Editorial June 3, 2019 Setting Positive End-Expiratory Pressure in Mechanically Ventilated Patients Undergoing Surgery Thomas Godet, Emmanuel Futier JAMA. 2019;321(23):2285-2287. doi:10.1001/jama.2019.7540 What is the optimal level of positive end-expiratory pressure (PEEP) for patients receiving mechanical ventilation? Despite decades of investigations, this question continues to be discussed among researchers and clinicians with no clear answer, leaving...

Reasonable Doubt Don't Be Fooled by New Study Tamiflu Still Pretty Worthless for H1N1 Runde, Dan, MD Emergency Medicine News: April 2019 - Volume 41 - Issue 4 - p 6 doi: 10.1097/01.EEM.0000554842.09002.7c It's possible that the Tamiflu pandemonium may be peaking for most emergency and primary care physicians because the dubious benefits of oseltamivir have now been well documented, discussed, and disseminated. (See box.) But there's also a new kid on the...

Original Investigation Effect of Intraoperative High Positive End-Expiratory Pressure (PEEP) With Recruitment Maneuvers vs Low PEEP on Postoperative Pulmonary Complications in Obese Patients: A Randomized Clinical Trial Writing Committee for the PROBESE Collaborative Group of the PROtective VEntilation Network (PROVEnet) for the Clinical Trial Network of the European Society of Anaesthesiology JAMA. 2019;321(23):2292-2305. doi:10.1001/jama.2019.7505 Abstract ...

Editorial June 11, 2019 Revisiting, Reframing, and Casting a New Light on Liberation From Mechanical Ventilation Timothy D. Girard, Karen E. A. Burns JAMA. 2019;321(22):2167-2169. doi:10.1001/jama.2019.7364 Every year, more than 1 million patients throughout the world receive mechanical ventilation for acute respiratory failure. One of the most important decisions clinicians make in managing these critically ill patients is how to liberate them ...

Fluid responsiveness in sepsis: the fluid challenge revisiting (FCREV) study Fluid challenge is a common practice in the ICU. It is one of the most important resuscitation manoeuvres of acute circulatory failure management in critically ill patients. Adequate fluid resuscitation is very important because both hypovolaemia and fluid overload can result in poor outcomes in the ICU. The criteria for fluid administration still remains controversial. A study was cond...

ORIGINAL ARTICLE Clinical Metagenomic Sequencing for Diagnosis of Meningitis and Encephalitis Michael R. Wilson, Hannah A. Sample, Kelsey C. Zorn, et al N Engl J Med 2019; 380:2327-2340DOI: 10.1056/NEJMoa1803396  Abstract BACKGROUND 背景 Metagenomic next-generation sequencing (NGS) of cerebrospinal fluid (CSF) has the potential to identify a broad range of pathogens in a single test. 脑脊液(CSF)的宏基因二代测序(NGS)能够通过一次检测鉴别多种致病微...

Original Investigation June 11, 2019 Association of Blood Donor Sex and Prior Pregnancy With Mortality Among Red Blood Cell Transfusion Recipients Gustaf Edgren Edward L. Murphy, Don J. Brambilla, et al JAMA. 2019;321(22):2183-2192. doi:10.1001/jama.2019.7084 Abstract 摘要 Importance 背景 Evidence regarding associations of blood donor sex with mortality among red blood cell transfusion recipients is conflicting. 有关献血者性别与接受输血...

Effect of ultra-short-term treatment of patients with iron deficiency or anaemia undergoing cardiac surgery: a prospective randomised trial Donat R Spahn, Felix Schoenrath, Gabriela H Spahn, et al Lancet 2019; 393: 2201-2212 DOI:https://doi.org/10.1016/S0140-6736(18)32555-8 Summary Background 背景 Anaemia and iron deficiency are frequent in patients scheduled for cardiac surgery. This study assessed whether immediate preoperative treatment could result...

Original Investigation June 11, 2019 Effect of Pressure Support vs T-Piece Ventilation Strategies During Spontaneous Breathing Trials on Successful Extubation Among Patients Receiving Mechanical Ventilation: A Randomized Clinical Trial Carles Subirà, Gonzalo Hernández, Antònia Vázquez, et al JAMA. 2019;321(22):2175-2182. doi:10.1001/jama.2019.7234Key Points Objective 目的 To evaluate the effect of an SBT consisting of 30 minutes of pressure support ventilat...

Individualised nutritional support in medical inpatients at nutritional risk: a randomised clinical trial Philipp Schuetz, Rebecca Fehr, Valerie Baechli, et al Lancet 2019 Published:April 25, 2019 DOI:https://doi.org/10.1016/S0140-6736(18)32776-4 Summary Background 背景 Guidelines recommend the use of nutritional support during hospital stays for medical patients (patients not critically ill and not undergoing surgical procedures) at risk of malnutrition...