世界危重病急救学杂志(英文版)最新文献

{"title":"Diagnostic utility of sepsis screening tools, procalcitonin, and C-reactive protein in nosocomial fever of unknown origin.","authors":"Shashikant Saini, Sapna Pahil, Ritin Mohindra, Naresh Sachdeva, Navneet Sharma, Ashok K Pannu","doi":"10.5492/wjccm.v14.i3.106496","DOIUrl":"10.5492/wjccm.v14.i3.106496","url":null,"abstract":"<p><strong>Background: </strong>Nosocomial fever of unknown origin (nFUO) is a frequent and challenging diagnostic entity, encompassing diverse infectious and non-infectious etiologies. Timely identification is crucial, yet evidence on the diagnostic accuracy of commonly employed sepsis screening tools and biomarkers remains sparse. We hypothesized that these tools and biomarkers measured at fever onset could distinguish infectious from non-infectious causes of nFUO in critically ill adults.</p><p><strong>Aim: </strong>To evaluate the diagnostic utility of sepsis tools and biomarkers in identifying infectious causes of nFUO.</p><p><strong>Methods: </strong>This prospective observational study included patients admitted to the Acute Care Emergency Medicine Unit, Postgraduate Institute of Medical Education and Research, Chandigarh, India (July 2023 to December 2024). nFUO was defined by Durack and Street criteria. Diagnostic performance of sepsis screening tools (systemic inflammatory response syndrome, Sequential Organ Failure Assessment, quick Sequential Organ Failure Assessment, National Early Warning Score, and Modified Early Warning Score) and biomarkers [procalcitonin (PCT), C-reactive protein (CRP)] at fever onset was assessed using receiver operating characteristic curve analysis.</p><p><strong>Results: </strong>Of 80 cases (mean age 42.9 ± 16.5 years; 80% male), 42.5% had infectious causes, 38.7% non-infectious, and 18.8% remained undiagnosed. Pneumonia (26.2%) and bloodstream infections (11.2%) were the most common infectious etiologies, while central fever and thrombophlebitis (each 7.5%) were predominant among non-infectious causes. Sepsis tools showed poor diagnostic accuracy, with area under the receiver operating characteristic curve (AUC) values close to 0.5. PCT demonstrated modest performance (AUC = 0.61; optimal cut-off: 0.85 μg/L), while CRP was paradoxically higher in non-infectious cases (AUC = 0.45). Overall mortality was 20% and was highest among undiagnosed patients (33.3%). Fever duration and hospitalization length were significantly greater in infectious cases.</p><p><strong>Conclusion: </strong>Sepsis tools, PCT, and CRP have limited utility in identifying infectious causes of nFUO in critically ill adults and should not solely guide initial decision-making.</p>","PeriodicalId":66959,"journal":{"name":"世界危重病急救学杂志(英文版)","volume":"14 3","pages":"106496"},"PeriodicalIF":0.0,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12305121/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144980222","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":"Artificial intelligence in traumatic brain injury: Brain imaging analysis and outcome prediction: A mini review.","authors":"Luca Marino, Federico Bilotta","doi":"10.5492/wjccm.v14.i3.107611","DOIUrl":"10.5492/wjccm.v14.i3.107611","url":null,"abstract":"<p><p>Integration of artificial intelligence increases in all aspects of human life, particularly in healthcare systems. Traumatic brain injury is a significant cause of mortality and long-term disability, with an important impact on the socio-economic system of healthcare. The role of artificial intelligence in imaging and outcome prediction for traumatic brain injury patients is reviewed with a particular emphasis to the characteristics of machine and deep learning methods. Evidence of potential improvement in the clinical practice in discussed.</p>","PeriodicalId":66959,"journal":{"name":"世界危重病急救学杂志(英文版)","volume":"14 3","pages":"107611"},"PeriodicalIF":0.0,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12304951/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144980374","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":"Racial differences in outcomes among patients with septic shock: A national cohort study.","authors":"Song-Peng Ang, Jia-Ee Chia, Jose Iglesias","doi":"10.5492/wjccm.v14.i3.106387","DOIUrl":"10.5492/wjccm.v14.i3.106387","url":null,"abstract":"<p><strong>Background: </strong>Sepsis and septic shock pose critical public health challenges with high mortality, particularly in critical care. While racial differences in sepsis incidence are documented, the impact of race on sepsis outcomes remains inconsistent.</p><p><strong>Aim: </strong>To evaluate racial disparities in clinical outcomes among patients hospitalized with septic shock, focusing on in-hospital mortality, length of stay (LOS), and hospitalization costs.