Zhonghua wei zhong bing ji jiu yi xue最新文献

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[An observational study on the clinical effects of in-line mechanical in-exsufflation in mechanical ventilated patients].
Zhonghua wei zhong bing ji jiu yi xue Pub Date : 2025-03-01 DOI: 10.3760/cma.j.cn121430-20241008-00821
Bilin Wei, Huifang Zhang, Xiang Si, Wenxuan Yu, Xiangru Chen, Hao Yuan, Fei Pei, Xiangdong Guan
{"title":"[An observational study on the clinical effects of in-line mechanical in-exsufflation in mechanical ventilated patients].","authors":"Bilin Wei, Huifang Zhang, Xiang Si, Wenxuan Yu, Xiangru Chen, Hao Yuan, Fei Pei, Xiangdong Guan","doi":"10.3760/cma.j.cn121430-20241008-00821","DOIUrl":"https://doi.org/10.3760/cma.j.cn121430-20241008-00821","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the safety and clinical therapeutic effect of in-line mechanical in-exsufflation to assist sputum clearance in patients with invasive mechanical ventilation.</p><p><strong>Methods: </strong>A prospective observational study was conducted at the department of critical care medicine, the First Affiliated Hospital of Sun Yat-sen University from April 2022 to May 2023. Patients who were invasively ventilated and treated with in-line mechanical in-exsufflation to assist sputum clearance were enrolled. Baseline data were collected. Sputum viscosity, oxygenation index, parameters of ventilatory function and respiratory mechanics, clinical pulmonary infection score (CPIS) and vital signs before and after day 1, 2, 3, 5, 7 of use of the in-line mechanical in-exsufflation were assessed and recorded. Statistical analyses were performed by using generalized estimating equation (GEE).</p><p><strong>Results: </strong>A total of 13 invasively ventilated patients using in-line mechanical in-exsufflation were included, all of whom were male and had respiratory failure, with the main cause being cervical spinal cord injury/high-level paraplegia (38.46%). Before the use of the in-line mechanical in-exsufflation, the proportion of patients with sputum viscosity of grade III was 38.46% (5/13) and decreased to 22.22% (2/9) 7 days after treatment with in-line mechanical in-exsufflation. With the prolonged use of the in-line mechanical in-exsufflation, the patients' CPIS scores tended to decrease significantly, with a mean decrease of 0.5 points per day (P < 0.01). Oxygenation improved significantly, with the oxygenation index (PaO<sub>2</sub>/FiO<sub>2</sub>) increasing by a mean of 23.3 mmHg (1 mmHg ≈ 0.133 kPa) per day and the arterial partial pressure of oxygen increasing by a mean of 12.6 mmHg per day (both P < 0.01). Compared to baseline, the respiratory mechanics of the patients improved significantly 7 days after in-line mechanical in-exsufflation use, with a significant increase in the compliance of respiratory system (Cst) [mL/cmH<sub>2</sub>O (1 cmH<sub>2</sub>O ≈ 0.098 kPa): 55.6 (50.0, 58.0) vs. 40.9 (37.5, 50.0), P < 0.01], and both the airway resistance and driving pressure (DP) were significantly decreased [airway resistance (cmH<sub>2</sub>O×L<sup>-1</sup>×s<sup>-1</sup>): 9.6 (6.9, 10.5) vs. 12.0 (10.0, 13.0), DP (cmH<sub>2</sub>O): 9.0 (9.0, 12.0) vs. 11.0 (10.0, 15.0), both P < 0.01]. At the same time, no new lung collapse was observed during the treatment period. No significant discomfort was reported by patients, and there were no substantial changes in heart rate, systolic blood pressure, diastolic blood pressure, and mean arterial pressure before and after the in-line mechanical in-exsufflation treatment.</p><p><strong>Conclusions: </strong>The combined use of the in-line mechanical in-exsufflation to assist sputum clearance in patients on invasive mechanical ventilation can effectively improve sputum ch","PeriodicalId":24079,"journal":{"name":"Zhonghua wei zhong bing ji jiu yi xue","volume":"37 3","pages":"262-267"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143812479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Practice guideline on the prevention and treatment of central line associated bloodstream infection in 2025].
