Сообщество анестезиологов-реаниматологов столицы

sarsmos Нравится 0
Это ваш канал? Подтвердите владение для дополнительных возможностей

Сообщество анестезиологов-реаниматологов столицы (САРС). САРС - это вы
Гео и язык канала
Россия, Русский
Категория
Медицина


Гео канала
Россия
Язык канала
Русский
Категория
Медицина
Добавлен в индекс
30.05.2017 07:21
Последнее обновление
16.11.2018 08:42
Telegram Analytics
Самые свежие новости сервиса TGStat. Подписаться →
Searchee Bot
Ваш незаменимый помощник в поиске Telеgram-каналов.
@TGStat_Bot
Бот для получения статистики каналов не выходя из Telegram
1 585
подписчиков
~1.2k
охват 1 публикации
~2.5k
дневной охват
~2
постов / день
77.6%
ERR %
2.58
индекс цитирования
Репосты и упоминания канала
4 упоминаний канала
0 упоминаний публикаций
76 репостов
AnesthChannel
AnesthChannel
AnesthChannel
AnesthChannel
AnesthChannel
AnesthChannel
AnesthChannel
AnesthChannel
AnesthChannel
AnesthChannel
AnesthChannel
AnesthChannel
AnesthChannel
AnesthChannel
AnesthChannel
AnesthChannel
AnesthChannel
AnesthChannel
AnesthChannel
AnesthChannel
AnesthChannel
Critical Doc
AnesthChannel
Нейрохирургия
Нейрохирургия
🌐 МедСправка 🌐
Нейрохирургия
AnesthChannel
Каналы, которые цитирует @sarsmos
Respiratory Care Specialty
Respiratory Care Specialty
Respiratory Care Specialty
Critical Doc
Яндекс
Respiratory Care Specialty
Respiratory Care Specialty
Critical Doc
Anesthesia Books
Critical Doc
Anesthesia Books
Anesthesia Books
Anesthesia Books
Anesthesia Books
Anesthesia Books
Medical Books Store
Anesthesia Books
Medical Books Store
Anesthesia Books
Медач | Medical Channel
Медач | Medical Channel
MedNews
Anesthesia Books
Anesthesia Books
Последние публикации
Удалённые
С упоминаниями
Репосты
https://ccforum.biomedcentral.com/articles/10.1186/s13054-018-2251-2
Is goal-directed fluid therapy based on dynamic variables alone sufficient to improve clinical outcomes among patients undergoing surgery? A meta-analysis
Whether goal-directed fluid therapy based on dynamic predictors of fluid responsiveness (GDFTdyn) alone improves clinical outcomes in comparison with standard fluid therapy among patients undergoing surgery remains unclear. PubMed, EMBASE, the Cochrane Library and ClinicalTrials.gov were searched for relevant studies. Studies comparing the effects of GDFTdyn with that of standard fluid therapy on clinical outcomes among adult patients undergoing surgery were considered eligible. Two analyses were performed separately: GDFTdyn alone versus standard fluid therapy and GDFTdyn with other optimization goals versus standard fluid therapy. The primary outcomes were short-term mortality and overall morbidity, while the secondary outcomes were serum lactate concentration, organ-specific morbidity, and length of stay in the intensive care unit (ICU) and in hospital. We included 37 studies with 2910 patients. Although GDFTdyn alone lowered serum lactate concentration (mean difference (MD) − 0.21 mmol/L, 95% confidence interval…
Аскорбиновая кислота, тиамин и гидрокортизон при сепсисе. Обзор
Attached file
Уважаемые коллеги!
Спешим сообщить, что в преддверии III Конгресса военных анестезиологов-реаниматологов вышел в свет полнометражный документальный фильм «Победители боли – спасители жизни. К 60-летию кафедры анестезиологии и реаниматологии Военно-медицинской Академии им. С.М. Кирова». Картина посвящена наиболее важным вехам в развитии кафедры и, конечно, легендарным врачам, которые влияли на развитие нашей специальности в масштабах всей страны.
Съёмки фильма проходили в Военно-медицинской Академии имени С.М. Кирова, Первом Санкт-Петербургском медицинском университете им. И.П. Павлова, Главном военном клиническом госпитале им. Н.Н. Бурденко и Центральном военном госпитале им. А.А. Вишневского. За два месяца съемок состоялось 15 интервью со спикерами в Москве, Санкт-Петербурге и Севастополе!
Автор сценария, режиссер: Павел Кутаренко, съемка и монтаж: Антон Ратников, оператор квадрокоптера: Дмитрий Филиппов, специалист по графическому оформлению: Андрей Шумейко, диктор: Борис Хасанов.
Среди главных действующих лиц фильма начальники первой в России кафедры анестезиологии и реаниматологии ВМедА им. С.М.Кирова разных лет:
Анатолий Ильич Левшанков, заслуженный врач России, профессор, начальник кафедры в 1986 – 1993 годах. Именно при профессоре Левшанкове было завершено штатно-организационное оформление анестезиологической помощи в Советской Армии. Анатолий Ильич и сейчас работает на родной кафедре. Уже более 60 лет!
Юрий Сергеевич Полушин, академик РАН, д. м.н., профессор, начальник кафедры в 1993 –2009 годах. Юрий Сергеевич возглавил кафедру в сложное для страны и военной медицины время, но это не помешало ему сохранить все ценные наработки и значительно продвинуться вперед.
Алексей Валерианович Щеголев, главный анестезиолог-реаниматолог МО РФ, заслуженный врач РФ, д. м. н., профессор, начальник кафедры с 2009 года и по настоящее время. Алексей Валерьянович – руководитель нового формата, он уже привнес немало инновационных решений в работу кафедры и имеет большие планы на ее дальнейшее развитие.
Смотрите фильм «Победители боли – Спасители жизни. К 60-летию кафедры анестезиологии и реаниматологии Военно-медицинской Академии им. С.М. Кирова»: https://www.youtube.com/watch?v=VuCqT6ZW_U4&feature=youtu.be&utm_medium=email&utm_source=UniSender&utm_campaign=180604781
We reserve POC ultrasonography for patients with undifferentiated hypotension in whom a diagnosis has not been suggested by standard clinical and laboratory testing, or for those in whom definitive imaging is unsafe. (See "Evaluation of and initial approach to the adult patient with undifferentiated hypotension and shock", section on 'Point-of-care ultrasonography'.)