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study using the National Inpatient Sample database from 2016 to 2021. Patients diagnosed with septic shock were identified using ICD-10 code R65.21. The primary outcome was in-hospital mortality; secondary outcomes included trends in septic shock hospitalizations, mortality, length of stay, and cost of hospitalizations.</p><p><strong>Results: </strong>Among 3581504 hospitalizations for septic shock, the racial distribution was 67% Non-Hispanic White (NHW), 15% Non-Hispanic Black (NHB), 11% Hispanic, and 7% other groups, with a mean age of 66.3 years. In-hospital mortality was 33.6%, highest among other racial groups (36.7%). Mortality was stable across racial groups from 2016-2019 but rose sharply in 2020-2021, especially among Hispanic patients. Adjusted in-hospital mortality were higher for NHB and Hispanic compared to NHW patients. NHB patients had the longest LOS, while other racial groups incurred the highest cost of hospitalizations.</p><p><strong>Conclusion: </strong>We found higher mortality among NHB, Hispanic, and other racial groups in septic shock patients, likely driven by higher risk of in-hospital complications among these racial groups. This highlights the need for future research to identify the factors contributing to the adverse outcomes in these populations.</p>","PeriodicalId":66959,"journal":{"name":"世界危重病急救学杂志(英文版)","volume":"14 3","pages":"106387"},"PeriodicalIF":0.0,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12305100/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144980382","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":"Jahi McMath case: A comprehensive and updated narrative.","authors":"Calixto Machado","doi":"10.5492/wjccm.v14.i3.107513","DOIUrl":"10.5492/wjccm.v14.i3.107513","url":null,"abstract":"<p><p>The Jahi McMath case represents a pivotal moment in the reevaluation of brain death or death by neurological criteria (BD/DNC) and disorders of consciousness. Declared brain dead on December 12, 2013, following surgical complications, Jahi's case became a landmark in challenging conventional BD/DNC definitions. As an independent consultant for the International Brain Research Foundation, I recommended advanced ancillary tests, including neuroimaging, electrophysiological, and heart rate variability assessments, conducted at Rutgers University Hospital and Jahi's apartment in New Jersey. My analyses revealed unprecedented findings: Significant preservation of intracranial structures, including the upper brainstem, despite extensive white matter damage and partial herniation. I identified residual cognitive processing and autonomic responses, which suggested a novel disorder of consciousness distinct from both BD/DNC, the unresponsive unawareness syndrome, the minimally conscious state, and the locked-in syndrome. These insights, reinforced by complementary evaluations by Dr. Alan Shewmon, who later documented Jahi's purposeful responses to commands by videos analysis, contributed to reshaping the discourse on consciousness disorders. Despite initial resistance from the scientific community, my findings during September 2014 were eventually published, presenting the first detailed anatomical and functional analysis of Jahi's condition. The Jahi McMath case underscores the need for advanced diagnostics, multidisciplinary collaboration, and a nuanced understanding of consciousness. This case has significant implications for the medical and legal communities, particularly in defining and diagnosing BD/DNC and studying disorders of consciousness. The novel disorder of consciousness might be integrated into existing diagnostic criteria and treatment protocols for BD/DNC and in classifying disorders of consciousness. It remains a cornerstone for future research and challenges in defining and diagnosing BD/DNC.</p>","PeriodicalId":66959,"journal":{"name":"世界危重病急救学杂志(英文版)","volume":"14 3","pages":"107513"},"PeriodicalIF":0.0,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12305069/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144980403","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":"Decline of the Sengstaken-Blakemore tube: A review of shifting practices in gastrointestinal hemorrhage management.","authors":"Gowthami Sai Kogilathota Jagirdhar, Chiamaka C Okafor, Muhammad Hussain, Praveen Reddy Elmati, Aleena Ghumman, Mehul Shah, Salim Surani","doi":"10.5492/wjccm.v14.i3.101856","DOIUrl":"10.5492/wjccm.v14.i3.101856","url":null,"abstract":"<p><p>The Sengstaken-Blakemore tube (SB tube), introduced in the 1950s, was a pivotal device for managing acute gastrointestinal (GI) bleeding, particularly from esophageal varices. This multi-lumen tube, featuring esophageal and gastric balloons, applied mechanical pressure to control bleeding and provided a temporary solution until more definitive treatments could be employed. It was historically significant in resource-limited settings where advanced endoscopic options were unavailable, enabling patient stabilization and transfer to specialized centers. However, the advent of GI endoscopy and its increased availability has rendered the SB tube obsolete. SB tubes are associated with complications, including esophageal perforation, aspiration pneumonia, and gastric ulceration. Additionally, the tube can cause significant discomfort, and its migration may lead to inadequate. Techniques such as endoscopic variceal ligation and endoscopic sclerotherapy offer superior precision, efficacy, and safety for managing variceal bleeding. Improved hospital transfer protocols now facilitate prompt endoscopic or surgical interventions, reducing the need for temporary measures like the SB tube. Additionally, advancements in pharmacological treatments, including vasoactive drugs, reliance on mechanical compression devices. While the SB tube remains an important historical artifact, its role in current medical practice reflecting safer and more effective treatment options in emergency GI care. This review discusses the declining role of the Sengstaken -Blakemore tube and its replacement by current intervention methods.</p>","PeriodicalId":66959,"journal":{"name":"世界危重病急救学杂志(英文版)","volume":"14 3","pages":"101856"},"PeriodicalIF":0.0,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12304998/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144980211","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":"Cardiopulmonary resuscitation duration and patient survival in a South Indian intensive care unit.","authors":"Christopher Mathew, Jitha Devan, Jasmin Jacob","doi":"10.5492/wjccm.v14.i3.105611","DOIUrl":"10.5492/wjccm.v14.i3.105611","url":null,"abstract":"<p><strong>Background: </strong>Return of spontaneous circulation (ROSC) following cardiopulmonary resuscitation (CPR) is a critical determinant of survival in patients experiencing cardiac arrest. This study aimed to investigate the relationship between the duration of CPR, the achievement of ROSC, and both short-term [intensive care unit (ICU) and in-hospital] and long-term survival outcomes in patients admitted to the medical intensive care unit (MICU) of Dr. Moopen's Medical College Hospital, Wayanad, Kerala, India.</p><p><strong>Aim: </strong>To assess how cardiopulmonary resuscitation duration impacts short-term and long-term survival in cardiac arrest patients in intensive care.</p><p><strong>Methods: </strong>A retrospective observational cohort study was conducted on adult patients who received CPR in the MICU between March 2023 and March 2024. Data were extracted from electronic medical records, including demographics, duration of CPR, ROSC achievement, and survival outcomes. Short-term survival was defined as survival to ICU discharge and in-hospital mortality, while long-term survival was assessed at six months post-arrest. Statistical analysis was performed using SPSS software, with Kaplan-Meier survival analysis and Cox regression used to identify predictors of mortality.</p><p><strong>Results: </strong>A total of 142 patients were included in the study. The median duration of CPR was 15 minutes. ROSC was achieved in 68 patients (47.9%). A significant association was observed between the duration of CPR and ROSC achievement (<i>P</i> < 0.001). Patients who achieved ROSC early had significantly higher rates of short-term and long-term survival compared to those who did not (<i>P</i> < 0.001). Each additional minute of CPR was associated with a 7% decrease in the odds of achieving ROSC. Longer CPR duration (HR: 1.05, 95%CI: 1.02-1.08), absence of ROSC (HR: 4.87, 95%CI: 2.31-10.28), older age (HR: 1.03, 95%CI: 1.01-1.06) and unwitnessed arrest (HR: 1.89, 95%CI: 1.05-3.41) were independent predictors of mortality.</p><p><strong>Conclusion: </strong>Timely, effective cardiopulmonary resuscitation improves survival in intensive care. Duration significantly predicts return of circulation and outcomes. Further research should explore factors affecting resuscitation length and optimize treatment strategies.