Zhonghua wei zhong bing ji jiu yi xue Pub Date : 2025-03-01 DOI: 10.3760/cma.j.cn121430-20250301-00199
Medicine Chinese Society Of Critical Care
{"title":"[Practice guideline on the prevention and treatment of central line associated bloodstream infection in 2025].","authors":"Medicine Chinese Society Of Critical Care","doi":"10.3760/cma.j.cn121430-20250301-00199","DOIUrl":"https://doi.org/10.3760/cma.j.cn121430-20250301-00199","url":null,"abstract":"<p><p>Central line associated bloodstream infection (CLABSI) is the most severe complication of indwelling intravascular catheters and one of the most common causes of intensive care unit (ICU)- or hospital-acquired infections. Once CLABSI occurs, it significantly increases the risk of mortality, long of hospital stay, and healthcare economic burden. In recent years, multiple large-scale clinical studies on the diagnosis, treatment, and prevention of CLABSI have been completed, providing evidence-based medical support for related practices. Additionally, evolving global trends in antibiotic resistance epidemiology and the development of novel antimicrobial agents necessitate adjustments in clinical management strategies. Based on these developments, the Chinese Society of Critical Care Medicine has updated and revised the Guideline on the Prevention and Treatment of Intravascular Catheter-Related Infections (2007). This guideline was developed following the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system for evidence quality assessment. Guided by clinical questions, the working group initiated the process by defining key clinical issues, conducting literature searches, screening studies, performing meta-analyses, and synthesizing evidence-based findings to draft preliminary recommendations. These recommendations underwent iterative revisions through expert panel reviews, remote and in-person meetings, and two rounds of voting by the Standing Committee of the Chinese Society of Critical Care Medicine before finalization. The guideline comprises 52 recommendations, focusing on adult patients with central venous catheters in ICU. Key areas addressed include: selection of catheter insertion sites and techniques, catheter type and design, catheter management, prevention, diagnosis, and treatment of CLABSI. The guideline aims to provide ICU healthcare professionals with best practices for central line management, ensuring standardized clinical protocols for adult CLABSI.</p>","PeriodicalId":24079,"journal":{"name":"Zhonghua wei zhong bing ji jiu yi xue","volume":"37 3","pages":"193-220"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143812597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Design and application of a height measuring instrument for ventricular drainage catheter].
Zhonghua wei zhong bing ji jiu yi xue Pub Date : 2025-03-01 DOI: 10.3760/cma.j.cn121430-20240812-00692
Qingchen Zhai, Guanjie Chen, Jianwei Li, Junping Li, Lu Ma
{"title":"[Design and application of a height measuring instrument for ventricular drainage catheter].","authors":"Qingchen Zhai, Guanjie Chen, Jianwei Li, Junping Li, Lu Ma","doi":"10.3760/cma.j.cn121430-20240812-00692","DOIUrl":"https://doi.org/10.3760/cma.j.cn121430-20240812-00692","url":null,"abstract":"<p><p>Ventriculostomy drainage is one of the commonly used surgical techniques in neurocritical care, which can relieve intracranial hypertension and facilitate postoperative cerebrospinal fluid and intracranial pressure monitoring. By placing a drainage tube in the ventricle, blood and fluid accumulation within the ventricle are drained out of the brain, reducing intracranial pressure and preventing brain tissue damage. Clinically, the speed of ventriculostomy drainage is often controlled by measuring the height difference between the drainage opening and the plane of the ventricle, ensuring the safe and effective reduction of intracranial pressure, facilitating the implementation of clinical management plans, and preventing complications. However, how to easily, safely, and effectively measure the height difference between the drainage opening and the ventricular plane remains a challenge in nursing management. Currently, clinical practice often uses a tape measure to measure the height of the ventriculostomy drainage, a process that is cumbersome and time-consuming and susceptible to human error, leading to inaccurate measurements. However, the challenge of easily, safely, and effectively detecting the height difference between the drainage opening and the ventricular plane remains a difficult problem in nursing management. To address this issue, the medical and nursing staff of the intensive care unit (ICU) at Zhongda Hospital, Southeast University, jointly designed a novel ventriculostomy drainage height measurement device, which has been granted a national utility model patent (patent number: ZL 2022 2 1400920.9). This device can be easily and securely fixed to an infusion stand. Using a level within the horizontal measuring part and a rotational structure, the vertical measuring part of the device is adjusted to be perpendicular to the ground. After opening the limit clip, the horizontal part is manually guided down to the appropriate height. The front end of the horizontal measuring part is then extended towards the patient's head, and after confirming the position, the limit clip is closed. At this point, the horizontal height difference between the drainage opening and the ventricular plane can be accurately measured. When temporarily finishing the height measurement of the drainage tube, the device can be folded and stored by retracting the horizontal measuring part and rotating components. This measuring device has a simple operation process, which can improve the accuracy and reliability of the drainage height measurement, enhance treatment outcomes and patient safety, reduce the workload of nursing staff, and has certain clinical promotion and practical value.</p>","PeriodicalId":24079,"journal":{"name":"Zhonghua wei zhong bing ji jiu yi xue","volume":"37 3","pages":"294-296"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143812547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Analysis of clinical characteristics and related risk factors of patients with Clostridioides difficile infection in the intensive care unit].
