ORIGINAL ARTICLE Early, Goal-Directed Therapy for Septic Shock — A Patient-Level Meta-Analysis The PRISM Investigators March 21, 2017 DOI: 10.1056/NEJMoa1701380 BACKGROUND 背景 After a single-center trial and observational studies suggesting that early, goal-directed therapy (EGDT) reduced mortality from septic shock, three multicenter trials (ProCESS, ARISE, and ProMISe) showed no benefit. This meta-analysis of individual patient data from the three recent trials was desi...

Sevoflurane for Sedation in Acute Respiratory Distress Syndrome. A Randomized Controlled Pilot Study Matthieu Jabaudon, Pierre Boucher, Etienne Imhoff, et al. Am J Respir Crit Care Med 2017; 195: 792-800 Rationale: 背景 Sevoflurane improves gas exchange, and reduces alveolar edema and inflammation in preclinical studies of lung injury, but its therapeutic effects have never been investigated in acute respiratory distress syndrome (ARDS). 有关肺损伤的临床前研究显示，七...

Epidemiology of Weaning Outcome according to a New Definition. The WIND Study Gaëtan Béduneau, Tài Pham, Frédérique Schortgen, et al. Am J Respir Crit Care Med 2017; 195: 772-783 Rationale: 背景 The weaning process concerns all patients receiving mechanical ventilation. A previous classification into simple, prolonged, and difficult weaning ignored weaning failure and presupposed the use of spontaneous breathing trials. 脱机过程涉及所有接受机械通气的患者。既往分类方法将患...

Recovery after Acute Kidney Injury John A. Kellum, Florentina E. Sileanu, Azra Bihorac, et al Am J Respir Crit Care Med 2017; 195: 784-791 Rationale: 背景 Little is known about how acute kidney injury (AKI) resolves, and whether patterns of reversal of renal dysfunction differ among patients with respect to ultimate recovery. 有关急性肾损伤(AKI)的恢复过程，以及不同患者肾脏功能障碍的逆转模式知之甚少。 Objectives: 目的 We sought to examine different patterns for AKI revers...

High-flow warm humidified oxygen versus standard low-flow nasal cannula oxygen for moderate bronchiolitis (HFWHO RCT): an open, phase 4, randomised controlled trial Elizabeth Kepreotes, Bruce Whitehead, John Attia, et al Lancet 2017; 389: 930-939 Summary Background 背景 Bronchiolitis is the most common lung infection in infants and treatment focuses on management of respiratory distress and hypoxia. High-flow warm humidified oxygen (HFWHO) is increasingly used, but has...

Prophylactic hydration to protect renal function from intravascular iodinated contrast material in patients at high risk of contrast-induced nephropathy (AMACING): a prospective, randomised, phase 3, controlled, open-label, non-inferiority trial Estelle C Nijssen, Roger J Rennenberg, Patty J Nelemans, et al Lancet 2017 (Published 20 February 2017) DOI: http://dx.doi.org/10.1016/S0140-6736(17)30057-0   Background 背景 Intravenous saline is recommended in clinical pract...

Research Vitamin D supplementation to prevent acute respiratory tract infections: systematic review and meta-analysis of individual participant data Adrian R Martineau, David A Jolliffe, Richard L Hooper, et al. doi: https://doi.org/10.1136/bmj.i6583 (Published 15 February 2017) Cite this as: BMJ 2017;356:i6583 Abstract Objectives To assess the overall effect of vitamin D supplementation on risk of acute respiratory tract infection, and to identify factors modifying this e...

Research Letter February 21, 2017 Website Characteristics and Physician Reviews on Commercial Physician-Rating Websites Tara Lagu, Katherine Metayer, Michael Moran; et al. JAMA. 2017;317(7):766-768. doi:10.1001/jama.2016.18553 Patients are increasingly seeking information about physicians online. Nearly 60% report that online reviews are important when choosing a physician. Because publicly reported quality data are not reported at the physician level, patients must consul...

Intravenous zanamivir or oral oseltamivir for hospitalised patients with influenza: an international, randomised, double-blind, double-dummy, phase 3 trial Francisco M Marty, Joan Vidal-Puigserver, Carol Clark, et al Lancet Respir Med Published: 13 January 2017 DOI: http://dx.doi.org/10.1016/S2213-2600(16)30435-0 Background 背景 Neuraminidase inhibitors are effective for the treatment of acute uncomplicated influenza. However, there is an unmet need for intravenous treat...

Original Investigation February 21, 2017 Effect of Fibrinogen Concentrate on Intraoperative Blood Loss Among Patients With Intraoperative Bleeding During High-Risk Cardiac SurgeryA Randomized Clinical Trial Süleyman Bilecen, Joris A. H. de Groot, Cor J. Kalkman, et al JAMA. 2017;317(7):738-747. doi:10.1001/jama.2016.21037 Abstract 摘要 Importance 背景 Fibrinogen concentrate might partly restore coagulation defects and reduce intraoperative bleeding. 纤维蛋白原可以部...