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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

Optimizing artificial intelligence in sepsis management: Opportunities in the present and looking closely to the future

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Journal of intensive medicine 2024年第1期4卷 34-45页

作者： Darragh O’Reilly Jennifer McGrath Ignacio Martin-Loeches Department of intensive care medicine Multidisciplinary Intensive Care Research Organization(MICRO)St James’HospitalDublinIreland Department of Respiratory intensive care Hospital ClinicUniversitat de BarcelonaIDIBAPSCIBERESBarcelonaSpain

Sepsis remains a major challenge internationally for healthcare *** incidence is rising due to poor public awareness and delays in its recognition and subsequent *** sepsis,mortality increases with every hour left *** intelligence(AI)is transforming worldwide healthcare delivery at *** review has outlined how AI can augment strategies to address this global disease *** and machine learning(ML)algorithms can analyze vast quantities of increasingly complex clinical datasets from electronic medical records to assist clinicians in diagnosing and treating sepsis earlier than traditional *** review highlights how these models can predict the risk of sepsis and organ failure even before it *** gives providers additional time to plan and execute treatment plans,thereby avoiding increasing complications associated with delayed diagnosis of *** potential for cost savings with AI implementation is also discussed,including improving workflow efficiencies,reducing administrative costs,and improving healthcare *** these advantages,clinicians have been slow to adopt AI into clinical *** of the limitations posed by AI solutions include the lack of diverse data sets for model building so that they are widely applicable for routine clinical ***,the subsequent algorithms are often based on complex mathematics leading to clinician hesitancy to embrace such ***,we highlight the need for robust political and regulatory frameworks in this area to achieve the trust and approval of clinicians and patients to implement this transformational technology。

关键词： Artificial intelligence Data science Machine learning intensive care unit(ICU) Critical care Sepsis

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

A Retrospective Analysis of Intoxicated Patients Admitted to the intensive care Unit: A Single-Institution Assessment in the Post-Pandemic Period

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Journal of Biosciences and medicines 2024年第3期12卷 159-167页

作者： Müge Arikan Abdullah Yeşilkaya Büşra Nur Taşdelen İbrahim Özyiğit Department of Anesthesia and intensive care Faculty of Medicine Karabuk University Karabuk Turkey

Background: The aim of this study was to evaluate the clinical and epidemiological characteristics of patients with acute intoxication admitted to the intensive care Unit (ICU). Material and Methods: An observational retrospective study was conducted on intoxicated patients who admitted to ICU between January 2022 and January 2024. Data were collected from the patients medical records. The demographic characteristics, causes of intoxications, clinical parameters, the mean stay in the ICU, treatment modalities and prognosis were recorded. Results: A total of 2875 critically ill patients were admitted during the study period, and 109 (3.79%) of them were acute intoxications. Their mean of ages was 38.09 ± 12.29. The female-to-male ratio was 1.37/1. Drugs were found to be the primary cause (62.39%) of intoxications, and analgesics, antidepressants, and antibiotics were the most frequent agents. Suicidal attempts were present in 66 patients, most of them were female (62.13%) and between 17 - 24 years (40.91%). The other common causes of intoxications were carbon monoxide (CO) (22.02%), methyl/ethyl alcohol (8.26%) and mushroom (5.50%). The mean stay in the ICU was 2.69 ± 0.89 days. Mechanical ventilation was applied to 10 of our patients. Renal replacement therapy was required in 6 patients. Despite all treatments, 6 of our patients died, and we found the mortality rate to be 5.50%. Conclusion: Intoxications were more frequent in young female patients and drugs were the most common cause with suicidal intent. Unfortunately, CO poisoning continues to be a very important problem in our city. These findings provided significant information about the characteristics of intoxications in Karabuk.

