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8442. Safe Central Venous Access in an Overburdened Health System.
A previously healthy man, intubated in the intensive care unit (ICU) for respiratory failure due to coronavirus disease 2019 (COVID-19), required central venous access for vasopressor infusion. The intensivists were occupied managing other critically ill patients, so an available intern attempted to place a triple-lumen catheter in the right internal jugular vein using only anatomic landmarks for guidance. When the access needle was inserted, pulsatile return of blood was noted.
8444. Effect of Discontinuing vs Continuing Angiotensin-Converting Enzyme Inhibitors and Angiotensin II Receptor Blockers on Days Alive and Out of the Hospital in Patients Admitted With COVID-19: A Randomized Clinical Trial.
作者: Renato D Lopes.;Ariane V S Macedo.;Pedro G M de Barros E Silva.;Renata J Moll-Bernardes.;Tiago M Dos Santos.;Lilian Mazza.;André Feldman.;Guilherme D'Andréa Saba Arruda.;Denílson C de Albuquerque.;Angelina S Camiletti.;Andréa S de Sousa.;Thiago C de Paula.;Karla G D Giusti.;Rafael A M Domiciano.;Márcia M Noya-Rabelo.;Alan M Hamilton.;Vitor A Loures.;Rodrigo M Dionísio.;Thyago A B Furquim.;Fábio A De Luca.;Ítalo B Dos Santos Sousa.;Bruno S Bandeira.;Cleverson N Zukowski.;Ricardo G G de Oliveira.;Noara B Ribeiro.;Jeffer L de Moraes.;João L F Petriz.;Adriana M Pimentel.;Jacqueline S Miranda.;Bárbara E de Jesus Abufaiad.;C Michael Gibson.;Christopher B Granger.;John H Alexander.;Olga F de Souza.; .
来源: JAMA. 2021年325卷3期254-264页
It is unknown whether angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin II receptor blockers (ARBs) have a positive, neutral, or negative effect on clinical outcomes in patients with coronavirus disease 2019 (COVID-19).
8445. Effect of Endovascular Treatment Alone vs Intravenous Alteplase Plus Endovascular Treatment on Functional Independence in Patients With Acute Ischemic Stroke: The DEVT Randomized Clinical Trial.
作者: Wenjie Zi.;Zhongming Qiu.;Fengli Li.;Hongfei Sang.;Deping Wu.;Weidong Luo.;Shuai Liu.;Junjie Yuan.;Jiaxing Song.;Zhonghua Shi.;Wenguo Huang.;Min Zhang.;Wenhua Liu.;Zhangbao Guo.;Tao Qiu.;Qiang Shi.;Peiyang Zhou.;Li Wang.;Xinmin Fu.;Shudong Liu.;Shiquan Yang.;Shuai Zhang.;Zhiming Zhou.;Xianjun Huang.;Yan Wang.;Jun Luo.;Yongjie Bai.;Min Zhang.;Youlin Wu.;Guoyong Zeng.;Yue Wan.;Changming Wen.;Hongbin Wen.;Wentong Ling.;Zhuo Chen.;Miao Peng.;Zhibing Ai.;Fuqiang Guo.;Huagang Li.;Jing Guo.;Haitao Guan.;Zhiyi Wang.;Yong Liu.;Jie Pu.;Zhen Wang.;Hansheng Liu.;Luming Chen.;Jiacheng Huang.;Guoqiang Yang.;Zili Gong.;Jie Shuai.;Raul G Nogueira.;Qingwu Yang.; .
来源: JAMA. 2021年325卷3期234-243页
For patients with large vessel occlusion strokes, it is unknown whether endovascular treatment alone compared with intravenous thrombolysis plus endovascular treatment (standard treatment) can achieve similar functional outcomes.
8446. Effect of Mechanical Thrombectomy Without vs With Intravenous Thrombolysis on Functional Outcome Among Patients With Acute Ischemic Stroke: The SKIP Randomized Clinical Trial.
作者: Kentaro Suzuki.;Yuji Matsumaru.;Masataka Takeuchi.;Masafumi Morimoto.;Ryuzaburo Kanazawa.;Yohei Takayama.;Yuki Kamiya.;Keigo Shigeta.;Seiji Okubo.;Mikito Hayakawa.;Norihiro Ishii.;Yorio Koguchi.;Tomoji Takigawa.;Masato Inoue.;Hiromichi Naito.;Takahiro Ota.;Teruyuki Hirano.;Noriyuki Kato.;Toshihiro Ueda.;Yasuyuki Iguchi.;Kazunori Akaji.;Wataro Tsuruta.;Kazunori Miki.;Shigeru Fujimoto.;Tetsuhiro Higashida.;Mitsuhiro Iwasaki.;Junya Aoki.;Yasuhiro Nishiyama.;Toshiaki Otsuka.;Kazumi Kimura.; .
来源: JAMA. 2021年325卷3期244-253页
Whether intravenous thrombolysis is needed in combination with mechanical thrombectomy in patients with acute large vessel occlusion stroke is unclear.
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