ORIGINAL ARTICLE FREE PREVIEW Early Surgery or Conservative Care for Asymptomatic Aortic Stenosis Duk-Hyun Kang, Sung-Ji Park, Seung-Ah Lee, et al N Engl J Med November 16, 2019DOI: 10.1056/NEJMoa1912846 BACKGROUND 背景 The timing and indications for surgical intervention in asymptomatic patients with severe aortic stenosis remain controversial. 无症状的严重主动脉瓣狭窄患者手术干预的时机及适应症存在争议。 METHODS 方法 In a multicenter trial, we ran...

Myocardial Ischaemia During Ventilator Weaning Weaning is a critical process for patients in intensive care. Weaning failure can result in poor outcomes and prolonged weaning which in turn can increase the risk of death. One of the main mechanisms of weaning failure is weaning-induced cardiac pulmonary oedema (WiPO). While advances in diagnosis have been made using tools such as bedside echocardiography or biomarkers, the underlying mechanisms of WiPO still remain uncl...

ORIGINAL ARTICLE Prevention of Early Ventilator-Associated Pneumonia after Cardiac Arrest Bruno François, Alain Cariou, Raphaël Clere-Jehl, et al N Engl J Med 2019; 381:1831-1842DOI: 10.1056/NEJMoa1812379 BACKGROUND 背景 Patients who are treated with targeted temperature management after out-of-hospital cardiac arrest with shockable rhythm are at increased risk for ventilator-associated pneumonia. The benefit of preventive short-term antibiotic therapy...

ORIGINAL ARTICLE FREE PREVIEW Diagnosis of Pulmonary Embolism with d-Dimer Adjusted to Clinical Probability Clive Kearon, Kerstin de Wit, Sameer Parpia, et al N Engl J Med 2019; 381:2125-2134DOI: 10.1056/NEJMoa1909159 BACKGROUND 背景 Retrospective analyses suggest that pulmonary embolism is ruled out by a d-dimer level of less than 1000 ng per milliliter in patients with a low clinical pretest probability (C-PTP) and by a d-dimer level o...

ICU Management & Practice, Volume 18 - Issue 3, 2018 Advances in source control in patients with sepsis and septic shock In the past decades there have been significant advances in the diagnosis and management of patients with sepsis and septic shock, and overall awareness has increased significantly (Angus and van der Poll 2013). Emphasis is currently on the early detection of sepsis and rapid initiation of fluid administration and antibiotic therapy, all ...

Research Weight change across adulthood in relation to all cause and cause specific mortality: prospective cohort study Chen Chen,  Yi Ye, Yanbo Zhang, et al BMJ 2019;367:l5584 doi: https://doi.org/10.1136/bmj.l5584 Objective 目的 To investigate the association between weight changes across adulthood and mortality. 研究成年期间体重改变与死亡率的相关性 Design 实验设计 Prospective cohort study. 前瞻队列研究 Setting 场景 U...

Effect of a fluid bolus on cardiovascular collapse among critically ill adults undergoing tracheal intubation (PrePARE): a randomised controlled trial David R Janz, Jonathan D Casey, Matthew W Semler, et al Lancet Respir Med. 2019 Oct 1. doi: 10.1016/S2213-2600(19)30246-2 Background 背景 Tracheal intubation is common in the care of critically ill adults and is frequently complicated by hypotension, cardiac arrest, or death. We aimed to evaluate ...

ONLINE FIRST (FREE ACCESS) What's new in intensive care ~ Lüsebrink E. et al. - Ten things ICU specialists need to know about new valvular procedures in interventional cardiology Less is more in Intensive Care ~ Ñamendys-Silva S.A - Less is more, but are we doing enough?Editorial ~ Shankar-Hari M. et al. - Should we consider blocking the inhibitory immune checkpoint molecules for treating T cell exhaustion in sepsis?Original ...

Maximal Recruitment Open Lung Ventilation in Acute Respiratory Distress Syndrome (PHARLAP): A Phase II, Multicenter, Randomized, Controlled Trial Hodgson CL, Cooper DJ, Arabi Y, et al Am J Respir Crit Care Med. 2019 Jul 29.doi: 10.1164/rccm.201901-0109OC. RATIONALE: 背景 Open lung ventilation strategies have been recommended in patients with acute respiratory distress syndrome (ARDS). 推荐ARDS患者采用肺开放通气策略。 OBJECTIVE: 目的 To determine ...

ARTICLES|ONLINE FIRST Effect of infectious disease consultation on mortality and treatment of patients with candida bloodstream infections: a retrospective, cohort study Carlos Mejia-Chew, Jane A O'Halloran, Margaret A Olsen, et al. Lancet Infect Dis September 24, 2019 DOI:https://doi.org/10.1016/S1473-3099(19)30405-0 Summary Background 背景 Candida bloodstream infection is associated with high mortality. Infectious disease consultation improves outcomes...