Journal of critical care最新文献

{"title":"Erythropoietin in ICU patients receiving early red blood cell transfusions: A retrospective study of the impact on transfusion requirements","authors":"Thomas Carpentier ,&nbsp;Anthony Merlin ,&nbsp;Arnaud Cappe ,&nbsp;Matthieu Metzelard ,&nbsp;Léonie Villeret ,&nbsp;Patrick Jeanjean ,&nbsp;Yazine Mahjoub ,&nbsp;Julien Maizel ,&nbsp;Hervé Dupont ,&nbsp;Stéphanie Malaquin ,&nbsp;Aurélien Mary","doi":"10.1016/j.jcrc.2025.155052","DOIUrl":"10.1016/j.jcrc.2025.155052","url":null,"abstract":"<div><h3>Purpose</h3><div>Anemia correlates with increased ICU mortality; but the use of erythropoietin (EPO) as a treatment remains debated. We sought to assess EPO use in ICU severe anemia.</div></div><div><h3>Methods</h3><div>A retrospective single-center study was conducted in four adult ICUs. Inclusion criteria were ICU stay ≥10 days (to limit immortality bias) and RBC transfusion within the first 48 h (an indication of severe anemia likely to justify EPO). EPO contraindication was an exclusion criterion. Univariate tests were followed by a multivariable analysis.</div></div><div><h3>Results</h3><div>Over a 28-month period, 190 patients (69 with EPO) were included. EPO subgroups displayed had a higher prevalence of hemorrhagic shock and surgical ICU admissions. EPO administration was significantly associated with a lower requirement for late RBC transfusions in trauma and non-trauma subgroups, with odds ratios [95 % confidence interval] of 0.29 [0.10–0.85] and 0.03 [0.004–0.18], respectively. In the EPO subgroup, the median hemoglobin level rose by 1.2 g/dL. Cox model showed a significant association with mortality at day 28 and 365.</div></div><div><h3>Conclusion</h3><div>Our study supports the hypothesis whereby EPO administration in severely anemic ICU patients reduces late transfusion needs, with a potentially higher survival rate. Systematic EPO use post-RBC transfusion in ICU patients warrants further investigation.</div></div>","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"88 ","pages":"Article 155052"},"PeriodicalIF":3.2,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143644842","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation of quality-controlled in-house dialysis solution for continuous renal replacement therapy: A solution for resource-limited settings","authors":"Khanittha Yimsangyad ,&nbsp;Tanat Lertussavavivat ,&nbsp;Akarathep Leewongworasingh ,&nbsp;Nattira Sorose ,&nbsp;Nattachai Srisawat","doi":"10.1016/j.jcrc.2025.155064","DOIUrl":"10.1016/j.jcrc.2025.155064","url":null,"abstract":"","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"88 ","pages":"Article 155064"},"PeriodicalIF":3.2,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Failure to reintroduce home medication in critically ill patients","authors":"Florens N. Polderman ,&nbsp;Hieronymus J. Derijks ,&nbsp;Maaike A. Sikma ,&nbsp;Rob J. van Marum","doi":"10.1016/j.jcrc.2025.155051","DOIUrl":"10.1016/j.jcrc.2025.155051","url":null,"abstract":"<div><h3>Purpose</h3><div>Home medication is often discontinued or adjusted during hospital admission. This study aims to investigate discrepancies between home medication before admission and at ICU discharge.</div></div><div><h3>Materials and methods</h3><div>In this retrospective cohort study, electronic health records of 200 patients admitted to the ICU of a large teaching hospital in the Netherlands between August 1, 2021, and September 30, 2022, were analyzed for (dis) continuation of home medication. Inclusion criteria: first-time ICU admission during hospital stay, a length of stay ≥48 h, survival at ICU discharge, and use of home medication at hospital admission. Exclusion criteria: transfer from/to another hospital, discharge with palliative care, or chronic ventilation with an elective admission.</div></div><div><h3>Results</h3><div>The mean patient age was 63.5 (±12.8) years, and 63.0 % were male. Most ICU admissions were non-surgical (76.0 %). Mean APACHE4 scores were 68.4 (±22.9). At ICU discharge, 46.7 % (535/1003) of home medications were not reintroduced, with 22.4 % incorrectly not reintroduced, while at hospital discharge, these rates were 12.1 % (106/876) and 14.2 %, respectively.</div></div><div><h3>Conclusions</h3><div>Nearly half of home medications were discontinued at ICU discharge, with nearly a quarter not properly reintroduced on ward transfer, posing unnecessary risks. However, at hospital discharge, most home medications were correctly reintroduced or appropriately discontinued.