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Post-Hospital Syndrome and Hyponatremia

Health 2021年第8期13卷 846-856页

作者： josé Bellod-Tonda Julio Blázquez-Encinar María Dolores Jover-Ríos Carmen Seguí-Pérez Juan Méndez-Mora francisco Caparrós-Hernández Álex Méndez-Jover Marc Seguí-Pérez David Baláž Leticia Espinosa del Barrio Jesús Corbacho-Redondo Carles García-Cervera Juan Manuel Núñez-Cruz Isidro Hernández-Isasi Javier Guzmán-Martínez Angie Gómez-Uranga Pedro Esteve-Atiénzar Jorge Peris-García Veronica Martínez-Sempere Eliana Damonte-White Óscar Hernando Ruiz-Ariza Juan Carlos López-Corbalán Lourdes Lajara-Villar Andrea Riaño-Pérez Paloma Chazarra-Pérez María Escamilla-Espínola Maria Luisa Asensio-Tomás Miguel Ángel Auladell-Alemany Laura Serna-Torres Asunción Pérez-Fullana Amparo Gómez-Siurana Sergio Menargues-Irles josé Miguel Seguí-Ripoll Internal Medicine Department University Hospital of San Juan Alicante Spain Internal Medicine Department Torrevieja University Hospital Alicante Spain Internal Medicine Department Hospital La Vega Baja of Orihuela Alicante Spain CEU Cardinal Herrera University Veterinary Hospital Valencia Spain Secondary School Marist Brothers High School Alicante Spain Department of Clinical Medicine Miguel Hernández University Elche Spain Primary Care Medicine Benilloba Spain Sub-Delegation of the Government Alicante Spain Chemical Engineering Department University of Alicante Alicante Spain

Introduction: Post-hospital syndrome (PHS) is defined as a period of vulnerability during the first 30 days after a patient is discharged from hospital, in which multiple factors come into play. Hyponatremia is the most frequent hydroelectrolytic disorder in hospitalized patients and may be related to the appearance of PHS. Objective: The objective is to estimate the prevalence of PHS that is assessed as the rate of readmissions in the first 30 days after discharge, in patients with hyponatremia. Material and Methods: It is a descriptive observational study of patients with hyponatremia who were discharged from 1 September 2010 to 2 February 2020 at the Internal Medicine Service of the Hospital University of San Juan (Alicante, Spain). Results: Of the 25 included patients, 5 (20%) were readmitted within a month of discharge, after a mean of 11.4 days (standard deviation [SD] 5.1). The overall mortality of the study was 20% (n = 5), with one case of death in the first 30 days post-hospitalization (4%). In 12 patients (48%) the origin of the hyponatremia was undetermined. The most frequently recorded etiology for the condition was pharmacological (n = 7, 28%), and there was pronounced variability in its clinical and laboratory study. The most widely used corrective measure was drug withdrawal, in 16 patients (64%). Water intake restriction was the most common treatment after discharge (5 patients, 20%), followed by urea (2 patients, 8%), while tolvaptan was not used. Conclusion: Hyponatremia may be the cause of PHS, which could increase the rate of early readmission. Hyponatremia is an underdiagnosed and undertreated entity, so it is necessary to apply an appropriate system to optimize its management and, in future studies, to assess its impact on PHS.

关键词： Hospitalization Hyponatremia Patient Readmission Inappropriate ADH Syndrome

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Septic shock 3.0 criteria application in severe COVID-19 patients:An unattended sepsis population with high mortality risk

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World Journal of Critical Care Medicine 2022年第4期11卷 246-254页

作者： joséPedro Cidade LM Coelho Vasco Costa Rui Morais Patrícia Moniz Luís Morais Pedro Fidalgo António Tralhão Carolina Paulino David Nora Bernardino Valério Vítor Mendes Camila Tapadinhas Pedro Povoa Polyvalent Intensive Care Unit Hospital São Francisco XavierCentro Hospitalar Lisboa OcidentalLisboa 1449-005Portugal Polyvalent Intensive Care Unit Hospital Sao Francisco XavierCentro Hospitalar Lisboa OcidentalLisbon 1449-005Portugal Polyvalent Intensive Care Unit Hospital São Francisco XavierCentro Hospitalar Lisboa OcidentalLisbon 1449-005Portugal Polyvalent Intesive Care Unit Hospital São Francisco XavierCentro Hospitalar Lisboa OcidentalLisbon 1449-005Portugal Polyvalent Intens Care Unit NOVA Medical SchoolHospital Sao Francisco XavierCentro Hospitalar Lisboa OcidentalLisbon 1449-005Portugal

