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Effects of nursing team communication and collaboration on treatment outcomes in intensive care unit patients with severe pneumonia

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World Journal of Clinical Cases 2024年第20期12卷 4166-4173页

作者： Xi-Fang Wei Ting Zhu Qiao Xia Department of intensive care Medicine The first People’s Hospital of Jiangxia DistrictUnion Jiangnan Hospital Huazhong University of Science and TechnologyWuhan 430200Hubei ProvinceChina Respiratory and Critical care Medicine The first People’s Hospital of Jiangxia DistrictUnion Jiangnan Hospital Huazhong University of Science and TechnologyWuhan 430200Hubei ProvinceChina

bACKGROUND Severe pneumonia is a common severe respiratory infection worldwide,and its treatment is challenging,especially for patients in the intensive care unit(ICU).AIM To explore the effect of communication and collaboration between nursing teams on the treatment outcomes of patients with severe pneumonia in *** We retrospectively analyzed 60 patients with severe pneumonia who were treated at the ICU of the hospital between January 1,2021 and December 31,*** compared and analyzed the respiratory mechanical indexes[airway resistance(Raw),mean airway pressure(mPaw),peak pressure(PIP)],blood gas analysis indexes(arterial oxygen saturation,arterial oxygen partial pressure,and oxygenation index),and serum inflammatory factor levels[C-reactive protein(CRP),procalcitonin(PCT),cortisol(COR),and high mobility group protein b1(HMGb1)]of all patients before and after *** before treatment,there was no significant difference in respiratory mechanics index and blood gas analysis index between 2 groups(P>0.05).However,after treatment,the respiratory mechanical indexes of patients in both groups were significantly improved,and the improvement of Raw,mPaw,plateau pressure,PIP and other indexes in the combined group after communication and collaboration with the nursing team was significantly better than that in the single care group(Pb1 before and after treatment were also significantly decreased between the two *** The communication and collaboration of the nursing team have a significant positive impact on respiratory mechanics indicators,blood gas analysis indicators and serum inflammatory factor levels in the treatment of severe pneumonia patients in ICU.

关键词： intensive care unit Severe pneumonia Nursing team Communication and collaboration Respiratory mechanics indicators blood gas analysis indicators Serum inflammatory factors

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Lipid infusion and intravenous access in newborn infants

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Chinese Medical Journal 2010年第20期123卷 2766-2768页

作者： Dominique Haumont neonatal intensive care unit Saint-Pierre University Hospital Rue Haute 322 B 1000 Brussels Belgium

The spectacular development of neonatal intensive care since the 1960s allowed a drop in neonatal mortality of very-low-birth-weight （VLbW） infants from 50% to less than 15% in the last decade.

关键词： lipid infusion intravenous access newborn infant

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中国非儿童癌症患者脓毒血症流行情况及地域分布:一项全国横断面研究

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Science bulletin 2024年第11期69卷 1637-1641页

作者：陆斌胥洋李娜周月阳马旭东陈燕董润周翔代敏陈宏达翁利杜斌中国国家重症医学质控中心和中国重症医学临床试验组 Center for Prevention and Early Intervention National Infrastructures for Translational MedicineInstitute of Clinical MedicinePeking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100730China Department of Cancer Epidemiology National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100021China Department of Pharmacy Administration and Clinical Pharmacy School of Pharmaceutical SciencesPeking University Health Science CenterBeijing 100191China Department of Medical Epidemiology and biostatistics Karolinska InstitutetStockholm 17177Sweden Department of Medical Administration National Health Commission of the People’s Republic of ChinaBeijing 100044China Medical intensive care unit State Key Laboratory of Complex Severe and Rare DiseasesPeking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100730China intensive care unit 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

Cancer poses a major public health burden worldwide,with approximately 18,094,716 newly diagnosed cases and 9,894,402 cancer-related deaths in 2020[1].Infections such as sepsis are among the leading causes of death in... 详细信息

关键词：脓毒血症横断面研究 death 地域分布

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Inhibition of microRNA-29b suppresses oxidative stress and reduces apoptosis in ischemic stroke

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Neural Regeneration Research 2022年第2期17卷 433-439页

作者： Yao-Hua Ma Wen-Jing Deng Zhi-Yi Luo Jing Jing Peng-Wei Pan Yao-bing Yao Yan-bo Fang Jun-Fang Teng Neurological intensive care unit the First Affiliated Hospital of Zhengzhou UniversityZhengzhouHenan ProvinceChina

