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Epidemiology and risk factors for mortality in critically ill patients with pancreatic infection

Journal of Intensive Medicine 2024年第1期4卷 81-93页

作者： Marie Dejonckheere Massimo Antonelli Kostoula Arvaniti Koen Blot Ben CreaghBrown Dylan Wde Lange Jan De Waele Mieke Deschepper Yalim Dikmen George Dimopoulos Christian Eckmann Guy Francois Massimo Girardis Despoina Koulenti Sonia Labeau Jeffrey Lipman Fernando Lipovestky Emilio Maseda Philippe Montravers Adam Mikstacki JoseArtur Paiva Cecilia Pereyra Jordi Rello JeanFrancois Timsit Dirk Vogelaers Stijn Blot the Abdominal Sepsis Study(AbSeS)group on behalf of the Trials group of the European Society of Intensive care Medicine Department of Internal Medicine and Pediatrics Faculty of Medicine and Health SciencesGhent UniversityGhentBelgium Department of Anesthesiology Intensive Care and Emergency MedicineFondazione Policlinico Universitario A.Gemelli IRCCSRomeItaly UniversitàCattolica del Sacro Cuore RomeItaly Intensive care Unit Papageorgiou University Affiliated HospitalThessaloníkiGreece Department of Epidemiology and Public Health SciensanoIxellesBelgium surrey perioperative Anaesthetic critical care collaborative research group(SPACeR) Royal Surrey County HospitalGuildfordUK Department of Clinical and Experimental Medicine University of SurreyGuildfordUK Department of Intensive care Medicine University Medical Center UtrechtUniversity UtrechtUtrechtthe Netherlands Department of Intensive care Medicine Ghent University HospitalGhentBelgium Data Science Institute Ghent University HospitalGhentBelgium Department of Anesthesiology and Reanimation Cerrahpasa School of MedicineIstanbul University-CerrahpasaIstanbulTurkey rd Department of critical care “EVGENIDIO”HospitalNational and Kapodistrian University of AthensAthensGreece Department of General Visceral and Thoracic SurgeryKlinikum Hannoversch-MuendenGoettingen UniversityGöttingenGermany Division of Scientific Affairs-research European Society of Intensive Care MedicineBrusselsBelgium Anesthesia and Intensive care Department University Hospital of ModenaModenaItaly UQ Centre for Clinical research Faculty of MedicineThe University of QueenslandBrisbaneQLDAustralia nd critical care Department Attikon University HospitalAthensGreece Department of Nursing Faculty of EducationHealth and Social WorkUniversity College GhentGhentBelgium Jamieson Trauma Institute The University of QueenslandBrisbaneQLDAustralia Nimes University Hospital University of MontpellierNimesFrance critical care Department Hospital of the Interamerican Open University(UAI)Buenos AiresArgentina Surgical critical care Department of AnesthesiaHospital Universitario

Background:The AbSeS-classification defines specific phenotypes of patients with intra-abdominal infection based on the(1)setting of infection onset(community-acquired,early onset,or late-onset hospital-acquired),(2)presence or absence of either localized or diffuse peritonitis,and(3)severity of disease expression(infection,sepsis,or septic shock).This classification system demonstrated reliable risk stratification in intensive care unit(ICU)patients with intra-abdominal *** study aimed to describe the epidemiology of ICU patients with pancreatic infection and assess the relationship between the components of the AbSeS-classification and ***:This was a secondary analysis of an international observational study(“AbSeS”)investigating ICU patients with intra-abdominal *** patients with pancreatic infection were included in this analysis(n=165).Mortality was defined as ICU mortality within 28 days of observation for patients discharged earlier from the *** with mortality were assessed using logistic regression analysis and reported as odds ratio(OR)and 95%confidence interval(CI).Results:The overall mortality was 35.2%(n=58).The independent risk factors for mortality included older age(OR=1.03,95%CI:1.0 to 1.1 P=0.023),localized peritonitis(OR=4.4,95%CI:1.4 to 13.9 P=0.011),and persistent signs of inflammation at day 7(OR=9.5,95%CI:3.8 to 23.9,P<0.001)or after the implementation of additional source control interventions within the first week(OR=4.0,95%CI:1.3 to 12.2,P=0.013).Gramnegative bacteria were most frequently isolated(n=58,49.2%)without clinically relevant differences in microbial etiology between survivors and ***:In pancreatic infection,a challenging source/damage control and ongoing pancreatic inflammation appear to be the strongest contributors to an unfavorable short-term *** this limited series,essentials of the AbSeS-classification,such as the setting of infection onset,diffuse

