<Intensive care monitor> 2008第3期介绍

<Intensive care monitor> 2008第3期的内容已经上网。这本薄薄的杂志每期荟萃危重医学的最新进展，如果接触时间长，大家会发现该杂志所编选的都是临床进展，少见前沿性基础类研究的报道，是危重医生必看的二次文献。

CARDIOVASCULAR
Schneeweiss S, Seeger JD, Landon J, Walker AM.
Aprotinin during coronary-artery bypass grafting and risk of death. N Engl J Med 2008; 358: 771-783
Evidence Level: IV （抑酞酶的报道）
 
Shaw AD, Stafford-Smith M, White WD et al.
The effect of aprotinin on outcome after coronary-artery bypass grafting. N Engl J Med 2008; 358: 784-793.
Evidence Level: IV 
 
Russell JA, Walley KR, Singer J et al.
Vasopressin versus norepinephrine infusion in patients with septic shock. New Engl J Med 2008; 358: 877-887.
Evidence Level: II 
 
Sayre MR, Berg RA, Cave DM, Page RL, Potts J, White RD.
Hands-only (compression-only) cardiopulmonary resuscitation: A call to action for bystander response to adults who experience out-of-hospital sudden cardiac arrest. A science advisory for the public from the American Heart Association Emergency Cardiovascular Care Committee. Circulation 2008;117:2162-2167. 52 references.
 如果我没有记错的话，对于AHA这个单纯徒手按压复苏的推荐意见，欧洲复苏委员会（ERC）并不认可。在ERC的网站上欧洲专家们列举的他们认为依据不充分的理由如下：The European Resuscitation Council has reviewed the available published scientific evidence. The ERC considers this evidence insufficient to alter its guidelines for BLS at this moment. There are several important considerations for this recommendation:
1. The recently published studies are uncontrolled, observational studies of experience, dating from 1990 to 2003. Such studies are generally considered to be insufficient to enable definitive conclusions about the superiority or equivalence of any methods of CPR. The outcomes of these studies are still compatible with the hypothesis that the currently recommended combination of chest compressions combined with mouth-to- mouth ventilations is superior to chest compression-only CPR.
2. At this moment a worldwide science evaluation process has been initiated to review all scientific data on resuscitation. A new consensus on science will be published in 2010 and it is appropriate to await the outcome of this process before new changes in the guidelines are recommended.
3. Following Guidelines 2005, the compression:ventilation ratio has increased from 15:2 to 30:2, already emphasizing the importance of minimally interrupted high-quality chest compressions. Furthermore, unlike the AHA guidelines, the ERC guidelines indicate that 30 compressions are given before attempting ventilation. There have been no studies published in which chest compression-only CPR has been compared with CPR performed according to the Guidelines 2005.
4. The Guidelines 2005 are being implemented throughout Europe. It is not in the interest of the quality of CPR and of teaching to so many hundreds of thousands of potential rescuers, to introduce new changes while the current Guidelines are just being implemented. The resulting confusion will be counterproductive.
5. In Europe, the proportion of resuscitation attempts in which trained lay rescuers perform CPR is already considerable. The percentage is cited between 27% and 67%, considerably higher that generally observed in the USA.(7, 8) Therefore, the need to simplify guidelines, potentially at the expense of quality, to encourage lay rescuers to perform CPR is less compelling as in the USA.
6. Ultimately, even if chest compression-only CPR is recommended, there will be several circumstances, in which ventilation remains critical. Such circumstances are unwitnessed cardiac arrest, cardiac arrest in children, most in-hospital cardiac arrests, cardiac arrest of non-cardiac origin such as drowning or airway obstruction, and during resuscitation attempts lasting more than approximately 4 minutes. This list may not be complete. It is unlikely that lay rescuers will be able to identify with confidence these circumstances and, if taught to give only chest compressions, may provide CPR of insufficient quality to many victims.
The European Resuscitation Council therefore continues to recommend the teaching and administration of high quality, minimally interrupted chest compressions at a rate of 100/minute alternated with two mouth-to-mouth ventilations in a ratio of 30:2. For those rescuers who are unwilling or unable to give mouth-to-mouth ventilations, chest compression-only is much more acceptable than performing no CPR at all.
References（略）.

ETHICS
Applbaum AI, Tilburt JC, Collins MT, Wendler D.
A family's request for complementary medicine after patient brain death. JAMA 2008; 299: 2188-2193. 12 references.
 
