Advances in monitoring expired CO2 in critically ill patients Reviews the potential uses and pitfalls of capnography in critically ill patients, especially for haemodynamic and respiratory monitoring. Expired CO2 can be easily monitored in the intensive care unit (ICU), especially in patients under invasive mechanical ventilation, using infrared measurement by sampling mainstream expiratory flow using an in-line chamber, or sidestream expiratory flow (by contin...

PUBLIC RELEASE: 14-FEB-2019 Antidepressant could stop deadly sepsis, study suggests Previous FDA approval could fast-track new treatment UNIVERSITY OF VIRGINIA HEALTH SYSTEM An antidepressant drug used to treat obsessive-compulsive disorder could save people from deadly sepsis, new research from the University of Virginia School of Medicine suggests. Sepsis is a significant cause of death around the world. The federal Centers for Disease Control an...

Blood biomarker can identify infection-related disease progression In settings such as the emergency department (ED), early assessment of the potential for further disease progression is vital. An early identification of infection severity is helpful in initiating appropriate treatment strategies. However, currently there is a lack of validated tools to assess risk of further disease progression in patients presenting to the ED with a suspected infection. A new ...

Mortality, morbidity, and hospitalisations due to influenza lower respiratory tract infections, 2017: an analysis for the Global Burden of Disease Study 2017 GBD 2017 Influenza Collaborators Lancet Respir Med 2019; 7: 69-89 Background 背景 Although the burden of influenza is often discussed in the context of historical pandemics and the threat of future pandemics, every year a substantial burden of lower respiratory tract infections (LRTIs) and other respirato...

Intensive Care Medicine ONLINE FIRST THIS WEEK(FREE ACCESS) Seven-Day Profile Publication ~ Alain Combes - Feasibility and safety of extracorporeal CO2 removal to enhance protective ventilation in Acute Respiratory Distress Syndrome: the SUPERNOVA study  Review ~ G. A. Schmidt - Ultrasound-guided vascular access in critical illness  Original ~ Gerald Chi - Extended-duration Betrixaban versus shorter-duration Enoxaparin for Venous Thromboembolism Prophylaxis in criti...

Original Investigation Effect of Electroencephalography-Guided Anesthetic Administration on Postoperative Delirium Among Older Adults Undergoing Major Surgery: The ENGAGES Randomized Clinical Trial Troy S. Wildes, Angela M. Mickle, Arbi Ben Abdallah, et al JAMA. 2019;321(5):473-483. doi:10.1001/jama.2018.22005Key Points Abstract Importance 背景 Intraoperative electroencephalogram (EEG) waveform suppression, often suggesting excessive general anesthesia, ...

Imaging and intensive care medicine An evolving partnership A major evolution is underway involving critical care and imaging.  The intensive care patient population is changing. Increasingly intensive care units (ICUs) are treating older patients, with more comorbidities, and variable prognosis, at a time when family expectations are different and often with higher expectations of recovery. Life support technology is increasingly sophisticated, surgery is minima...

Intensive blood pressure reduction with intravenous thrombolysis therapy for acute ischaemic stroke (ENCHANTED): an international, randomised, open-label, blinded-endpoint, phase 3 trial Craig S Anderson, Yining Huang, Richard I Lindley, et al Lancet Published:February 07, 2019 DOI:https://doi.org/10.1016/S0140-6736(19)30038-8 Summary Background 背景 Systolic blood pressure of more than 185 mm Hg is a contraindication to thrombolytic treatment with intraven...

Antifungal treatment in the ICU Best practice in managing fungal infections Invasive candidiasis: Every milligram of antifungal counts! Think Aspergillus! Invasive fungal infections (IFIs) are a major cause of morbidity and mortality in critically ill patients. Almost 80% of IFIs are due to Candida spp., which are the third most common isolated microorganisms in the intensive care unit (ICU) (Kett et al. 2011; Bassetti et al. 2017). Although the incidence of inva...

Efficacy and safety of minimally invasive surgery with thrombolysis in intracerebral haemorrhage evacuation (MISTIE III): a randomised, controlled, open-label, blinded endpoint phase 3 trial Daniel F Hanley, Richard E Thompson, Michael Rosenblum, et al Lancet Published:February 07, 2019 DOI:https://doi.org/10.1016/S0140-6736(19)30195-3 Summary Background 背景 Acute stroke due to supratentorial intracerebral haemorrhage is associated with high morbidity and ...