Society guidelines on sedation for agitated adults in the ICU (September 2018)

The Society of Critical Care Medicine (SCCM) recently issued guidelines on sedation of agitated patients in the intensive care unit (ICU) [16]. Compared with 2013 guidelines, the new recommendations focus on minimizing sedation, regular use of protocols and daily awakening strategies, screening for delirium, and early mobilization in the ICU. They continue to endorse the avoidance of benzodiazepines when feasible, treatment of pain when present, and promote use of propofol or dexmedetomidine for select subgroups. UpToDate authors agree with the SCCM strategies. (See "Sedative-analgesic medications in critically ill adults: Selection, initiation, maintenance, and withdrawal" and "Post-intensive care syndrome (PICS)".)

Glucocorticoid therapy for sepsis (September 2018)

Two new meta-analyses summarize the effect of glucocorticoids in patients with sepsis and septic shock [17,18]. Both analyses, in agreement with previous studies, found that glucocorticoid administration (typically hydrocortisone) resulted in faster resolution of shock with no or minimal effect on mortality. Glucocorticoids also appear to reduce the duration of mechanical ventilation and length of intensive care unit or hospital stay but increase the risk of adverse effects including hypernatremia, hyperglycemia, and neuromuscular weakness. These results support our recommendation to evaluate the use of glucocorticoid therapy on a case-by-case basis and, in general, to reserve administration of glucocorticoid therapy for those with refractory septic shock. (See "Glucocorticoid therapy in septic shock", section on 'Meta-analyses'.)

Infectious Diseases Society of America position paper regarding 2016 sepsis guidelines (September 2018)

A position paper issued by the Infectious Diseases Society of America (IDSA) does not endorse the Society of Critical Care Medicine/European Society of Intensive Care Medicine (SCCM/ESICM) 2016 Surviving Sepsis Campaign guidelines for the management of sepsis and septic shock [19]. In particular, while the IDSA agrees that the SCCM/ESICM recommendations are life-saving for patients with septic shock, they may lead to overtreatment for those with milder variants of sepsis and sepsis syndromes. The IDSA does not endorse routine initiation of antibiotic therapy within one hour of suspecting sepsis, nor administration of combination antibiotic therapy and a 7 to 10 day course of antibiotic therapy for all patients, regardless of presentation factors. The IDSA also notes unclear recommendations for removal of catheters when considered as the source of sepsis, and for the role of calcitonin when following the therapeutic response. UpToDate agrees with the IDSA on many of these issues, as outlined in our topic on management of sepsis and septic shock. (See "Evaluation and management of suspected sepsis and septic shock in adults", section on 'Introduction'.)

