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21st century critical care medicine:An overview

World Journal of critical care medicine 2024年第1期13卷 1-14页

作者： Smitesh Padte Vikramaditya Samala Venkata Priyal Mehta Sawsan Tawfeeq Rahul Kashyap Salim Surani Department of Research Global Remote Research Scholars ProgramSt.PaulMN 55104United States Department of Hospital medicine Cheshire Medical Center/Dartmouth HealthKeeneNH 03431United States Department of Research WellSpan HealthYorkPA 17403United States Department of Pulmonary&critical care medicine Mayo ClinicRochesterMN 55905United States Department of medicine&Pharmacology Texas A&M UniversityCollege StationTX 77843United States

critical care medicine in the 21st century has witnessed remarkable advancements that have significantly improved patient outcomes in intensive care units(ICUs).This abstract provides a concise summary of the latest developments in critical care,highlighting key areas of *** advancements in critical care include Precision medicine:Tailoring treatments based on individual patient characteristics,genomics,and biomarkers to enhance the effectiveness of *** objective is to describe the recent advancements in critical care ***:The integration of telehealth technologies for remote patient monitoring and consultation,facilitating timely *** intelligence(AI):AI-driven tools for early disease detection,predictive analytics,and treatment optimization,enhancing clinical *** Support:Advanced life support systems,such as Extracorporeal Membrane Oxygenation and Continuous Renal Replacement Therapy provide better organ *** Control:Innovative infection control measures to combat emerging pathogens and reduce healthcare-associated *** Strategies:Precision ventilation modes and lung-protective strategies to minimize ventilatorinduced lung *** Management:Early recognition and aggressive management of sepsis with tailored ***-Centered care:A shift towards patient-centered care focusing on psychological and emotional wellbeing in addition to medical *** conducted a thorough literature search on PubMed,EMBASE,and Scopus using our tailored strategy,incorporating keywords such as critical care,telemedicine,and sepsis management.A total of 125 articles meeting our criteria were included for qualitative *** ensure reliability,we focused only on articles published in the English language within the last two decades,excluding animal studies,in vitro/molecular studies,and non-original data like editorials,letters,protocols,and conference abs

关键词： critical care medicine Intensive care unit Precision medicine Telemedicine Artificial intelligence Organ support Sepsis Infection control Patient-centered care

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critical care medicine 2017： Bigger Picture, Better Future

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Chinese Medical Journal 2017年第10期130卷 1135-1136页

作者： Xiang-Dong Guan Li Tong Department of critical care medicine The First Affiliated Hospital Sun Yat-sen University Guangzhou Guangdong 510080 China

A lot of new progress has been made in critical care medicine during 2016, including the new definition of Sepsis-3, the tburth revision of the SttrvivhTg Sepsis Guidelines presenting, increasing using of point-of-car... 详细信息

关键词： ARDS critical care medicine ECMO EGDT: Sepsis

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critical care medicine in China： history and perspective

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Chinese Medical Journal 2013年第10期126卷 1806-1808页

作者： LIU Ling LIU Da-wei QIU Hai-bo Department of critical care medicine Nanjing Zhongda HospitalSoutheast University Nanjing Jiangsu 210009 China Department of critical care medicine Peking Union MedicalCollege Hospital Beijing 100730 China

critical care medicine began in 1982 in China and is still in a phase of rapid development. Despite theinadequate resources compared with-those of developed countries, critical care medicine has been recognized as a specialty by the government and by other specialties. National critical care societies are dedicated to promoting professional education and the academic improvement of critical care medicine in China. Although critical care services and clinical research are still underdeveloped due to scarce resources, great improvement is expected in the near future.

关键词： critical care medicine " China " intensive care unit

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《PEDIATRIC critical care medicine》主论文直通车

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中国小儿急救医学 2007年第3期14卷 275-276页

作者：杨明（译）樊寻梅（校）首都医科大学附属北京儿童医院ICU

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Journal of Intensive medicine:A leading forum for breakthroughs and progress in critical care medicine

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Journal of Intensive medicine 2021年第1期1卷 1-1页

作者： Dechang Chen Department of critical care medicine Ruijin HospitalShanghai Jiao Tong University School of MedicineNo 197Rui Jin 2nd roadShanghai 200025China

Dear Readers,critical care medicine is a discipline that was established in the early 1980s in *** 40 years later,its importance is widely recognized and it has been developed as a second-tier discipline with its own systems of clinical practice,teaching,and *** care medicine has seen rapid progress in the last decade and has played an important role in emerging public health events,and is expected to further evolve in the post-pandemic era.