关键词： Pancreatic infection Intensive care unit Mortality Intra-abdominal infection Sepsis

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Enhanced recovery for liver resection—early recovery pathway for hepatectomy: data-driven liver resection care and recovery

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Hepatobiliary Surgery and Nutrition 2018年第3期7卷 217-220页

作者： Benjamin Morrison Leigh Kelliher Chris Jones surrey peri-operative anaesthesia and critical care collaborative research group Royal Surrey County Hospital NHS Foundation TrustGuildfordUK

First described as a model for perioperative care in the early 1990's, the success of the enhanced recovery after surgery (ERAS) approach in colorectal surgery has given rise to pathways being developed for an ever-in... 详细信息

关键词： surgery colorectal liver

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Integrated strategies for chemotherapy cycles in nasopharyngeal carcinoma patients: Real-world data from two epidemic centers guiding decision-making

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Chinese Journal of Cancer research 2023年第2期35卷 126-139页

作者： Zejiang Zhan Yingying Huang Jiayu Zhou Zhuochen Cai Haoyang Huang Ying Deng Wenze Qiu Xun Cao Xi Chen Chixiong Liang Lulu Zhang Xiang Guo Taize Yuan Xing Lyu Department of Nasopharyngeal Carcinoma Sun Yat-sen University Cancer Centerthe State Key Laboratory of Oncology in South ChinaCollaborative Innovation Center for Cancer MedicineGuangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and TherapyGuangzhou 510060China Department of Radiation Oncology Affiliated Cancer Hospital and Institute of Guangzhou Medical UniversityGuangzhou 510095China Department of critical care Medicine Sun Yat-sen University Cancer Centerthe State Key Laboratory of Oncology in South ChinaCollaborative Innovation Center for Cancer MedicineGuangzhou 510060China Department of Radiation Oncology Guangzhou Concord Cancer CenterGuangzhou 510045China

objective:Two cycles of induction chemotherapy(IC)followed by 2 cycles of platinum-based concurrent chemoradiotherapy(CCRT)(2IC+2CCRT)for locoregionally advanced nasopharyngeal carcinoma(LA-NPC)is widely adopted but not *** study aimed to determine the clinical value of 2IC+2CCRT regarding efficacy,toxicity and ***:This real-world study from two epidemic centers used propensity score matching(PSM)and inverse probability of treatment weighting(IPTW)*** enrolled patients were divided into three groups based on treatment modality:group A(2IC+2CCRT),group B(3IC+2CCRT or 2IC+3CCRT)and group C(3IC+3CCRT).Long-term survival,acute toxicities and cost-effectiveness were compared among the *** developed a prognostic model dividing the population into high-and low-risk cohorts,and survivals including overall survival(OS),progression-free survival(PFS),distant metastasis-free survival(DMFS)and locoregional relapse-free survival(LRRFS)were compared among the three groups according to certain risk ***:Of 4,042 patients,1,175 were enrolled,with 660,419,and 96 included in groups A,B and C,***-year survivals were similar among the three groups after PSM and confirmed by *** 3-4 neutropenia and leukocytopenia were significantly higher in groups C and B than in group A(52.1%vs.41.5%vs.25.2%;41.7%vs.32.7%vs.25.0%)as were grade 3-4 nausea/vomiting and oral mucositis(29.2%vs.15.0%vs.6.1%;32.3%vs.25.3%vs.18.0%).Cost-effective analysis suggested that 2IC+2CCRT was the least expensive,while the health benefits were similar to those of the other *** exploration showed that 2IC+2CCRT tended to be associated with a shorter PFS in high-risk patients,while 3IC+3CCRT potentially contributed to poor PFS in low-risk individuals,mainly reflected by ***:In LA-NPC patients,2IC+2CCRT was the optimal choice regarding efficacy,toxicity and costeffectiveness;however,2IC+2CCRT and 3IC

