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Assessing and improving outcome of quality control of integrated in-hospital emergency department and intensive care unit systems:an eight-year survey in Shanghai

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Assessing and improving outcome of quality control of integr...

Early peripheral perfusion index predicts 28-day outcome in patients with septic shock

中华医学会急诊医学分会第十六次全国急诊医学学术年会

作者： wenfang li zhaofen lin department of emergency and intensive care Unit Changzheng Hospital Second Military Medical University

Objectives Evaluating data of quality control in a large cohort of integrated in-hospital emergency department (ED) and intensive care unit(ICU) projects to improve the outcome of rescue on acutely critical patients. ...

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World Journal of emergency Medicine 2024年第5期15卷 372-378页

作者： Cheng Chi Hao Gong Kai Yang Peng Peng Xiaoxia Zhang department of emergency Peking University People's HospitalBeijing 100044China department of emergency intensive care Unit the First Affi liated Hospital of Xinjiang Medical UniversityUrumqi 830000China

BACKGROUND:To investigate the prognostic value of the peripheral perfusion index(PPI)in patients with septic ***:This prospective cohort study,conducted at the emergency intensive care unit of Peking University People's Hospital,recruited 200 patients with septic shock between January 2023 and August *** patients were divided into survival(n=84)and death(n=116)groups based on 28-day *** evaluations included laboratory tests and clinical scores,with lactate and PPI values assessed upon admission to the emergency room and at 6 h and 12 h after *** factors associated with mortality were analyzed using univariate and multivariate Cox regression *** operator characteristic(ROC)curve was used to assess predictive *** rates were compared,and Kaplan-Meier survival plots were ***:Compared to the survival group,patients in the death group were older and had more severe liver damage and coagulation dysfunction,necessitating higher norepinephrine doses and increased fl uid *** lactate levels and lower PPI levels at 0 h,6 h,and 12 h were observed in the death *** Cox regression identifi ed prolonged prothrombin time(PT),decreased 6-h PPI and 12-h PPI as independent risk factors for *** area under the curves for 6-h PPI and 12-h PPI were 0.802(95%CI 0.742-0.863,P<0.001)and 0.945(95%CI 0.915-0.974,P<0.001),respectively,which were superior to Glasgow Coma Scale(GCS),Sequential Organ Failure Assessment(SOFA)scores(0.864 and 0.928).Cumulative mortality in the low PPI groups at 6 h and 12 h was signifi cantly higher than in the high PPI groups(6-h PPI:77.52%vs.22.54%;12-h PPI:92.04%vs.13.79%,P<0.001).CONCLUSION:PPI may have value in predicting 28-day mortality in patients with septic shock.

关键词： Peripheral perfusion index Septic shock Prognosis Predictive value

Integrated emergency department and general intensive care unit management on health outcomes

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Chinese Medical Journal 2021年第21期134卷 2553-2555页

作者： Shan-Lin Mao Zi Ge Hui Zhao Yan-Xue Wang Jun Cao Zhi-Jie Xia emergency and Acute Critical care department Huashan Hospital NorthFudan UniversityShanghai 201907China

The emergency department(ED)should reliably provide the required medical treatment to patients who are in an emergency or are critically ***,the ED faced two challenges in China.

关键词： China department critically

Opinions and attitudes toward targeted temperature management in the emergency department and intensive care unit in a developing country: a survey study

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World Journal of emergency Medicine 2023年第2期14卷 138-142页

作者： Abdullah Bakhsh Hadeel Alotaibi Sara Alothman Abdulrahman Alothman Rahaf Alothman Abdulrahman Alsulami Malak Alamoudi Ali Alothman Ali Al-Shareef department of emergency Medicine the King Abdulaziz UniversityJeddah 21589Saudi Arabia Faculty of Medicine the King Abdulaziz UniversityJeddah 21589Saudi Arabia department of Anesthesia Intensive Care Unitthe King Abdulaziz UniversityJeddah 21589Saudi Arabia College of Medicine King Saud Bin Abdulaziz University for Health SciencesCollege of MedicineJeddah 21589Saudi Arabia King Abdulaziz Medical City Jeddah 21589Saudi Arabia King Abdullah International Medical Research Center Jeddah 21589Saudi Arabia