Use of ECMO for postcardiotomy cardiogenic shock (July 2018)

In a meta-analysis of 31 studies (nearly 3000 patients) receiving venoarterial extracorporeal membrane oxygenation (ECMO) for postcardiotomy cardiogenic shock unresponsive to high-dose inotropic support, approximately one-third survived to hospital discharge [20]. A subsequently published single-center study reported similar results [21]. Factors associated with survival in both studies included younger age, lower baseline blood lactate levels, and use of ECMO as a bridge to cardiac transplantation.
Prediction of outcome after ECMO insertion in this setting is challenging due to heterogeneity of specific patient- and procedure-related reasons for failure to wean from cardiopulmonary bypass. (See "Management of intraoperative problems after cardiopulmonary bypass", section on 'Extracorporeal membrane oxygenation'.)

Incidence of and risk factors for overly rapid correction of hyponatremia (July 2018)

In patients with severe hyponatremia (serum sodium
The endotracheal tube introducer (ETI), or gum elastic bougie, is an inexpensive adjunct to endotracheal intubation that is widely used and recommended for difficult airway management. In a trial of over 750 adults undergoing emergency intubation, the first-pass success rate was higher when an ETI was used during direct laryngoscopy compared with the use of a styletted endotracheal tube regardless of whether a difficult airway was predicted or not [28]. Thus, ETIs appear to be an effective means to enhance emergency endotracheal intubation by direct laryngoscopy. This study did not evaluate the benefit of ETIs for patients undergoing intubation using videolaryngoscopes or other advanced airway techniques. (See "Endotracheal tube introducers (gum elastic bougie) for emergency intubation", section on 'Evidence of effectiveness'.)

Propranolol in addition to amiodarone for treatment of electrical storm (May 2018)

Beta blockers reduce the adrenergic surge associated with frequent ventricular tachyarrhythmias (VT) requiring defibrillator shocks. However, there have been limited data to guide the choice of a selective or non-selective beta blocker in the management of VT, in particular electrical storm (three or more episodes of sustained VT within 24 hours). In a randomized, double-blind study of patients with an implantable cardioverter-defibrillator (ICD) and electrical storm in which all patients received intravenous (IV) amiodarone and were randomized to propranolol (40 mg every 6 hours) or metoprolol (50 mg every 6 hours) for the first 48 hours, VT terminated significantly earlier in patients receiving propranolol (3 hours versus 18 hours with metoprolol) [29]. Additionally, patients receiving propranolol had lower rates of ICD shocks during the intensive care unit (ICU) stay and shorter hospitalizations. For patients with electrical storm, we now recommend propranolol, rather than metoprolol, to be used in addition to IV amiodarone. (See "Electrical storm and incessant ventricular tachycardia", section on 'Beta blockers'.)

Reversal agent for direct factor Xa inhibitor anticoagulants (May 2018)

Andexanet alfa is a modified form of factor Xa that acts as a decoy and sequesters direct factor Xa inhibitors; it could be used to treat life-threatening bleeding associated with these anticoagulants. Data on efficacy are limited but show good reversal of anti-factor Xa activity. Many patients treated with andexanet in an earlier study had excellent hemostasis; however, some had arterial and venous thromboembolism and arterial ischemia, including stroke, cardiac arrest, and sudden death. This agent has received approval from the US Food and Drug Administration and is expected to be available in limited quantities in summer 2018 [30]. (See "Management of bleeding in patients receiving direct oral anticoagulants", section on 'Rivaroxaban, apixaban, edoxaban, betrixaban (reversal)'.)

LUNG CANCER

Bioengineered tracheobronchial reconstruction using stented aortic matrices (June 2018)

Large proximal tumors of the trachea or proximal bronchus are generally considered inoperable, and treatment is mostly palliative. A recent study described the outcomes of 13 patients with tracheobronchial lesions who underwent radical resection followed by airway reconstruction with a novel technique that used cryopreserved aortic allografts and stenting to generate a new airway [31]. At 90 days, there were no deaths and no adverse events related to the surgery. Stents were removed at about 18 months and at four years, 79 percent of patients remained alive, the majority of whom were able to breathe through their newly formed airway. This technique remains investigational but offers future promise to those with inoperable tracheobronchial lesions. (See "Clinical presentation, diagnostic evaluation, and management of central airway obstruction in adults", section on 'Investigational'.)

Lung cancer incidence among young men and women (May 2018)
However, among the subgroup of patients with severe acute kidney injury (defined as a twofold or greater increase in serum creatinine or oliguria), bicarbonate therapy reduced 28-day mortality (46 versus 63 percent) and the need for dialysis (51 versus 73 percent). For patients with acute metabolic acidosis and an arterial pH 7.1 to 7.2, UpToDate suggests bicarbonate therapy when severe acute kidney injury is also present. (See "Bicarbonate therapy in lactic acidosis", section on 'Which patients should receive bicarbonate therapy'.)