关键词： Nasopharyngeal carcinoma treatment modality chemotherapy cycle survival toxicity costeffectiveness real world

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Efficacy and safety of Kangxian Huanji Granule as adjunctive treatment in acute exacerbation of idiopathic pulmonary fibrosis:An exploratory randomized controlled trial

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Journal of Integrative Medicine 2023年第6期21卷 543-549页

作者： Jian-sheng Li Hai-long Zhang Wen Guo Lu Wang Dong Zhang Li-min Zhao Miao Zhou Co-construction collaborative Innovation Center for Chinese Medicine and Respiratory Diseases by Henan&Education Ministry of China Henan Key Laboratory of Chinese Medicine for Respiratory DiseasesHenan University of Chinese MedicineZhengzhou 450046Henan ProvinceChina Respiratory Department the First Affiliated Hospital of Henan University of Chinese MedicineZhengzhou 450000Henan ProvinceChina Department of Respiratory and critical care Medicine Henan Provincial People’s HospitalZhengzhou 463599Henan ProvinceChina Respiratory Department the Third Affiliated Hospital of Henan University of Chinese MedicineZhengzhou 450003Henan ProvinceChina

Background:Acute exacerbation of idiopathic pulmonary fibrosis(AE-IPF)is an important occurrence in the natural history of idiopathic pulmonary fibrosis(IPF),associated with high hospitalization rates,high mortality and poor *** present,there is no effective treatment for *** herbal medicine has some advantages in treating IPF,but its utility in AE-IPF is ***:The treatment of AE-IPF with Kangxian Huanji Granule(KXHJ),a compound Chinese herbal medicine,lacks an evidence-based *** study explores the efficacy and safety of KXHJ in patients with ***,setting,participants and interventions:Wedesigned a randomized,double-blind,placebo-controlled,exploratory clinical trial.A total of 80 participants diagnosed with AE-IPF were randomly assigned to receive KXHJ or a matching placebo;the treatment included a 10 g dose,administered twice daily for 4 weeks,in addition to conventional *** were followed up for 12 weeks after the *** outcome measures:The primary endpoints were treatment failure rate and all-cause *** endpoints included the length of hospitalization,overall survival,acute exacerbation rate,intubation rate,the modified British Medical research Council(mMRC)score,and the St George’s Respiratory Questionnaire for IPF(SGRQ-I)***:The rate of treatment failure at 4 weeks was lower in the intervention groupcompared to the control group(risk ratio[RR]:0.22;95%confidence interval[CI]:0.051 to 0.965,P=0.023).There was no significant difference in all-causemortality at 16 weeks(RR:0.75;95%CI:0.179 to 3.138;P>0.999)or in the acute exacerbation rate during the 12-week follow-up period(RR:0.69;95%CI:0.334 to 1.434;P=0.317).The intervention group had a shorter length of hospitalization than the control group(mean difference[MD]:–3.30 days;95%CI,–6.300 to–0.300;P=0.032).Significant differences in the mean change from baseline in the mMRC(between-group difference:–0.67;

关键词： Idiopathic pulmonary fibrosis Acute exacerbation Chinese herbal medicine Integrative medicine Randomized controlled trial

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Colorectal cancer-derived extracellular vesicles induce liver premetastatic immunosuppressive niche formation to promote tumor early liver metastasis

