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Assessing a novel critical care ultrasonography training program for intensive care unit nurses in China

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Chinese Medical Journal 2022年第8期135卷 977-979页

作者： Jianhua Sun Yue Wang Qing Zhang Xin Li Wei He Yangong Chao Xiaoting Wang Dawei Liu critical care Ultrasound Study Grop(CCUSG) Department of critical care Medicine Peking Union Medical College HospitalPeking Union Medical CollegeChinese Academy of Medical ScienceBeijing 100730China Institute for Medical Device Standardization Administration National Institutes for Food and Drug ControlBeijing 100050China Department of critical care Medicine Beijing Tongren HospitalCapital Medical UniversityBeijing 100730China Department of critical care Medicine The First Hospital of Tsing Hua UniversityBeijing 100016China. 不详

critical care ultrasonography(CCUS)is essential in the evaluation of shock,respiratory failure,and to guide central venous access.[1] Nurses also use ultrasound for nursing practice such as thrombosis screening,ultrasound-guided vascular puncture,feeding tube placement,and lung physical therapy.[2]CCUS strengths are lack of radiation,portability,and low costs.Therefore,CCUS has considerable clinical use in critical care.

关键词： CCUS critical nurse

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Clinical practice of sepsis-induced immunosuppression:Current immunotherapy and future options

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Chinese Journal of Traumatology 2024年第2期27卷 63-70页

作者： Fei Pei Bin Gu Shu-Min Miao Xiang-Dong Guan Jian-Feng Wu Department of critical care Medicine The First Affiliated HospitalSun Yat-sen UniversityGuangzhou510080China Guangdong Clinical Research Center for critical care Medicine Guangzhou510080China

Sepsis is a potentially fatal condition characterized by the failure of one or more organs due to a disordered host response to infection.The development of sepsis is closely linked to immune dysfunction.As a result,immunotherapy has gained traction as a promising approach to sepsis treatment,as it holds the potential to reverse immunosuppression and restore immune balance,thereby improving the prognosis of septic patients.However,due to the highly heterogeneous nature of sepsis,it is crucial to carefully select the appropriate patient population for immunotherapy.This review summarizes the current and evolved treatments for sepsis-induced immunosuppression to enhance clinicians'understanding and practical application of immunotherapy in the management of sepsis.

关键词： Sepsis Sepsis-induced immunosuppression Immunotherapy Enrichment Classifier

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Artificial intelligence:Applications in critical care gastroenterology

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Artificial Intelligence in Gastrointestinal Endoscopy 2024年第1期5卷 1-10页

作者： Deven Juneja Department of critical care Medicine Max Super Speciality HospitalNew Delhi 110017India

Gastrointestinal(GI)complications frequently necessitate intensive care unit(ICU)admission.Additionally,critically ill patients also develop GI complications requiring further diagnostic and therapeutic interventions.However,these patients form a vulnerable group,who are at risk for developing side effects and complications.Every effort must be made to reduce invasiveness and ensure safety of interventions in ICU patients.Artificial intelligence(AI)is a rapidly evolving technology with several potential applications in healthcare settings.ICUs produce a large amount of data,which may be employed for creation of AI algorithms,and provide a lucrative opportunity for application of AI.However,the current role of AI in these patients remains limited due to lack of large-scale trials comparing the efficacy of AI with the accepted standards of care.

关键词： Artificial intelligence critical care Gastroenterology Hepatology Intensive care unit Machine learning

Dietary fiber intake and its association with diabetic kidney disease in American adults with diabetes:A cross-sectional study

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World Journal of Diabetes 2024年第3期15卷 475-487页

作者： Xin-Hua Jia Sheng-Yan Wang Ai-Qin Sun Department of critical care Medicine Dezhou People’s HospitalDezhou 253000Shandong ProvinceChina Emergency Intensive care unit Dezhou People’s HospitalDezhou 253000Shandong ProvinceChina

