#ISICEM19: Critical care medicine in space Dr. Matthieu Komorowski, Consultant in Intensive Care and Machine Learning researcher at Imperial College, London, talked about critical care in space at the 39th International Symposium on Intensive Care and Emergency Medicine.   One of the most distinct features about his talk (apart from the fact that it was about space), was that instead of presenting a lecture on space medicine, he narrated a story. The story is se...

Original Investigation January 16, 2019 Association Between Postoperative Delirium and Long-term Cognitive Function After Major Nonemergent Surgery C. Adrian Austin, Thomas O’Gorman, Elizabeth Stern, et al JAMA Surg. 2019;154(4):328-334. doi:10.1001/jamasurg.2018.5093 Abstract Importance 背景 Postoperative delirium is associated with decreases in long-term cognitive function in elderly populations. 老年人术后谵妄伴随远期认知功能减退。 Objectiv...

Acute-on-chronic liver failure: criteria for ICU admission Cirrhosis is a leading cause of morbidity and mortality throughout the world. Patients with cirrhosis may develop decompensated disease with portal hypertension and functional impairment of the liver, resulting in numerous complications including infection, variceal bleeding, hepatic encephalopathy (HE), and hepatorenal syndrome (HRS). Along with decompensation of cirrhosis, the concept of acute-on-chron...

亚洲ICU中肺保护性通气的国际多中心观察性研究 International Multi-Center Observational Study of Lung-protective Ventilation in Asian ICUs 请登陆IMPROVE study registration网站进行注册 研究目的 了解亚洲国家ICU中急性呼吸功能衰竭患者肺保护通气（如小潮气量，根据FiO2水平设置PEEP等）的依从性研究肺保护性通气依从性与ICU管理模式及患者预后的相关性研究入选患者符合ARDS诊断标准的比例以及医生的认知 研究方法 国际多中心观察性研究基于网络收集研究数据（包括参研ICU...

PERFECT protocol: volume-based feeding in ventilated adults Underfeeding in critical illness is common and associated with poor outcomes. Researchers in the UK designed a before-and-after study to evaluate the safety, efficacy and clinical outcomes associated with volume-based feeding (VBF) compared to rate-based feeding (RBF) in a single intensive care unit (ICU).The prospective before-and-after study suggests that VBF safely and effectively increased the delivery...

Original Investigation April 24, 2019 Association of Duration and Type of Surgical Prophylaxis With Antimicrobial-Associated Adverse Events Westyn Branch-Elliman, William O’Brien, Judith Strymish, et al JAMA Surg. Published online April 24, 2019. doi:10.1001/jamasurg.2019.0569 Importance 背景 The benefits of antimicrobial prophylaxis are limited to the first 24 hours postoperatively. Little is known abo...

ICU Management & Practice, Volume 19 - Issue 1, 2019 Protecting ward patients Finding patients before they crash might be the next major opportunity to improve patient safety. This article describes recent advances and perspectives for ward monitoring with wearable sensors and smart algorithms. Hospital wards are dangerous. Indeed, they are where most unexpected deaths occur within institutions. In a UK national audit study, among 23,554 adult in-hospita...

ESICM/ESCMID task force on practical management of invasive candidiasis in critically ill patients Question 1: Can we recommend the use of risk prediction models in daily clinical practice?我们能否推荐工作中采用风险预测模型？ Recommendations 推荐意见 Risk prediction models, because of their simplicity and high negative predictive values, should be used for identifying high-risk patients (Strong recommendation, low-quality evidence). 由于风险预测模型简单且阴性...

Innovations in ICU ventilation The future delivered In this article, we aim to summarise the developments in mechanical ventilation that we believe are shaping the present and will shape the future ahead. Introduction Many centuries ago, Socrates stated that “the secret of change is to focus all of your energy, not on fighting the old, but on building the new.” Nowadays, we may relate his quote with the concept of innovation, which is considered the process of...

Is Sepsis-Associated Mortality Often Preventable? Authors: News Author: Veronica Hackethal, MD CME Author: Charles P. Vega, MD Clinical Context Approximately 1.7 million US adults are diagnosed annually with sepsis, and sepsis can contribute to more than a quarter of a million deaths among US residents per year. The authors of the current study acknowledged multiple programs to improve the care and outcomes of patients with sepsis; one of the best known of the...