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Signal Transduction and Targeted Therapy 2023年第4期8卷 1357-1360页

作者： Xuyang Yang Yaguang Zhang Yang Zhang Huifang Li Li Li Yangping Wu Xiangzheng Chen Lei Qiu Junhong Han Ziqiang Wang Colorectal Cancer Center Department of General SurgeryState Key Laboratory of Biotherapy and Cancer Centerand Frontiers Science Center for Disease-related Molecular NetworkWest China HospitalSichuan UniversityChengdu 610041 Sichuan ProvinceChina State Key Laboratory of Biotherapy and Cancer Center and Frontiers Science Center for Disease-related Molecular NetworkWest China HospitalSichuan UniversityChengdu 610041 Sichuan ProvinceChina Core Facility Institute of Clinical PathologyDepartment of Respiratory and Critical Care Medicineand Department of Liver Surgery&Liver TransplantationState Key Laboratory of Biotherapy and Cancer CenterWest China HospitalSichuan University and Collaborative Innovation Center of BiotherapyChengdu 610041China

Dear Editor,To date,the effect of colorectal cancer(CRC)-derived extracellular vesicles(EVs)on liver pre-metastatic niche(PMN)remain incompletely understood.1 To investigate the role of CRC-derived EVs in the remodeling of the liver PMN,we isolated EVs from CT26 cell culture *** characteristics of EVs(the morphology,size,and markers)were identified by transmission electron microscopy(TEM),Nanoparticle Tracking Analysis(NTA),and western blotting(Supplementary Fig.S1a–e).Then,BALB/c mice with an intact liver immune status were pretreated with CRCderived EVs and phosphate-buffered saline(PBS)for one month,and a liver metastasis model was established via spleen injection of tumor cells to determine whether EVs influence liver metastasis(Fig.1a).Two hours after the operation,in vivo imaging indicated that the animal model was successfully established,and the tumor fluorescence intensity in the liver was consistent between the two groups(Supplementary Fig.S2a,b).Amazingly,the liver tumor fluorescence intensity in the EVs group was significantly stronger than that in the PBS group after 24 h(Fig.1b;Supplementary Fig.S2c,d).The number of liver tumor nodules in the EVs group was also significantly higher than that in the PBS group on day 4(Fig.1c;Supplementary Fig.S2e,f).

关键词： metastasis metastatic cancer

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Envonalkib versus crizotinib for treatment-naive ALK-positive non-small cell lung cancer: a randomized, multicenter, open-label, phase III trial

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Signal Transduction and Targeted Therapy 2023年第9期8卷 4338-4345页

作者： Yunpeng Yang Jie Min Nong Yang Qitao Yu Ying Cheng Yanqiu Zhao Manxiang Li Hong Chen Shou’an Ren Jianying Zhou Wu Zhuang Xintian Qin Lejie Cao Yan Yu Jian Zhang Jianxing He Jifeng Feng Hao Yu Li Zhang Wenfeng Fang Department of Medical Oncology Sun Yat-sen University Cancer CenterState Key Laboratory of Oncology in South ChinaCollaborative Innovation Center for Cancer MedicineGuangzhou 510060China Department of Oncology The Second Affiliated Hospital of Air Force Medical UniversityXi’an 710038China Department of Medical Oncology Lung Cancer and Gastrointestinal UnitHunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of MedicineCentral South UniversityChangsha 410013China Department of Medical Oncology of Respiratory Affiliated Tumor Hospital of Guangxi Medical UniversityGuangxiNanning 530021China Department of Thoracic Medical Oncology Jilin Provincial Cancer HospitalChangchun 130012China Department of Medical Oncology The Affiliated Cancer Hospital of Zhengzhou UniversityZhengzhou 450003China Department of Respiratory First Affiliated Hospital of Xian Jiaotong UniversityXi’an 710061China Department of Respiratory and critical care Medicine The First Affiliated Hospital of Chongqing Medical UniversityChongqing 400050China Department of Respiratory The First Hospital of Shanxi Medical UniversityTaiyuan 030001China Department of Respiratory Disease The First Affiliated HospitalZhejiang University School of MedicineHangzhou 310003China Department of Medical Oncology Fujian Cancer HospitalFuzhou 350014China The First Department of Oncology The First Affiliated Hospital of Guangdong Pharmaceutical UniversityGuangzhou 510699China Department of Respiratory and critical care Medicine Anhui Provincial HospitalHefei 230000China Department of Respiratory Medicine Affiliated Cancer Hospital of Harbin Medical UniversityHarbin 150000China Department of Respiratory Medicine The First Affiliated Hospital of Air Force Medical UniversityXi’an 710032China Department of Cardiothoracic Surgery The First Affiliated Hospital of Guangzhou Medical CollegeGuangzhou Research Institute of Respiratory Disease and China State Key Laboratory of Respiratory DiseaseGuangzhou 510120China Department