关键词： Medical journal Publication critical care medicine

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《PEDIATRIC critical care medicine〉）主论文直通车

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中国小儿急救医学 2009年第1期16卷 10-10页

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Evaluation of ICUs and weight of quality control indicators:an exploratory study based on Chinese ICU quality data from 2015 to 2020

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Frontiers of medicine 2023年第4期17卷 675-684页

作者： Longxiang Su Xudong Ma Sifa Gao Zhi Yin Yujie Chen Wenhu Wang Huaiwu He Wei Du Yaoda Hu Dandan Ma Feng Zhang Wen Zhu Xiaoyang Meng Guoqiang Sun Lian Ma Huizhen Jiang Guangliang Shan Dawei Liu Xiang Zhou China-NCCQC Department of critical care medicine State Key Laboratory of Complex Severe and Rare DiseasesPeking Union Medical College HospitalPeking Union Medical College and Chinese Academy of Medical SciencesBeijing 100730China Department of Medical Administration National Health Commission of the People’s Republic of ChinaBeijing 100044China Intensive care Unit The People’s Hospital of ZizhongNeijiang 641000China Department of Epidemiology and Biostatistics Institute of Basic Medicine SciencesChinese Academy of Medical Sciences&School of Basic MedicinePeking Union Medical CollegeBeijing 100730China Information Center State Key Laboratory of Complex Severe and Rare DiseasesPeking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100730China 不详

This study aimed to explore key quality control factors that affected the prognosis of intensive care unit(ICU)patients in Chinese mainland over six years(2015–2020).The data for this study were from 31 provincial and municipal hospitals(3425 hospital ICUs)and included 2110685 ICU patients,for a total of 27607376 ICU hospitalization *** found that 15 initially established quality control indicators were good predictors of patient prognosis,including percentage of ICU patients out of all inpatients(%),percentage of ICU bed occupancy of total inpatient bed occupancy(%),percentage of all ICU inpatients with an APACHE II score≥15(%),three-hour(surviving sepsis campaign)SSC bundle compliance(%),six-hour SSC bundle compliance(%),rate of microbe detection before antibiotics(%),percentage of drug deep venous thrombosis(DVT)prophylaxis(%),percentage of unplanned endotracheal extubations(%),percentage of patients reintubated within 48 hours(%),unplanned transfers to the ICU(%),48-h ICU readmission rate(%),ventilator associated pneumonia(VAP)(per 1000 ventilator days),catheter related blood stream infection(CRBSI)(per 1000 catheter days),catheter-associated urinary tract infections(CAUTI)(per 1000 catheter days),in-hospital mortality(%).When exploratory factor analysis was applied,the 15 indicators were divided into 6 core elements that varied in weight regarding quality evaluation:nosocomial infection management(21.35%),compliance with the Surviving Sepsis Campaign guidelines(17.97%),ICU resources(17.46%),airway management(15.53%),prevention of deep-vein thrombosis(14.07%),and severity of patient condition(13.61%).Based on the different weights of the core elements associated with the 15 indicators,we developed an integrated quality scoring system defined as F score=21.35%xnosocomial infection management+17.97%xcompliance with SSC guidelines+17.46%×ICU resources+15.53%×airway management+14.07%×DVT prevention+13.61%×severity of patient *** evidence-based quality

关键词： critical care medicine quality control evaluation exploratory factor analysis(EFA)model

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Problems associated with glucose toxicity:Role of hyperglycemia-induced oxidative stress

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World Journal of Gastroenterology 2009年第33期15卷 4137-4142页

作者： Shinji Kawahito Hiroshi Kitahata Shuzo Oshita Department of Anesthesiology Tokushima University Medical and Dental Hospital

Glucose homeostasis deficiency leads to a chronic increase in blood glucose concentration. In contrast to physiological glucose concentration, chronic super-physiological glucose concentration negatively affects a large number of organs and tissues. Glucose toxicity means a decrease in insulin secretion and an increase in insulin resistance due to chronic hyperglycemia. It is now generally accepted that glucose toxicity is involved in the worsening of diabetes by affecting the secretion of B-cells. Several mechanisms have been proposed to explain the adverse effects of hyperglycemia. It was found that persistent hyperglycemia caused the functional decline of neutrophils. Infection is thus the main problem resulting from glucose toxicity in the acute phase. In other words, continued hyperglycemia is a life-threatening risk factor, not only in the chronic but also the acute phase, and it becomes a risk factor for infection, particularly in the perioperative period.

