世界危重病急救学杂志(英文版)最新文献

{"title":"Revisiting acute kidney injury outcomes in traumatic brain injury.","authors":"Nupur Karan, Rohit Patnaik","doi":"10.5492/wjccm.v15.i1.114998","DOIUrl":"10.5492/wjccm.v15.i1.114998","url":null,"abstract":"<p><p>Acute kidney injury in traumatic brain injury is a major concern, affecting up to 10% of the patients in intensive care unit due to multifaceted mechanisms, including hemorrhagic shock, rhabdomyolysis, and brain-kidney cross-talk, compounded by hyperosmolar therapies. A significant challenge is that serum creatinine is considered a late and nonspecific marker, often missing the critical early insult phase. Future strategies for early prediction and prevention must focus on emerging factors, such as preventing hyperchloremia and utilizing novel biomarkers, such as neutrophil gelatinase-associated lipocalin and kidney injury molecule 1, which detect subclinical injury and predict the need for renal replacement therapy. Composite risk stratification tools (<i>e.g.</i>, renal angina index) are vital for personalized management. Although over 90% of patients recover renal function, prevention of collateral damage to the kidney must be recognized as a critical priority in traumatic brain injury care.</p>","PeriodicalId":66959,"journal":{"name":"世界危重病急救学杂志(英文版)","volume":"15 1","pages":"114998"},"PeriodicalIF":0.0,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13010807/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147517186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Death in patients with immune-mediated inflammatory diseases in the intensive care unit: First week data.","authors":"Ilia S Avrusin, Natalia N Abramova, Liudmila A Firsova, Yury S Aleksandrovich, Dmitry O Ivanov, Mikhail M Kostik","doi":"10.5492/wjccm.v15.i1.112265","DOIUrl":"10.5492/wjccm.v15.i1.112265","url":null,"abstract":"<p><strong>Background: </strong>Systemic immune-mediated diseases can be quite severe in both course and complications, causing multiple organ failure and death. These patients are often required to be hospitalized in an intensive care unit (ICU).</p><p><strong>Aim: </strong>To find early predictors of death in patients with immune-inflammatory diseases hospitalized in the ICU.</p><p><strong>Methods: </strong>The study included 51 patients (23 boys, 28 girls) with immune-inflammatory diseases, including multisystem inflammatory syndrome associated with coronavirus disease 2019 (<i>n</i> = 18), systemic rheumatic diseases (<i>n</i> = 24), and generalized infections (<i>n</i> = 9) aged from 7 months up to 17 years old, admitted to the ICU of the clinic of Saint Petersburg State Pediatric Medical University in the period from 2007 to 2023. All patients were divided into those with a fatal outcome (<i>n</i> = 13) and those who recovered (<i>n</i> = 38). Macrophage activation syndrome (MAS) was diagnosed by the 2016 European League Against Rheumatism/American College of Rheumatology/Paediatric Rheumatology International Trials Organisation criteria.</p><p><strong>Results: </strong>First-day predictors were white blood cell ≤ 3.1 × 10⁹/L, platelets ≤ 168 × 10⁹/L, diuresis ≤ 1.5 mL/kg/hour, low saturation, K⁺ > 4.7 mmol/L, albumin ≤ 30 g/L, creatinine > 74 μmol/L, pH ≤ 7.36, HCO3^- ≤ 22.2, Glasgow Coma Scale score ≤ 13, Sequential Organ Failure Assessment (SOFA) score > 2, oxygen therapy, mechanical ventilation (MV), fresh frozen plasma transfusions and biological treatment. The third-day predictors were: White blood cell ≤ 4.0 × 10⁹/L, platelets ≤ 63 × 10⁹/L, hemoglobin ≤ 87 g/L, C-reactive protein (CRP) > 129 mg/L, triglycerides > 2.45 mmol/L, albumin ≤ 28 g/L, creatinine > 83.5 μmol/L, pH ≤ 7.38, Glasgow Coma Scale score ≤ 10, SOFA score > 2 and need in MV, intravenous immunoglobulin, and blood transfusion requirements. On the fifth day, the main predictors were CRP > 28 mg/L, triglycerides > 2.3 mmol/L, creatinine > 58 μmol/L, fibrinogen > 3.3 g/L, compliance with the MAS criteria, Glasgow Coma Scale score ≤ 14, SOFA score > 2, and need for MV, vasopressors, and anticoagulant therapy, as well as blood and fresh frozen plasma transfusions. The seventh-day predictors were CRP > 19.1 mg/L, albumin ≤ 35 g/L, total protein ≤ 55 g/L, compliance with the MAS criteria, Glasgow Coma Scale score ≤ 12, SOFA score > 3, and need for MV and biological and anticoagulant therapy.</p><p><strong>Conclusion: </strong>Hemaphagocytosis (leukopenia, thrombocytopenia, hyperferritinemia, increased histochemistry score), progressive decline in Glasgow Coma Scale, increasing SOFA scores, and persistent high CRP levels were markers of an unfavorable outcome in patients with immune-mediated inflammatory diseases.