Anaplastic lymphoma kinase(ALK)rearrangements are present in about 5–6%of non-small cell lung cancer(NSCLC)cases and associated with increased risks of central nervous system(CNS)***,a novel ALK inhibitor,demonstrated promising anti-tumor activity and safety in advanced ALK-positive NSCLC in the first-in-human phase I *** phase III trial(*** NCT04009317)investigated the efficacy and safety of first-line envonalkib in advanced ALK-positive NSCLC *** 264 participants were randomized 1:1 to receive envonalkib(n=131)or crizotinib(n=133).Median independent review committee(IRC)-assessed progression-free survival(PFS)times were 24.87(95%confidence interval[CI]:15.64–30.36)and 11.60(95%CI:8.28–13.73)months in the envonalkib and crizotinib groups,respectively(hazard ratio[HR]=0.47,95%CI:0.34–0.64,pgroup compared with the crizotinib *** participants with baseline brain target lesions,IRC-assessed CNS-ORR was improved with envonalkib compared with crizotinib(78.95%vs.23.81%).Overall survival(OS)data were immature,and median OS was not reached in either group(HR=0.84,95%CI:0.48–1.47,p=0.5741).The 12-month OS rates were 90.6%(95%CI,84.0%–94.5%)and 89.4%(95%CI,82.8%–93.6%)in the envonalkib and crizotinib groups,***≥3 treatment-related adverse events were observed in 55.73%and 42.86%of participants in the envonalkib and crizotinib groups,*** significantly improved PFS and delayed brain metastasis progression in advanced ALK-positive NSCLC.

关键词： crizotinib randomized cancer

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Development of a prediction model to identify undiagnosed chronic obstructive pulmonary disease patients in primary care settings in China

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Chinese Medical Journal 2023年第6期136卷 676-682页

作者： Buyu Zhang Dong Sun Hongtao Niu Fen Dong Jun Lyu Yu Guo Huaidong Du Yalin Chen Junshi Chen Weihua Cao Ting Yang Canqing Yu Zhengming Chen Liming Li on behalf of the China Kadoorie Biobank collaborative group Department of Epidemiology and Biostatistics School of Public HealthPeking UniversityBeijing 100191China Department of Pulmonary and critical care Medicine Center of Respiratory MedicineChina–Japan Friendship HospitalBeijing 100029China National Center for Respiratory Medicine and National Clinical research Center for Respiratory Diseases Beijing 100029China Institute of Respiratory Medicine Chinese Academy of Medical SciencesBeijing 100007China Peking University Center for Public Health and Epidemic Preparedness and Response Beijing 100191China Key Laboratory of Molecular Cardiovascular Sciences(Peking University) Ministry of EducationBeijing 100191China National Center for Cardiovascular Diseases Fuwai HospitalChinese Academy of Medical SciencesBeijing 100037China Medical research Council Population Health research Unit at the University of Oxford Oxford OX37LFUK Clinical Trial Service Unit and Epidemiological Studies Unit Nuffield Department of Population HealthUniversity of OxfordOxford OX37LFUK Maiji Center for Disease Control and Prevention TianshuiGansu 741020China China National Center for Food Safety Risk Assessment Beijing 100022China 不详

