小剂量阿奇霉素可能减少COPD急性加重住院患者的治疗失败。这是American Journal of Respiratory and Critical Care Medicine杂志在线发表的一项多中心随机对照试验的结果。 既往研究表明，阿奇霉素能够预防COPD的急性加重。然而，尚不清楚这种抗生素如何能够COPD急性加重的住院患者强化治疗的需求，或者在上述患者出院后为何能够减少急性加重的风险。 在新的研究中，即比利时阿奇霉素治疗COPD加重住院患者研究(BACE)，除住院期间的其他用药外，患者使用小剂量阿奇霉素，并在出院后继续使用小剂量阿奇霉...

ICU Management & Practice, Volume 18 - Issue 2, 2018 Is pre-hospital coagulation management in trauma feasible? Coagulation management remains a formidable challenge in severely bleeding trauma patients. A strong rationale suggests starting treatment of trauma-induced coagulopathy in the pre-hospital phase.The burden of trauma is increasing worldwide, particularly in less well-resourced nations. There are an estimated 5 million deaths per year, more than TB...

Original Investigation April 29, 2019 Diagnostic Performance of Creatinine-Based Equations for Estimating Glomerular Filtration Rate in Adults 65 Years and Older Luciano da Silva Selistre, Dener L. Rech, Vandréa de Souza, et al JAMA Intern Med. Published online April 29, 2019. doi:10.1001/jamainternmed.2019.0223 Abstract Importance 背景 Estimating glomerular filtration rate (GFR) is useful in many clinical conditions. However, very few stu...

Azithromycin may reduce treatment failure in acute COPD exacerbations Low‐dose azithromycin may reduce treatment failure in patients hospitalised for acute exacerbations of chronic obstructive pulmonary disease (COPD). This finding is from a multicentre, randomised controlled trial published online in the American Journal of Respiratory and Critical Care Medicine. The antibiotic azithromycin prevents acute exacerbations in COPD as shown in previous studies. It w...

Research Estimates of all cause mortality and cause specific mortality associated with proton pump inhibitors among US veterans: cohort study BMJ 2019; 365: l1580 https://doi.org/10.1136/bmj.l1580 Abstract Objective 目的 To estimate all cause mortality and cause specific mortality among patients taking proton pump inhibitors (PPIs). 估算服用质子泵抑制剂(PPI)患者的全因病死率及疾病特异性病死率。 Design 试验设计 Longitudinal o...

Research Intensive care use and mortality among patients with ST elevation myocardial infarction: retrospective cohort study BMJ 2019; 365: l1927 https://doi.org/10.1136/bmj.l1927 Cite this as: BMJ 2019;365:l1927 Abstract Objective 目的 To evaluate the effect of intensive care unit (ICU) admission on mortality among patients with ST elevation myocardial infarction (STEMI). 评价收治ICU对STEMI患者病死率的影响 Design 试验...

Editorial June 3, 2019 Setting Positive End-Expiratory Pressure in Mechanically Ventilated Patients Undergoing Surgery Thomas Godet, Emmanuel Futier JAMA. 2019;321(23):2285-2287. doi:10.1001/jama.2019.7540 What is the optimal level of positive end-expiratory pressure (PEEP) for patients receiving mechanical ventilation? Despite decades of investigations, this question continues to be discussed among researchers and clinicians with no clear answer, leaving...

Reasonable Doubt Don't Be Fooled by New Study Tamiflu Still Pretty Worthless for H1N1 Runde, Dan, MD Emergency Medicine News: April 2019 - Volume 41 - Issue 4 - p 6 doi: 10.1097/01.EEM.0000554842.09002.7c It's possible that the Tamiflu pandemonium may be peaking for most emergency and primary care physicians because the dubious benefits of oseltamivir have now been well documented, discussed, and disseminated. (See box.) But there's also a new kid on the...

Original Investigation Effect of Intraoperative High Positive End-Expiratory Pressure (PEEP) With Recruitment Maneuvers vs Low PEEP on Postoperative Pulmonary Complications in Obese Patients: A Randomized Clinical Trial Writing Committee for the PROBESE Collaborative Group of the PROtective VEntilation Network (PROVEnet) for the Clinical Trial Network of the European Society of Anaesthesiology JAMA. 2019;321(23):2292-2305. doi:10.1001/jama.2019.7505 Abstract ...

Editorial June 11, 2019 Revisiting, Reframing, and Casting a New Light on Liberation From Mechanical Ventilation Timothy D. Girard, Karen E. A. Burns JAMA. 2019;321(22):2167-2169. doi:10.1001/jama.2019.7364 Every year, more than 1 million patients throughout the world receive mechanical ventilation for acute respiratory failure. One of the most important decisions clinicians make in managing these critically ill patients is how to liberate them ...