</p>","PeriodicalId":66959,"journal":{"name":"世界危重病急救学杂志(英文版)","volume":"15 1","pages":"112265"},"PeriodicalIF":0.0,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13010833/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147516328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"MicroRNAs in sepsis: Advances in diagnosis and prognostic monitoring.","authors":"Valeria Fraioli, Marco Sanvitti, Federico Bilotta","doi":"10.5492/wjccm.v15.i1.114225","DOIUrl":"10.5492/wjccm.v15.i1.114225","url":null,"abstract":"<p><p>Sepsis and septic shock remain major global health challenges, with persistently high mortality despite advances in critical care. Conventional diagnostic tools, including the Sequential Organ Failure Assessment score and biomarkers such as C-reactive protein and procalcitonin, lack sufficient sensitivity and specificity, particularly in early disease. Circulating microRNAs (miRNAs), small non-coding RNAs regulating gene expression, have emerged as promising biomarkers for early diagnosis, prognostic assessment, and therapeutic monitoring. This narrative review synthesizes clinical studies published after 2022, highlighting the evolving role of circulating and extracellular vesicle-derived miRNAs in sepsis. Diagnostic investigations confirmed the accuracy of miRNA-451a (miR-451a) and miR-9-5p, while expanding evidence supports miR-193b-5p and miR-135a as additional diagnostic candidates. Contrasting results on miR-181a-5p emphasize the need for further validation. Prognostic and therapeutic monitoring studies identified miR-155, miR-182, miR-146b-5p, miR-126-5p, miR-195, and miR-497 as dynamic markers reflecting immune modulation and disease trajectory. Collectively, these findings highlight circulating miRNAs as powerful, versatile biomarkers that advance precision medicine in sepsis, pending multicenter validation and methodological standardization for clinical translation.</p>","PeriodicalId":66959,"journal":{"name":"世界危重病急救学杂志(英文版)","volume":"15 1","pages":"114225"},"PeriodicalIF":0.0,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13010834/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147516771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Point-of-care ultrasound for evaluating acute dyspnoea in emergency departments: Systematic review and meta-analysis.","authors":"Issam Seyala, Jonathan Soldera","doi":"10.5492/wjccm.v15.i1.113426","DOIUrl":"10.5492/wjccm.v15.i1.113426","url":null,"abstract":"<p><strong>Background: </strong>Acute dyspnoea is a common yet diagnostically complex presentation in emergency departments (EDs), representing approximately 2.4% of all visits. Traditional diagnostic tools-clinical assessment, chest radiography, and laboratory tests-may lack the precision required for timely and accurate diagnosis. Point-of-care ultrasound (POCUS) offers real-time, bedside imaging and has emerged as a promising tool to address these limitations.</p><p><strong>Aim: </strong>To evaluate the diagnostic accuracy and clinical effectiveness of POCUS <i>vs</i> conventional modalities in adults with acute dyspnoea in the ED.</p><p><strong>Methods: </strong>A comprehensive literature search was conducted across PubMed, EBSCO Host, MAG Online Library, Elsevier, and ProQuest without date restrictions. Studies were included if they involved adult ED patients undergoing POCUS for dyspnoea evaluation. Following PRISMA 2020 guidelines and PROSPERO registration (CRD42025649145), eligible studies were assessed using QUADAS-2, and diagnostic performance was analysed using MetaDisc software. Pooled sensitivity, specificity, likelihood ratios, diagnostic odds ratio (DOR), and receiver operating characteristic curves were calculated.</p><p><strong>Results: </strong>Out of 581 identified records, 44 studies met the inclusion criteria, with 19 included in the meta-analysis. The pooled sensitivity of POCUS was 85.6% (95%CI: 84.0%-87.2%) and specificity was 80.8% (95%CI: 79.0%-82.5%). The DOR was 68.09 (95%CI: 27.07-171.28), and the negative likelihood ratio was 0.14 (95%CI: 0.085-0.231), indicating strong potential to rule out serious pathology. Substantial heterogeneity was noted, mainly due to operator variability, study design, and diagnostic protocols.</p><p><strong>Conclusion: </strong>POCUS offers accurate, rapid, and cost-effective evaluation of acute dyspnoea in EDs. Standardised training and further research on outcomes, protocols, and underrepresented populations are essential for consistent, effective implementation.</p>","PeriodicalId":66959,"journal":{"name":"世界危重病急救学杂志(英文版)","volume":"15 1","pages":"113426"},"PeriodicalIF":0.0,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13010558/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147517121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Persistent health complications in COVID-19 hospitalized patients at tertiary care hospital in Western India.","authors":"Ashish Jain, Pushpendra Saraswat, Ayushi Sharma, Vinod Sharma, Ravi Jain","doi":"10.5492/wjccm.v15.i1.114620","DOIUrl":"10.5492/wjccm.v15.i1.114620","url":null,"abstract":"<p><strong>Background: </strong>Long coronavirus disease (COVID) is a condition characterized by persistent health issues following severe acute respiratory syndrome coronavirus 2 infection. The condition remains poorly understood, especially in terms of long-term impact on health and the quality of life. This study hypothesized that majority of the discharged patients experience long-term post-COVID-19 complications.