Zhonghua wei zhong bing ji jiu yi xue Pub Date : 2025-03-01 DOI: 10.3760/cma.j.cn121430-20240725-00633
Hongming Yu, Qinfu Liu, Shenglin Su, Gang Li, Xiaojun Yang
{"title":"[Analysis of clinical characteristics and related risk factors of patients with Clostridioides difficile infection in the intensive care unit].","authors":"Hongming Yu, Qinfu Liu, Shenglin Su, Gang Li, Xiaojun Yang","doi":"10.3760/cma.j.cn121430-20240725-00633","DOIUrl":"https://doi.org/10.3760/cma.j.cn121430-20240725-00633","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the clinical characteristics and related risk factors of Clostridium difficile infection (CDI) in intensive care unit (ICU).</p><p><strong>Methods: </strong>A retrospective study was conducted. Patients with diarrhea admitted to the ICU of the General Hospital of Ningxia Medical University from May 1 to August 30, 2023 were selected. Patients were divided into CDI group and non-CDI group based on the presence or absence of CDI. Clinical data from two groups of patients meeting the criteria were collected and compared, including gender, age, acute physiology and chronic health evaluation II (APACHE II), length of hospital stay, serum lactic acid, parenteral nutrition time, white blood cell count (WBC), procalcitonin (PCT), C-reactive protein (CRP), coagulation indicators, albumin, antibiotic exposure, etc. Multivariate Logistic regression analysis was performed to analyze the risk factors for CDI in ICU diarrhea patients. Receiver operator characteristic curve (ROC curve) was drawn to analyze the predictive value of each index for CDI in diarrhea patients.</p><p><strong>Results: </strong>A total of 24 patients with diarrhea were enrolled, including 9 patients in the CDI group and 15 patients in the non-CDI group. The time of parenteral nutrition in the CDI group was significantly longer than that in the non-CDI group [days: 18.0 (13.5, 19.5) vs. 10.0 (4.0, 18.0)], the serum lactic acid level [mmol/L: 4.40 (3.00, 15.25) vs. 2.50 (1.90, 3.20)] and the ratio of serum lactic acid > 3.9 mmol/L [66.67% (6/9) vs. 6.67% (1/15)] were significantly higher than those in the non-CDI group, with statistical significance (all P < 0.05). Multivariate binary Logistic regression analysis showed that the serum lactic acid level of the patients was an independent risk factor for CDI [odds ratio (OR) = 3.193, 95% confidence interval (95%CI) was 1.011-10.080, P = 0.048]. ROC curve showed that serum lactic acid level had a high predictive value for CDI in ICU patients with diarrhea, and the area under the curve (AUC) was 0.815, respectively. When the cut-off value of serum lactic acid was 3.9 mmol/L, the sensitivity was 66.7% and the specificity was 93.3%.</p><p><strong>Conclusion: </strong>Patients with diarrhea who have higher serum lactate levels (> 3.9 mmol/L) on admission are at increased risk of developing CDI.</p>","PeriodicalId":24079,"journal":{"name":"Zhonghua wei zhong bing ji jiu yi xue","volume":"37 3","pages":"251-254"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143812481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Association between albumin treatment and the prognosis of acute kidney injury patients: a retrospective study based on the MIMIC-IV database]. [白蛋白治疗与急性肾损伤患者预后的关系:基于 MIMIC-IV 数据库的回顾性研究]。
Zhonghua wei zhong bing ji jiu yi xue Pub Date : 2025-03-01 DOI: 10.3760/cma.j.cn121430-20230901-00723
Xinyuan Zhang, Yan Zhuang, Linfeng Dai, Haidong Zhang, Qiuhua Chen, Qingfang Nie