MicroRNAs(miRNAs) regulate protein expression by antagonizing the translation of mRNAs and are effective regulators of normal nervous system development, function, and disease. Micro RNA-29 b(mi R-29 b) plays a broad and critical role in brain homeostasis. In this study, we tested the function of mi R-29 b in animal and cell models by inhibiting mi R-29 b expression. Mouse models of middle cerebral artery occlusion were established using the modified Zea-Longa suture method. Prior to modeling, 50 nmol/kg mi R-29 b antagomir was injected via the tail vein. Mi R-29 b expression was found to be abnormally increased in ischemic brain tissue. The inhibition of mi R-29 b expression decreased the neurological function score and reduced the cerebral infarction volume and cell apoptosis. In addition, the inhibition of mi R-29 b significantly decreased the malondialdehyde level, increased superoxide dismutase activity, and bcl-2 expression, and inhibited bax and Caspase3 expression. PC12 cells were treated with glutamate for 12 hours to establish in vitro cell models of ischemic stroke and then treated with the mi R-29 antagomir for 48 hours. The results revealed that mi R-29 b inhibition in PC12 cells increased bcl-2 expression and inhibited cell apoptosis and oxidative damage. These findings suggest that the inhibition of mi R-29 b inhibits oxidative stress and cell apoptosis in ischemic stroke, producing therapeutic effects in ischemic stroke. This study was approved by the Laboratory Animal care and Use Committee of the First Affiliated Hospital of Zhengzhou University(approval No. 201709276 S) on September 27, 2017.

关键词： Akt apoptosis cerebral artery occlusion ischemic stroke malondialdehyde microRNA-29b oxidative stress PI3K superoxide dismutase

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Axon regeneration impediment: the role of paired immunoglobulin-like receptor b

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Neural Regeneration Research 2015年第8期10卷 1338-1342页

作者： Jing Liu Yan Wang Wei Fu neonatal intensive care Center BAYI Children’s Hospital Beijing Military General Hospital of Chinese PLA Graduate School Southern Medical University

Regenerative capacity is weak after central nervous system injury because of the absence of an enhancing microenvironment and presence of an inhibitory microenvironment for neuronal and axonal repair. In addition to the Nogo receptor（Ng R）, the paired immunoglobulin-like receptor b（Pir b） is a recently discovered coreceptor of Nogo, myelin-associated glycoprotein, and myelin oligodendrocyte glycoprotein. Concurrent blocking of Ng R and Pir b almost completely eliminates the inhibitory effect of myelin-associated inhibitory molecules on axonal regeneration. Pir b participates in a key pathological process of the nervous system, specifically axonal regeneration inhibition. Pir b is an inhibitory receptor similar to Ng R, but their effects are not identical. This study summarizes the structure, distribution, relationship with common nervous system diseases, and known mechanisms of Pir b, and concludes that Pir b is also distributed in cells of the immune and hematopoietic systems. Further investigations are needed to determine if immunomodulation and blood cell migration involve inhibition of axonal regeneration.

关键词： nerve regeneration brain injury paired immunoglobulin-like receptor b myelin inhibi-tory molecule axons regeneration Rho-ROCK signaling pathway NSFC grant neural regeneration

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Serial physical examinations, a simple and reliable tool for managing neonates at risk for early-onset sepsis

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World Journal of Clinical Pediatrics 2016年第4期5卷 358-364页

作者： Alberto berardi Anna Maria buffagni Cecilia Rossi Eleonora Vaccina Chiara Cattelani Lucia Gambini Federica baccilieri Francesca Varioli Fabrizio Ferrari neonatal intensive care unit Department of Mother and Child Policlinic University Hospital neonatal intensive care unit Department of Obstetric and Pediatric Arcispedale Santa Maria Nuova