</div></div>","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"88 ","pages":"Article 155051"},"PeriodicalIF":3.2,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143576955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of opioid utilization in the intensive care unit and opioid prescriptions at hospital discharge in opioid-naïve non-surgical patients who received enhanced oxygen therapy","authors":"Lan N. Bui PharmD, MPH ,&nbsp;Qian Ding BPharm, MS, PhD ,&nbsp;Rowan Rosewarne PharmD, MPH ,&nbsp;Tilyn Digiacomo PharmD, MSHIA ,&nbsp;Jacob Jarboe PharmD ,&nbsp;Whitney Seals BS ,&nbsp;Emem Etukinoh PharmD, MSN ,&nbsp;Denise H. Rhoney PharmD","doi":"10.1016/j.jcrc.2025.155048","DOIUrl":"10.1016/j.jcrc.2025.155048","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the association between opioid utilization in community-based intensive care units and the continuation of opioid prescriptions at hospital discharge for non-surgical, opioid-naïve patients.</div></div><div><h3>Materials and methods</h3><div>This nested case-control study included adults without opioid prescriptions 45 days before hospital admission who had intensive care unit stays of 48 h or longer and received enhanced oxygen therapy. Patients were excluded if they had opioid allergies, cancer, in-hospital death, palliative care, major surgery, or substance use disorders. Opioid utilization was measured using cumulative oral morphine equivalents and average daily morphine equivalents during the intensive care unit stay. Multivariable regression models examined the association between opioid utilization and opioid prescription at discharge.</div></div><div><h3>Results</h3><div>Among 260 patients, 33 patients (12.7 %) received opioid prescriptions at discharge. These patients had significantly higher cumulative morphine equivalents during their intensive care unit stay (cases: 3362.4, standard error 1102.5; controls: 1024.9, standard error 240.0; <em>p</em> = 0.002) and higher average daily morphine equivalents during their stay (cases: 129.8, standard error 36.9; controls: 61.2, standard error 10.7; <em>p</em> = 0.03). Patients who received more than 90 cumulative morphine equivalents during their intensive care unit stay had 6.63 times higher odds of receiving an opioid prescription at discharge (<em>p</em> &lt; 0.001). Each additional 10 daily morphine equivalents increased the odds of discharge continuation by 3 % (<em>p</em> = 0.011).</div></div><div><h3>Conclusions</h3><div>Increased opioid utilization during intensive care unit stays was associated with higher odds of opioid prescriptions at discharge in opioid-naïve, non-surgical patients.</div></div><div><h3>Abstract key points</h3><div><strong>Question:</strong> Does opioid use in community-based ICUs correlate with continued opioid prescriptions at discharge for opioid-naïve, non-surgical patients?</div><div><strong>Findings:</strong> This nested case-control study found that patients who received opioids during their ICU stay had a higher likelihood of being prescribed opioids at discharge. Specifically, those with cumulative opioid use &gt;90 MME had 6.63 times higher odds of opioid continuation at discharge.</div><div><strong>Meaning:</strong> The study concludes that higher opioid use during ICU stays significantly increases the likelihood of opioid prescription continuation at hospital discharge for opioid-naïve, non-surgical patients.</div></div>","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"88 ","pages":"Article 155048"},"PeriodicalIF":3.2,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143563568","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors for transitions and outcomes of subsyndromal delirium in the ICU: Post-hoc analysis of a prospective multicenter cohort study","authors":"Lisa Smit ,&nbsp;Eveline J.A. Wiegers ,&nbsp;Zoran Trogrlic ,&nbsp;Diederik Gommers ,&nbsp;Erwin Ista ,&nbsp;Mathieu van der Jagt","doi":"10.1016/j.jcrc.2025.155041","DOIUrl":"10.1016/j.jcrc.2025.155041","url":null,"abstract":"<div><h3>Purpose</h3><div>Identify risk factors for progression to delirium and outcomes of subsyndromal delirium (SSD) in critically ill adults.</div></div><div><h3>Methods</h3><div>Multicenter prospective study screening patients with the Intensive Care Delirium Screening Checklist (ICDSC), excluding those with primary neurologic diagnosis or persistent coma. SSD was defined as an ICDSC score 1–3. Main outcomes were risk factors for SSD progression and association with hospital mortality. Secondary outcomes included ICU mortality and length of stay.</div></div><div><h3>Results</h3><div>Among 1572 patients, 562 (35.8 %) had no delirium, 488 (31 %) SSD without delirium, 180 (11.5 %) SSD progressing to delirium and 174 (11.1 %) delirium without prior SSD. For 168 (10.7 %) delirium status was unknown. SSD onset risk factors were female sex, higher APACHE IV score, and medical /emergency surgery admissions. SSD progression risk factors included higher APACHE IV score, medical/emergency surgery admissions, metabolic acidosis and morphine dosage in the first 24 h. SSD patients had lower hospital mortality than delirium patients (OR 0.57, 95 %CI 0.36 to 0.90), but no significant difference compared to non-delirious patients (OR 1.30, 95 %CI 0.69 to 2.42). SSD patients had shorter ICU stays than delirium patients but longer than non-delirious patients.