Extracorporeal membrane oxygenation (ECMO) in patients with severe ARDS (May 2018)

The role of extracorporeal membrane oxygenation (ECMO) as initial treatment for patients with severe acute respiratory distress syndrome (ARDS) was recently evaluated in a randomized trial comparing ECMO with conventional low-tidal volume low-pressure mechanical ventilation (CMV) with late (rescue) ECMO option [25]. The trial was stopped early because of efficacy between the two arms of study, although the actual survival difference of 11 percent was not significant. ECMO resulted in improved oxygenation, more days free of renal failure, lower rate of ischemic stroke, and a mortality benefit that almost reached statistical significance. While this study does not definitively support the routine use of ECMO for all patients with ARDS, it does support the early application of ECMO in those for whom conventional care does not improve oxygenation. (See "Extracorporeal membrane oxygenation (ECMO) in adults", section on 'Acute respiratory failure'.)

Vasopressin as a second agent in septic shock (May 2018)

In patients with distributive shock from sepsis, norepinephrine is the agent of choice, but the optimal additive agent is unknown. One recent meta-analysis of 23 trials reported that the addition of vasopressin to catecholamine agents (eg, epinephrine, norepinephrine) in such patients did not decrease mortality, but it did result in a lower rate of atrial fibrillation [26]. Although not specifically studied, the protective effect of vasopressin on arrhythmia is likely due to a reduced need for catecholamines. Despite the lack of mortality benefit, these results provide support for vasopressin as an additive agent to norepinephrine in patients with septic shock whose blood pressure does not respond to a catecholamine alone. (See "Evaluation and management of suspected sepsis and septic shock in adults", section on 'Vasopressors'.)

Support intervention for surrogate decision makers of critically ill patients (May 2018)

The negative psychological impact of critical illness on surrogate decision makers of critically ill patients is well known, but the effect of support interventions is poorly studied. A recent randomized trial involving surrogate decision makers of critically ill patients at high risk of death or poor functional outcomes reported that the psychological well-being of surrogates was not affected by a critical care nurse-led intervention that involved daily meetings with surrogates, frequent clinician meetings, and follow-up for surrogate support [27]. Interestingly, while the intensive care unit length of stay was shorter, in-hospital mortality was higher and the quality of communication was perceived as better by surrogates. These results suggest that support interventions reduce length of ICU stay and improve communication between health care teams and surrogates of critically ill patients with a poor prognosis, but they do not necessarily reduce the psychological burden of decision-making. (See "Communication in the ICU: Holding a family meeting", section on 'Psychological impact' and "Legal aspects in palliative and end of life care in the United States", section on 'Problems with surrogates'.)

Endotracheal tube introducers (gum elastic bougie) for emergency endotracheal intubation (May 2018)
Lung cancer incidence has historically been higher in men than women. However, a study using 20 years of data from a United States cancer registry found that, although the overall incidence of lung cancer has generally decreased among both men and women 30 to 54 years old, the incidence of lung cancer in non-Hispanic whites in the 30- to 49-year-old age group is now higher in women than in men [32]. This reversal in trends is not fully explained by gender differences in smoking behaviors. More study is required to understand the reasons for the relatively higher incidence of lung cancer among young women compared with young men. (See "Women and lung cancer", section on 'Comparison of men and women'.)

PULMONARY VASCULAR DISEASE

Rivaroxaban prophylaxis for venous thromboembolism following discharge not indicated (September 2018)

A recent trial studied the efficacy of the direct oral anticoagulant, rivaroxaban, in medical patients at risk of venous thromboembolism (VTE) following hospital discharge [33]. Compared with placebo, 45 days of rivaroxaban had a marginal effect on reducing the rates of nonfatal symptomatic VTE but had no effect on VTE-related death. Although rates of major bleeding were higher with rivaroxaban, the overall incidence was low in both groups (
In August 2018, the World Health Organization (WHO) issued an advisory statement regarding anticipated modifications to their recommended treatment approach for adults with MDR-TB; the statement prioritizes use of oral agents over injectable agents [38]. Pending finalization of the WHO guidelines, we favor substitution of bedaquiline for the injectable agent; expert consultation is essential. (See "Treatment of drug-resistant pulmonary tuberculosis in adults", section on 'Conventional regimen'.)

Mortality due to community-acquired pneumonia in the United States (October 2018)

Community-acquired pneumonia (CAP) is a leading cause of morbidity and mortality worldwide. In a retrospective review of 2320 adults hospitalized with CAP at five tertiary care centers in the United States, 52 (2.2 percent) died during hospitalization [39]. Approximately half of those deaths were directly attributable to CAP, and more than 60 percent occurred in patients ≥65 years old and those with multiple comorbidities. A lapse in the quality of care (eg, delayed or inappropriate antibiotic use) that could have contributed to death was identified in four patients. While mortality in this study was low, it highlights that early recognition of those at risk for poor outcomes and prompt treatment is critical to care. (See "Prognosis of community-acquired pneumonia in adults", section on 'In-hospital and postdischarge mortality'.)