BACKGROUND Coronavirus disease 2019(COVID-19)can be associated with life-threatening organ dysfunction due to septic shock,frequently requiring intensive care unit(ICU)admission,respi-ratory and vasopressor ***-fore,clear clinical criteria are pivotal for early recognition of patients more likely to need prompt organ *** most patients with severe COVID-19 meet the Sepsis-3.0 criteria for septic shock,it has been increasingly recognized that hyperlactatemia is frequently absent,possibly leading to an underestimation of illness severity and mortality *** To identify the proportion of severe COVID-19 patients with vasopressor support requirements,with and without hyperlactatemia,and describe their clinical outcomes and mortality METHODS We performed a single-center prospective cohort *** adult patients admitted to the ICU with COVID-19 were included in the analysis and were further divided into three groups:Sepsis group,without both criteria;Vasoplegic Shock group,with persistent hypotension and vasopressor support without hyperlactatemia;and Septic Shock 3.0 group,with both ***-19 was diagnosed using clinical and radiologic criteria with a severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)positive RT-PCR *** 118 patients(mean age 63 years,87%males)were included in the analysis(n=51 Sepsis group,n=26 Vasoplegic Shock group,and n=41 Septic Shock 3.0 group).SOFA score at ICU admission and ICU length of stay were different between the groups(P<0.001).Mortality was significantly higher in the Vasoplegic Shock and Septic Shock 3.0 groups when compared with the Sepsis group(P<0.001)without a significant difference between the former two groups(P=0.713).The log rank tests of Kaplan-Meier survival curves were also different(P=0.007).Ventilator-free days and vasopressor-free days were different between the Sepsis vs Vasoplegic Shock and Septic Shock 3.0 groups(both P<0.001),and similar in the last two groups(P=0.128

关键词： COVID-19 Critical care SARS-CoV-2 Septic shock Lactate Sepsis 3.0 criteria

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Dendritic cell deficiencies persist seven months after SARS-CoV-2 infection

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Cellular & Molecular Immunology 2021年第9期18卷 2128-2139页