Background:At present,a large number of chronic obstructive pulmonary disease(COPD)patients are undiagnosed in ***,this study aimed to develop a simple prediction model as a screening tool to identify patients at risk for ***:The study was based on the data of 22,943 subjects aged 30 to 79 years and enrolled in the second resurvey of China Kadoorie Biobank during 2012 and 2013 in *** stepwisely selected the predictors using logistic regression *** we tested the model validity through P-P graph,area under the receiver operating characteristic curve(AUROC),ten-fold cross validation and an external validation in a sample of 3492 individuals from the Enjoying Breathing Program in ***:The final prediction model involved 14 independent variables,including age,sex,location(urban/rural),region,educational background,smoking status,smoking amount(pack-years),years of exposure to air pollution by cooking fuel,family history of COPD,history of tuberculosis,body mass index,shortness of breath,sputum and *** model showed an area under curve(AUC)of 0.72(95%confidence interval[CI]:0.72-0.73)for detecting undiagnosed COPD patients,with the cutoff of predicted probability of COPD=0.22,presenting a sensitivity of 70.13%and a specificity of 62.25%.The AUROC value for screening undiagnosed patients with clinically significant COPD was 0.68(95%CI:0.66-0.69).Moreover,the ten-fold cross validation reported an AUC of 0.72(95%CI:0.71-0.73),and the external validation presented an AUC of 0.69(95%CI:0.68-0.71).Conclusion:This prediction model can serve as a first-stage screening tool for undiagnosed COPD patients in primary care settings.

关键词： Chronic obstructive pulmonary disease Screening Prediction model China Kadoorie Biobank

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Efficacy,safety and pharmacokinetics of Unecritinib(TQ-B3101)for patients with ROS1 positive advanced non-small cell lung cancer:a Phase I/II Trial

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Signal Transduction and Targeted Therapy 2023年第7期8卷 3536-3546页

作者： Shun Lu Hongming Pan Lin Wu Yu Yao Jianxing He Yan Wang Xiuwen Wang Yong Fang Zhen Zhou Xicheng Wang Xiuyu Cai Yan Yu Zhiyong Ma Xuhong Min Zhixiong Yang Lejie Cao Huaping Yang Yongqian Shu Wu Zhuang Shundong Cang Jian Fang Kai Li Zhuang Yu Jiuwei Cui Yang Zhang Man Li Xinxuan Wen Jie Zhang Weidong Li Jianhua Shi Xingxiang Xu Diansheng Zhong Tao Wang Jiajia Zhu Department of Medical Oncology Shanghai Chest HospitalSchool of MedicineShanghai Jiao Tong University200030 ShanghaiChina Department of Medical Oncology Sir Run Run Shaw HospitalZhejiang University310016 HangzhouChina Department of Thoracic Medical Oncology The Affiliated Cancer Hospital of Xiangya School of MedicineCentral South University(Hunan Cancer Hospital)410031 ChangshaChina Department of Medical Oncology The First Affiliated Hospital of Xi’an Jiaotong University710061 XianChina Department of Thoracic Surgery The First Affiliated Hospital of Guangzhou Medical University510120 GuangzhouChina Department of Medical Oncology National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical College100021 BeijingChina Department of Oncology Qilu Hospital of Shandong University250012 JinanChina Department of Oncology The First Affiliated Hospital/School of Clinical Medicine of Guangdong Pharmaceutical University510699 GuangzhouChina Department of Medical Oncology Sun Yat-sen University Cancer Center510060 GuangzhouChina Department of Respiratory Medicine Harbin Medical University Cancer Hospital150081 HarbinChina Department of Medical Oncology Henan Tumor Hospital450003 ZhengzhouChina Department of Oncology Radiotherapy Anhui Chest Hospital230022 HefeiChina Department of Cancer Center Affiliated Hospital of Guangdong Medical University524000 ZhanjiangChina Department of Respiratory Medicine The First Affiliated Hospital of the University of Science and Technology of ChinaAnhui Provincial Hospital230031 HefeiChina Department of Respiratory and critical care Medicine Xiangya Hospital Central South University410008 ChangshaChina Department of Cancer Center Jiangsu Province Hospital210029 NanjingChina Department of Thoracic Oncology Fujian Cancer Hospital and Fujian Medical University Cancer Hospital350014 FuzhouChina Department of Medical Oncology Henan Province People’s Hospital450003 ZhengzhouCh

