Critical Care and Resuscitation最新文献_第2页

Science-based fluid therapy in the intensive care unit: Professor Rinaldo Bellomo’s legacy 重症监护室的科学液体疗法：里纳尔多·贝洛莫教授的遗产

IF 1.7 4区医学

Critical Care and Resuscitation Pub Date : 2025-09-01 DOI: 10.1016/j.ccrj.2025.100145

Simon R. Finfer DrMed , Naomi E. Hammond PhD , John A. Myburgh PhD

{"title":"Science-based fluid therapy in the intensive care unit: Professor Rinaldo Bellomo’s legacy","authors":"Simon R. Finfer DrMed , Naomi E. Hammond PhD , John A. Myburgh PhD","doi":"10.1016/j.ccrj.2025.100145","DOIUrl":"10.1016/j.ccrj.2025.100145","url":null,"abstract":"<div><div>Research into the use of resuscitation and “maintenance” fluids in the intensive care unit was integral to the development of the Australian and New Zealand Intensive Care Society Clinical Trials Group (CTG) and the CTG being recognised as one of the most productive and influential trials groups in the world. Professor Rinaldo Bellomo (Rinaldo) played a central and critical role in this research and in this article; we focus on Rinaldo’s many roles and contributions to the key large clinical trials that changed the critical care research landscape in Australia and New Zealand and clinical practice worldwide. With a proposed recruitment of 7000 participants, the Saline versus Albumin Fluid Evaluation study was the first large pragmatic trial conducted in intensive care units anywhere in the world. Rinaldo brought the concept of the trial to the CTG and was critical to securing funding from multiple sources at a time when Australian National Health and Medical Research Council’s funding limits would cover only a fraction of the costs of such a trial. His personal contacts at CSL Ltd. and the Australian Red Cross Blood Service helped secure the supply of study fluids and made possible the seemingly impossible task of blinding a trial of two fluids that were macroscopically different with one supplied in glass bottles and the other in polyvinyl chloride bags. The successful conduct of the Saline versus Albumin Fluid Evaluation trial, the CTG’s first publication in <em>The New England Journal of Medicine</em> and presentation at the US Food and Drugs Administration, established the CTG on the global stage and served as a template for the Crystalloid versus Hydroxyethyl Starch Study and PlasmaLyte-148® versus Saline Study trials; we can only speculate what fraction of this could have been achieved without Rinaldo.</div></div>","PeriodicalId":49215,"journal":{"name":"Critical Care and Resuscitation","volume":"27 3","pages":"Article 100145"},"PeriodicalIF":1.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145278196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Rinaldo Bellomo's contribution to trauma and traumatic brain injury research 雷纳多·贝洛莫对创伤和创伤性脑损伤研究的贡献

IF 1.7 4区医学

Critical Care and Resuscitation Pub Date : 2025-09-01 DOI: 10.1016/j.ccrj.2025.100130

Craig French

引用次数: 0

One hundred trials of solitude: A call to action 孤独的一百次考验：行动的呼唤

IF 1.7 4区医学

Critical Care and Resuscitation Pub Date : 2025-09-01 DOI: 10.1016/j.ccrj.2025.100122

Glenn Eastwood

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Rinaldo Bellomo's seminal contribution to observational research using the ANZICS CORE registry Rinaldo Bellomo对使用ANZICS CORE注册表进行观察研究的开创性贡献

IF 1.7 4区医学

Critical Care and Resuscitation Pub Date : 2025-09-01 DOI: 10.1016/j.ccrj.2025.100140

Michael Bailey PhD , Sean M. Bagshaw MD, MSc , Graeme K. Hart MBBS , David Pilcher MBBS

{"title":"Rinaldo Bellomo's seminal contribution to observational research using the ANZICS CORE registry","authors":"Michael Bailey PhD , Sean M. Bagshaw MD, MSc , Graeme K. Hart MBBS , David Pilcher MBBS","doi":"10.1016/j.ccrj.2025.100140","DOIUrl":"10.1016/j.ccrj.2025.100140","url":null,"abstract":"<div><div>Rinaldo Bellomo advanced critical care not only through randomised trials but also through rigorous use of observational data, particularly from the ANZICS Centre for Outcome and Resource Evaluation (ANZICS CORE) Registry. At a time when retrospective analyses were often confined to hypothesis generation, he showed that carefully curated, clinically grounded registry studies could inform policy and change practice. Recognising early the potential of ANZICS CORE to become a leading registry, he worked to strengthen its data architecture and published in journals such as <em>The New England Journal of Medicine</em> and <em>JAMA</em>, helping to spark global dialogue and shape guidelines. Using the Adult Patient Database, he described epidemiological trends, identified clinically relevant questions, designed, justified and evaluated randomised trials, and monitored the uptake of evidence-based practice. His work addressed key challenges in sepsis, acute kidney injury, glycaemic control, temperature management and health equity, and was marked by clear case definitions, extensive sensitivity analyses and transparent reporting. This article reviews selected contributions using ANZICS CORE data and outlines how his legacy endures through the value of these datasets and the many researchers he mentored.</div></div>","PeriodicalId":49215,"journal":{"name":"Critical Care and Resuscitation","volume":"27 3","pages":"Article 100140"},"PeriodicalIF":1.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145278195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Rinaldo Bellomo and the evolution of critical care survivorship 里纳尔多·贝洛莫和重症监护生存的演变

IF 1.7 4区医学

Critical Care and Resuscitation Pub Date : 2025-09-01 DOI: 10.1016/j.ccrj.2025.100143

Carol L. Hodgson PhD, PT, Sue Berney BPhysio, PhD

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Unveiling “The Bellomo Effect”: A tribute from Professor Rinaldo Bellomo’s Research Fellow Family 揭开“贝洛莫效应”：来自雷纳多·贝洛莫教授的研究员家庭的致敬

