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Optimal indicator for changing the filter during the continuous renal replacement therapy in intensive care unit patients with acute kidney injury:A crossover randomized trial

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World Journal of Emergency Medicine 2022年第3期13卷 196-201页

作者： Cheng Hang Li-jun Liu Zhao-yun Huang Jian-liang Zhu Bao-chun Zhou Xiao-zhen Li intensive care unit Kunshan Hospital of TCMSuzhou 215300China intensive care unit the Second Affiliated Hospital of Soochow UniversitySuzhou 215004China

BACKGROUND:The study aims to investigate an optimal indicator for changing the filter during the continuous renal replacement therapy(CRRT)in intensive care unit(ICU)patients with acute kidney injury(AKI).METHODS:Patients with AKI requiring CRRT in an ICU were randomly divided into two groups for crossover trial,i.e.,groups A and *** in the group A were firstly treated with continuous veno-venous hemofiltration(CVVH),followed by continuous veno-venous hemodiafiltration(CVVHDF).Patients in the group B were firstly treated with CVVHDF followed by *** doses of solutes with different molecular weights at the indicated time points between groups were compared.A correlation analysis between the delivered dose and pre-filter pressure(P_(PRE))and transmembrane pressure(P_(TM))was *** operating characteristic(ROC)curves were constructed to evaluate the accuracy of P_(TM) as an indicator for filter ***:A total of 50 cases were analyzed,27 in the group A and 23 in the group *** doses of different molecular-weight solutes significantly decreased before changing the filter in both modalities,compared with those at the initiation of treatment(all P<0.05).In the late stage of CRRT,the possible rebound of serum medium-molecular-weight solute concentration was observed.P_(TM) was negatively correlated with the delivered dose of medium-molecular-weight solute in both *** threshold for predicting the rebound of serum concentration of medium-molecularweight solute by P_(TM) was 146.5 mm Hg(1 mm Hg=0.133 k Pa).CONCLUSIONS:The filter can be used as long as possible within the manufacturer’s safe use time limits to remove small-molecular-weight solutes.P_(TM) of 146.5 mm Hg may be an optimal indicator for changing the filter in CRRT therapies to remove medium-molecular-weight solutes.

关键词： Acute kidney injury Continuous renal replacement therapy Solute removal efficiency Delivered dose

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Clinical and Microbiological Characteristics of Patients with Complicated Intra-abdominal Infections in intensive care unit

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Current Medical Science 2020年第1期40卷 104-109页

作者： Yang-mei XIONG Xin RAO Department of intensive care unit Zhongnan Hospital of Wuhan UniversityWuhan 430071China

In order to investigate the clinical and microbiological characteristics of patients with complicated intra-abdominal infections(cIAIs)in intensive care unit(ICU),the clinical data of 612 cIAIs patients from January 2016 to December 2018 were retrospectively *** characteristics,distribution of pathogens and drug resistance were statistically *** was found that patients with community-acquired intra-abdominal infections(CA-IAIs)made up a majority of cIAIs *** positive rate of abdominal drainage fluid culture was 55.56%.Gramnegative bacteria accounted for the majority,the most commonly isolated bacteria of which were Escherichia coli(20.96%),Klebsiella pneumoniae(10.20%)and Pseudomonas aeruginosa(5.57%).The most commonly isolated gram-positive bacteria were Enterococcus(16.88%)and Methicillinresistant staphylococcus aureus(MRSA,3.90%).Enterobacter isolates showed high resistance rate to most cephalosporins and low resistance rate to piperacillin/tazobactam and *** spectrum beta-lactamase(ESBL)screen positive isolates from CA-IAIs patients showed an increasing trend in past three *** and MRSA showed high resistance rate to clindamycin,quinolone,erythromycin and tetracycline,while they showed high sensitivity rate to linezolid,tegacycline,teicoplanin and *** results indicate that isolated bacteria from abdominal drainage fluid show high resistance rates to commonly used antibiotics in ICU patients with *** curative effects on diseases should be monitored continuously when antibiotics are ***,we should always keep eyes on drug-resistant bacteria,especially when the treatment efficacy is not good.