BACKGROUND Dietary fiber(DF)intake may have a protective effect against type 2 diabetes(T2D);however,its relationship with diabetic kidney disease(DKD)remains unclear.AIM To investigate the potential association between DF intake and the prevalence of DKD in individuals diagnosed with T2D.METHODS This cross-sectional study used data from the National Health and Nutrition Examination Survey collected between 2005 and 2018.DF intake was assessed through 24-h dietary recall interviews,and DKD diagnosis in individuals with T2D was based on predefined criteria,including albuminuria,impaired glomerular filtration rate,or a combination of both.Logistic regression analysis was used to assess the association between DF intake and DKD,and comprehensive subgroup and sensitivity analyses were performed.RESULTS Among the 6032 participants,38.4%had DKD.With lower DF intake-T1(≤6.4 g/1000 kcal/day)-as a reference,the adjusted odds ratio for DF and DKD for levels T2(6.5-10.0 g/1000 kcal/day)and T3(≥10.1 g/1000 kcal/day)were 0.97(95%CI:0.84-1.12,P=0.674)and 0.79(95%CI:0.68-0.92,P=0.002),respectively.The subgroup analysis yielded consistent results across various demographic and health-related subgroups,with no statistically significant interactions(all P>0.05).CONCLUSION In united States adults with T2D,increased DF intake may be related to reduced DKD incidence.Further research is required to confirm these findings.

关键词： Dietary fiber Diabetic kidney disease Type 2 diabetes National Health and Nutrition Examination Survey Crosssectional study

Nasogastric tube syndrome:A Meta-summary of case reports

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World Journal of Clinical Cases 2024年第1期12卷 119-129页

作者： Deven Juneja Prashant Nasa Gunjan Chanchalani Ravi Jain Department of critical care Medicine Max Super Speciality HospitalNew Delhi 110017India Department of critical care Medicine NMC Specialty HospitalDubai 7832United Arab Emirates Department of critical care Medicine Karamshibhai Jethabhai Somaiya Hospital and Research CentreMumbai 400022India Department of critical care Medicine Mahatma Gandhi Medical College and HospitalJaipur 302022RajasthanIndia

BACKGROUND Since its description in 1790 by Hunter,the nasogastric tube(NGT)is commonly used in any healthcare setting for alleviating gastrointestinal symptoms or enteral feeding.However,the risks associated with its placement are often underes-timated.Upper airway obstruction with a NGT is an uncommon but potentially life-threatening complication.NGT syndrome is characterized by the presence of an NGT,throat pain and vocal cord(VC)paralysis,usually bilateral.It is poten-tially life–threatening,and early diagnosis is the key to the prevention of fatal upper airway obstruction.However,fewer cases may have been reported than might have occurred,primarily due to the clinicians'unawareness.The lack of specific signs and symptoms and the inability to prove temporal relation with NGT insertion has made diagnosing the syndrome quite challenging.AIM To review and collate the data from the published case reports and case series to understand the possible risk factors,early warning signs and symptoms for timely detection to prevent the manifestation of the complete syndrome with life-threatening airway obstruction.METHODS We conducted a systematic search for this meta-summary from the database of PubMed,EMBASE,Reference Citation Analysis(https://***/)and Google scholar,from all the past studies till August 2023.The search terms included major MESH terms"Nasogastric tube","Intubation,Gastrointestinal","Vocal Cord Paralysis",and“Syndrome”.All the case reports and case series were evaluated,and the data were extracted for patient demographics,clinical symptomatology,diagnostic and therapeutic interventions,clinical course and outcomes.A datasheet for evaluation was further prepared.RESULTS Twenty-seven cases,from five case series and 13 case reports,of NGT syndrome were retrieved from our search.There was male predominance(17,62.96%),and age at presentation ranged from 28 to 86 years.Ten patients had diabetes mellitus(37.04%),and nine were hypertensive(33.33%).Only three(11.11%)patients were reported to be immunocompromised.

