COMMENT|ONLINE FIRST Uncovering covert stroke in surgical patients Phillip E Vlisides, Michael S Avidan, George A Mashour Lancet epub August 15, 2019 DOI:https://doi.org/10.1016/S0140-6736(19)31770-2 Stroke can be a devastating complication of surgery, with few effective strategies for detection or prevention. Overt stroke (ie, stroke with clinically apparent manifestations) occurs in approximately 0·1–1·0% of patients undergoing non-cardiac surgery and is ass...

ICU Management & Practice, Volume 19 - Issue 1, 2019 Extravascular lung water as a target for intensive care The paper highlights the present clinical rationale for extravascular lung water measurement as a key to personalisation of haemodynamic therapy. Introduction Extravascular lung water (EVLW) remains a useful guide for monitoring pulmonary oedema (PO) and vascular permeability in sepsis, acute respiratory distress syndrome (ARDS), and ...

ARTICLES|ONLINE FIRST Mechanical and oral antibiotic bowel preparation versus no bowel preparation for elective colectomy (MOBILE): a multicentre, randomised, parallel, single-blinded trial Laura Koskenvuo, Taru Lehtonen, Selja Koskensalo, et al Lancet epub August 08, 2019 DOI:https://doi.org/10.1016/S0140-6736(19)31269-3 Summary Background 背景 Decreased surgical site infections (SSIs) and morbidity have been reported with mechanical and oral antibiotic...

ICU Management & Practice, Volume 18 - Issue 4, 2018 How to manage severe dengue infection A review of diagnosis and treatment of dengue, a mosquito-borne febrile illness caused by flavivirus with a clinical spectrum ranging from self-limited fever to dengue haemorrhagic fever with shock.  Dengue is a febrile illness, caused by one of the serotypes of Flavivirus (DENV1-4), transmitted by Aedes aegypti and Aedes albopictus mosquitoes during a blood m...

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...