关键词： complicated intra-abdominal infection pathogens extended spectrum beta-lactamase screen positive isolates resistance rate

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Effects of strengthening prospective nursing practice on sleep quality,anxiety,and depression of awake patients in intensive care unit

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World Journal of Psychiatry 2024年第5期14卷 735-741页

作者： Fei Lin Lei Liu Department of intensive care unit Dushu Lake Hospital Affiliated to Soochow UniversitySuzhou 215000Jiangsu ProvinceChina

BACKGROUND The intensive care unit(ICU)is a specialized hospital *** patients in the ICU frequently encounter adverse psychological states,such as anxiety and fear,often accompanied by poor sleep *** situation has garnered significant attention within the medical *** To investigate the impact of prospective nursing intervention strategies on the sleep quality and negative emotional state of conscious ICU *** One hundred and twenty ICU awake patients admitted to our hospital were selected and randomly divided into control(n=60)and observation(n=60)*** in the control group were cared for using the conventional nursing model,while patients in the observation group were cared for using the prospective nursing *** improvement was assessed using the International Standardized Sleep Efficiency Formula and Pittsburgh Sleep Quality Index(PSQI).The PSQI,Generalized Anxiety Disorder 7-item(GAD-7)scale,Self-Depression Scale(SDS),and satisfaction before and after treatment were used to assess the negative emotional states of patients under the two care *** Patient satisfaction in the observation group was significantly higher than in the control *** GAD-7 and SDS scores in the observation group were significantly lower than those in the control group,and the total effective rate of sleep improvement in the observation group was significantly higher than in the control *** treatment,the PSQI scores of the two groups significantly decreased(P<0.05).The decrease in the observation group was more significan than that in the control group,and the difference between the two groups was statistically *** Prospective nursing interventions can improve sleep quality and psychological levels and significantly affect conscious patients in the ICU,which is worthy of clinical application.

关键词： Prospective nursing intensive care unit Sobriety Mental health sleep quality Anxiety and depression

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Preventable readmission to intensive care unit in critically ill cancer patients

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World Journal of Emergency Medicine 2018年第3期9卷 211-215页

作者： Hai-jun Wang Yong Gao Shi-ning Qu Chu-lin Huang Hao Zhang Hao Wang Quan-hui Yang Xue-zhong Xing Department of intensive care unit National Cancer Center/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College

BACKGROUND:Readmission to intensive care unit(ICU)after discharge to ward has been reported to be associated with increased hospital mortality and longer length of stay(LOS).The objective of this study was to investigate whether ICU readmission are preventable in critically ill cancer ***:Data of patients who readmitted to intensive care unit(ICU)at National Cancer Center/Cancer Hospital of Chinese Academy of Medical Sciences(CAMS)and Peking Union Medical College(PUMC)between January 2013 and November 2016 were retrospectively collected and ***:A total of 39 patients were included in the final analysis,and the overall readmission rate between 2013 and 2016 was 1.32%(39/2,961).Of 39 patients,32(82.1%)patients were judged as unpreventable and 7(17.9%)patients were *** were no significant differences in duration of mechanical ventilation,ICU LOS,hospital LOS,ICU mortality and in-hospital mortality between patients who were unpreventable and *** 24 early readmission patients,7(29.2%)patients were preventable and 17(70.8%)patients were *** who were late readmission were all *** was a trend that patients who were preventable had longer 1-year survival compared with patients who were unpreventable(100%vs.66.8%,log rank=1.668,P=0.196).CONCLUSION:Most readmission patients were unpreventable,and all preventable readmissions occurred in early period after discharge to *** were no significant differences in short term outcomes and 1-year survival in critically ill cancer patients whose readmissions were preventable or not.

关键词： Readmission Cancer Preventability Outcomes

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Significant risk factors for intensive care unit-acquired weakness:A processing strategy based on repeated machine learning

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World Journal of Clinical Cases 2024年第7期12卷 1235-1242页

作者： Ling Wang Deng-Yan Long intensive care unit People's Hospital of Qiandongnan Miao and Dong Autonomous PrefectureKaili 556000Guizhou ProvinceChina