{"title":"[Association between albumin treatment and the prognosis of acute kidney injury patients: a retrospective study based on the MIMIC-IV database].","authors":"Xinyuan Zhang, Yan Zhuang, Linfeng Dai, Haidong Zhang, Qiuhua Chen, Qingfang Nie","doi":"10.3760/cma.j.cn121430-20230901-00723","DOIUrl":"https://doi.org/10.3760/cma.j.cn121430-20230901-00723","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To assess the impact of albumin (Alb) administration on the prognosis of patients with acute kidney injury (AKI).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Clinical data of AKI patients in the intensive care unit (ICU) were retrospectively analyzed from the American Medical Information Mart of Intensive Care-IV (MIMIC-IV), including demographic data, acute physiology score (APS), comorbidities, vital signs, laboratory indicators, treatment status, ICU length of stay, and outcome indicators. The main outcome measure is ICU mortality. AKI patients were divided into Alb infusion group and Alb non infusion group based on whether they received Alb treatment. Multiple imputation was used to process missing data and eliminate variables that missing more than 30%. To ensure the stability of the results, propensity score matching (PSM) and inverse probability weighting (IPW) were used to correct the results. Using Kaplan-Meier survival curve and Cox proportional hazards regression model to evaluate the effect of Alb infusion on ICU survival rate in AKI patients. Perform subgroup analysis based on patient age, gender, and comorbidities to evaluate the prognostic effects of Alb on different patient subgroups.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 6 390 AKI patients were included, including 1 721 in the Alb infusion group and 4 669 in the Alb non infusion group. After adjusting for key covariates in the Cox regression model, compared with the Alb non infusion group, patients in the Alb infusion group were significantly younger in age, with APS III score, proportion of vasoactive drugs and continuous renal replacement therapy (CRRT) use, sepsis proportion, heart rate, respiratory frequency, aspartate aminotransferase (AST), alanine aminotransferase (ALT), creatinine (Cr), lactic acid (Lac), and arterial partial pressure of carbon dioxide (PaCO&lt;sub&gt;2&lt;/sub&gt;) levels significantly higher. The proportion of hypertension, myocardial infarction, and congestive heart failure, as well as blood pressure, urine output, platelet count (PLT), and Alb levels were significantly lower. The results of univariate and multivariate Cox regression analysis on the raw data showed that the risk of death in the Alb infusion group was significantly lower than that in the Alb non infusion group [hazard ratio (HR) = 0.69, 95% confidence interval (95%CI) was 0.60-0.80, all P &lt; 0.05]. The results after propensity score matching (PSM) and inverse probability weighting (IPW) processing are consistent with the original data trend (both P &lt; 0.05). The Kaplan-Meier survival curve showed that the cumulative survival rate during ICU stay in the Alb infusion group was significantly higher than that in the Alb non infusion group (24.48% vs. 12.17%, Log-Rank test: χ&lt;sup&gt;2&lt;/sup&gt; = 74.26, P &lt; 0.05). Subgroup analysis shows that Alb infusion has a more significant survival benefit for AKI patients who use vasoactive drugs, have concurrent sepsis, and do not have liver diseas","PeriodicalId":24079,"journal":{"name":"Zhonghua wei zhong bing ji jiu yi xue","volume":"37 3","pages":"280-286"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143812524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Impact and clinical significance of different types of fluid resuscitation on the glycocalyx in patients with early sepsis and septic shock: a single center, prospective, randomized controlled trial].