关键词： Nasogastric tube Nasogastric tube syndrome Ryle’s tube Sofferman syndrome Vocal cord paralysis

Neuroprotective effects of chaperone-mediated autophagy in neurodegenerative diseases

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Neural Regeneration Research 2024年第6期19卷 1291-1298页

作者： Qi Jia Jin Li Xiaofeng Guo Yi Li You Wu Yuliang Peng Zongping Fang Xijing Zhang Department of Anesthesiology and Perioperative Medicine and Department of Intensive care unit Xijing Hospital The Fourth Military Medical University Department of critical care Medicine Translational Research Institute of Brain and Brain-Like Intelligence Shanghai Fourth People's Hospital School of Medicine Tongji University

Chaperone-mediated autophagy is one of three types of autophagy and is characterized by the selective degradation of proteins. Chaperone-mediated autophagy contributes to energy balance and helps maintain cellular homeostasis, while providing nutrients and support for cell survival. Chaperone-mediated autophagy activity can be detected in almost all cells, including neurons. Owing to the extreme sensitivity of neurons to their environmental changes, maintaining neuronal homeostasis is critical for neuronal growth and survival. Chaperone-mediated autophagy dysfunction is closely related to central nervous system diseases. It has been shown that neuronal damage and cell death are accompanied by chaperone-mediated autophagy dysfunction. Under certain conditions, regulation of chaperone-mediated autophagy activity attenuates neurotoxicity. In this paper, we review the changes in chaperone-mediated autophagy in neurodegenerative diseases, brain injury, glioma, and autoimmune diseases. We also summarize the most recent research progress on chaperone-mediated autophagy regulation and discuss the potential of chaperone-mediated autophagy as a therapeutic target for central nervous system diseases.

关键词： chaperone-mediated autophagy neurodegenerative disease neuronal homeostasis neuroprotection

Application and Satisfaction Analysis of Humanized Quality Nursing Intervention in the care of Patients with critical Respiratory Failure

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Journal of Clinical and Nursing Research 2024年第5期8卷 200-205页

作者： Li Xu Department of critical care Medicine Shiyan Yunyang District People’s HospitalShiyan 442500HubeiChina

Objective:To implement humanized quality care in critical respiratory failure nursing,observe the effect,and analyze the satisfaction.Methods:80 patients with severe respiratory failure were divided into 40 cases per group(admitted from February 2022 to December 2023)by double-blind method,the control group performed routine care,and the observation group was given humanized quality care.Results:After the nursing care,two respiratory function indexes of the observation group were lower than those of the control group,and two pulmonary function indexes were higher than those of the control group(Pcare satisfaction situation,the observation group had a higher level of total satisfaction(Pcare of critical respiratory failure can actively improve patients’respiratory status and lung function,reduce complications,and satisfy patients.

关键词： critical respiratory failure Humanized quality nursing Nursing satisfaction

Gastrointestinal manifestations of critical ill heatstroke patients and their associations with outcomes:A multicentre,retrospective,observational study

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World Journal of Gastroenterology 2024年第4期30卷 346-366页

作者： Yu-Cong Wang Xin-Yang Jin Zheng Lei Xiao-Jiao Liu Yu Liu Bang-Guo Zhang Jian Gong Lie-Tao Wang Lv-Yuan Shi Ding-Yuan Wan Xin Fu Lu-Ping Wang Ai-Jia Ma Yi-Song Cheng Jing Yang Min He Xiao-Dong Jin Yan Kang Bo Wang Zhong-Wei Zhang Qin Wu Department of critical care Medicine West China HospitalSichuan UniversityChengdu 610041Sichuan ProvinceChina School of Pharmacy Macao University of Science and TechnologyMacao 999078China Department of critical care Medicine The First People's Hospital of Ziyang CityZiyang 641399Sichuan ProvinceChina Department of critical care Medicine The First People's Hospital of Guanghan CityChengdu 618399Sichuan ProvinceChina Department of critical care Medicine Lezhi County Traditional Chinese Medicine HospitalChengdu 641599Sichuan ProvinceChina Department of critical care Medicine Chengdu Qingbaijiang District People's HospitalChengdu 610399Sichuan ProvinceChina Department of critical care Medicine Ziyang People's HospitalChengdu 641399Sichuan ProvinceChina

