Anaesthesia and Intensive Care Medicine最新文献_第8页

Sepsis in 2024: a review 2024 年的败血症：回顾

IF 0.2

Anaesthesia and Intensive Care Medicine Pub Date : 2024-10-01 DOI: 10.1016/j.mpaic.2024.06.010

Jeffrey Wayland, J. Pedro Teixeira, Nathan D. Nielsen

{"title":"Sepsis in 2024: a review","authors":"Jeffrey Wayland, J. Pedro Teixeira, Nathan D. Nielsen","doi":"10.1016/j.mpaic.2024.06.010","DOIUrl":"10.1016/j.mpaic.2024.06.010","url":null,"abstract":"<div><div>Sepsis is responsible for tremendous morbidity, mortality, and healthcare expenditure worldwide. Over the past decade, the conceptualization of sepsis has shifted from one based upon an inflammatory response to one defined by a dysregulated immune response to infection and resulting organ dysfunction. The definitions of sepsis and septic shock were revised to improve their diagnostic specificity and facilitate accurate and timely diagnoses at the bedside. The core of sepsis management remains <em>early</em> identification and diagnostic testing, <em>early</em> antimicrobial therapy, and <em>early</em> haemodynamic resuscitation. Recently, there has been additional movement towards classifying and treating sepsis based on genotype, phenotype, and endotype, though these methods are not yet widely accessible or adopted. Current guidelines recommend that the first steps in treatment and resuscitation take place within <em>1 hour</em> from when septic shock is suspected. Additional essential elements in the current sepsis management guidelines include using dynamic parameters to assess fluid responsiveness, a conservative fluid strategy following initial resuscitation (with subsequent de-resuscitation when possible), serial reassessments of haemodynamic status, and adaptable treatment plans. This review provides a summary of the most recent clinical trials and practice guidelines for the diagnosis and treatment of sepsis in the critical care setting.</div></div>","PeriodicalId":45856,"journal":{"name":"Anaesthesia and Intensive Care Medicine","volume":"25 10","pages":"Pages 642-651"},"PeriodicalIF":0.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142419787","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

Physical rehabilitation and critical illness 身体康复和危重病

IF 0.2

Anaesthesia and Intensive Care Medicine Pub Date : 2024-10-01 DOI: 10.1016/j.mpaic.2024.06.012

Katherine Cox, Alana Rix, Carol L. Hodgson

{"title":"Physical rehabilitation and critical illness","authors":"Katherine Cox, Alana Rix, Carol L. Hodgson","doi":"10.1016/j.mpaic.2024.06.012","DOIUrl":"10.1016/j.mpaic.2024.06.012","url":null,"abstract":"<div><div>With the evolution of interventions in the intensive care unit (ICU), an increasing number of patients are surviving critical illness. Survivors of critical illness commonly experience post-intensive care syndrome (PICS), which encompasses a range of physical, cognitive, social, and psychological impairments that persist well beyond discharge from hospital. Physical rehabilitation is an intervention that is implemented to prevent and treat the physical impairments that manifest as part of PICS. There is significant evidence to support functional, goal-directed physical rehabilitation interventions in ICU as it is shown to improve physical function without increasing the risk of adverse events. There are clear guidelines that outline the specific safety criteria for commencing physical rehabilitation in ICU, however, there is further research warranted to determine the optimal dosage. Beyond the ICU admission, there are limited recommendations regarding ongoing physical rehabilitation however there is emerging evidence to support the implementation of home-based telehealth programmes to help improve patient's strength, endurance, and quality of life. Regardless, it is recommended that physical rehabilitation is delivered as part of routine care during an ICU admission and continue throughout the transitions of care to enable the best possible recovery.</div></div>","PeriodicalId":45856,"journal":{"name":"Anaesthesia and Intensive Care Medicine","volume":"25 10","pages":"Pages 664-670"},"PeriodicalIF":0.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142419798","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

Self-assessment 自我评估

IF 0.2

Anaesthesia and Intensive Care Medicine Pub Date : 2024-10-01 DOI: 10.1016/j.mpaic.2024.08.014

Vijayanand Nadella

引用次数: 0

Consent for anaesthesia: considerations in children and young people 麻醉同意：儿童和青少年的注意事项

IF 0.2

Anaesthesia and Intensive Care Medicine Pub Date : 2024-10-01 DOI: 10.1016/j.mpaic.2024.07.002

Niall Tierney, Caoimhe Casby, Barry Lyons

引用次数: 0

Histamine and antihistamines 组胺和抗组胺剂

IF 0.2

Anaesthesia and Intensive Care Medicine Pub Date : 2024-10-01 DOI: 10.1016/j.mpaic.2024.06.007