</p><p><strong>Aim: </strong>To evaluate the long-term post-COVID-19 complications and its impact on the patients' quality of life.</p><p><strong>Methods: </strong>This retrospective cohort study, with telephonic interview-based follow-up, was conducted at a tertiary care hospital in western India between March and August 2024. The medical records of the patients hospitalized with COVID-19 during the second wave (between March and June 2021) and discharged, were reviewed. The data were collected from the patients <i>via</i> structured telephonic interviews that focused on post-infection sequelae across various bodily systems and was summarized using percentages and proportions.</p><p><strong>Results: </strong>A total of 1139 patients who met the inclusion criteria, participated in the study with a follow-up period of three years. Amongst the survivors (<i>n</i> = 1052) at the end of three years, 150 (14.25%) developed new or ongoing diseases after recovery from acute COVID-19, while 51 (4.8%) were still under treatment at the time of follow-up. Amongst these 150 long-COVID-19 patients, pulmonary disease (<i>n</i> = 27, 2.57%), body pain (<i>n</i> = 20, 1.90%), coronary artery disease or angioplasty, and diabetes mellitus (<i>n</i> = 17, 1.61% each), hypertension (<i>n</i> = 16, 1.52%), and fatigue (<i>n</i> = 13, 1.24%) were frequently reported. Although statistically insignificant, the patients who received three or more vaccine doses after the second wave of the pandemic reported slightly lower rates of post-COVID-19 morbidity and treatment requirements.</p><p><strong>Conclusion: </strong>The current study highlights the burdens of long-term complications following COVID-19 infection, with a broad spectrum of post-infection sequelae. However, the impact of vaccination on the course of development and treatment of long COVID could not be ascertained. This finding emphasizes the need for continued research and healthcare planning to address the persistent impact of COVID-19 upon the survivors.</p>","PeriodicalId":66959,"journal":{"name":"世界危重病急救学杂志(英文版)","volume":"15 1","pages":"114620"},"PeriodicalIF":0.0,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13010471/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147517027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neurobiological rhythms in critical care: A commentary on intensive care unit music therapy efficacy and mechanism.","authors":"Takahiko Nagamine","doi":"10.5492/wjccm.v15.i1.116487","DOIUrl":"10.5492/wjccm.v15.i1.116487","url":null,"abstract":"<p><p>This is a commentary on the randomized controlled trial by Mukhtar <i>et al</i>, which reported findings from a single, 30-minute music therapy session administered prior to extubation in mechanically ventilated intensive care unit (ICU) patients. The study found significant acute improvements in psychological distress and physiological stability, alongside an extraordinary, unexpected reduction in ICU length of stay and ICU mortality. These dramatic hard outcomes suggest a mechanism beyond distraction, requiring sustained modulation of the prefrontal cortex-limbic circuit and the substantial upregulation of neuroplasticity markers, specifically brain-derived neurotrophic factor (BDNF). Critically, the molecular changes required for structural reorganization and clinical benefits like reduced mortality necessitate repeated, sustained stimulus, a condition that sharply contrasts with the study's brief protocol. This presents a major mechanistic conundrum. Future research must therefore employ multisession, placebo-controlled, multicenter trials designed to measure objective, sustained neurobiological changes (<i>e.g.</i>, serum BDNF, heart rate variability) to definitively link music therapy to reduced morbidity and mortality in critical care.