Zhonghua wei zhong bing ji jiu yi xue Pub Date : 2025-03-01 DOI: 10.3760/cma.j.cn121430-20240711-00583
Lipeng Dong, Xinhui Wu, Congcong Zhao, Shengmei Ge, Zhihong Liu
{"title":"[Impact and clinical significance of different types of fluid resuscitation on the glycocalyx in patients with early sepsis and septic shock: a single center, prospective, randomized controlled trial].","authors":"Lipeng Dong, Xinhui Wu, Congcong Zhao, Shengmei Ge, Zhihong Liu","doi":"10.3760/cma.j.cn121430-20240711-00583","DOIUrl":"https://doi.org/10.3760/cma.j.cn121430-20240711-00583","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To evaluate the risks and benefits of different resuscitation fluids in patients with early sepsis and septic shock by observing and comparing clinical indicators, clinical outcomes, and the concentration changes of glycocalyx biomarkers, and to determine how to appropriately select suitable resuscitation fluids for sepsis patients to aid fluid therapy.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A single center, prospective, randomized controlled trial was conducted. Patients with early sepsis and septic shock who have required fluid resuscitation after capacity status assessment admitted to the department of critical care medicine of Fourth Hospital of Hebei Medical University from April to October 2023 were enrolled. Patients were randomly assigned to either the experimental group (balanced crystalloid solution+albumin) or the control group (balanced crystalloid solution) by a random number table method. Clinical data of both groups of patients before and after resuscitation at 3, 8, and 24 hours were monitored, and blood samples were collected, enzyme-linked immunosorbent assay (ELISA) was used to measure the concentration of plasma glycocalyx biomarker syndecan-1. The 28-day and 90-day survival rates and complications were also assessed.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 66 patients were enrolled, including 44 in the experimental group and 22 in the control group. The baseline data of two groups were balanced and comparable. There was no statistically significant difference in the plasma concentration of syndecan-1 between the experimental group and the control group before and after resuscitation, and both showed a trend of first increasing and then decreasing. However, the plasma syndecan-1 level in the control group at 8 hours and 24 hours after resuscitation were significantly higher than the baseline level before resuscitation [ng/L: 19.02 (14.41, 27.80), 18.95 (12.40, 22.50) vs. 14.67 (11.57, 21.14), both P &lt; 0.05], while there was no statistically significant difference at any time point within the experimental group. The correlation analysis between plasma syndecan-1 level and lactic acid, albumin, and sequential organ failure assessment (SOFA) in all patients showed that a positive correlation between syndecan-1 level and SOFA score before resuscitation (r = 0.247, P = 0.046), and a negative correlation between syndecan-1 level and albumin level at 24 hours after resuscitation (r = -0.308, P = 0.012). There were no statistically significant differences in 28-day and 90-day mortality, length of hospital stay, length of intensive care unit (ICU) stay, duration of mechanical ventilation, blood purification time, number of organ injuries, and complications between the two groups. However, the baseline albumin level in the experimental group was significantly lower than that in the control group (g/L: 28.7±4.5 vs. 31.6±4.2, P &lt; 0.05). Analysis of clinical treatment data showed that compared with the control gr","PeriodicalId":24079,"journal":{"name":"Zhonghua wei zhong bing ji jiu yi xue","volume":"37 3","pages":"237-244"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143812564","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Clinical features and early warning of the sepsis in immunocompromised host sepsis].
Zhonghua wei zhong bing ji jiu yi xue Pub Date : 2025-03-01 DOI: 10.3760/cma.j.cn121430-20240729-00638
Yanqing Chen, Runjing Guo, Xiao Huang, Xiaoli Liu, Huanhuan Tian, Bingjie Lyu, Fangyu Ning, Tao Wang, Dong Hao
{"title":"[Clinical features and early warning of the sepsis in immunocompromised host sepsis].","authors":"Yanqing Chen, Runjing Guo, Xiao Huang, Xiaoli Liu, Huanhuan Tian, Bingjie Lyu, Fangyu Ning, Tao Wang, Dong Hao","doi":"10.3760/cma.j.cn121430-20240729-00638","DOIUrl":"https://doi.org/10.3760/cma.j.cn121430-20240729-00638","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To explore the clinical features of the sepsis in immunocompromised hosts and establish an early warning equation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A retrospective study was conducted on sepsis patients admitted to the intensive care unit (ICU) of Binzhou Medical University Hospital from October 2011 to October 2022. General information, infection site, etiology results and drug susceptibility, clinical symptoms, inflammatory indicators, acute physiology and chronic health status evaluation II (APACHE II), sequential organ failure assessment (SOFA), incidence of immune paralysis, and outcome during hospitalization were collected. Based on whether they met the diagnostic criteria for immunocompromised hosts, patients were divided into immunocompromised group and immune normal group. The clinical information of the two groups were compared. Multivariate Logistic regression was used to analyze the risk factors of patients with immunocompromised sepsis and the regression equation model was initially established. Omnibus test and Hosmer-Lemeshow test were used to evaluate the model.