作者： Alberto Pérez-Gómez Joana Vitallé Carmen Gasca-Capote Alicia Gutierrez-Valencia María Trujillo-Rodriguez Ana Serna-Gallego Esperanza Muñoz-Muela María de los Reyes Jiménez-Leon Mohamed Rafii-El-Idrissi Benhnia Inmaculada Rivas-Jeremias Cesar Sotomayor Cristina Roca-Oporto Nuria Espinosa Carmen Infante-Domínguez Juan Carlos Crespo-Rivas Alberto Fernández-Villar Alexandre Pérez-González Luis Fernando López-Cortés Eva Poveda Ezequiel Ruiz-Mateos joséMiguel Cisneros Sonsoles Salto-Alejandre Judith Berastegui-Cabrera Pedro Camacho-Martínez Carmen Infante-Domínguez Marta Carretero-Ledesma Juan Carlos Crespo-Rivas Eduardo Márquez joséManuel Lomas Claudio Bueno Rosario Amaya joséAntonio Lepe Jerónimo Pachón Elisa Cordero Javier Sánchez-Céspedes Manuela Aguilar-Guisado Almudena Aguilera Clara Aguilera Teresa Aldabo-Pallas Verónica Alfaro-Lara Cristina Amodeo Javier Ampuero María Dolores Avilés Maribel Asensio Bosco Barón-Franco Lydia Barrera-Pulido Rafael Bellido-Alba Máximo Bernabeu-Wittel Candela Caballero-Eraso Macarena Cabrera Enrique Calderón Jesús Carbajal-Guerrero Manuela Cid-Cumplido Yael Corcia-Palomo Juan Delgado Antonio Domínguez-Petit Alejandro Deniz Reginal Dusseck-Brutus Ana Escoresca-Ortega Fátima Espinosa Nuria Espinosa Michelle Espinoza Carmen Ferrándiz-Millón Marta Ferrer Teresa Ferrer Ignacio Gallego-Texeira Rosa Gámez-Mancera Emilio García Horacio García-Delgado Manuel García-Gutiérrez María Luisa Gascón-Castillo Aurora González-Estrada Demetrio González Carmen Gómez-González Rocío González-León Carmen Grande-Cabrerizo Sonia Gutiérrez Carlos Hernández-Quiles Inmaculada Concepción Herrera-Melero Marta Herrero-Romero Luis Jara Carlos Jiménez-Juan Silvia Jiménez-Jorge Mercedes Jiménez-Sánchez Julia Lanseros-Tenllado Carmina López Isabel López Álvaro López-Barrios Luis F.López-Cortés Rafael Luque-Márquez Daniel Macías-García Guillermo Martín-Gutiérrez Luis Martín-Villén joséMolina Aurora Morillo María Dolores Navarro-Amuedo Dolores Nieto-Martín francisco Ortega María Paniagua-García Amelia Peña-Rodríguez E Clinical Unit of Infectious Diseases Microbiology and Preventive MedicineInstitute of Biomedicine of Seville(IBiS)Virgen del Rocío University HospitalCSICUniversity of SevilleSevilleSpain Department of Medical Biochemistry Molecular Biologyand ImmunologySchool of MedicineUniversity of SevilleSevilleSpain Pneumology Service Galicia Sur Health Research Instituto(IIS Galicia Sur)SERGAS-UVigoVigoSpain Infectious Diseases Unit Department of Internal MedicineComplexo HospitalarioUniversitario de VigoIIS Galicia SurSERGAS-UVigoVigoSpain Group of Virology and Pathogenesis Galicia Sur Health Research Institute(IIS Galicia Sur)-Complexo Hospitalario Universitario de VigoSERGAS-UVigoVigoSpain Unit of Infectious Diseases Microbiologyand Preventive MedicineVirgen del Rocío University HospitalSevilleSpain Institute of Biomedicine of Seville(IBiS) Virgen del Rocío University Hospital/CSIC/University of SevilleSevilleSpain Medico-Surgical Unit of Respiratory Diseases Virgen del Rocío University HospitalSevilleSpain Unit of Emergencies Virgen del Rocío University HospitalSevilleSpain Intensive Care Unit Virgen del Rocío University HospitalSevilleSpain Department of Medicine University of SevilleSevilleSpain Cardiology and Cardiovascular Surgery Unit Virgen del Rocío University HospitalSevilleSpain Rheumatology Unit Virgen del Rocío University HospitalSevilleSpain Internal Medicine Unit Virgen del Rocío University HospitalSevilleSpain Digestive and Hepatobiliary Unit Virgen del Rocío University HospitalSevilleSpain Neurology and Clinical Neurophysiology Unit Virgen del Rocío University HospitalSevilleSpain Endocrinology and Nutrition Unit Virgen del Rocío University HospitalSevilleSpain Urology and Nephrology Unit Virgen del Rocío University HospitalSevilleSpain Unit of Clinical Investigation and Clinical Trials Virgen del Rocío University HospitalSevilleSpain

Severe Acute Respiratory Syndrome Coronavirus(SARS-CoV)-2 infection induces an exacerbated inflammation driven by innate immunity *** cells(DCs)play a key role in the defense against viral infections,for instance plasmacytoid DCs(pDCs),have the capacity to produce vast amounts of interferon-alpha(IFN-α).In COVID-19 there is a deficit in DC numbers and IFN-αproduction,which has been associated with disease *** this work,we described that in addition to the DC deficiency,several DC activation and homing markers were altered in acute COVID-19 patients,which were associated with multiple inflammatory ***,previously hospitalized and nonhospitalized patients remained with decreased numbers of CD1c+myeloid DCs and pDCs seven months after SARS-CoV-2 ***,the expression of DC markers such as CD86 and CD4 were only restored in previously nonhospitalized patients,while no restoration of integrinβ7 and indoleamine 2,3-dyoxigenase(IDO)levels were *** findings contribute to a better understanding of the immunological sequelae of COVID-19.