</p>","PeriodicalId":66959,"journal":{"name":"世界危重病急救学杂志(英文版)","volume":"15 1","pages":"116487"},"PeriodicalIF":0.0,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13010572/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147517008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predicting acute kidney injury in septic shock patients using inflammatory indices in the intensive care unit.","authors":"Jackson Rajendran, Song-Peng Ang, Maria Jose Lorenzo-Capps, Carlos Valladares, Eunseuk Lee, Veera Jayasree Latha Bommu, George Altarcha, Svitlana Pominov, Bryan Gregory, Jia Ee Chia, Jose Iglesias","doi":"10.5492/wjccm.v15.i1.114318","DOIUrl":"10.5492/wjccm.v15.i1.114318","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Acute kidney injury (AKI) is a prevalent and common complication in critically ill patients with septic shock, associated with increased morbidity, mortality, and healthcare resource utilization in the intensive care unit (ICU). While inflammatory indices derived from standard laboratory tests - such as the neutrophil-to-lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), neutrophil percentage to albumin ratio (NPAR) and aggregate index of systemic inflammation (AISI) - have emerged as promising biomarkers for systemic immune activation in critical illness, their direct value as predictors of AKI in large ICU cohorts remains uncertain.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;To evaluate the predictive value of inflammatory indices derived from standard laboratory tests as predictors of AKI in ICU patients with septic shock.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This retrospective cohort study utilized the eICU Collaborative Research Database, including adult patients with septic shock admitted to over 200 ICUs across the United States from 2014 to 2015. Patients with pre-existing end-stage renal disease, death within 24 hours, or insufficient data for inflammatory indices were excluded. Inflammatory markers (NLR, PLR, MLR, NPAR, SII, SIRI, AISI) and clinical variables were analyzed. Multivariable logistic regression, principal component analysis, and multilayer perceptron neural network modeling were employed to identify independent predictors of AKI, defined by Kidney Disease Global Outcomes criteria.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Among 12660 septic shock patients, 6552 (51.7%) developed AKI during their ICU stay. Patients with AKI were older, had higher body mass index and Sequential Organ Failure Assessment scores, and a greater burden of comorbidities such as chronic kidney disease and diabetes. Univariate analysis showed significantly higher levels of NLR, MLR, SII, NPAR, SIRI, and AISI in the AKI group, suggesting an association between systemic inflammation and kidney injury. However, these indices displayed strong multicollinearity with other clinical and laboratory variables. In logistic regression, traditional predictors such as baseline serum creatinine, blood urea nitrogen, Sequential Organ Failure Assessment score, chronic kidney disease, vasopressor use, and selected comorbidities remained independently associated with AKI, while most individual inflammatory indices did not retain independent significance due to multicollinearity. To address this, principal component analysis employed, which identified three major components - an inflammatory/hematological component, a metabolic/renal/inflammatory component, and an electrolyte/age component. Incorporating these composite dimensions into predictive models significantly improved discrimination for AKI risk. Neural network models further expoun","PeriodicalId":66959,"journal":{"name":"世界危重病急救学杂志(英文版)","volume":"15 1","pages":"114318"},"PeriodicalIF":0.0,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13010851/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147517178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Critical care in hematopoietic stem cell transplantation: Common complications and management.","authors":"Nishkarsh Gupta, Prateek Maurya, Prakriti Maurya, Anju Gupta","doi":"10.5492/wjccm.v15.i1.113235","DOIUrl":"10.5492/wjccm.v15.i1.113235","url":null,"abstract":"<p><p>This narrative review synthesizes contemporary evidence regarding critical care complications following hematopoietic stem cell transplantation (HSCT) and evaluates management strategies for improving outcomes in this complex population. We conducted a comprehensive literature search of MEDLINE/PubMed databases from January 2014 to December 2024, focusing on critical care complications, prognostic factors, and therapeutic interventions in HSCT recipients. Intensive care unit (ICU) admission affects 8.8%-40% of HSCT recipients, with contemporary 30-day survival reaching 57.7% in specialized centers. Respiratory failure predominates as the primary indication for ICU support. The Lung Injury Prevention Score for Bone Marrow Transplant demonstrates strong predictive accuracy for acute respiratory distress syndrome development. Novel therapeutic approaches show promise, including inhaled tranexamic acid protocols for diffuse alveolar hemorrhage showing promising hemostasis rates in cohort studies, though randomized controlled trial data are lacking. JAK inhibitors achieve improved response rates compared to best available therapy for steroid-refractory graft-versus-host disease (GVHD). The Mount Sinai Acute GVHD International Consortium algorithm provides validated biomarker-based prognostication. Post-transplant cyclophosphamide reduces acute GVHD incidence, while complement inhibition improves outcomes in transplant-associated thrombotic. Early recognition using validated scoring systems and integration of standard ICU protocols with specialized HSCT expertise are essential for optimizing outcomes. Despite advances, significant knowledge gaps remain regarding optimal management strategies for many complications, with most evidence derived from retrospective cohort studies.