BACKGROUND intensive care unit-acquired weakness(ICU-AW)is a common complication that significantly impacts the patient's recovery process,even leading to adverse ***,there is a lack of effective preventive *** To identify significant risk factors for ICU-AW through iterative machine learning techniques and offer recommendations for its prevention and *** Patients were categorized into ICU-AW and non-ICU-AW groups on the 14th day post-ICU *** data from the initial 14 d of ICU stay,such as age,comorbidities,sedative dosage,vasopressor dosage,duration of mechanical ventilation,length of ICU stay,and rehabilitation therapy,were *** relationships between these variables and ICU-AW were *** iterative machine learning techniques,a multilayer perceptron neural network model was developed,and its predictive performance for ICU-AW was assessed using the receiver operating characteristic *** Within the ICU-AW group,age,duration of mechanical ventilation,lorazepam dosage,adrenaline dosage,and length of ICU stay were significantly higher than in the non-ICU-AW ***,sepsis,multiple organ dysfunction syndrome,hypoalbuminemia,acute heart failure,respiratory failure,acute kidney injury,anemia,stress-related gastrointestinal bleeding,shock,hypertension,coronary artery disease,malignant tumors,and rehabilitation therapy ratios were significantly higher in the ICU-AW group,demonstrating statistical *** most influential factors contributing to ICU-AW were identified as the length of ICU stay(100.0%)and the duration of mechanical ventilation(54.9%).The neural network model predicted ICU-AW with an area under the curve of 0.941,sensitivity of 92.2%,and specificity of 82.7%.CONCLUSION The main factors influencing ICU-AW are the length of ICU stay and the duration of mechanical ventilation.A primary preventive strategy,when feasible,involves minimizing both ICU stay and mechani

关键词： intensive care unit-acquired weakness Risk factors Machine learning Prevention Strategies

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intensive care unit-acquired weakness: Recent insights

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Journal of intensive Medicine 2024年第1期4卷 73-80页

作者： Juan Chen Man Huang Department of General intensive care unit The Second Affiliated Hospital of Zhejiang University School of MedicineHangzhou 310009ZhejiangChina

intensive care unit-acquired weakness(ICU-AW)is a common complication in critically ill patients and is associated with a variety of adverse *** include the need for prolonged mechanical ventilation and ICU stay;higher ICU,in-hospital,and 1-year mortality;and increased in-hospital ***-AW is associated with multiple risk factors including age,underlying disease,severity of illness,organ failure,sepsis,immobilization,receipt of mechanical ventilation,and other factors related to critical *** pathological mechanism of ICUAW remains unclear and may be considerably *** review aimed to evaluate recent insights into ICU-AW from several aspects including risk factors,pathophysiology,diagnosis,and treatment strategies;this provides new perspectives for future research.

关键词： intensive care unit-acquired weakness Muscle weakness Muscle atrophy Risk factor Mechanism Treatment

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Antibiotic sensitivity pattern of bacterial pathogens in the intensive care unit of Fatmawati Hospital,Indonesia

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Asian Pacific Journal of Tropical Biomedicine 2011年第1期1卷 39-42页

作者： Maksum Radji Siti Fauziah Nurgani Aribinuko Laboratory of Microbiology and Biotechnology Department of PharmacyFaculty of Mathematics and ScienceUniversity of Indonesia Department of intensive care unit Fatmawati Hospital

Objective:To evaluate the sensitivity pattern of bacterial pathogens in the intensive care unit(ICU) of a tertiary care of Falmawati Hospital Jakarta ***:A cross sectional retrospective study of bacterial pathogen was carried out on a total of 722 patients that were admitted to the ICU of Fatmawati Hospital Jakarta Indonesia during January 2009 to March 2010. All bacteria were identified by standard microbiologic methods,and(heir antibiotic susceptibility testing was performed using disk diffusion ***:Specimens were collected from 385 patients who were given antimicrobial treatment,of which 249(64.68%) were cultured positive and 136(35.32%) were *** most predominant isolate was Pseudomonas aeruginosa(***)(26.5%) followed by Klebsiella pneumoniae(***)(15.3%) and Staphylococcus epidermidis(14.9%).*** isolates showed high rate of resistance to cephalexin(95.3%),cefotaxime(64.1%),and ceftriaxone(60.9%).Amikacin was the most effective(84.4%) antibiotic against *** followed by imipenem(81.2%),and meropenem(75.0%).*** showed resistance to cephalexin(86.5%),ceftriaxone(75.7%),ceftazidime(73.0%),cefpirome(73.0%) and cefotaxime(67.9%),***:Most bacteria isolated from ICU of Fatmawati Hospital Jakarta Indonesia were resistant to the third generation of cephalosporins,and quinolone *** surveillance of antibiotic susceptibility pallerns is very important for setting orders to guide the clinician in choosing empirical or directed therapy of infected patients.

关键词： Antibiotic susceptibility intensive care unit Bacterial Resistance Bacterial pathogen Sensitivity pattern Antimicrobial Resistance Pseudomonas aeruginosa Klebsiella pneumoniae Isolate Specimen

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Is every microorganism detected in the intensive care unit a nosocomial infection?Isn’t prevention more important than detection?