AIM To investigate whether serial physical examinations(SPEs) are a safe tool for managing neonates at risk for early-onset sepsis(EOS). METHODS This is a retrospective cohort study of neonates(≥ 34 wks' gestation) delivered in three high-volume level Ⅲbirthing centres in Emilia-Romagna(Italy) during a 4-mo period(from September 1 to December 31, 2015). Neonates at risk for EOS were managed according to the SPEs strategy, these were carried out in turn by bedside nursing staff and physicians. A standardized form detailing general wellbeing, skin colour and vital signs was filled in and signed at standard intervals(at age 3, 6, 12, 18, 36 and 48 h) in neonates at risk for EOS. Three independent reviewers reviewed all charts of neonates and abstracted data(gestational age, mode of delivery, group b streptococcus status, risk factors for EOS, duration of intrapartum antibiotic prophylaxis, postpartum evaluations, therapies and outcome). Rates of sepsis workups, empirical antibiotics and outcome of neonates at-risk(or not) for EOS were *** There were 2092 live births and 1 culture-proven EOS(Haemophilus i)(incidence rates of 0.48/1000 live births). Most newborns with signs of illness(51 out of 101, that is 50.5%), and most of those who received postpartum antibiotics(17 out of 29, that is 58.6%) were not at risk for EOS. Compared to neonates at risk, neonates not at risk for EOS were less likely to have signs of illness(51 out of 1442 vs 40 out of 650, P = 0.009) or have a sepsis workup(25 out of 1442 vs 28 out of 650, P biotics(17 out of 1442 vs 12 out of 650, P = 0.3). Thirty-two neonates were exposed to intrapartum fever or chorioamnionitis: 62.5%(n = 20) had a sepsis workup and 21.9%(n = 7) were given empirical antibiotics. Among 216 neonates managed through the SPEs strategy, only 5.6%(n = 12) had subsequently a sepsis workup and only 1.9%(n = 4) were given empirical antibiotics. Al

关键词： Sepsis Group b streptococcus Intrapartum antibiotic prophylaxis Newborn Prevention

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Caffeine therapy in preterm infants

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World Journal of Clinical Pediatrics 2015年第4期4卷 81-93页

作者： Hesham Abdel-Hady Nehad Nasef Abd Elazeez Shabaan Islam Nour neonatal intensive care unit Mansoura University Children's Hospital

Caffeine is the most commonly used medication for treatment of apnea of prematurity. Its effect has been well established in reducing the frequency of apnea, intermittent hypoxemia, and extubation failure in mechanically ventilated preterm infants. Evidence for additional short-term benefits on reducing the incidence of bronchopulmonary dysplasia and patent ductus arteriosus has also been suggested. Controversies existamong various neonatal intensive care units in terms of drug efficacy compared to other methylxanthines, dosage regimen, time of initiation, duration of therapy, drug safety and value of therapeutic drug monitoring. In the current review, we will summarize the available evidence for the best practice in using caffeine therapy in preterm infants.

关键词： Apnea Caffeine Preterm Methylxanthines

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Lactate -asuicide mode or survival kit

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中国病理生理杂志 2001年第11期 60-61页

作者： Iqbal Mustafa MD FCCM intensive care unit National Cardiac Center Jakarta Indonesia

Cellular energy status is often believed to be crucial in the patho physiology of severe acute diseases involving sepsis or trauma such as multiorgan failure, mu ltiorgan dysfunction syndrome, systemic inflammatory response system, etc. Wit h this in mind increased blood lactate, mainly considered only as a marker or t issue hypoxia is a classical tool used to assess the severity of the illness an d to predict the pejorative outcome. However, during the past years the actual r ole of hypoxia in the pathophysiology of such acute diseases with an increased b lood lactate has been questioned. The association between increased blood lactate concentration and poor prognosi s in ICU patients is well documented but it is clearly not a cause-effect relat ionship. It is similar to what occurs in the case of increased blood ketone I n severe insulin deficient state and it would be a major understanding to be lieve that lactate is a toxic compound in acute states. In acute illness, incre ased lactate concentration or lactate metabolism can be due to the combination of various origin in which the role of splanchnic bed is prominent. In the case of strong reduction in oxygen delivery, such as severe shock, it is quite clear that there is a relationship between cellular energy defect and increased lact ate production. but even in these cases a decrease in lactate metabolism (eithe r oxidative or recycling routes) may also be involved. In septic states, the ro le of blood lactate is a matter of controversy and several reports have e mphasiz ed the fact that hyperlactatemia in sepsis was not due to the oxygen d eficit. It has been shown that mild hyperlactatemia in stable septic patients was due to an impaired lactate clearance rather than overproduction. besides the main conc lusion that any therapeutic attempts to increase oxygen delivery in such situa tion may not be adapted, another point can be raised concerning the meaning of s uch lactate increase. In fact, increased blood l