关键词： Glucose toxicity Diabetes Complication Surgery Surgical site infection Emergency medicine critical care medicine

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Relationship of calcitonin gene-related peptide with disease progression and prognosis of patients with severe traumatic brain injury

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Neural Regeneration Research 2018年第10期13卷 1782-1786页

作者： Li-Xiong Chen Wei-Feng Zhang Ming Wang Pi-Feng Jia Department of critical care medicine North Hospital of Ruijin Hospital Department of Neurosurgery North Hospital of Ruijin Hospital

Calcitonin gene-related peptide（CGRP） has been implicated in multiple functions across many bioprocesses; however, whether CGRP is associated with severe traumatic brain injury（TBI） remains poorly understood. In this study, 96 adult patients with TBI（enrolled from September 2015 to December 2016） were divided into a mild/moderate TBI group（36 males and 25 females, aged 38 ± 13 years） and severe TBI group（22 males and 13 females, aged 38 ± 11 years） according to Glasgow Coma Scale scores. In addition, 25 healthy individuals were selected as controls（15 males and 10 females, aged 39 ± 13 years）. Radioimmunoassay was used to detect serum levels of CGRP and endothelin-1 at admission and at 12, 24, 48, 72 hours, and 7 days after admission. CGRP levels were remarkably lower, but endothelin-1 levels were obviously higher in the severe TBI group compared with mild/moderate TBI and control groups. Levels of CGRP were remarkably lower, but endothelin-1 levels were obviously higher in deceased patients compared with patients who survived. Survival analysis and logistic regression showed that both CGRP and endothelin-1 levels were associated with patient mortality, with each serving as an independent risk factor for 6-month mortality of severe TBI patients. Moreover, TBI patients with lower serum CGRP levels had a higher risk of death. Thus, our retrospective analysis demonstrates the potential utility of CGRP as a new biomarker, monitoring method, and therapeutic target for TBI.

关键词： nerve regeneration calcitonin gene-related peptide severe traumatic brain injury prognosis biomarkers endothelin-1 mortality dynamic serum levels critical care medicine neural regeneration

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Development of a prediction model for enteral feeding intolerance in intensive care unit patients:A prospective cohort study

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World Journal of Gastrointestinal Surgery 2022年第12期14卷 1363-1374页

作者： Xue-Mei Lu Deng-Shuai Jia Rui Wang Qing Yang Shan-Shan Jin Lan Chen School of Nursing Shanghai Jiao Tong UniversityShanghai 200025China Department of Nursing Shanghai General HospitalShanghai Jiao Tong UniversityShanghai 200080China Department of critical care medicine Shanghai General HospitalShanghai Jiao Tong UniversityShanghai 200080China

BACKGROUND Enteral nutrition(EN)is essential for critically ill ***,some patients will have enteral feeding intolerance(EFI)in the process of *** To develop a clinical prediction model to predict the risk of EFI in patients receiving EN in the intensive care *** A prospective cohort study was *** enrolled patients’basic information,medical status,nutritional support,and gastrointestinal(GI)symptoms were *** baseline data and influencing factors were *** regression analysis was used to establish the model,and the bootstrap resampling method was used to conduct internal *** The sample cohort included 203 patients,and 37.93%of the patients were diagnosed with *** the final regression analysis,age,GI disease,early feeding,mechanical ventilation before EN started,and abnormal serum sodium were *** the internal validation,500 bootstrap resample samples were performed,and the area under the curve was 0.70(95%CI:0.63-0.77).CONCLUSION This clinical prediction model can be applied to predict the risk of EFI.

关键词： Enteral feeding intolerance critical care medicine Clinical prediction model Nutrition assessment Nutritional support critical care nursing

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