</div></div><div><h3>Conclusions</h3><div>This study identified risk profiles and validated SSD as an intermediate prognostic condition, supporting early interventions to prevent delirium-associated harms.</div><div><em>Trial registration</em>: <span><span>ClinicalTrials.gov</span><svg><path></path></svg></span> Identifier <span><span>NCT01952899</span><svg><path></path></svg></span> (registered September 30, 2013).</div></div>","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"88 ","pages":"Article 155041"},"PeriodicalIF":3.2,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143550666","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute kidney injury detection with additional point-of-care creatinine vs central laboratory serum creatinine measurement in critically ill patients","authors":"Kyle C. White ,&nbsp;Jason Meyer ,&nbsp;Kevin B. Laupland ,&nbsp;Siva Senthuran ,&nbsp;Kiran Shekar ,&nbsp;James McCullough ,&nbsp;Rinaldo Bellomo ,&nbsp;On behalf of the Queensland Critical Care Research Network (QCRCN)","doi":"10.1016/j.jcrc.2025.155050","DOIUrl":"10.1016/j.jcrc.2025.155050","url":null,"abstract":"<div><h3>Background</h3><div>Serum creatinine measured by point-of-care testing (CrP) correlates with central laboratory serum creatinine (CrC) measurement and can be performed frequently, which might lead to an earlier diagnosis of acute kidney injury (AKI). We aimed to test whether the combination of CrP and CrC measurement would achieve earlier and more freuent AKI diagnosis than routine CrC testing alone.</div></div><div><h3>Methods</h3><div>Retrospective study of critically ill patients with two or more CrP measurements 24 h before an AKI was diagnosed on CrC.</div></div><div><h3>Results</h3><div>1591 patients with a median APACHE 3 score of 67 (IQR 52-85) and a median number of CrP of 5 (IQR 3-6) measurements. The median individual differences in time to AKI diagnosis between CrC and CrP was −5 h (−11-−1). As the number of point-of-care tests increased in the 24 h before CrC-defined AKI diagnosis, the difference in hours increased (−3 (IQR −6-−1) to −8 (IQR −13– −2); <em>p</em> &lt; 0.001). Compared to CrC alone, the use of both CrC and CrP detected more increases in AKI severity to each AKI stage (stage 1: 1767 (34 %) vs 1.170 (30 %); stage 2: 1.301 (25 %) vs 809 (21 %) and stage 3: 2071 (40 %) vs 1920 (49 %); p &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>Combined with CrC, CrP measurement resulted in the earlier diagnosis of AKI during ICU admission. Compared to CrC alone, using CrP measurements in combination with CrC was also associated with a higher maximum AKI stage and more detection of worsening AKI.</div></div>","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"88 ","pages":"Article 155050"},"PeriodicalIF":3.2,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143550078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What every intensivist should know about type D hyperlactatemia","authors":"Raquel Simões Ballarin,&nbsp;Taline Lazzarin,&nbsp;Marcos Ferreira Minicucci","doi":"10.1016/j.jcrc.2025.155049","DOIUrl":"10.1016/j.jcrc.2025.155049","url":null,"abstract":"","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"88 ","pages":"Article 155049"},"PeriodicalIF":3.2,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143550077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Should diuresis remain a diagnostic criterion for surgery associated acute kidney injury? Revisiting the role of perioperative oliguria","authors":"Rodolpho Augusto de Moura Pedro ,&nbsp;Guilherme Bittar Cunha ,&nbsp;Igor Pietrobom ,&nbsp;Bruna Carla Scharanch ,&nbsp;Daniel Caraca Cubos ,&nbsp;Rafael Alves Franco ,&nbsp;Fernando Zampieri ,&nbsp;Thiago Gomes Romano","doi":"10.1016/j.jcrc.2025.155047","DOIUrl":"10.1016/j.jcrc.2025.155047","url":null,"abstract":"","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"87 ","pages":"Article 155047"},"PeriodicalIF":3.2,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143550308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Measuring family engagement in intensive care: Validation of the FAME tool","authors":"Jillian Kifell ,&nbsp;Karen E.A. Burns ,&nbsp;Julia Duong ,&nbsp;Kirsten Fiest ,&nbsp;Catherine Gagné ,&nbsp;Céline Gélinas ,&nbsp;Karla Krewulak ,&nbsp;Chella Price ,&nbsp;Amelia Stephenson ,&nbsp;Han Ting Wang ,&nbsp;Michael Goldfarb","doi":"10.1016/j.jcrc.2025.155046","DOIUrl":"10.1016/j.jcrc.2025.155046","url":null,"abstract":"<div><h3>Introduction</h3><div>Engaging family members in patient care in the intensive care unit (ICU) is a recommended practice by critical care societies. However, there are currently no validated tools to measure family engagement in the ICU setting. The objective of this study was to validate the FAMily Engagement (FAME) tool in the ICU.