ICU Management & Practice, Volume 19 - Issue 1, 2019 Trends in epidemiology and antimicrobial resistance in intensive care units The intensive care unit has a unique environment, mainly because it treats severe and critically ill patients who require special care. Critical care patients often require high-risk surgeries, and there is also a frequent need for invasive devices such as central or peripheral venous catheters, urinary catheters or tracheal tubes...

COMMENT|ONLINE FIRST Carbapenem-resistant Enterobacteriaceae: global action required Federico Perez, Robert A Bonomo Lancet Infect Dis Published: April 29, 2019 DOI: https://doi.org/10.1016/S1473-3099(19)30210-5 Enterobacteriaceae are common pathogens in hospitals and in the community. When resistant to powerful and versatile antibiotics such as carbapenems, they can have devastating consequences, particularly in the most vulnerable individuals.1 Much infor...

ARTICLES|ONLINE FIRST Effect of carbapenem resistance on outcomes of bloodstream infection caused by Enterobacteriaceae in low-income and middle-income countries (PANORAMA): a multinational prospective cohort study Andrew J Stewardson, Kalisvar Marimuthu, Sharmila Sengupta, et al Lancet Infect Dis Published: April 29, 2019 DOI:https://doi.org/10.1016/S1473-3099(18)30792-8 Summary Background 背景 Low-income and middle-income countries (LMICs) are under...

Early Paralytic Agents for ARDS? Yes, No, and Sometimes Arthur S. Slutsky, Jesús Villar N Engl J Med May 19, 2019DOI: 10.1056/NEJMe1905627 Lung-protective ventilation, which includes low tidal volumes and limitation of plateau pressures, is the standard approach in patients with acute respiratory distress syndrome (ARDS).1 Almost a decade ago, the ARDS et Curarisation Systematique (ACURASYS) trial2 showed that in patients with moderate-to-severe ARDS, a strategy ...

ORIGINAL ARTICLE Early Sedation with Dexmedetomidine in Critically Ill Patients Yahya Shehabi, Belinda D. Howe, Rinaldo Bellomo, et al Abstract BACKGROUND 背景 Dexmedetomidine produces sedation while maintaining a degree of arousability and may reduce the duration of mechanical ventilation and delirium among patients in the intensive care unit (ICU). The use of dexmedetomidine as the sole or primary sedative agent in patients undergoing mechanical ventilati...

ORIGINAL ARTICLE Nasal High-Flow Therapy for Newborn Infants in Special Care Nurseries Brett J. Manley, Gaston R.B. Arnolda, Ian M.R. Wright, et al N Engl J Med 2019; 380:2031-2040DOI: 10.1056/NEJMoa1812077 Abstract BACKGROUND 背景 Nasal high-flow therapy is an alternative to nasal continuous positive airway pressure (CPAP) as a means of respiratory support for newborn infants. The efficacy of high-flow therapy in nontertiary special care nurseries is un...

ORIGINAL ARTICLE Early Neuromuscular Blockade in the Acute Respiratory Distress Syndrome The National Heart, Lung, and Blood Institute PETAL Clinical Trials Network N Engl J Med May 19, 2019DOI: 10.1056/NEJMoa1901686 Abstract BACKGROUND 背景 The benefits of early continuous neuromuscular blockade in patients with acute respiratory distress syndrome (ARDS) who are receiving mechanical ventilation remain unclear. 接受机械通气的ARDS患者早期使用神经肌肉阻...

Comment & Response May 14, 2019 Acute Kidney Injury Related to Sepsis—Reply Matthieu Legrand, John A. Kellum JAMA. 2019;321(18):1828-1829. doi:10.1001/jama.2019.2072 In Reply 回答 Dr Seres comments on the effect of low muscle mass on serum creatinine level. We agree that muscle mass and cachexia can decrease sensitivity of serum creatinine to detect a drop in GFR and AKI. Recently, Yoo and colleagues1 reporte...

Original Investigation Caring for the Critically Ill PatientMay 19, 2019 Derivation, Validation, and Potential Treatment Implications of Novel Clinical Phenotypes for Sepsis Christopher W. Seymour, Jason N. Kennedy, Shu Wang, et al JAMA. Published online May 19, 2019. doi:10.1001/jama.2019.5791 Abstract 摘要 Importance 背景 Sepsis is a heterogeneous syndrome. Identification of distinct clinical phenotypes may allow more precise therapy and...

Original Investigation Caring for the Critically Ill PatientMay 19, 2019 Effect of a Recombinant Human Soluble Thrombomodulin on Mortality in Patients With Sepsis-Associated Coagulopathy: The SCARLET Randomized Clinical Trial Jean-Louis Vincent, Bruno Francois, Igor Zabolotskikh, et al JAMA. Published online May 19, 2019. doi:10.1001/jama.2019.5358 Abstract Importance 背景 Previous research suggested that soluble human recombinant thrombom...