</p>","PeriodicalId":66959,"journal":{"name":"世界危重病急救学杂志(英文版)","volume":"15 1","pages":"113235"},"PeriodicalIF":0.0,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13010842/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147517208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Peripartum cardiomyopathy in an intensive care unit setting.","authors":"Syeda Farheen Zaidi, Ajavindu Prasad, Aakash M Gangadhar, Syed A Khan, Amaar H Zaidi, Moisza Mushtaq, Gokhan Anil, Salim Surani","doi":"10.5492/wjccm.v15.i1.113515","DOIUrl":"10.5492/wjccm.v15.i1.113515","url":null,"abstract":"<p><p>Managing pregnant patients in the coronary care unit and the intensive care unit has been a challenge for many clinicians, as they do not encounter those special populations on a routine basis. Peripartum cardiomyopathy (PPCM) is an uncommon but potentially life-threatening condition that occurs during the last month of pregnancy or within five months of delivery. It is associated with left ventricular systolic dysfunction, leading to reduced ejection fraction and heart failure. Although the exact etiology remains unclear, potential contributing factors can include factors such as myocarditis, abnormal immune responses, genetic predispositions, and hormonal imbalances. The future implications of PPCM are wide. Besides physical illness, mental illness can also limit functionality and impose health challenges. Additionally, subsequent pregnancies carry an increased risk of recurrence, especially if cardiac function remains poor. Ongoing research into the molecular and genetic underpinnings of PPCM may pave the way for different targeted therapies and strategies focusing on prevention. Increasing awareness, early detection, and advances in treatment can significantly reduce morbidity and mortality associated with PPCM. Multidisciplinary care is crucial in optimizing outcomes for women affected and their families. This mini review aims to help appraise healthcare providers and clinicians in addressing and managing this challenging condition.</p>","PeriodicalId":66959,"journal":{"name":"世界危重病急救学杂志(英文版)","volume":"15 1","pages":"113515"},"PeriodicalIF":0.0,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13010881/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147517050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intracranial pressure management in severe intraventricular hemorrhage: A minireview.","authors":"Wu-Si Qiu, Hao-Dong Chen, Wen-Jie Yang, Ming-Min Chen","doi":"10.5492/wjccm.v15.i1.115169","DOIUrl":"10.5492/wjccm.v15.i1.115169","url":null,"abstract":"<p><p>Severe intraventricular hemorrhage (IVH) is a life-threatening neurological emergency that poses significant risks of morbidity and mortality, particularly due to the associated elevated intracranial pressure (ICP). Studies have shown that the incidence of IVH in very preterm infants is high, with management strategies playing a significant role in its development. Moreover, predictive models have been developed to forecast early mortality and severe IVH in very-low birth weight preterm infants, indicating the complexity and multifactorial nature of this condition. This mini-review synthesizes recent advances in the understanding of intracranial dynamics, monitoring technologies, and therapeutic strategies for managing ICP in IVH. The Monro-Kellie 4.0 framework integrates cerebrovascular autoregulation, intracranial compliance, and glymphatic clearance as core determinants of ICP. Pathophysiological mechanisms include obstructive hydrocephalus, hemoglobin-mediated neurotoxicity, and cortical spreading depolarizations. Advancements in non-invasive monitoring techniques, such as ICP monitoring and genetic testing, coupled with the integration of artificial intelligence, are significantly improving early detection capabilities and enabling more personalized management strategies. Therapeutic advances include algorithmic cerebrospinal fluid drainage, glymphatic-enhanced therapies, and precision hyperosmolar therapy. This review highlights the need for standardized protocols, large-scale trials, and artificial intelligence-driven approaches to improve outcomes in severe IVH.</p>","PeriodicalId":66959,"journal":{"name":"世界危重病急救学杂志(英文版)","volume":"15 1","pages":"115169"},"PeriodicalIF":0.0,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13010538/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147516753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}