Martin Ince, Peter Ruether

{"title":"Histamine and antihistamines","authors":"Martin Ince, Peter Ruether","doi":"10.1016/j.mpaic.2024.06.007","DOIUrl":"10.1016/j.mpaic.2024.06.007","url":null,"abstract":"<div><div>Histamine is one of the most important and extensively studied biological molecules in the human body. It plays a constitutive role within almost every bodily system, but most notably within the stomach, where it regulates acid secretion, the central nervous system, where it acts as a neurotransmitter, the cardiovascular system, where it affects cardiac output and vascular permeability, and it has a well-established role in allergy and anaphylaxis. Histamine exerts its effects through four distinct receptor subtypes: H1, H2, H3 and H4. Predominantly, though not exclusively, these take the form of G-protein-coupled receptors. Clinically used antihistamines demonstrate inverse agonism to the histamine receptor and drugs are available with activity at H1, H2 and H3 receptors. H1 antihistamines are used in the treatment of allergy, and are classified as either first or second generation. First-generation antihistamines have significant sedative side effects. H2 antihistamines are predominantly used for the treatment of gastrooesophageal reflux and peptic ulcer disease; however, the most widely used of these, ranitidine, has been withdrawn from use due to (impurity related) safety concerns. H3 antihistamines have been explored for the treatment of neurological disease and to date the only licensed H3 antihistamine is used for the treatment of narcolepsy. Multiple uses have been suggested for H4 antihistamines, including immunomodulation, the treatment of asthma and even as an analgesic. However, no (commercially available) drug exists as of yet.</div></div>","PeriodicalId":45856,"journal":{"name":"Anaesthesia and Intensive Care Medicine","volume":"25 10","pages":"Pages 734-740"},"PeriodicalIF":0.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142419794","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

Recognition of the critically ill patient and escalation of therapy 危重病人的识别和治疗升级

IF 0.2

Anaesthesia and Intensive Care Medicine Pub Date : 2024-10-01 DOI: 10.1016/j.mpaic.2024.06.009

Amy Brown, Apoorva Ballal, Mo Al-Haddad

{"title":"Recognition of the critically ill patient and escalation of therapy","authors":"Amy Brown, Apoorva Ballal, Mo Al-Haddad","doi":"10.1016/j.mpaic.2024.06.009","DOIUrl":"10.1016/j.mpaic.2024.06.009","url":null,"abstract":"<div><div>Critical illness often involves multiple organ failures and is associated with significant morbidity and mortality. In the vast majority of patients, there is a recognizable period of physiological deterioration which heralds the development of organ failure and critical illness. Despite efforts to improve the detection and management of critical illness, signs of deterioration are often missed and decisions to move patients to critical care units are delayed. Standardized approaches which implement an effective ‘chain of response’ are now utilized worldwide. They focus on attempting to reduce the incidence of serious adverse events (SAEs) such as in-hospital cardiac arrest and unplanned intensive care unit (ICU) admission using preventative measures. These systems should include: accurate recording and documentation of vital signs, recognition and interpretation of abnormal values, rapid bedside patient assessment by trained teams and appropriate interventions. Early warning systems (EWS) are an important part of this and can help identify patients at risk of deterioration and SAEs. Assessment of the critically ill patient should be undertaken by an appropriately trained clinician and follow a structured ABCDE (airway, breathing, circulation, disability and exposure) format. This facilitates correction of life-threatening problems by priority and provides a standardized communication framework between professionals. Lastly, timely support and input from members of the critical care team are vital to ensure optimal outcomes for critically ill patients.</div></div>","PeriodicalId":45856,"journal":{"name":"Anaesthesia and Intensive Care Medicine","volume":"25 10","pages":"Pages 637-641"},"PeriodicalIF":0.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142419701","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

Pharmacological modulation of cardiac function and control of blood vessel calibre 药理调节心脏功能和控制血管口径

IF 0.2

Anaesthesia and Intensive Care Medicine Pub Date : 2024-10-01 DOI: 10.1016/j.mpaic.2024.08.002

John Nicholls, Elliott Bertram-Ralph

引用次数: 0

Update on ENT anaesthesia in children 儿童耳鼻喉科麻醉的最新进展

IF 0.2

Anaesthesia and Intensive Care Medicine Pub Date : 2024-10-01 DOI: 10.1016/j.mpaic.2024.06.011

Rory W Blackler, Zoë E Brown, Neil K Chadha

引用次数: 0

Haematological problems in intensive care: recent advances and developments 重症监护中的血液学问题：最新进展与发展

IF 0.2

Anaesthesia and Intensive Care Medicine Pub Date : 2024-10-01 DOI: 10.1016/j.mpaic.2024.07.004

Samantha Gaw, Christopher J Wright

引用次数: 0

Bacterial infections of the respiratory tract and their pharmacological treatment 呼吸道细菌感染及其药物治疗

IF 0.2

Anaesthesia and Intensive Care Medicine Pub Date : 2024-09-01 DOI: 10.1016/j.mpaic.2024.06.006

Abubaker Eltayeb, Susannah Leaver

{"title":"Bacterial infections of the respiratory tract and their pharmacological treatment","authors":"Abubaker Eltayeb, Susannah Leaver","doi":"10.1016/j.mpaic.2024.06.006","DOIUrl":"10.1016/j.mpaic.2024.06.006","url":null,"abstract":"<div><p>Bacterial infections of the respiratory tract contribute to significant morbidity and mortality worldwide. Early recognition of lower respiratory tract infections is fundamental for the management and prevention of complications such a sepsis. Common respiratory infections such as community-acquired, hospital-acquired pneumonia, atypical bacterial infection, and acute infective exacerbations of chronic disease such as chronic obstructive pulmonary disease and bronchiectasis are caused by a wide range of pathogens which can be treated in the community or in the hospital setting based on assessment of severity. Antibiotics are by far the most commonly used pharmacological intervention in the management of bacterial infections. Antibiotics have different and unique mechanisms of action against bacteria and several guidelines exist to direct treatment of chest infections. However, with inappropriate use of antibiotics, the resistance of bacteria to antimicrobials has seen significant growth globally, causing concern to the public health. Other pharmacological interventions for the management of infections and sepsis are in the development phase.</p></div>","PeriodicalId":45856,"journal":{"name":"Anaesthesia and Intensive Care Medicine","volume":"25 9","pages":"Pages 623-629"},"PeriodicalIF":0.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142148235","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