INTRODUCTION The past two decades have witnessed one of the most contentious scientific debates in the field of temperature management after cardiac arrest in *** started in 2002,following the publication of two groundbreaking trials showing lower mortality rates and improved neurologic recovery with the use of active cooling.[1,2]International recommendations advocate active cooling in the range of 32–34℃for comatose survivors of out-of-hospital cardiac arrest (OHCA).[3,4]The year2013 marked the tipping point with the release of the TTM 1 trial.

关键词： breaking release showing

Extracorporeal membrane oxygenation as a bridging therapy for patients with thiamine deficiency-induced pulmonary arterial hypertension

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World Journal of emergency Medicine 2024年第2期15卷 147-149页

作者： Fangfang Qiu Weixing Dai Tengyue Huang Min Li department of intensive care Unit the Fourth Affiliated Hospital of Zhejiang University School of MedicineYiwu 322000China department of intensive care Unit the Second Affiliated Hospital of Zhejiang University School of MedicineHangzhou 310009China

Thiamine deficiency is characterized by a deficiency of thiamine(vitamin B1),lactic acidosis,pulmonary arterial hypertension(PAH),right-sided heart failure,and peripheral nerve *** deficiency is easily misdiagnosed and missed during clinical practice and is associated with death in severe cases.[1,2]Here we reported a patient who was admitted to the hospital with severe metabolic acidosis and pulmonary hypertension and finally diagnosed with thiamine deficiency by detecting plasma vitamin B1 *** clinically obvious thiamine deficiency is rare,and cases of thiamine deficiency requiring extracorporeal membrane oxygenation(ECMO)treatment are rarer,we believe that our case will be helpful for emergency clinicians.

关键词： vitamin hypertension arterial

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 *** To investigate the potential association between DF intake and the prevalence of DKD in individuals diagnosed with *** This cross-sectional study used data from the National Health and Nutrition Examination Survey collected between 2005 and *** 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 *** regression analysis was used to assess the association between DF intake and DKD,and comprehensive subgroup and sensitivity analyses were *** Among the 6032 participants,38.4%had *** 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),*** 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 *** 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

High-risk factors for delirium in severely ill patients and the application of emotional nursing combined with pain nursing

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World Journal of Psychiatry 2024年第7期14卷 1027-1033页

作者： Hong-Ru Li Yu Guo emergency intensive care Unit The Fourth Affiliated Hospital of Soochow University(Suzhou Dushu Lake Hospital)Suzhou 215000Jiangsu ProvinceChina

BACKGROUND Delirium is a neuropsychiatric syndrome characterized by acute disturbances of consciousness with rapid onset,rapid progression,obvious fluctuations,and preventable,reversible,and other *** with delirium in the intensive care unit(ICU)are often missed or misdiagnosed and do not receive adequate *** To analyze the risk factors for delirium in ICU patients and explore the applica-tion of emotional nursing with pain nursing in the management of *** General data of 301 critically ill patients were retrospectively collected,including histories(cardiovascular and cerebrovascular diseases,hypertension,smoking,alcoholism,and diabetes),age,sex,diagnosis,whether surgery was performed,and patient origin(emergency/clinic).Additionally,the duration of sedation,Richmond Agitation Sedation Scale score,combined emotional and pain care,ven-tilator use duration,vasoactive drug use,drainage tube retention,ICU stay du-ration,C-reactive protein,procalcitonin,white blood cell count,body tempe-rature,Acute Physiology and Chronic Health Evaluation II(APACHE II)score,and Sequential Organ Failure Assessment score were recorded within 24 h after ICU *** were assessed for delirium according to confusion assessment method for the ICU,and univariate and multivariate logistic regre-ssion analyses were performed to identify the risk factors for delirium in the *** Univariate logistic regression analysis was performed on the 24 potential risk factors associated with delirium in ICU *** results showed that 16 risk factors were closely related to delirium,including combined emotional and pain care,history of diabetes,and patient *** logistic regression analysis revealed that no combined emotional and pain care,history of diabetes,emergency source,surgery,long stay in the ICU,smoking history,and high APACHE II score were independent risk factors for de-lirium in ICU *** Patients

