6 million deaths worldwide every year. Although new medical treatments are continually being proposed and tested, the greatest reduction in sepsis-related deaths over the past few decades has come from the early recog...

Editorial July 16, 2019 Psychological Consequences of Admission to the ICU： Helping Patients and Families Louise Rose, Fiona Muttalib, Neill K. J. Adhikari JAMA. 2019;322(3):213-215. doi:10.1001/jama.2019.9059 For most patients and their families, admission to the intensive care unit (ICU) is an unanticipated event that causes substantial psychological distress. For patients, short- and long-term consequences include delirium, anxiety, depressi...

Original Investigation  Association Between State-Mandated Protocolized Sepsis Care and In-hospital Mortality Among Adults With Sepsis Jeremy M. Kahn, Billie S. Davis, Jonathan G. Yabes, et al JAMA. 2019;322(3):240-250. doi:10.1001/jama.2019.9021 Abstract Importance 背景 Beginning in 2013, New York State implemented regulations mandating that hospitals implement evidence-based protocols for sepsis management, ...

Original Investigation | Caring for the Critically Ill Patient Effect of an ICU Diary on Posttraumatic Stress Disorder Symptoms Among Patients Receiving Mechanical Ventilation: A Randomized Clinical Trial Maité Garrouste-Orgeas, Cécile Flahault, Isabelle Vinatier, et al JAMA. 2019;322(3):229-239. doi:10.1001/jama.2019.9058 Abstract Importance 背景 Keeping a diary for patients while they are in the intensive ca...

ICU Management & Practice, Volume 19 - Issue 1, 2019 Technology innovations in delivering accurate nutrition Preventing malnutrition and enforcing nutritional guidelines An overview of the key obstacles for the enforcement of nutritional guidelines and innovative approaches that can be used to overcome these obstacles. Recent studies suggest that nutritional guidelines across the majority of intensive care units (ICUs) are not being implemented (Benda...

Original Investigation | Caring for the Critically Ill Patient Effect of Flexible Family Visitation on Delirium Among Patients in the Intensive Care Unit: The ICU Visits Randomized Clinical Trial Regis Goulart Rosa, Maicon Falavigna, Daiana Barbosa da Silva, et al JAMA. 2019;322(3):216-228. doi:10.1001/jama.2019.8766 Abstract Importance 背景 The effects of intensive care unit (ICU) visiting hours remain uncert...