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 169 patients with sepsis were included, including 61 in the immunocompromised group and 108 in the normal immune group. The top 3 infection sites in the immunocompromised group were bloodstream infection, pulmonary infection and abdominal infection. The top 3 infection sites in the normal immune group were pulmonary infection, bloodstream infection and abdominal infection. The infection rate of Gram-negative bacteria in the immunocompromised group was significantly lower than that in the normal group [49.2% (30/61) vs. 64.8% (70/108), P &lt; 0.05]. The infection rate of Gram-positive bacteria [27.9% (17/61) vs. 13.9% (15/108)] and multidrug-resistant bacteria [54.1% (33/61) vs. 29.6% (32/108)] were significantly higher than those in normal immune group (both P &lt; 0.05). In terms of clinical symptoms, the proportion of fever in the immunocompromised group was significantly lower than that in the immune normal group [49.2% (30/61) vs. 66.7% (72/108), P &lt; 0.05]. Neutrophil count (NEU) and neutrophil percentage (NEU%) in the immunocompromised group were significantly lower than those in the normal immune group. Lymphocyte percentage (LYM%), neutrophil/lymphocyte ratio (NLR), C-reactive protein (CRP), procalcitonin (PCT), APACHE II score, combined shock rate, incidence of immune paralysis, and mortality during hospitalization in the immunocompromised group were significantly higher than those in the normal immune group. Logistic regression analysis showed that NLR, CRP and PCT were risk factors for patients with immunocompromised sepsis (all P &lt; 0.05). The above indicators were used as covariables to construct a Logistic regression equation, that was, Logit (P) = 0.025X&lt;sub&gt;1&lt;/sub&gt;+0.010X&lt;sub&gt;2&lt;/sub&gt;+0.013X&lt;sub&gt;3&lt;/sub&gt;-2.945, where X&lt;sub&gt;1&lt;/sub&gt;, X&lt;sub&gt;2&lt;/sub&gt; and X&lt;sub&gt;3&lt;/sub&gt; represent NLR, CRP and PCT respe","PeriodicalId":24079,"journal":{"name":"Zhonghua wei zhong bing ji jiu yi xue","volume":"37 3","pages":"245-250"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143812526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Current status and visual analysis of the burn-related sepsis].
Zhonghua wei zhong bing ji jiu yi xue Pub Date : 2025-03-01 DOI: 10.3760/cma.j.cn121430-20240806-00669
Like Zhang, Wei Yi, Lijing Zhu, Weibo Xie, Zhicheng Gu, Guosheng Wu, Zhaofan Xia
{"title":"[Current status and visual analysis of the burn-related sepsis].","authors":"Like Zhang, Wei Yi, Lijing Zhu, Weibo Xie, Zhicheng Gu, Guosheng Wu, Zhaofan Xia","doi":"10.3760/cma.j.cn121430-20240806-00669","DOIUrl":"https://doi.org/10.3760/cma.j.cn121430-20240806-00669","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To explore the current status, evolution, hot topics, and future research trends in the field of burn-related sepsis research through a visual analysis of literature.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A bibliometric method was employed to retrieve articles related to burn-related sepsis from January 1, 1994, to May 16, 2024, in the China National Knowledge Infrastructure (CNKI) and the Web of Science database. The CiteSpace 6.3.R1 software was used to analyze the retrieved literature. The number of publications, authors, countries, and institutions in both Chinese and English literature was statistically analyzed. Co-occurrence analysis, clustering analysis, and co-citation analysis of keywords were performed.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 1 090 articles from the CNKI database and 1 143 articles from the Web of Science database were retrieved. Over the past 20 years, the volume of Chinese publications has remained stable, although there has been a slight decline in the past two years. In contrast, the number of English publications, after a period of growth, showed a sharp decline over the past three years. In Chinese literature, 1 457 authors published articles on burn-related sepsis as first authors, with 14 core authors publishing four or more articles. In English literature, 98 authors published articles on burn-related sepsis as first authors. Research on burn-related sepsis was conducted by 76 countries, with the United States having the most collaborations and publications. Globally, 1 349 institutions published articles on burn-related sepsis, with the top institutions being the First Affiliated Hospital of the PLA General Hospital (8 articles) for Chinese literature and the University of Texas Medical Branch (57 articles) for English literature. In the co-occurrence analysis, 208 Chinese keywords and 211 English keywords were included. Excluding keywords related to search terms, the top five most frequent keywords in Chinese literature were burn, sepsis, infection, severe burn, and procalcitonin; the top five most frequent keywords in English literature were sepsis, septic shock, mortality, injury, and burn injury. Chinese keyword analysis identified six clusters, with the largest being sepsis, followed by procalcitonin, infection, and severe burn. English keyword analysis identified seven clusters, with the largest being expression, followed by epidemiology, inhalation injury, and acute kidney injury. The persistent clusters in Chinese literature were procalcitonin, with recent emerging nodes being severe burn, inflammatory response, platelets, and predictive value. In English literature, the persistent clusters were inhalation injury and nitric oxide, with recent emerging nodes being continuous renal replacement therapy, hemorrhagic shock, and early enteral nutrition. The longest-lasting emergent keyword in Chinese literature was delayed resuscitation (2003-2010), with the highest emergent stre","PeriodicalId":24079,"journal":{"name":"Zhonghua wei zhong bing ji jiu yi xue","volume":"37 3","pages":"255-261"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143812532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Design of a head auxiliary support device in prone position].