关键词： SARS-CoV-2 COVID-19 Dendritic cell Long-COVID

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Clinical relevance of the use of Dentoxol® for oral mucositis induced by radiotherapy: A phase II clinical trial

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World Journal of Clinical Oncology 2022年第10期13卷 813-821页

作者： Sebastián Solé Sergio Becerra Claudia Carvajal Piero Bettolli Hernán Letelier Alejandro Santini Lorena Vargas Alexander Cifuentes francisco Larsen Natalia Jara Jorge Oyarzún Eva Bustamante Benjamín Martínez David Rosenberg Tomas Galván Department of Radiotherapy Radiomedicine InstituteAmérico Vespucio Norte 1314 Vitacura7630370SantiagoChile National Institute of Cancer SantiagoServicio de Salud Metropolitano NorteAv Profesor Zañartu 1010Independencia8380455SantiagoChile Oncologic Institute Arturo López Pérez Foundation JoséManuel Infante 805Providencia7500691SantiagoChile Hospital Base Valdivia Bueras 1003 s/n XIV Región5100238ValdiviaChile Oncologic Center of Antofagasta Los Pumas 10255Antofagasta1267348AntofagastaChile Universidad Mayor SantiagoAv Libertador Bernardo O´Higgins 20138340585SantiagoChile Ingalfarma Dr Manuel Barros Borgoño 71Oficina 1308Providencia7500593SantiagoChile

BACKGROUND Severe oral mucositis associated with cancer therapy is a frequent complication that may affect a patient's systemic condition,resulting in interruption and/or prolongation of cancer ***®is a medical solution in the form of a mouthwash that has been shown to result in statistically significant improvement in the prevention of severe oral ***,knowing the measures of the clinical significance of this therapy is important for accurate *** describe the clinical impact of Dentoxol®use in severe oral *** Clinical significance was measured using the results obtained in a randomized controlled clinical trial previously conducted by the same group of *** measures of clinical significance evaluated were the absolute risk or incidence,relative risk,absolute risk reduction,relative risk reduction,number needed to treat,and odds *** The data obtained show that the impact of Dentoxol®on reducing the severity of oral mucositis has important clinical *** The results of this study justify the incorporation of Dentoxol®mouth rinse into clinical protocols as a complement to cancer therapy to prevent and/or treat oral mucositis secondary to radiotherapy.

关键词： Clinical trial Dentoxol Oral mucositis Prevention Radiotherapy Treatment

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Turbo-taxonomy to assemble a megadiverse lichen genus:seventy new species of Cora(Basidiomycota:Agaricales:Hygrophoraceae),honouring David Leslie Hawksworth’s seventieth birthday

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Fungal Diversity 2017年第3期84卷 139-207页

