好多没看懂？

July 1, 2020—The first day of my critical care fellowship in the eye of a pandemic and my first day back in American healthcare after practicing for five years in resourcelimited hospitals in Kenya. Comparatively speaking, I felt like I was returning to the land of limitless options. Sure, it was a little overwhelming at first, but having more time before saying, “That is all we can do, ” was incredibly encouraging.

2020年7月1日——这天是我面对大流行而在重症监护病房做研究员的第一天，也是我在资源匮乏的肯尼亚医院执业5年后返回美国医疗系统的第一天。相比之下，我觉得自己回到了无限的选择之地。当然，一开始这让我有点不知所措，但是想到我能在说“我们已经尽力了”之前，有更多的时间，让我得到了难以置信的鼓舞。

fellowship研究员？

One morning while making endless laps in the unit, a resident on the team and I made the decision to transfuse one of our patients. They were positive for coronavirus disease 2019 (COVID-19) and also positive for all of the critical care accoutrements: mechanically ventilated, proned, vasopressors, and a few nephrons shy of renal replacement therapy. Their hemoglobin had drifted down to 7.2 g/dL and seeing their pressor requirement continue to climb, I gave the go ahead for transfusion. Later during rounds, the resident came to the hematology section of their presentation and proudly announced that we had decided to transfuse. Much to our dismay, our attending was not impressed. Instead, they reminded us of laboratory margin of error, the Villanueva [1] and TRISS trials [2], and how that unit of blood could have gone to someone else before sticking the landing with “less is more.

一天早上，当在病房里反复观察后，我和团队中的一名住院医决定给其中的一名患者输血，这是COVID-19阳性患者中的一位，他们所有的重症监护（机械通气、俯卧位、血管加压药和缺乏一定的肾单位而行肾脏替代疗法）设备检测COVID-19也阳性。他们的血红蛋白已经降至7.2g/dL，看到他们的升压药的需求继续攀升，我建议继续输血。后来在查房时，住院医生来到他们就诊血液科，自豪地宣布我们决定输血。令我们沮丧的是，我们的主诊医生并不以为然。相反，他们提醒我们实验室的误差范围（Villanueva 和TRISS研究），以及在坚持“少即是多”之前，再想想这单位血液如果输给其他人会有什么效果。

a few nephrons shy of renal replacement therapy. 缺乏一定的肾单位而行肾脏替代疗法？

Their 每个人的血红蛋白都降至7.2g/dL？

gave the go ahead for 建议继续？

presentation就诊？

attending主诊医生？

they reminded us of laboratory margin of error, the Villanueva [1] and TRISS trials [2],他们提醒我们实验室的误差范围（Villanueva 和TRISS研究）？the Villanueva [1] and TRISS trials指两项研究，可以说明实验室的误差范围？

how that unit of blood could have gone to someone else？再想想这单位血液如果输给其他人会有什么效果？