Zhonghua wei zhong bing ji jiu yi xue Pub Date : 2025-03-01 DOI: 10.3760/cma.j.cn121430-20240723-00625
Xinyu Li, Weilian Ni, Weiqiang Huo, Xueqin Zhao
{"title":"[Design of a head auxiliary support device in prone position].","authors":"Xinyu Li, Weilian Ni, Weiqiang Huo, Xueqin Zhao","doi":"10.3760/cma.j.cn121430-20240723-00625","DOIUrl":"https://doi.org/10.3760/cma.j.cn121430-20240723-00625","url":null,"abstract":"<p><p>Prone position ventilation (PPV) is an important protective strategy for lung ventilation, widely used in clinical practice, especially since the novel coronavirus infection pandemic. Since PPV is a non-physiological position, improper implementation and management can lead to serious adverse events such as pressure injury, facial edema, unplanned extubation and (or) reintubation, and even asphyxia. At present, preventive and protective strategies are mainly used to manage PPV-related complications in clinical practice. These strategies not only increase the workload of medical staff and the use of consumables, but also increase the medical cost of patients, further burdening patients and their families economically. To overcome the above problems, the medical staff of the department of critical care medicine of Tianjin Third Central Hospital designed a prone position head auxiliary support device and obtained a national utility model patent (patent number: ZL 2022 2 1751906.3). The device consists of annular plate, folding plate, support frame, reflector and wheel bodies. It serves to reduce pressure on the head and facial skin, while also exposing the mouth, nose, eyes, and ears to the hollow position of the annular plate according to the patient's position. At the same time, the patient's face or side skin can be observed through the lower reflector. The height of the annular plate was adjusted by adjusting the support frame, and the head was raised to reduce facial edema. The setting of strip groove, through hole and hook can sort out the facial pipeline, keep the drainage unobstructed, prevent catheter displacement and unplanned extubation, and has certain clinical promotion and practical value.</p>","PeriodicalId":24079,"journal":{"name":"Zhonghua wei zhong bing ji jiu yi xue","volume":"37 3","pages":"297-299"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143812552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Research status of experimental animal models of sepsis].
Zhonghua wei zhong bing ji jiu yi xue Pub Date : 2025-03-01 DOI: 10.3760/cma.j.cn121430-20240226-00162
Zhenglin Chang, Bingsen Chen, Haojie Wu, Zhangkai Cheng, Baoqing Sun
{"title":"[Research status of experimental animal models of sepsis].","authors":"Zhenglin Chang, Bingsen Chen, Haojie Wu, Zhangkai Cheng, Baoqing Sun","doi":"10.3760/cma.j.cn121430-20240226-00162","DOIUrl":"https://doi.org/10.3760/cma.j.cn121430-20240226-00162","url":null,"abstract":"<p><p>Sepsis is a lethal condition resulting from the host's dysregulated response, involving complex pathophysiological mechanisms, including the host's biphasic immune response and metabolic disturbances. Diagnosing and treating sepsis remain formidable challenges, with the absence of definitive biomarkers and effective therapeutic interventions to date. Animal models of sepsis are pivotal in unraveling the disease's pathogenesis and identifying potential treatments, playing a crucial role in enhancing our comprehension of its intrinsic nature. However, there is no animal model that can comprehensively and accurately simulate the complex pathophysiological process of human sepsis. This review discusses the widely used sepsis animal models, exploring their advantages and limitations in terms of pathogenesis, inflammatory response, pathophysiological changes, and organ dysfunction. It summarizes the application scenarios and latest research advancements of these models and provides an outlook on potential future improvements.</p>","PeriodicalId":24079,"journal":{"name":"Zhonghua wei zhong bing ji jiu yi xue","volume":"37 3","pages":"310-316"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143812604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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