作者： Robert Lücking Manuela Dal Forno Bibiana Moncada Luis Fernando Coca Leidy Yasmín Vargas-Mendoza André Aptroot Laura Juliana Arias Betty Besal Frank Bungartz Diego Mauricio Cabrera-Amaya Marcela E.S.Cáceres josé Luis Chaves Sionara Eliasaro Martha Cecilia Gutiérrez Jesús E.Hernández Marin María de los Ángeles Herrera-Campos María E.Holgado-Rojas Harald Jonitz Martin Kukwa Fabiane Lucheta Santiago Madriñán Marcelo Pinto Marcelli Suzana Maria de Azevedo Martins Joel A.Mercado-Díaz Jorge Alberto Molina Eduardo A.Morales Peter R.Nelson Freddy Nugra francisco Ortega Telma Paredes Ayda Lucía Patiño Rouchi Nadine Peláez-Pulido Rosa Emilia Pérez Pérez Gary B.Perlmutter Eimy Rivas-Plata Javier Robayo Camilo Rodríguez Diego Fernando Simijaca Edier Soto-Medina Adriano Afonso Spielmann Alejandra Suárez-Corredor Jean-Marc Torres Carlos Alberto Vargas Alba Yánez-Ayabaca Gothamie Weerakoon Karina Wilk Marcela Celis Pacheco Mauricio Diazgranados Grischa Brokamp Thomas Borsch Patrick M.Gillevet Masoumeh Sikaroodi James D.Lawrey Botanical Garden and Botanical Museum Berlin KöniginLuise-Straße 6-814195 BerlinGermany Science Education The Field Museum1400 South Lake ShoreChicagoIL 60605USA Department of Botany Smithsonian InstitutionNational Museum of Natural History10th St Constitution Ave NWWashingtonDC 20560USA Department of Environmental Science and Policy George Mason UniversityFairfaxVA 22030-4444USA Licenciatura en Biologı´a Universidad Distrital Francisco Jose´de CaldasCra.4 No.26D-54Torre de LaboratoriosHerbarioBogota´D.C.Colombia Herbario Universidad de Caldas(FAUC) Edificio BicentenarioCalle 65No.26-10ManizalesA.A.275CaldasColombia ABL Herbarium G.v.d.Veenstraat 1073762 XK SoestThe Netherlands Biologı´a Universidad del Quindı´oCarrera 15 Calle 12 NorteArmeniaQuindı´oColombia 120 Chavis Avenue LexingtonVA 24450USA Charles Darwin Foundation Puerto AyoraSanta Cruz IslandGala´pagosEcuador Schedestraße 8 53113 BonnGermany Jardı´n Bota´nico de Bogota´jose´Celestino Mutis Avenida Calle 63 No.68-95Bogota´D.C.Colombia Departamento de Biocieˆncias Universidade Federal de SergipeAvenida Vereador Olı´mpio Grandes/n.ItabaianaCEP:49.500-000 SergipeBrazil Laboratorio de Hongos Instituto Nacional de Biodiversidad(INBio)Apdo.22-3100Santo Domingo de HerediaCosta Rica Departamento de Botaˆnica Universidade Federal do Parana´Campus Polite´cnicoSetor de Cieˆncias Biolo´gicasAv.Cel.Francisco H.dos Santoss/nJardim das Ame´ricas81531-980 CuritibaPRBrazil Ingenierı´a Ambiental Universidad Distrital Francisco Jose´de CaldasCarrera 5 Este No.15-82Av.CircumvalarBogota´D.C.Colombia Instituto Experimental Jardı´n Bota´nico Dr.Tobı´as Lasser Centro de Investigacio´n y DesarrolloUniversidad Central de VenezuelaAve.Salvador AllendeJardı´n Bota´nico de CaracasApartado#2156Caracas 1010-AVenezuela Departamento de Bota´nica Instituto de Biologı´aUniversidad Nacional Auto´noma de Me´xicoApartado Postal 70-36704510 Ciudad De Me´xicoMexico Facultad de Ciencias Escuela Profesional de Biologı´aUniv

Following a large-scale phylogenetic study of the lichenized genus Cora(Basidiomycota:Agaricales:Hygrophoraceae),we formally describe 70 new species,honouring the seventieth birthday of David Leslie Hawksworth,one of the preeminent figures in mycology and lichenology in the past 50 *** on an updated phylogeny using the ITS fungal barcoding locus,we now recognize 189 taxa in a genus that until recently was considered to represent a single species;including this contribution,92 of these are formally recognized,including five taxa based on historical names or collections that have not been *** of Cora can be recognized by a combination of morphological(size,colour,lobe configuration,surface hairs,hymenophore size and shape),anatomical(thallus thickness,cortex structure,photobiont type,hyphal papillae),and ecogeographical features(substrate,habitat,distribution),and a keytable allowing the identification of all accepted taxa is *** new species are:Cora accipiter Moncada,Madrin˜a´n&Lücking ***.,*** Moncada,Soto-Medina&Lücking ***.,*** Moncada,Dal Forno&Lücking ***.,*** Dal Forno,Chaves&Lücking ***.,*** Moncada,***ı´guez&Lücking ***.,*** Lücking,Moncada&*** ***.,*** Moncada,Ya´nez-Ayabaca&Lücking ***.,*** Moncada,Patin˜o&Lücking ***.,*** Lücking,***&Dal Forno ***.,*** Holgado,Rivas Plata&Perlmutter ***.,*** Dal Forno,Eliasaro&Spielmann ***.,*** Nugra,Dal Forno&Lücking ***.,*** Lücking,Martins&Lucheta ***.,*** Moncada,R.-***´rez&Lücking ***.,*** Moncada,***.&Lücking ***.,*** Moncada,CabreraAmaya&Lücking ***.,*** Moncada,R.-***´rez&***.,*** Lücking,***&Dal Forno ***.,*** Moncada,***´rez-Corredor&Lücking ***.,*** Moncada,***&Lücking ***.,***

关键词： Bolivia Citizen science Chile Mexico Puerto Rico Sri Lanka

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Mexican Guidelines for the Diagnosis and Treatment of Chronic Myeloid Leukaemia

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Journal of Cancer Therapy 2013年第3期4卷 747-764页

