ORIGINAL ARTICLE Early Sedation with Dexmedetomidine in Critically Ill Patients Yahya Shehabi, Belinda D. Howe, Rinaldo Bellomo, et al Abstract BACKGROUND 背景 Dexmedetomidine produces sedation while maintaining a degree of arousability and may reduce the duration of mechanical ventilation and delirium among patients in the intensive care unit (ICU). The use of dexmedetomidine as the sole or primary sedative agent in patients undergoing mechanical ventilati...

ORIGINAL ARTICLE Nasal High-Flow Therapy for Newborn Infants in Special Care Nurseries Brett J. Manley, Gaston R.B. Arnolda, Ian M.R. Wright, et al N Engl J Med 2019; 380:2031-2040DOI: 10.1056/NEJMoa1812077 Abstract BACKGROUND 背景 Nasal high-flow therapy is an alternative to nasal continuous positive airway pressure (CPAP) as a means of respiratory support for newborn infants. The efficacy of high-flow therapy in nontertiary special care nurseries is un...

ORIGINAL ARTICLE Early Neuromuscular Blockade in the Acute Respiratory Distress Syndrome The National Heart, Lung, and Blood Institute PETAL Clinical Trials Network N Engl J Med May 19, 2019DOI: 10.1056/NEJMoa1901686 Abstract BACKGROUND 背景 The benefits of early continuous neuromuscular blockade in patients with acute respiratory distress syndrome (ARDS) who are receiving mechanical ventilation remain unclear. 接受机械通气的ARDS患者早期使用神经肌肉阻...

Original Investigation Caring for the Critically Ill PatientMay 19, 2019 Derivation, Validation, and Potential Treatment Implications of Novel Clinical Phenotypes for Sepsis Christopher W. Seymour, Jason N. Kennedy, Shu Wang, et al JAMA. Published online May 19, 2019. doi:10.1001/jama.2019.5791 Abstract 摘要 Importance 背景 Sepsis is a heterogeneous syndrome. Identification of distinct clinical phenotypes may allow more precise therapy and...

Original Investigation Caring for the Critically Ill PatientMay 19, 2019 Effect of a Recombinant Human Soluble Thrombomodulin on Mortality in Patients With Sepsis-Associated Coagulopathy: The SCARLET Randomized Clinical Trial Jean-Louis Vincent, Bruno Francois, Igor Zabolotskikh, et al JAMA. Published online May 19, 2019. doi:10.1001/jama.2019.5358 Abstract Importance 背景 Previous research suggested that soluble human recombinant thrombom...

ARTICLES OF THE MONTH - APRIL 2019 ORIGINAL ~ Nasal high-flow preoxygenation for endotracheal intubation in the critically ill patient: a randomised clinical trial Guitton et al.: Nasal high-flow preoxygenation for endotracheal intubation in the critically ill patient: a randomised clinical trial This is the first randomised multicentre study comparing the use of HFNC with HFFM for the preoxygenation of non-severely hypoxemic patients in the ICU.  In thi...

Original Investigation February 6, 2019 Association Between Emergency Medical Service Response Time and Motor Vehicle Crash Mortality in the United States James P. Byrne, N. Clay Mann, Mengtao Dai, et al JAMA Surg. 2019;154(4):286-293. doi:10.1001/jamasurg.2018.5097 Abstract Importance 背景 Motor vehicle crashes (MVCs) are a leading public health concern. Emergency medical service (EMS) response time is a modi...

Original Investigation May 14, 2019 Effect of Restriction of the Number of Concurrently Open Records in an Electronic Health Record on Wrong-Patient Order Errors: A Randomized Clinical Trial Jason S. Adelman, Jo R. Applebaum, Clyde B. Schechter, et al JAMA. 2019;321(18):1780-1787. doi:10.1001/jama.2019.3698 Abstract Importance 背景 Recommendations in the United States suggest limiting the number of p...

Original Investigation|Caring for the Critically Ill PatientMay 7, 2019 Effect of Trans-Nasal Evaporative Intra-arrest Cooling on Functional Neurologic Outcome in Out-of-Hospital Cardiac Arrest: The PRINCESS Randomized Clinical Trial Per Nordberg, Fabio Silvio Taccone, Anatolij Truhlar, et al JAMA. 2019;321(17):1677-1685. doi:10.1001/jama.2019.4149 Importance 背景 Therapeutic hypothermia may increase survival wit...

#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...