Maximal Recruitment Open Lung Ventilation in Acute Respiratory Distress Syndrome (PHARLAP): A Phase II, Multicenter, Randomized, Controlled Trial Hodgson CL, Cooper DJ, Arabi Y, et al Am J Respir Crit Care Med. 2019 Jul 29.doi: 10.1164/rccm.201901-0109OC. RATIONALE: 背景 Open lung ventilation strategies have been recommended in patients with acute respiratory distress syndrome (ARDS). 推荐ARDS患者采用肺开放通气策略。 OBJECTIVE: 目的 To determine ...

Emergency Department to ICU Time and Mortality Delays in transferring patients from the Emergency Department (ED) to the ICU could delay treatment, leaving the patient at risk. A recent study explored the impact of this and found that increased ED to ICU wait times were associated with increased hospital mortality. Data was used from the Dutch quality registry National Intensive Care Evaluation, covering 14,788 patients admitted to the ICU through the ED from 2009 ...

ARTICLES|ONLINE FIRST Effect of infectious disease consultation on mortality and treatment of patients with candida bloodstream infections: a retrospective, cohort study Carlos Mejia-Chew, Jane A O'Halloran, Margaret A Olsen, et al. Lancet Infect Dis September 24, 2019 DOI:https://doi.org/10.1016/S1473-3099(19)30405-0 Summary Background 背景 Candida bloodstream infection is associated with high mortality. Infectious disease consultation improves outcomes...

Original Investigation Mobile Photoplethysmographic Technology to Detect Atrial Fibrillation Guo Y, Wang H, Zhang H, et al J Am Coll Cardiol. 2019 Nov 12;74(19):2365-2375. doi: 10.1016/j.jacc.2019.08.019 Background Low detection and nonadherence are major problems in current management approaches for patients with suspected atrial fibrillation (AF). Mobile health devices may enable earlier AF detection and improved AF management. Objectives This study...

Research Methods & Reporting A guide to prospective meta-analysis Anna Lene Seidler, Kylie E Hunter, Saskia Cheyne, et al BMJ 2019; 367: l5342 DOI:https://doi.org/10.1136/bmj.l5342 Summary points In a prospective meta-analysis (PMA), studies are identified and determined to be eligible for inclusion before the results of the studies related to the PMA research question are knownPMAs are applicable to high priority research questions where limited previo...

ORIGINAL ARTICLE Large-Scale Assessment of a Smartwatch to Identify Atrial Fibrillation Marco V. Perez, Kenneth W. Mahaffey, Haley Hedlin, et al. N Engl J Med 2019; 381:1909-1917DOI: 10.1056/NEJMoa1901183 BACKGROUND Optical sensors on wearable devices can detect irregular pulses. The ability of a smartwatch application (app) to identify atrial fibrillation during typical use is unknown. METHODS Participants without atrial fibrillation (as reported by ...

JAMA Clinical Guidelines Synopsis September 23, 2019 Prevention and Management of Venous Thromboembolism Jonathan D. Paul, Adam S. Cifu JAMA. Published online September 23, 2019. doi:10.1001/jama.2019.13853 Guideline title 指南题目 2018 Guidelines for Management of Venous Thromboembolism 2018静脉血栓栓塞治疗指南 Developers 制定者 American Society of Hematology (ASH) and McMaster University GRADE Centre 美国血液病学会(ASH)及McM...

Mechanical Ventilation Effects on Neurocognitive Functions The hypothesis that mechanical ventilation (MV) can cause neurotoxicity in critically ill patients has long been debated. First reported in 1999, MV is thought to trigger chronic cognitive disorders. Brain damage induced by MV can be caused by alveolar stretching, abnormalities in PaO2/PaCO2, biotrauma and MV causing direct brain inflammation. Alveolar stretching, induced by MV, goes on to produce system...

ARTICLES|ONLINE FIRST Ceftolozane–tazobactam versus meropenem for treatment of nosocomial pneumonia (ASPECT-NP): a randomised, controlled, double-blind, phase 3, non-inferiority trial Marin H Kollef, Martin Nováček, Ülo Kivistik, et al Lancet Infect Dis September 25, 2019 DOI:https://doi.org/10.1016/S1473-3099(19)30403-7 Summary Background 背景 Nosocomial pneumonia due to antimicrobial-resistant pathogens is associated with high mortality. We assessed th...

Nighttime Intensivist Staffing The work hours and sleep schedules of physicians who have completed training have seldom been studied. But there is ample evidence that suggests that sleep deprivation can cause errors in decision-making even in easy and familiar circumstances. Keeping in mind that the critical care setting is usually quite stressful, long working hours and sleep deprivation can increase the likelihood of errors. The fact is that critical care pati...