作者： Eduardo Cervera Federico Godínez Rosa Sosa Ramón Rivas Carlos Best Juan Hernández Adrián Morales Hugo Zurita Ivette Carrasco Jorge Cruz álvaro Aguayo josé Espinoza Juan Labardini Luis Valero Judith Cruz Diana Arcos Diego Limón Omar López-Navarro Daniela Gordillo-Bastidas Myrna Candelaria francisco Torres Juan Kassack Oscar de Jesús Pérez Ramírez Jorge Aquino Guillermo Díaz Mariela Cardiel Margarita Rodríguez Patricia Montoya Juan Contreras María Chávez Sandra Chávez David Gómez Olga Cantú Jorge Duque Luis Pita Eduardo Lobato Julio López Antonio López Pedro González Jorge Cortés Haematology and Oncology Department National Institute of Medical and Nutrition Sciences “Dr. Salvador Zubirán” Mexico City Mexico Haematology Deparment from Hospital Juárez Mexico City Mexico Haematology Department Blood Bank and Unit of Aphaeresis General Hospital of Culiacán Health Ministry Culiacán Mexico Haematology Department Bone Marrow Transplant and Blood Bank from Hospital Regional de Alta Especialidad “Dr. Juan Graham Casassus” Villahermosa Mexico Haematology Department Cancerology National Institute (INCan) Mexico City Mexico Haematology Department Cancerology National Institute (INCan) Mexico City Mexico 2Internal Medicine Haematology Hospital ISSSTECALI Tijuana Mexico Haematology Department Centenario Hospital Miguel Hidalgo Health Ministry Aguascalientes Mexico Haematology Department General Hospital of Sonora State Sonora Mexico Haematology Department Hospital Universitario UANL Monterrey Mexico Haematology Haematology Service Hospital General Regional SSG León Mexico Haematology Head of Haematology Service School of Medicine Autonomous University of San Luis Potosí San Luis Potosí Mexico Haematology Hospital “Aranda de la Parra” León Mexico Haematology Hospital General de Especialidades Campeche Mexico Haematology Hospital General de México Mexico City Mexico Haematology Hospital General de Occidente SSA Guadalajara Mexico Haematology Hospital Regional de Alta Especialidad de Oaxaca Oaxaca Mexico Haematology Mérida Clinic Yucatán Mexico Haematology Oncology Unit SSEP Puebla Mexico Hospital Betania Puebla Mexico Hospital of the Poblano Child Puebla Mexico Internal Medicine Haematology Hospital ISSSTECALI Tijuana Mexico Leukaemias Clinic at ISSEMyM Toluca Mexico Leukemia Department MD Anderson Cancer Center Houston Mexico Los Mochis General Hospital Sinaloa Mexico Renaissance Clinic Morelia Mexico State Council for AIDS Prevention and Control Chihuahua Mexico Universidad Autónoma de Yucatán Mérida Mexico

Background: This document includes recommendations and guidelines issued by a group of Mexican researchers and specialists gathered in the First National Colloquium for the Diagnosis and Management of Chronic Myeloid Leukaemia (CML) by initiative of Instituto Nacional de Cancerología and with the support of the Leukaemia Department of the MD Anderson Cancer Center. Mexico lacks of updated information taken from its own reality on the diagnosis and treatment of CML and other haematological disorders;besides, there are no national guidelines. Aim: To publish a consensus document with guidelines for the management of CML adjusted to the national environment and overall characteristics. Method: The participants answered a DELPHI questionnaire about the overall aspects of the disease, aiming to target controversial topics, discuss them in the colloquium, and to agree on the best ones. After those meetings, a final document was drawn up. Results: The group presents recommendations for definition, diagnosis, prognosis, monitoring, and treatment of CML in Mexico. Conclusions: Having consensus guidelines for the clinical management of CML in our country will enable the consensual practice of Mexican specialists regarding the clinical approach to CML, as well as optimize the resources which allow the rational planning of the medical care strategies.

关键词： Chronic Myeloid Leukaemia Management Guidelines Diagnosis Treatment.