BACKGROUND Extreme heat exposure is a growing health problem,and the effects of heat on the gastrointestinal(GI)tract is unknown.This study aimed to assess the incidence of GI symptoms associated with heatstroke and its impact on outcomes.AIM To assess the incidence of GI symptoms associated with heatstroke and its impact on outcomes.METHODS Patients admitted to the intensive care unit(ICU)due to heatstroke were included from 83 centres.Patient history,laboratory results,and clinically relevant outcomes were recorded at ICU admission and daily until up to day 15,ICU discharge,or death.GI symptoms,including nausea/vomiting,diarrhoea,flatulence,and bloody stools,were recorded.The characteristics of patients with heatstroke concomitant with GI symptoms were described.Multivariable regression analyses were performed to determine significant predictors of GI symptoms.RESULTS A total of 713 patients were included in the final analysis,of whom 132(18.5%)patients had at least one GI symptom during their ICU stay,while 26(3.6%)suffered from more than one symptom.Patients with GI symptoms had a significantly higher ICU stay compared with those without.The mortality of patients who had two or more GI symptoms simultaneously was significantly higher than that in those with one GI symptom.Multivariable logistic regression analysis revealed that older patients with a lower GCS score on admission were more likely to experience GI symptoms.CONCLUSION The GI manifestations of heatstroke are common and appear to impact clinically relevant hospitalization outcomes.

关键词： Extreme heat Flatulence Sunstroke Intensive care units Diarrhea

Prognostic value of time-varying dead space estimates in mechanically ventilated patients with acute respiratory distress syndrome

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Journal of Intensive Medicine 2024年第2期4卷 187-193页

作者： Lianlian Jiang Hui Chen Jianfeng Xie Ling Liu Yi Yang Jiangsu Provincial Key Laboratory of critical care Medicine Department of Critical Care MedicineZhongda HospitalSchool of MedicineSoutheast UniversityNanjingJiangsuChina Department of critical care Medicine The First Affiliated Hospital of Soochow UniversitySoochow UniversitySuzhouJiangsuChina

Background The dead space fraction(VD/VT)has proven to be a powerful predictor of higher mortality in acute respiratory distress syndrome(ARDS).However,its measurement relies on expired carbon dioxide,limiting its widespread application in clinical practice.Several estimates employing routine variables have been found to be reliable substitutes for direct measurement of VD/VT.In this study,we evaluated the prognostic value of these dead space estimates obtained in the first 7 days following the initiation of ventilation.Methods This retrospective observational study was conducted using data from the Chinese database in intensive care(CDIC).Eligible participants were adult ARDS patients receiving invasive mechanical ventilation while in the intensive care unit between 1st January 2014 and 31st March 2021.We collected data during the first 7 days of ventilation to calculate various dead space estimates,including ventilatory ratio(VR),corrected minute ventilation(V_(Ecorr)),VD/VT(Harris–Benedict),VD/VT(Siddiki estimate),and VD/VT(Penn State estimate)longitudinally.A time-dependent Cox model was used to handle these time-varying estimates.Results A total of 392 patients(median age 66[interquartile range:55–77]years,median SOFA score 9[interquartile range:7–12])were finally included in our analysis,among whom 132(33.7%)patients died within 28 days of admission.VR(hazard ratio[HR]=1.04 per 0.1 increase,95%confidence interval[CI]:1.01 to 1.06;P=0.013),V_(Ecorr)(HR=1.08 per 1 increase,95%CI:1.04 to 1.12;P1.3,V_(Ecorr)>7.53,and VD/VT(Harris–Benedict)>0.59 was independently

关键词： Acute respiratory distress syndr ome Mechanical ventilation Dead space 28-day mortality