Large Decreases in ICU-Acquired Infections - National Infection Campaign ICUs in the UK have seen an 80% drop in bloodstream infections according to NIHR Guy's and St Thomas' Biomedical Research Centre-funded research. In collaboration with Guy's and St Thomas' clinicians and researchers from ICNARC (Intensive Care National Audit & Research Centre), the study analysed 1 million adult patients from 276 NHS ICUs across the UK from 2007-2012. Published in ...

Energy Balance in Obese, Mechanically Ventilated Patients in ICU Clinical evidence shows that overfeeding critically ill patients is associated with poor outcomes. Obesity is a major challenge in ICU patients because of the comorbidities and anomalies associated with it. Determining an appropriate dose of enteral nutrition is difficult in this patient population and the risk of overfeeding quite high. An association between negative energy balance and increased inf...

Original Investigation October 8, 2019 Association of Surgical Hematoma Evacuation vs Conservative Treatment With Functional Outcome in Patients With Cerebellar Intracerebral Hemorrhage Joji B. Kuramatsu, Alessandro Biffi, Stefan T. Gerner, et al JAMA. 2019;322(14):1392-1403. doi:10.1001/jama.2019.13014 Importance 背景 The association of surgical hematoma evacuation with clinical outcomes in patients with cerebellar intracerebral hemorrhage (...

Noninvasive Ventilation in Early Stage Mild ARDS A recent study assessed the ability of early noninvasive ventilation (NIV) intervention to decrease the need for invasive ventilation in patients with mild forms of acute respiratory distress syndrome (ARDS). This method has already proved successful for acute respiratory failure patients but has not been tested in ARDS. Use of NIV in ARDS patients has been highly debated, especially in cases of mild pneumonia-induce...

October 21, 2019 Effect of Fibrinogen Concentrate vs Cryoprecipitate on Blood Component Transfusion After Cardiac Surgery: The FIBRES Randomized Clinical Trial Jeannie Callum, Michael E. Farkouh, Damon C. Scales, et al JAMA. Published online October 21, 2019. doi:10.1001/jama.2019.17312 Abstract Importance 背景 Excessive bleeding is a common complication of cardiac surgery. An important cause of bleeding is acquired hypofibrinogenemia (fibrinog...

ICU Management & Practice, Volume 18 - Issue 4, 2018 Clinical assessment of critically ill patients by whole-body ultrasonography In this article we focus on the evidence of whole-body ultrasonography used for hypotension or shock. We first highlight individual ultrasound components in association to hypotension and shock. Second, we provide an outline of current literature on whole-body ultrasonography, its effect on outcome, and try to integrate the previ...

ORIGINAL ARTICLE Targeted Temperature Management for Cardiac Arrest with Nonshockable Rhythm Jean-Baptiste Lascarrou, Hamid Merdji, Amélie Le Gouge, et al N Engl J Med October 2, 2019DOI: 10.1056/NEJMoa1906661 BACKGROUND 背景 Moderate therapeutic hypothermia is currently recommended to improve neurologic outcomes in adults with persistent coma after resuscitated out-of-hospital cardiac arrest. However, the effectiveness of moderate therapeutic hypothermia i...

ICU Management & Practice, Volume 17 - Issue 4, 2017 Molecular diagnostics in severe respiratory virus infection Recent trends in virus detection assays and host response biomarkers This article provides an overview of the recent advances in molecular testing for patients with suspected respiratory tract infection. Respiratory tract infections are common reasons for admission to intensive care units. For decades conventional culture techniques were th...

CORRESPONDENCE| VOLUME 7, ISSUE 10, PE31, OCTOBER 01, 2019 Secondary re-analysis of the FEAST trial – Authors' reply Michael Levin, Aubrey J Cunnington, Clive J Hoggart Lancet Respir Med 2019; 7: e31 DOI:https://doi.org/10.1016/S2213-2600(19)30264-4 Kathyrn Maitland and colleagues have voiced concerns about the difference between findings in our re-analysis of the FEAST trial1 and their 2013 report2 on which one of us (ML) was also an author. T...

#LIVES2019: Vitamin C for Sepsis Dr. Alpha A. Fowler of Virginia Commonwealth University presented findings from the CITRIS-ALI trial that studied the role of vitamin C in patients with septic ARDS. The findings were presented @ESICM in Berlin and have just been published in JAMA. The CITRIS-ALI randomised trial addressed the use of high dose intravenous vitamin C to study the effects of organ failure and the effects of vitamin C on inflammation and vascular inj...