Phrenic neuropathy in patients with neuralgic amyotrophy (August 2018)

Unilateral or bilateral phrenic neuropathy causing diaphragm dysfunction can occur in patients with neuralgic amyotrophy, a common cause of nontraumatic brachial plexopathy, but it is not well studied and may be overlooked clinically. A recent study identified over 100 patients with clinical diaphragm dysfunction, representing approximately 7 percent of a larger cohort of patients with neuralgic amyotrophy [40]. The most common symptoms were exertional dyspnea, sleep disturbance, and orthopnea. Supine and sitting spirometry should be performed in patients suspected of having phrenic neuropathy, as chest radiograph has suboptimal sensitivity, particularly when involvement is bilateral. Many patients improve spontaneously within two years, although others have persistent symptoms. (See "Brachial plexus syndromes", section on 'Clinical variability'.)

Advisory Committee on Immunization Practices recommendations for influenza vaccination for the 2018 to 2019 season (August 2018)

The United States Advisory Committee on Immunization Practices recommendations for the 2018 to 2019 influenza season include live attenuated influenza vaccine (LAIV) as an option for appropriate patients [41,42]. This is a change from the previous two influenza seasons, during which LAIV was not recommended because it had low effectiveness against H1N1 influenza in children [42]. The manufacturer subsequently changed the H1N1 strain used to produce the vaccine to one with better replicative fitness and immunogenicity, comparable to the one used to make the vaccine in prior seasons in which LAIV was effective against H1N1 viruses. (See "Seasonal influenza vaccination in adults", section on 'Live attenuated vaccine' and "Seasonal influenza in children: Prevention with vaccines", section on 'Choice of vaccine'.)

Rifampin for latent tuberculosis infection (August 2018)

Regimen preference for treatment of latent tuberculosis infection (LTBI) is based largely on the likelihood of adherence and the potential for adverse effects; thus far, no regimen has been shown to be of superior efficacy. In two randomized trials including more than 6800 adults and 800 children with LTBI, rifampin daily for four months (4R) resulted in similar efficacy for prevention of active tuberculosis but better adherence rates compared with isoniazid daily for nine months (9H) [43,44].
Higher Lung Cancer Incidence in Young Women Than Young Men in the United States. N Engl J Med 2018; 378:1999.
Raskob GE, van Es N, Verhamme P, et al. Edoxaban for the treatment of cancer-associated venous thromboembolism. N Engl J Med 2018; 378:615.
Wesselius HM, van den Ende ES, Alsma J, et al. Quality and Quantity of Sleep and Factors Associated With Sleep Disturbance in Hospitalized Patients. JAMA Intern Med 2018; 178:1201.
Milani RV, Bober RM, Lavie CJ, et al. Reducing Hospital Toxicity: Impact on Patient Outcomes. Am J Med 2018; 131:961.
Malhotra RK, Kirsch DB, Kristo DA, et al. Polysomnography for Obstructive Sleep Apnea Should Include Arousal-Based Scoring: An American Academy of Sleep Medicine Position Statement. J Clin Sleep Med 2018; 14:1245.
Collaborative Group for the Meta-Analysis of Individual Patient Data in MDR-TB treatment–2017, Ahmad N, Ahuja SD, et al. Treatment correlates of successful outcomes in pulmonary multidrug-resistant tuberculosis: an individual patient data meta-analysis. Lancet 2018; 392:821.
World Health Organization. Rapid Communication: Key changes to treatment of multidrug- and rifampicin-resistant tuberculosis (MDR/RR-TB). http://www.who.int/tb/publications/2018/WHO_RapidCommunicationMDRTB.pdf?ua=1 (Accessed on August 28, 2018).
Waterer GW, Self WH, Courtney DM, et al. In-Hospital Deaths Among Adults With Community-Acquired Pneumonia. Chest 2018; 154:628.
van Alfen N, Doorduin J, van Rosmalen MHJ, et al. Phrenic neuropathy and diaphragm dysfunction in neuralgic amyotrophy. Neurology 2018; 91:e843.
Grohskopf LA, Sokolow LZ, Broder KR, et al. Prevention and control of seasonal influenza with vaccines: Recommendations of the Advisory Committee on Immunization Practices United States 2018-2019 influenza season. MMWR Morb Mortal Wkly Rep 2018.
Grohskopf LA, Sokolow LZ, Fry AM, et al. Update: ACIP Recommendations for the Use of Quadrivalent Live Attenuated Influenza Vaccine (LAIV4) - United States, 2018-19 Influenza Season. MMWR Morb Mortal Wkly Rep 2018; 67:643.
Menzies D, Adjobimey M, Ruslami R, et al. Four Months of Rifampin or Nine Months of Isoniazid for Latent Tuberculosis in Adults. N Engl J Med 2018; 379:440.
Diallo T, Adjobimey M, Ruslami R, et al. Safety and Side Effects of Rifampin versus Isoniazid in Children. N Engl J Med 2018; 379:454.
Bergeron A, Chevret S, Granata A, et al. Effect of Azithromycin on Airflow Decline-Free Survival After Allogeneic Hematopoietic Stem Cell Transplant: The ALLOZITHRO Randomized Clinical Trial. JAMA 2017; 318:557.
U.S. Food and Drug Administration. FDA warns about increased risk of cancer relapse with long-term use of azithromycin (Zithromax, Zmax) antibiotic after donor stem cell transplant https://www.fda.gov/Drugs/DrugSafety/ucm614085.htm (Accessed on August 06, 2018).
Shapiro AJ, Davis SD, Polineni D, et al. Diagnosis of Primary Ciliary Dyskinesia. An Official American Thoracic Society Clinical Practice Guideline. Am J Respir Crit Care Med 2018; 197:e24.
Attached file
Among adults, the rate of adverse events was lower with 4R than 9H; among children, the rates of adverse events were comparable with the two regimens. The trial findings support our preference for 4R in adults; given the findings in children, we now suggest 4R as one of our preferred options for treatment of children with LTBI. (See "Treatment of latent tuberculosis infection in HIV-uninfected nonpregnant adults", section on 'Rifampin' and "Latent tuberculosis infection in children", section on 'Rifampin'.)