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World Journal of Clinical Cases 2022年第20期10卷 7184-7186页

作者： Fatma Yildirim Irem Karaman Mehmet Yildirim Department of Pulmonary Disease and Critical care Medicine Pulmonary Intensive Care UnitUniversity of Health SciencesDışkapıYıldırım Beyazıt Training and Research HospitalAnkara 06110Turkey School of Medicine Bahcesehir UniversityIstanbul 34740Turkey Department of Internal Medicine Internal Medicine Intensive Care UnitUniversity of Health SciencesDışkapıYıldırım Beyazıt Training and Research HospitalAnkara 06110Turkey

The present letter to the editor is related to the study entitled“Multidrug-resistant organisms in intensive care units and logistic analysis of risk factors.”Not every microorganism grown in samples taken from critically ill patients can be considered as an infectious *** and adequate information about nosocomial infections is essential in introducing effective prevention programs in ***,the development and implementation of care bundles for frequently used medical devices and invasive treatment devices(e.g.,intravenous catheters and invasive ventilation),adequate staffing not only for physicians,nurses,and other medical staff but also for housekeeping staff,and infection surveillance and motivational feedback are key points of infection prevention in the intensive care unit.

关键词： Critical care Prevention intensive care unit Nosocomial infection Detection

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Bispectral index in predicting the prognosis of patients with coma in intensive care unit

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World Journal of Emergency Medicine 2014年第1期5卷 53-56页

作者： Lin Dou Hong-mei Gao Ling Lu Wen-xiu Chang intensive care unit Tianjin First Central Hospital

BACKGROUND: The bispectral(BIS) index is a processed electroencephalogram(EEG) parameter with extensive validation and demonstrated clinical utility. The study aimed to investigate the correlation between the BIS index and the prognosis of patients with coma in the ***: A total of 208 patients with coma in the ICU were enrolled in this study. According to the BIS value, the patients were divided into four groups: group I, BIS value 0 to 20; group II, BIS value 21 to 40; group III, BIS value 41 to 60; and group IV, BIS value greater than 60. The difference in BIS values with the differences in prognosis of patients with coma was compared between the four groups, and the prognosis of patients with coma was stratified into consciousness, coma, vegetative state, and brain death. Subsequently, the best cut-off score of BIS values calculated for determining the correlation between BIS value and mental state was ***: There are no significant differences in the age and APACHE II scores between the four groups(P>0.05). An inverse correlation was observed between BIS value and mental state(r= –0.749, P=0.00). According to the ROC curve, as BIS value was greater than 42.5, there were higher sensitivity and specificity in conscious-coma ***: BIS value is correlated with the prognosis of patients with coma in ICU, and BIS value can be a useful marker for estimating the prognosis of comatose patients.

关键词： Bispectral index Coma Prognosis

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Echography in brain imaging in intensive care unit: State of the art

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World Journal of Radiology 2014年第9期6卷 636-642页

作者： Anselmo Caricato Sara Pitoni Luca Montini Maria Grazia Bocci Pina Annetta Massimo Antonelli Department of Anes-thesiology and intensive care Medicine Catholic University of the Sacred Heart "A. Gemelli" Teaching Hospital Intensive Care Unit

Transcranial sonography(TCS)is an ultrasound-based imaging technique,which allows the identification of several structures within the brain *** the past it has been applied for bedside assessment of different intracranial pathologies in ***-ently,TCS is also used on adult patients to diagnose intracranial space occupying lesions of various origins,intracranial hemorrhage,hydrocephalus,midline shift and neurodegenerative movement disorders,in both acute and chronic clinical *** comparison with conventional neuroimaging methods(such as com-puted tomography or magnetic resonance),TCS has the advantages of low costs,short investigation times,repeatability,and bedside *** noninva-sive characteristics,together with the possibility of of-fering a continuous patient neuro-monitoring system,determine its applicability in the monitoring of multiple emergency and non-emergency ***,TCS is a still underestimated imaging modality that requires a wider diffusion and a qualified training *** this review we focused on the main indications of TCSfor the assessment of acute neurologic disorders in in-tensive care unit.

关键词： Brain sonography Transcranial sonography Ultrasounds Cerebral sonography Brain imaging Hy-drocephalus Cerebral hemorrhage

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