This phase I/II trial characterized the tolerability,safety,and antitumor activities of unecritinib,a novel derivative of crizotinib and a multi-tyrosine kinase inhibitor targeting ROS1,ALK,and c-MET,in advanced tumors and ROS1 inhibitor-naive advanced or metastatic non-small cell lung cancer(NSCLC)harboring ROS1 *** patients received unecritinib 100,200.

关键词： patients lung cancer

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Extracorporeal membrane oxygenation for pediatric respiratory failure: History, development and current status

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World Journal of critical care Medicine 2013年第4期2卷 29-39页

作者： Anna Maslach-Hubbard Susan L Bratton Division of critical care Medicine Department of Pediatrics University of UtahSalt Lake City UT 84158 United States

Extracorporeal membrane oxygenation(ECMO) is currently used to support patients of all ages with acute severe respiratory failure non-responsive to conventional treatments, and although initial use was almost exclusively in neonates, use for this age group is decreasing while use in older children remains stable(300-500 cases annually) and support for adults is increasing. Recent advances in technology include: refinement of double lumen veno-venous(VV) cannulas to support a large range of patient size, pumps with lower prime volumes, more efficient oxygenators, changes in circuit configuration to decrease turbulent flow and hemolysis. Veno-arterial(VA) mode of support remains the predominant type used; however, VV support has lower risk of central nervous injury and mortality. Key to successful survival is implementation of ECMO before irreversible organ injury develops, unless support with ECMO is used as a bridge to transplant. Among pediatric patients treated with ECMO mortality varies by pulmonary diagnosis, underlying condition, other nonpulmonary organ dysfunction as well as patient age, but has remained relatively unchanged overall(43%)over the past several decades. Additional risk factors associated with death include prolonged use of mechanical ventilation(> 2 wk) prior to ECMO, use of VA ECMO, older patient age, prolonged ECMO support as well as complications during ECMO. Medical evidence regarding daily patient management specifically related to ECMO is scant, it usually mirrors care recommended for similar patients treated without ECMO. Linkage of the Extracorporeal Life Support Organization dataset with other databases and collaborative research networks will be required to address this knowledge deficit as most centers treat only a few pediatric respiratory failure patients each year.

关键词： Respiratory failure Pediatrics Extracorporeal life support Veno-arterial Veno-venous

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Expert consensus on emergency procedures for portal hypertension bleeding(2022)

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Journal of Interventional Medicine 2023年第1期6卷 1-9页

作者： Lin Sun Lin Long Qing Wang Hua Xiang Chinese Society of Emergency Medicine Interventional Physician Branch of Chinese Medical Doctor AssociationChina Interventional group of Radiology Society of Chinese Medical Association China Haemorrhage Professional Committee of Chinese research Hospital Association China China Haemorrhage Center Alliance China Hunan Provincial People's Hospital(The First Affiliated Hospital of Hunan Normal University) Changsha410005China

Expert consensus proposes an emergency treatment protocol for portal hypertension bleeding. Herein, the emergency treatment procedures, which include first aid, medical, interventional, and surgical treatments, are described. In addition, the indications, contraindications, operating norms, precautions, and prevention of complications of portal hypertension are described to optimize the first aid process.

关键词： Consensus Portal hypertension bleeding First aid process

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