关键词： mode Lactate asuicide mode or survival kit

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Epidemic to Different Strains of SERRATIA: Experience of neonatal intensive care unit: About 30 Cases

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Open Journal of Pediatrics 2023年第2期13卷 253-261页

作者： Fatima-Ezzahra Tahiri Abdessamad Lalaoui Hasna Rafi Fatiha bennaoui Nadia El Idrissi Slitine Nabila Soraa Fadl Marabih Rabou Maoulainine neonatal intensive care unit CHU Mohammed VI Marrakech Morocco Health Childhood and Development Faculty of Medicine Research Team Cadi Ayyad University Marrakech Morocco Microbiology Department CHU Mohammed VI Marrakech Morocco

Serratia is an opportunistic pathogenic bacterium of the Enterobacteriaceae family, occasionally responsible for epidemics of nosocomial infections in critical departments;in particular in neonatal intensive care units Enterobacteriaceae form a large family of Gram-negative bacteria, which cause diseases of highly variable severity, due to distinct pathogenic mechanisms. This family is heterogeneous as it consists of about 30 genera of bacteria and more than 100 species. However, all these germs have in common their preferential location in the digestive system, some being part of the normal flora although they are also present in the environment. Several metabolic processes characterize this bacterial family. These include the ability to reduce nitrate to nitrite (for energy generation), ferment glucose, lack cytochrome oxidase, be aerobic or anaerobic, motile or immobile, … Enterobacteriaceae constitute more than 80% of the germs isolated in the laboratory: Escherichia, Salmonella, Shigella, Klebsiella, Enterobacter, Serratia, Proteus, Morganella and Yersinia are the rods most often found. Regarding nosocomial infection to Serratia, this bacterium colonizes the respiratory, digestive and urinary systems of patients, mainly responsible for bacteremia, infections of the lower respiratory tract, urinary and skin infections. Through our work, we report the epidemic experienced in the neonatal intensive care unit MOHAMMED VI university hospital, mother-child hospital MARRAKECH MOROCCO for three months from December at February 2023 interesting 30 newborns whose clinical presentation was different, the positive diagnosis was based on blood and geographical samples taken by the bacteriology department to isolate the offending germs, the therapeutic management of our patients consisted essentially of various hygiene measures in association with dual antibiotic therapy based on meropenem and amikacin. The evolution was marked by the death of 21 patients (70%) and the recov

关键词： Epidemic neonatal Resuscitation Nosocomial Infection Serratiamarcesens Serratiaureitylica Serratia Nematodiphila Antibiotic Resistance

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Magnesium sulfate and fetal neuroprotection: overview of clinical evidence

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Neural Regeneration Research 2018年第12期13卷 2044-2049页

作者： Clément Chollat Stéphane Marret Institut National de la Santé et de la Recherche Médicale U1245 Genetics and Pathophysiology of Neurodevelopmental Disorders Team 4Neovasc Institute of Research and Innovation in Biomedicine Rouen School of Medicine Normandy University Department of neonatal intensive care Port Royal University Hospital Department of neonatal Pediatrics and intensive care and Neuropediatrics Charles-Nicolle University Hospital

Antenatal administration of magnesium sulfate is an important part of the neuroprotective strategy for preterm infants. Strong evidence from five randomized controlled trials and five meta-analyses has demonstrated that magnesium sulfate, when administered before preterm delivery, significantly reduces the risk of cerebral palsy at two years. Through secondary analyses of randomized controlled trials and other original clinical studies, this state-of-the-art review highlights the absence of serious adverse effects in both pregnant women and neonates, as well as the impact of maternal body mass index and preeclamptic status on the maternal and neonatal magnesium levels, which could influence the magnitude of the neuroprotective effect. Although antenatal magnesium sulfate is a cost-effective strategy, some practice surveys have demonstrated that the use of magnesium sulfate is not sufficient and that its use is heterogeneous, differing among different maternity wards. Since 2010, an increasing number of obstetrical societies have recommended its use to improve the neurological outcomes of preterm infants, especially the International Federation of Gynecology and Obstetrics and World Health Organization in 2015, and France in 2017. Considering the neuroprotective impact of magnesium sulfate when administered before delivery, postnatal administration should be considered, and its effects should be assessed using randomized controlled trials.

关键词： magnesium sulfate preterm birth neuroprotection cerebral palsy neurodevelopment international recommendations clinical studies meta-analysis preeclampsia cost-effectiveness

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