关键词： Critical illness Delirium Risk factor intensive care unit Emotional nursing Pain nursing

A novel predictor of unsustained return of spontaneous circulation in cardiac arrest patients through a combination of capnography and pulse oximetry: a multicenter observational study

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World Journal of emergency Medicine 2024年第1期15卷 16-22页

作者： Jing Yang Hanqi Tang Shihuan Shao Feng Xu Yangyang Fu Shengyong Xu Chen Li Yan Li Yang Liu Joseph Harold Walline Huadong Zhu Yuguo Chen Xuezhong Yu Jun Xu emergency department State Key Laboratory of Complex Severe and Rare DiseasesPeking Union Medical College HospitalChinese Academy of Medical Science and Peking Union Medical CollegeBeijing 100730China emergency department Peking University People’s HospitalBeijing 100044China department of emergency and Chest Pain Center Shandong Provincial Clinical Research Center for Emergency and Critical Care MedicineKey Laboratory of Emergency and Critical Care Medicine of Shandong ProvinceQilu Hospital of Shandong UniversityJinan 250012China emergency department Beijing Jishuitan HospitalBeijing 100035China emergency department Tianjin Medical University General HospitalTianjin 300052China department of emergency Medicine Penn State Health Milton S.Hershey Medical Center and Penn State College of MedicineHershey 17033USA

BACKGROUND:Unsustained return of spontaneous circulation(ROSC)is a critical barrier to survival in cardiac arrest *** study examined whether end-tidal carbon dioxide(ETCO_(2))and pulse oximetry photoplethysmogram(POP)parameters can be used to identify unsustained ***:We conducted a multicenter observational prospective cohort study of consecutive patients with cardiac arrest from 2013 to ***’general information,ETCO_(2),and POP parameters were collected and statistically ***:The included 105 ROSC episodes(from 80 cardiac arrest patients)comprised 51 sustained ROSC episodes and 54 unsustained ROSC *** 24-hour survival rate was significantly higher in the sustained ROSC group than in the unsustained ROSC group(29.2%vs.9.4%,P<0.05).The logistic regression analysis showed that the difference between after and before ROSC in ETCO_(2)(ΔETCO_(2))and the difference between after and before ROCS in area under the curve of POP(ΔAUCp)were independently associated with sustained ROSC(odds ratio[OR]=0.931,95%confi dence interval[95%CI]0.881-0.984,P=0.011 and OR=0.998,95%CI 0.997-0.999,P<0.001).The area under the receiver operating characteristic curve ofΔETCO_(2),ΔAUCp,and the combination of both to predict unsustained ROSC were 0.752(95%CI 0.660-0.844),0.883(95%CI 0.818-0.948),and 0.902(95%CI 0.842-0.962),***:Patients with unsustained ROSC have a poor *** combination ofΔETCO_(2) andΔAUCp showed signifi cant predictive value for unsustained ROSC.

关键词： Return of spontaneous circulation Pulse oximetry photoplethysmogram End-tidal carbon dioxide Cardiac arrest Cardiopulmonary resuscitation

A case of Rickettsia felis infection-induced encephalitis in a pregnant woman

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World Journal of emergency Medicine 2024年第2期15卷 150-152页

作者： Jinghua Qiu Hui Feng Lijun Liu Jianjun Zhu department of emergency and Critical care Medicine the Second Affiliated Hospital of Soochow UniversitySuzhou 215004China

Rickettsia felis is an exclusively cytozoic Gram-negative prokaryote with cat fleas as the major vectors.[1]As early as 1918,Rickettsia felis was detected in cat fleas in Europe and named Rickettsia ctenocephali.[2]Symptoms of fever,malaise,headache,maculopapular rash and eschar are observed in patients with Rickettsia felis infection.

关键词： encephalitis headache infection