IF 1.7 4区医学

Critical Care and Resuscitation Pub Date : 2025-09-01 DOI: 10.1016/j.ccrj.2025.100141

引用次数: 0

A legacy in print: The publication impact of Professor Rinaldo Bellomo 印刷中的遗产：里纳尔多·贝洛莫教授的出版影响

IF 1.7 4区医学

Critical Care and Resuscitation Pub Date : 2025-09-01 DOI: 10.1016/j.ccrj.2025.100124

Michael Bailey PhD , Ary Serpa Neto MD, PhD , Paul J. Young MD, PhD

引用次数: 0

Seeking truth: Less about being right, more about being less wrong 寻求真理：少做正确的事，少做错误的事

IF 1.7 4区医学

Critical Care and Resuscitation Pub Date : 2025-09-01 DOI: 10.1016/j.ccrj.2025.100144

Derek C. Angus MD, MPH

引用次数: 0

Rinaldo’s role in the medical emergency team and rapid response systems 雷纳多在医疗急救队和快速反应系统中的作用

IF 1.7 4区医学

Critical Care and Resuscitation Pub Date : 2025-09-01 DOI: 10.1016/j.ccrj.2025.100127

Daryl Jones BSc(Hons), MBBS, FRACP, FCICM, MD, PhD , Donna Goldsmith BN, MN, MBA , Michael DeVita MD, FRCP, FCCM , Ken Hillman AO MBBS, FRCA, FCICM, FRCP, MD

{"title":"Rinaldo’s role in the medical emergency team and rapid response systems","authors":"Daryl Jones BSc(Hons), MBBS, FRACP, FCICM, MD, PhD , Donna Goldsmith BN, MN, MBA , Michael DeVita MD, FRCP, FCCM , Ken Hillman AO MBBS, FRCA, FCICM, FRCP, MD","doi":"10.1016/j.ccrj.2025.100127","DOIUrl":"10.1016/j.ccrj.2025.100127","url":null,"abstract":"<div><div>In the 1990s, there was emerging evidence that patients admitted to hospitals frequently suffered in-hospital cardiac arrest, unplanned admission to the intensive care unit (ICU), and potentially preventable in-hospital death. These events were often preceded by objective signs of instability and suboptimal recognition and response by hospital ward staff. Rinaldo Bellomo collaborated with key Australian and international leaders to develop a novel and paradigm-shifting model of care referred to as the medical emergency team (MET). This team is comprised of senior staff members who are experts in the assessment and management of acutely deteriorating patients.</div><div>In Australia and New Zealand, staff members from the ICU are frequently the team leaders for the MET. The team is called when a patient develops objective signs of clinical deterioration, prior to the onset of cardiac arrest. Rinaldo led, mentored, and supervised a systematic and structured research program that evaluated the nature and effectiveness of the MET at Austin Health and throughout Australia. This commenced with single-centre before-and-after studies and progressed to the first Australian ICU cluster-randomised controlled trial. His unique skillset was pivotal in the emergence and promulgation of this model of care worldwide resulting in countless lives saved from preventable morbidity and mortality.</div></div>","PeriodicalId":49215,"journal":{"name":"Critical Care and Resuscitation","volume":"27 3","pages":"Article 100127"},"PeriodicalIF":1.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145278414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Redefining the modern paradigm of vasopressor therapy for vasodilatory shock 重新定义血管舒张性休克的血管加压治疗的现代范例

IF 1.7 4区医学

Critical Care and Resuscitation Pub Date : 2025-09-01 DOI: 10.1016/j.ccrj.2025.100148

Emily J. See MBBS , Lakhmir S. Chawla MD

{"title":"Redefining the modern paradigm of vasopressor therapy for vasodilatory shock","authors":"Emily J. See MBBS , Lakhmir S. Chawla MD","doi":"10.1016/j.ccrj.2025.100148","DOIUrl":"10.1016/j.ccrj.2025.100148","url":null,"abstract":"<div><div>Vasodilatory shock remains a leading cause of morbidity and mortality in the intensive care unit. Vasopressors are the cornerstone of treatment when vasodilatory shock persists despite adequate fluid resuscitation, yet their effects on organ-specific blood flow, perfusion, and oxygenation are complex and may contribute to harm. This review summarises the extensive contributions of Professor Rinaldo Bellomo to advancing our knowledge of vasopressor therapy in clinical practice. Central to his work was the concept of personalised haemodynamic targets, introduced through the concept of “mean perfusion pressure deficit”, which linked premorbid perfusion pressure to outcomes and challenged the universal application of a mean arterial pressure threshold of ≥65 mmHg. In collaboration with Professor Clive May, Bellomo established a chronically instrumented large animal model of hyperdynamic sepsis, yielding fundamental insights into the discordance between the macrocirculation and microcirculation, the vulnerability of the renal medulla to hypoxia, and the mechanisms of septic acute kidney injury. This model enabled direct comparison of vasopressor drugs in both healthy animals and during septic shock, demonstrating their heterogeneous effects on global and regional blood flow, perfusion, and tissue oxygenation. Knowledge translation to the bedside was achieved through the conduct of pivotal clinical trials, from early studies refuting the utility of “renal-dose dopamine” to landmark contributions to the ATHOS (angiotensin II treatment of high-ouput shock) program, which established angiotensin II as a novel vasopressor in refractory vasodilatory shock. Collectively, Bellomo’s work has transformed vasopressor therapy from empirical convention towards individualised practice, and it continues to inform clinical investigation and guideline development.</div></div>","PeriodicalId":49215,"journal":{"name":"Critical Care and Resuscitation","volume":"27 3","pages":"Article 100148"},"PeriodicalIF":1.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145278413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0