News Oxygen after surgery: review questions WHO advice that high levels reduce infection BMJ 2019; 364 doi: https://doi.org/10.1136/bmj.l777 (Published 18 February 2019)Cite this as: BMJ 2019;364:l777 World Health Organization guidelines on using high levels of oxygen during and after surgery have been questioned after claims that research by an Italian surgeon lacks credibility. Mario Schietroma of the University of L’Aquila in central Italy is the author of ...

Value-based incentive programmes and CAUTI rates Value-based incentive programmes (VBIPs) aim to drive improvements in quality and reduce costs by linking financial incentives or penalties to hospital performance. A new study evaluated the association of two U.S. federal VBIPs – the Hospital Value-Based Purchasing (VBP) Program and the Hospital-Acquired Condition Reduction Program (HACRP) – and catheter-associated urinary tract infections (CAUTIs) in the critical c...

Original Investigation|March 19, 2019 Associations of Dietary Cholesterol or Egg Consumption With Incident Cardiovascular Disease and Mortality Victor W. Zhong, Linda Van Horn, Marilyn C. Cornelis, et al JAMA. 2019;321(11):1081-1095. doi:10.1001/jama.2019.1572 Importance  背景 Cholesterol is a common nutrient in the human diet and eggs are a major source of dietary cholesterol. Whether dietary cholesterol or egg ...

Research True 99th centile of high sensitivity cardiac troponin for hospital patients: prospective, observational cohort study Mark Mariathas, Rick Allan, Sanjay Ramamoorthy, et al BMJ 2019;364:l729 Abstract Objective 目的 To determine the distribution, and specifically the true 99th centile, of high sensitivity cardiac troponin I (hs-cTnI) for a whole hospital population by applying the hs-cTnI assay currently used routinely at a large teaching hos...

Original Investigation |March 19, 2019 Levels of Evidence Supporting American College of Cardiology/American Heart Association and European Society of Cardiology Guidelines, 2008-2018 Alexander C. Fanaroff, Robert M. Califf, Stephan Windecker, et al JAMA. 2019;321(11):1069-1080. doi:10.1001/jama.2019.1122 Importance  背景 Clinical decisions are ideally based on evidence generated from multiple randomized control...

Declining rate of ARDS-related mortality There have been multiple advances in the management of acute respiratory distress syndrome (ARDS), but the temporal trends in ARDS-related mortality are not well known. Conservative fluid management strategy for ARDS, in particular, has been extensively studied and is increasingly being used in clinical practice. However, it is largely unknown whether this changing practice parallels with the improvement in survival outcome....

Post-anaesthesia pulmonary complications after use of muscle relaxants (POPULAR): a multicentre, prospective observational study Eva Kirmeier, Lars I Eriksson, Heidrun Lewald, et al Lancet Respir Med 2019; 7: 129-140 Background 背景 Results from retrospective studies suggest that use of neuromuscular blocking agents during general anaesthesia might be linked to postoperative pulmonary complications. We therefore aimed to assess whether the use of neuromus...

Intensive Care Medicine移植专刊 Organ Donation and Transplant in the ICU Editorial ~ Tobias Welte 10 tips for the Intensive care management of transplanted lung patients Editorial ~ Hasse Møller-Sørensen 10 tips for intensive care management of transplanted heart patients Editorial ~ Samir Jaber 10 tips for intensive care management of transplanted liver patients Editorial ~ Michael Darmon Ten tips to manage renal transplant rec...

Preliminary Communication | February 19, 2019 Effect of Intravenous Acetaminophen vs Placebo Combined With Propofol or Dexmedetomidine on Postoperative Delirium Among Older Patients Following Cardiac Surgery: The DEXACET Randomized Clinical Trial Balachundhar Subramaniam, Puja Shankar, Shahzad Shaefi, et al JAMA. 2019;321(7):686-696. doi:10.1001/jama.2019.0234 Abstract Importance 背景 Postoperative d...

Harvard study: machine learning improves ED triage The increasing number of emergency department (ED) visits often correlates with ED crowding and delays in care. This problem highlights the need for ED triage systems that accurately differentiate and prioritise critically ill from stable patients, enabling efficient allocation of finite ED resources.   Currently, the Emergent Severity Index (ESI) is the most commonly used triage algorithm in U.S. EDs....