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神经重症监护患者的液体治疗:ESICM专家共识及临床实践推荐

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国际脑血管病杂志 2019年第2期27卷 84-97页

作者： Mauro Oddo Daniele Poole Raimund Helbok Geert Meyfroidt Nino Stocchetti Pierre Bouzat Maurizio Cecconi Thomas Geeraerts Ignacio-Martin Loeches Herve Quintard Fabio Silvio Taccone Romergryko G. Geocadin Claude Hemphill Carole Ichai David Menon Jean-Francois Payen Anders Perner Martin Smith jose Suarez Walter Videtta Elisa R. Zanier Giuseppe Citerio 何毅华(译) 常远(译) 王晓蔷(译) 潘速跃(译) Department of Medic al-Surgical Intensive Care Medicine Faculty of Biology and Medicine Centre Hospitalier Universitaire VauDOIs (CHUV) Lhiversity of Lausanne Rue du Bugnon 46 B4 08.623 1011 Lausanne Switzerland Department of Intensive Care Medicine St James's Lhiversity Hospital James's St Ushers P.O. Box 580 Dublin & Ireland Service de Reanimation Medic o-chirurgic ale Hopital Pasteur 2 UniversiteCote d'Azur CHU de Nice 06000 Nice France Unite CNRS 7275 Sophia-Antipolis France Department of Intensive Care Erasme Hospital University Libre de Bruxelles Brussels Belgium Neurosciences Critical Care Departments of Anesthesiology and Critical Care Medicine Neurology and Neurosurgery Johns Hopkins Lhiversity Baltimore MD USA Department of Neurology University of California San Francisco San Francisco CA LKA Service de Reanimation Polyvalente Hopital Pasteur 2 CHU de Nice 30 Voie Romaine CS 51069 06001 Nice Cedex 1 France Division of Anaesthesia University of Cambridge Addenbrooke's Ffospital Box 93 Hfills Road Cambridge Cambridgeshire CB2 2QQ UK Department of Intensive Care 4131 Copenhagen University Hospital- Rigshospitalet Copenhagen Denmark Department of Neuroanesthesia and Neurocritic al Care The National Ffospital for Neurosurgery and Neurology Lhiversity College London Hospitals London UK Anesthesia and Intensive Care Operative th it S. Martino Hospital Belluno Italy Hospital Nacional Professor Alejandro Posadas Buenos Aires Argentina Department of Neurosciences IRCCS-Istituto di Ricerche Farmacotogiche Mario Negri Milan Italy School of Medicine and Surgery University of Milan-Bicocca Milan Italy Neurointensive Care San Gerardo Hospital ASST-Monza 20900 Monza Italy 南方医科大学南方医院神经内科广州510515 Neurological Intensive Care Lhit Department of Neurology Medical University of Innsbruck Innsbruck Austria Department of Intensive Care Medicine University Hospitals Leuven Louvain Belgium Neuroscience Intensive Care Unit Department of Anesthesia and C

目的发布欧洲重症医学学会(European Society of Intensive Care Medicine, ESICM)关于神经重症监护患者液体治疗的专家共识和临床实践推荐意见。设计在2016年10月召开的ESICM LIVE 2016会议上召集了一个由22名国际专家组成的共识委员会... 详细信息

目的发布欧洲重症医学学会(European Society of Intensive Care Medicine, ESICM)关于神经重症监护患者液体治疗的专家共识和临床实践推荐意见。设计在2016年10月召开的ESICM LIVE 2016会议上召集了一个由22名国际专家组成的共识委员会,随后委员会成员通过电话会议和在线讨论制定本专家共识。方法回顾人群、干预、对比和结局(population, intervention,comparison, and outcomes, PICO)问题,根据需要进行更新并得到证据概要。本共识关注3个主要议题:(1)神经重症监护患者的液体复苏和维持;(2)高渗液体在颅内压控制中的应用;(3)蛛网膜下腔出血后迟发性脑缺血的液体管理。经过广泛的文献检索,应用推荐分级的评估、制订与评价(Gradingof Recommendations Assessment, Development and Evaluation, GRADE)系统原则评估证据质量(从高到极低),制定治疗推荐(强或弱),并在适用时发布最佳实践声明。基于文献和专家意见提供的综合证据,应用改良德尔菲方法(使用序贯方法以避免偏倚和误解)产生最终共识声明。结果最终共识包含总共32条声明,其中13条为强推荐,17条为弱推荐,另外2条声明未提供推荐意见。结论我们发布了一份关于神经重症监护患者液体治疗的共识声明和临床实践推荐。

关键词：循证医学指南液体治疗创伤性脑损伤蛛网膜下腔出血脑出血卒中甘露醇高渗神经重症监护

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