 
HAEMATOLOGY
Koch CG, Li L, Sessler DI eet al.
Duration of red-cell storage and complications after cardiac surgery. N Engl J Med 2008; 358: 1229-1239.
Evidence Level: IV
 
Zarychanski R, Turgeon AF, McIntyre L, Fergusson DA.
Erythropoietin-receptor agonists in critically ill patients: a meta-analysis of randomized controlled trials. CMAJ Can Med Assoc J2007; 177: 725-734.
Evidence Level: I  本文我之前的BLOG介绍过，目前的依据并不支持该疗法。
 
ORGANIZATION
Berwick DM.
The science of improvement. JAMA 2008;299:1182-1184. 20 references.

Gosselinnck R, Bott J, Johnson M et al.
Physiotherapy for adult patients with critical illness: recommendations of the European Respiratory Society and European Society of Intensive Care Medicine Task Force on Physiotherapy For Critically Ill Patients. Intensive Care Med 2008 Feb (E published ahead of print). 114 references

Griffiths RD, Jones C.
Seven lessons from 20 years of follow-up of intensive care unit survivors. Curr Opinion Crit Care 2007;13:508-513. 57 references. 这篇文章应该去看看。

Lyons M.
Do classical origins of medical terms endanger patients? Lancet 2008;371:1321-1322. 12 references. 
 
PAEDIATRIC
Albuali WH, Singh RN, Fraser DD et al.
Have changes in ventilation practice improved outcome in children with acute lung injury? Pediatr Crit Care Med 2007; 8: 324-330.
Evidence Level: IV 
 
 RENAL
Eachempati SR, Wang JCL, Hydo LJ, Shou J, Barie PS. Acute renal failure in critically ill surgical patients: persistent lethality despite new modes of renal replacement therapy. J Trauma 2007; 63: 987-993.
Evidence Level: IV

Kellum JA.
Defining and classifying AKI: one set of criteria. Nephrol Dial Transplant 2008;23:1471-1472. 14 references. 
 
RESPIRATORY
Gajic O, Rana R, Winters JL et al.
Transfusion-related acute lung injury in the critically ill. Prospective nested case-control study. Am J Respir Crit Care Med 2007; 176: 886-891. Online supplement accessible from this issue's table of contents at www.atsjournals.org
Evidence Level: III
 
Meade MO, Cook DJ, Guyatt GH et al.
Ventilation strategy using low tidal volumes, recruitment maneuvers, and high positive end-expiratory pressure for acute lung injury and acute respiratory distress syndrome. A randomized controlled trial. JAMA 2008; 299: 637-645.
Evidence Level: II
 
Mercat A, Richard J-CM, Vielle B eet al.
Positive end-expiratory pressure setting in adults with acute lung injury and acute respiratory distress syndrome. A randomized controlled trial. JAMA 2008; 299: 646-655.
Evidence Level: II
 
Wildman MJ, Sanderson C, Groves J et al.
Implications of prognostic pessimism in patients with chronic obstructive pulmonary disease (COPD) or asthma admitted to intensive care in the UK within the COPD and asthma outcome study (CAOS): multicentre observational cohort study. BMJ 2007; 335: 1132-1134.
Evidence Level: III 
 
 SEPSIS
Ioannidou E, Siempos II, Falagas ME.
Administration of antimicrobials via the respiratory tract for the treatment of patients with nosocomial pneumonia: a meta-analysis. J Antimicrob Chemother 2007; 60: 1216-1226.
Evidence Level: I
 
Giamarellos-Bourboulis EJ, Pech?re J-C, Routsi C et al. Effect of clarithromycin in patients with sepsis and ventilator-associated pneumonia. Clin Infect Dis 2008; 46: 1157-1164. 
Evidence Level: II 
 
TRAUMA
Seamon MJ, Pathak SA, Bradley KM et al.
Emergency department thoracotomy: still useful after abdominal exsanguination? J Trauma 2008;64: 1-8.
Evidence Level: IV

Jansen JO, Yule SR, Loudon MA.
Investigation of blunt abdominal trauma. BMJ 2008;336:938-942. 29 references. 
 
 TROPICAL DISEASE
Chandralekha, Gupta P, Trikha A.
The north Indian dengue outbreak 2006: a retrospective analysis of intensive care unit admissions in a tertiary care hospital. Trans R Soc Trop Med Hyg 2008; 102:143-147.
Evidence Level: IV