</div></div><div><h3>Methods</h3><div>The FAME study was a multicenter prospective cohort study of family members of ICU patients in 8 Canadian ICUs. Family members completed the FAME questionnaire during the ICU stay. The FAME questionnaire comprised 12 items that assessed various domains of family engagement behavior. FAME scores were reported in a 0–100 scoring system with higher scores indicating increased care engagement. Following hospital discharge, we assessed associations between the FAME score and family satisfaction with care and mental health (anxiety and depression). The internal consistency (reliability), convergent validity, and predictive validity of the FAME tool were evaluated.</div></div><div><h3>Results</h3><div>There were 269 family members (age 56.8 ± 15.1; 68.4 % women) included in the analysis. The most common relationships to the patient were spouse/partner (40.5 %) and daughter/son (33.8 %). The overall mean FAME score was 77.7 ± 14.8. The FAME score had high internal consistency (Cronbach's <em>α</em> = 0.83) and the tool demonstrated convergent and predictive validity. The FAME score was associated with family satisfaction, but not with mental health outcomes.</div></div><div><h3>Conclusion</h3><div>The FAME tool demonstrated reliability, convergent, and predictive validity in this multicenter ICU cohort. The FAME tool could be used to evaluate the effectiveness of family engagement interventions.</div></div>","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"87 ","pages":"Article 155046"},"PeriodicalIF":3.2,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143528627","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effects of hypnosis and music intervention on comfort and anxiety during weaning from mechanical ventilation: A pilot study","authors":"Marianne Devroey ,&nbsp;Diego Orbegozo Cortes ,&nbsp;Nicolas Gaspard ,&nbsp;Jennifer Foucart ,&nbsp;Jean-Charles Preiser ,&nbsp;Fabio Silvio Taccone","doi":"10.1016/j.jcrc.2025.155044","DOIUrl":"10.1016/j.jcrc.2025.155044","url":null,"abstract":"<div><h3>Objective</h3><div>To compare the efficacy of hypnosis or music intervention in alleviating distressing symptoms in critically ill patients facing extended or challenging liberation from mechanical ventilation (MV).</div></div><div><h3>Study design</h3><div>Single-center, prospective interventional trial.</div></div><div><h3>Methods</h3><div>Critically ill patients experiencing extended or challenging MV weaning were assigned to either a hypnosis group or a music intervention group where participants chose calming music from a provided list for a 30-min session. Inclusion criteria encompassed periods during pressure support ventilation, spontaneous breathing trials with tracheostomy or immediately after MV weaning. Hemodynamic, respiratory and electroencephalogram (EEG) parameters were collected before, during and after the intervention. Cortisol blood levels were also assessed. The primary outcome was the patient comfort and anxiety levels assessed using a Visual Analog Scale (VAS).</div></div><div><h3>Results</h3><div>Twenty-nine patients out of 75 eligible patients were enrolled in the study (15 in the hypnosis group and 14 in the music intervention group). The comfort level increased from 4 [2–6] to 8 [7–9] (<em>p</em> &lt; 0.01) and from 5 [4–6] to 7 [5–8] (p &lt; 0.01) for the hypnosis and music intervention groups, respectively (both <em>p</em> &lt; 0.01). The anxiety level decreased from 5 [5–7] to 3 [2–5] (<em>p</em> &lt; 0.01) and from 6 [5–8] to 4 [3–6] (p &lt; 0.01) for the hypnosis and music intervention groups, respectively (both p &lt; 0.01). No differences were observed between the study groups. Respiratory rate decreased after hypnosis from 28 [25–37] to 24 [23–35] (<em>p</em> &lt; 0.01), but was unchanged with music intervention. Heart rate showed a significant decline from baseline values after both interventions, but reverted to initial values subsequently. Mean arterial pressure exhibited an elevation from 94 (86–110) to 99 (80–108) mmHg after hypnosis (<em>p</em> = 0.01), while a reduction from 87 (75–101) to 82 (74–88) mmHg after music intervention (p = 0.01). Cortisol concentrations significantly decreased from 249 [175–291] to 207 [145–242] μg/L after music intervention (<em>p</em> = 0.02), but was unchanged after hypnosis (both <em>p</em> = 0.04). Both interventions led to a significant decrease in slow delta power and an increase in theta and alpha power on EEG, indicative of a hypnosis-like state.</div></div><div><h3>Conclusions</h3><div>In this pilot study, a single session of either hypnosis or music intervention was demonstrated to effectively reduce anxiety and enhance comfort, in critically ill patients facing extended or challenging MV weaning.</div></div>","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"87 ","pages":"Article 155044"},"PeriodicalIF":3.2,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143528715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}