FDA advises against prophylactic azithromycin after hematopoietic cell transplantation (August 2018)

A previously published randomized trial in almost 500 patients found that long-term azithromycin to prevent bronchiolitis obliterans syndrome (BOS) following hematopoietic cell transplantation (HCT) increased the rate of hematologic relapse compared with placebo [45]. The cause of the increased relapse rate is not known. Additionally, azithromycin did not protect against development of airflow limitation. Based on these data, the US Food and Drug Administration (FDA) issued a safety alert recommending that long-term azithromycin not be administered for prophylaxis after HCT for cancers of the blood or lymph nodes [46]. (See "Pulmonary complications after allogeneic hematopoietic cell transplantation", section on 'Airflow obstruction and bronchiolitis obliterans'.)

American Thoracic Society guidelines for the diagnosis of primary ciliary dysfunction (July 2018)

The 2018 American Thoracic Society has published new guidelines for the diagnosis of primary ciliary dysfunction (PCD) [47]. The guidelines suggest use of extended panel genetic testing (assessing >12 genes for pathogenic variants) for PCD diagnosis, where available, as a less labor intensive alternative to transmission electron microscopy (TEM) (algorithm 1). The previous standard panel genetic tests (≤12 genes) have a high false negative rate. However, even the extended panel can miss some cases of PCD. (See "Primary ciliary dyskinesia (immotile-cilia syndrome)", section on 'Genetic testing'.)