关键词： Intoxication intensive care Unit Suicidal Mortality

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

Implementation of gastrointestinal function protection in severe acute pancreatitis

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Hepatobiliary & Pancreatic Diseases International 2024年第5期23卷 521-522页

作者： Fu-Zheng Tao Rong-Lin Jiang Shui-Fang Jin intensive care Unit Taizhou Integrated Traditional Chinese and Western Medicine HospitalTaizhou 310075China intensive care Unit the First Affiliated Hospital of Zhejiang Chinese Medical University(Zhejiang Provincial Hospital of Chinese Medicine)Hangzhou 310006China

Severe acute pancreatitis(SAP)is a serious systemic disease associated with strong local inflammatory reactions and serious systemic pathophysiological disorders caused by trypsin *** with SAP are prone to exhibit gastrointestinal ***,gastrointestinal dysfunction further aggravates the systemic inflammatory response and metabolic abnormalities,resulting in a more critical condition of *** dysfunction is considered to be the“trigger”of multiple organ dysfunction syndrome[1].Thus,it is important to maintain gastrointestinal homeostasis in the treatment of SAP.

关键词： gastrointestinal pancreatitis acute

Advancing understanding and management of invasive fungal diseases in the intensive care unit: Insights from FUNDICU consensus definitions

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重症医学（英文） 2024年第4期04卷 482-483页

作者： Martin-Loeches Ignacio Department of intensive care medicine Multidisciplinary Intensive Care Research Organization (MICRO) St James’ Hospital Dublin Ireland Hospital Clinic Universitat de Barcelona IDIBAPS CIBERES Barcelona Spain

Invasive fungal diseases(IFDs)are increasingly relevant in critical care medicine.[1]Due to the population being admitted to an intensive care unit(ICU),the type of patient has significantly changed over the last two decades.[2]More often,patients affected by comorbid conditions are candidates for being admitted to an *** are mainly two sources of patients.

关键词： admitted unit diseases

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

Quality of life and functional capacity in patients after cardiac surgery intensive care unit

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World Journal of Cardiology 2024年第8期16卷 436-447页

作者： Vasiliki Raidou Katerina Mitete Christos Kourek Michael Antonopoulos Theodora Soulele Kyriaki Kolovou Ioannis Vlahodimitris Ioannis Vasileiadis Stavros Dimopoulos Clinical Ergospirometry Exerciseand Rehabilitation LaboratoryDepartment of First Critical Care MedicineEvangelismos HospitalNational and Kapodistrian University of AthensAthens 10676Greece Cardiac Surgery intensive care Unit Onassis Cardiac Surgery CenterAthens 17674Greece

Coronary heart disease and aortic stenosis are prevalent cardiovascular diseases worldwide,leading to morbidity and *** artery bypass grafting(CABG)and surgical aortic valve replacement(SAVR)have therapeutic benefits,including improved postoperative quality of life(QoL)and enhanced patient functional capacity which are key indicators of cardiac surgery *** this article,we review the latest studies of QoL outcomes and functional capacity in patients who underwent cardiac *** standardized instruments are used to evaluate QoL and functional *** health status,age,length of intensive care unit stay,operative risk,type of procedure,and other pre-,intra-,and postoperative factors affect postoperative *** patients experience impaired physical status soon after cardiac surgery,but it improves in the following *** and SAVR are associated with increases of physical and mental health and functional capacity in the immediate postoperative and the long *** rehabilitation improves patient functional capacity,QoL,and frailty following cardiac surgery.

关键词： Quality of life Health-related quality of life Functional capacity Cardiac rehabilitation Cardiac surgery Coronary artery bypass grafting Heart valve surgery Heart valve replacement

New strategy for distal limb perfusion in veno-arterial extracorporeal membrane oxygenation treatment: application of continuous renal replacement therapy tubing

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World Journal of Emergency medicine 2024年第4期15卷 311-312页

作者： Zhaokun Fan Zhirong Zhang Department of intensive care Unit the First Affiliated Hospital of Zhejiang Chinese Medical University(Zhejiang Provincial Hospital of Chinese Medicine)Hangzhou 310006China

Extracorporeal membrane oxygenation(ECMO)is a technology that can temporarily take over the functions of the heart and *** kidney injury is a common issue in patients receiving ECMO treatment,with reported incidence rates ranging from 70%to 85%.[1]To maintain the balance of fluids and electrolytes in patients,continuous renal replacement therapy(CRRT)is frequently employed.

关键词： Acute treatment perfusion