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Prone Positioning During ECMO for ARDS There is sufficient evidence to show that prone positioning improves oxygenation and respiratory mechanics and is also associated with lower mortality in patients with moderate to severe ARDS. However, some patients can develop refractory hypoxaemia and hypercapnia that could require the use of venovenous extracorporeal membrane oxygenation (VV-ECMO) support and need to be cared for in a supine position. Hence, the physiologic...
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Effect of oral chlorhexidine de-adoption and implementation of an oral care bundle on mortality for mechanically ventilated patients in the intensive care unit (CHORAL): a multi-center stepped wedge cluster-randomized controlled trial Craig M. Dale, Louise Rose, Sarah Carbone, et al Intensive Care Med Published: 05 October 2021 Abstract Purpose Oral chlorhexidine is used widely for mechanically ventilated patients to prevent pneumonia, but recent studies sh...
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AKI in Critically Ill Patients With COVID-19 Acute kidney injury is highly prevalent among severely ill COVID-19 patients. However, there is very limited data on the progression of AKI and long-term outcomes in these patients. In this study, researchers aimed to describe the prevalence and risk factors for the development of acute kidney injury, its clinical course and progression and renal recovery or dialysis dependence and survival. The study was conducted...
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ONLINE FIRST (FREE ACCESS) LATEST ARTICLES OPEN ACCESS ~ OriginalRole of total lung stress on the progression of early COVID-19 pneumoniaCoppola S. et al. Conference Reports and Expert PanelCritically ill cancer patient’s resuscitation: a Belgian/French societies’ consensus conferenceMeert A-P. et al.  EditorialThe goal of personalized glucose control in the critically ill remains elusiveKrinsley J.S., Deane A.M. and Gunst J. Imaging in Intensive Care Medic...
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Ethics in Extracorporeal Life Support Extracorporeal life support has had a significant impact on modern medicine. However, the use of this technology has significant ethical challenges. In this review, the authors identify three ethical discourses: trials and evidence accompanying the use of ECLS, the ECLS allocation, decision-making and limiting care and death on ECLS and ECLS in organ donation. They then provide a narrative synthesis of all major arguments ex...
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Original Investigation Caring for the Critically Ill PatientOctober 4, 2021 Effect of Convalescent Plasma on Organ Support–Free Days in Critically Ill Patients With COVID-19: A Randomized Clinical Trial Writing Committee for the REMAP-CAP Investigators JAMA. Published online October 4, 2021. doi:10.1001/jama.2021.18178 Abstract Importance  The evidence for benefit of convalescent plasma for critically ill patients with COVID-19 is i...
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Trends in Sepsis-Related Mortality in the U.S. Sepsis is a life-threatening organ dysfunction. It is the leading cause of death in the U.S. It is also one of the most expensive conditions to treat. However, the burden of sepsis-related mortality in the U.S. in recent years is not well-characterised. Previous studies utilise hospital databases and electronic health records to determine trends, but these have been limited to only a few hospital systems and geogr...
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Original Investigation October 5, 2021 Effect of a Pulmonary Embolism Diagnostic Strategy on Clinical Outcomes in Patients Hospitalized for COPD Exacerbation: A Randomized Clinical Trial David Jiménez, Alvar Agustí, Eva Tabernero, et al JAMA. 2021;326(13):1277-1285. doi:10.1001/jama.2021.14846 Abstract Importance  Active search for pulmonary embolism (PE) may improve outcomes in patients hospitalized for exacerbations of chronic obs...
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Mental Disorders and Risk of Severe COVID-19 Over the last few months, several risk factors have been identified for severe COVID-19 illness and mortality. These include age, male sex, obesity and cardiovascular disease. Recent evidence from a meta-analysis also demonstrates an increased risk of severe or fatal COVID-19 among patients with a pre-existing mental disorder.  Since then, several studies have found that patients with psychiatric disorders are also ...
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[JAMA发表论文]:预防性皮下注射丁溴东莨菪碱对终末期患者临终痰声的影响已关闭评论
Original Investigation Caring for the Critically Ill PatientOctober 5, 2021 Effect of Prophylactic Subcutaneous Scopolamine Butylbromide on Death Rattle in Patients at the End of Life: The SILENCE Randomized Clinical Trial Harriëtte J. van Esch, Lia van Zuylen, Eric C. T. Geijteman, et al JAMA. 2021;326(13):1268-1276. doi:10.1001/jama.2021.14785 Abstract Importance  Death rattle, defined as noisy breathing caused by the presence of ...
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