REFERENCES
Gill MA, Liu AH, Calatroni A, et al. Enhanced plasmacytoid dendritic cell antiviral responses after omalizumab. J Allergy Clin Immunol 2018; 141:1735.
Byars SG, Stearns SC, Boomsma JJ. Association of Long-Term Risk of Respiratory, Allergic, and Infectious Diseases With Removal of Adenoids and Tonsils in Childhood. JAMA Otolaryngol Head Neck Surg 2018; 144:594.
O'Byrne PM, FitzGerald JM, Bateman ED, et al. Inhaled Combined Budesonide-Formoterol as Needed in Mild Asthma. N Engl J Med 2018; 378:1865.
Bateman ED, Reddel HK, O'Byrne PM, et al. As-Needed Budesonide-Formoterol versus Maintenance Budesonide in Mild Asthma. N Engl J Med 2018; 378:1877.
Sobieraj DM, Baker WL, Nguyen E, et al. Association of Inhaled Corticosteroids and Long-Acting Muscarinic Antagonists With Asthma Control in Patients With Uncontrolled, Persistent Asthma: A Systematic Review and Meta-analysis. JAMA 2018; 319:1473.
Daubin C, Valette X, Thiollière F, et al. Procalcitonin algorithm to guide initial antibiotic therapy in acute exacerbations of COPD admitted to the ICU: a randomized multicenter study. Intensive Care Med 2018; 44:428.
Criner GJ, Sue R, Wright S, et al. A Multicenter Randomized Controlled Trial of Zephyr Endobronchial Valve Treatment in Heterogeneous Emphysema (LIBERATE). Am J Respir Crit Care Med 2018; 198:1151.
Kemp SV, Slebos DJ, Kirk A, et al. A Multicenter Randomized Controlled Trial of Zephyr Endobronchial Valve Treatment in Heterogeneous Emphysema (TRANSFORM). Am J Respir Crit Care Med 2017; 196:1535.
PulmonX. Zephyr Endobronchial Valve System: Instructions for Use https://www.accessdata.fda.gov/cdrh_docs/pdf18/P180002C.pdf (Accessed on July 26, 2018).
Lipson DA, Barnhart F, Brealey N, et al. Once-Daily Single-Inhaler Triple versus Dual Therapy in Patients with COPD. N Engl J Med 2018; 378:1671.
Global Initiative for Chronic Obstructive Lung Disease (GOLD).
Attached file
Global Strategy for the Diagnosis, Management and Prevention of chronic obstructive pulmonary disease: 2018 Report. www.goldcopd.org (Accessed on April 20, 2018).
Wittekamp BH, Plantinga NL, Cooper BS, et al. Decontamination Strategies and Bloodstream Infections With Antibiotic-Resistant Microorganisms in Ventilated Patients: A Randomized Clinical Trial. JAMA 2018.
Barbar SD, Clere-Jehl R, Bourredjem A, et al. Timing of Renal-Replacement Therapy in Patients with Acute Kidney Injury and Sepsis. N Engl J Med 2018; 379:1431.
Effect of Cricoid Pressure Compared With a Sham Procedure in the Rapid Sequence INduction of Anesthesia. JAMA Surg 2018.
Atkinson PR, Milne J, Diegelmann L, et al. Does Point-of-Care Ultrasonography Improve Clinical Outcomes in Emergency Department Patients With Undifferentiated Hypotension? An International Randomized Controlled Trial From the SHoC-ED Investigators. Ann Emerg Med 2018; 72:478.
Devlin JW, Skrobik Y, Gélinas C, et al. Clinical Practice Guidelines for the Prevention and Management of Pain, Agitation/Sedation, Delirium, Immobility, and Sleep Disruption in Adult Patients in the ICU. Crit Care Med 2018; 46:e825.
Rygård SL, Butler E, Granholm A, et al. Low-dose corticosteroids for adult patients with septic shock: a systematic review with meta-analysis and trial sequential analysis. Intensive Care Med 2018; 44:1003.
Rochwerg B, Oczkowski SJ, Siemieniuk RAC, et al. Corticosteroids in Sepsis: An Updated Systematic Review and Meta-Analysis. Crit Care Med 2018; 46:1411.
IDSA Sepsis Task Force. Infectious Diseases Society of America (IDSA) POSITION STATEMENT: Why IDSA Did Not Endorse the Surviving Sepsis Campaign Guidelines. Clin Infect Dis 2018; 66:1631.
Biancari F, Perrotti A, Dalén M, et al. Meta-Analysis of the Outcome After Postcardiotomy Venoarterial Extracorporeal Membrane Oxygenation in Adult Patients. J Cardiothorac Vasc Anesth 2018; 32:1175.
Rubino A, Costanzo D, Stanszus D, et al. Central Veno-Arterial Extracorporeal Membrane Oxygenation (C-VA-ECMO) After Cardiothoracic Surgery: A Single-Center Experience. J Cardiothorac Vasc Anesth 2018; 32:1169.
George JC, Zafar W, Bucaloiu ID, Chang AR. Risk Factors and Outcomes of Rapid Correction of Severe Hyponatremia. Clin J Am Soc Nephrol 2018; 13:984.
Pagel JI, Rehm M, Kammerer T, et al. Hydroxyethyl Starch 130/0.4 and Its Impact on Perioperative Outcome: A Propensity Score Matched Controlled Observation Study. Anesth Analg 2018; 126:1949.
Jaber S, Paugam C, Futier E, et al. Sodium bicarbonate therapy for patients with severe metabolic acidaemia in the intensive care unit (BICAR-ICU): a multicentre, open-label, randomised controlled, phase 3 trial. Lancet 2018; 392:31.
Combes A, Hajage D, Capellier G, et al. Extracorporeal Membrane Oxygenation for Severe Acute Respiratory Distress Syndrome. N Engl J Med 2018; 378:1965.
Association of Vasopressin Plus Catecholamine Vasopressors vs Catecholamines Alone With Atrial Fibrillation in Patients With Distributive Shock. JAMA 2018; 319:1889.
White DB, Angus DC, Shields AM, et al. A Randomized Trial of a Family-Support Intervention in Intensive Care Units. N Engl J Med 2018; 378:2365.
Driver BE, Prekker ME, Klein LR, et al. Effect of Use of a Bougie vs Endotracheal Tube and Stylet on First-Attempt Intubation Success Among Patients With Difficult Airways Undergoing Emergency Intubation: A Randomized Clinical Trial. JAMA 2018; 319:2179.
Chatzidou S, Kontogiannis C, Tsilimigras DI, et al. Propranolol Versus Metoprolol for Treatment of Electrical Storm in Patients With Implantable Cardioverter-Defibrillator. J Am Coll Cardiol 2018; 71:1897.
https://www.fda.gov/downloads/BiologicsBloodVaccines/CellularGeneTherapyProducts/ApprovedProducts/UCM606687.pdf (Accessed on May 07, 2018).
Martinod E, Chouahnia K, Radu DM, et al. Feasibility of Bioengineered Tracheal and Bronchial Reconstruction Using Stented Aortic Matrices. JAMA 2018; 319:2212.
Jemal A, Miller KD, Ma J, et al.
Attached file
Воскресное! Что нового в секции «Медицина критических состояний» в UpToDate #longread:
CRITICAL CARE

No benefit of oral and digestive tract decontamination when antibiotic resistance is prevalent (November 2018)

Modest mortality benefits have been demonstrated among intensive care unit (ICU) patients treated with orally applied or ingested non-absorbable antimicrobials (selective oropharyngeal and digestive decontamination [SOD and SDD]) in trials from the Netherlands, a region with low baseline antimicrobial resistance. However, in a trial among European ICUs with a moderate to high prevalence of antibiotic resistance, chlorhexidine mouthwash, SOD, and SDD were not associated with reductions in mortality or in ICU-acquired multidrug-resistant gram-negative bacteremia compared with baseline care [12]. These findings support the current practice of ICUs with a moderate to high prevalence of antibiotic resistance to forgo SOD and SDD. (See "Infections and antimicrobial resistance in the intensive care unit: Epidemiology and prevention", section on 'Digestive and oropharyngeal decontamination'.)

Timing of renal replacement therapy in patients with acute kidney injury and septic shock (November 2018)

The optimal timing of initiating renal replacement therapy (RRT) for patients with sepsis and severe acute kidney injury (AKI) is unclear. A randomized trial of nearly 500 patients compared earlier (within 12 hours of AKI diagnosis) versus delayed (development of an emergent indication for RRT or at 48 hours after AKI diagnosis) initiation of RRT in patients with early septic shock and severe AKI [13]. There was no difference in mortality at 90 days between the groups, although the trial was stopped early for futility. These findings support our recommendation not to electively initiate RRT in patients with severe AKI without an urgent indication, such as clinically significant uremic symptoms, severe electrolyte abnormalities, or volume overload. (See "Renal replacement therapy (dialysis) in acute kidney injury in adults: Indications, timing, and dialysis dose", section on 'Timing of elective initiation'.)

Cricoid pressure for rapid sequence induction and intubation (October 2018)

The literature on the benefits and risks of cricoid pressure during rapid sequence induction and intubation (RSII) is inconclusive. The first large multicenter randomized trial, which included nearly 3500 patients who required RSII for general anesthesia, reported no difference in the incidence of aspiration with and without cricoid pressure (0.6 versus 0.5 percent) [14]. Median intubation time was longer in patients who had cricoid pressure applied (27 versus 23 seconds), and there was higher incidence of Cormack Lehane grade 3 or 4 laryngeal views with cricoid pressure (10 versus 5 percent). Practice varies, and some UpToDate contributors routinely use cricoid pressure for RSII, while others do not. If used, cricoid pressure may have to be released if intubation proves difficult. (See "Rapid sequence induction and intubation (RSII) for anesthesia", section on 'Cricoid pressure controversies'.)

Bedside ultrasonography in patients with undifferentiated hypotension (September 2018)

Observational evidence supports point-of-care (POC) ultrasonography for the bedside assessment of patients with undifferentiated hypotension. However, a recent randomized trial in over 250 patients seen in an emergency department with undifferentiated hypotension found that POC ultrasonography did not alter the 30-day survival, CT scanning rate, inotrope or intravenous fluid use, or length of stay [15]. A large number of exclusion criteria and a relatively small study population may have limited the ability of the trial to detect an impact of bedside ultrasonography.
https://www.facebook.com/events/2212299039016729/?ti=ia
Заместительная почечная терапия. Обзор ‘18
Attached file
Инфузия по шоке https://healthmanagement.org/uploads/article_attachment/icu-v18-i3-messina-greco-cecconi-fluids-in-shock.pdf
Attached file
Attached file
Advanced Trauma Life Support 2018 (10th edition):
Attached file
Всё, что вы хотели знать про антибиотики и резистентность!