</p>","PeriodicalId":66959,"journal":{"name":"世界危重病急救学杂志(英文版)","volume":"14 3","pages":"105611"},"PeriodicalIF":0.0,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12305047/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144980351","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 evaluation of cardio-cerebral coupling.","authors":"Ignacio J Previgliano, Hatem Soliman Aboumarie, Francisco M Tamagnone, Pablo M Merlo, Fernando A Sosa, Jose Feijoo, Maria C Carruega","doi":"10.5492/wjccm.v14.i3.101462","DOIUrl":"10.5492/wjccm.v14.i3.101462","url":null,"abstract":"<p><p>Cardio-cerebral coupling (CCC) refers to the dynamic interplay between cardiac function and cerebral blood flow, essential for maintaining hemodynamic stability. Disruptions in CCC are particularly relevant in critical care, where they can exacerbate primary and secondary brain injuries. Ultrasound-based techniques, including transcranial Doppler, transcranial color-coded Doppler, and echocardiography, provide non-invasive methods to assess this relationship at the bedside. This scoping review explores the pathophysiology of CCC, ultrasound methodologies for its evaluation, and its clinical relevance. Key mechanisms such as cerebral autoregulation and neurovascular coupling are discussed, along with ultrasound-derived parameters like pulsatility index, resistance index, and cerebral perfusion pressure. While ultrasound is a valuable tool, its limitations include operator dependency and equipment variability. Emerging evidence suggests that ultrasound-guided protocols, including ultrasound-guided cardio-cerebral resuscitation protocol and ultrasound-guided brain injury treatment protocol, may improve resuscitation strategies and neurocritical care monitoring. Despite its potential, further research is necessary to standardize assessment methods and integrate ultrasound-based CCC evaluation into routine clinical practice. Ongoing multicenter studies are expected to provide robust evidence supporting its clinical utility in managing brain-injured patients.</p>","PeriodicalId":66959,"journal":{"name":"世界危重病急救学杂志(英文版)","volume":"14 3","pages":"101462"},"PeriodicalIF":0.0,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12304930/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144980360","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":"Significance of a hypotensive episode following traumatic injury: A retrospective observational study.","authors":"Hassan Al-Thani, Ayman El-Menyar, Ahammed Mekkodathil, Ibrahim Taha, Saeed Mahmood, Adam Shunni, Abdel Aziz Hammo, Mushreq Al-Ani, Mohammad Asim","doi":"10.5492/wjccm.v14.i3.104778","DOIUrl":"10.5492/wjccm.v14.i3.104778","url":null,"abstract":"<p><strong>Background: </strong>Early hemodynamic assessment remains crucial for proper management in trauma settings. Hypotension is a vital indication in trauma patients to be considered upon initial triaging to assess the risk of bleeding and hypovolemic shock which entails significant clinical attention during initial resuscitation.</p><p><strong>Aim: </strong>To assess whether an initial episode of prehospital or emergency department hypotension is associated with an increased risk of morbidity and mortality in trauma patients.</p><p><strong>Methods: </strong>A retrospective analysis was performed to include all trauma patients hospitalized between 2011 and 2021. Hypotension was defined as a systolic blood pressure ≤ 90 mmHg in the prehospital setting or upon arrival to the hospital. Patients were classified into normotensive <i>vs</i> hypotensive and survivors <i>vs</i> non-survivors. Data was analyzed and compared, and multivariable logistic regression analysis was performed to identify the predictors of mortality.</p><p><strong>Results: </strong>Over the ten years, 17341 trauma admissions were analyzed, of which 1188 (6.9%) patients had hypotension episodes either at the scene or upon hospital arrival. Patients with hypotension were two years younger (<i>P</i> = 0.001) in age and were more likely to have higher pulse rate (<i>P</i> = 0.001), elevated shock index (<i>P</i> = 0.001), sustained more severe injuries, frequently required blood transfusion and laparotomy, and had higher complications and mortality rates. Multivariable regression analysis identified hypotension [adjusted odds ratio (aOR) = 2.505; 95% confidence interval (95%CI) = 1.798-3.489; <i>P</i> = 0.001] and acute respiratory distress syndrome (ARDS; aOR = 5.482; 95%CI = 3.297-9.116; <i>P</i> = 0.001) as independent predictors of mortality. Among hypotensive trauma patients, only ARDS (aOR = 3.518; 95%CI = 1.385-7.204; <i>P</i> = 0.006) was significantly associated with mortality.</p><p><strong>Conclusion: </strong>Hypotensive episodes following trauma are associated with higher severity and mortality. The development of ARDS is an independent predictor of mortality in hypotensive trauma patients. A hypotensive episode is a warning sign and calls for aggressive, timely management following trauma.</p>","PeriodicalId":66959,"journal":{"name":"世界危重病急救学杂志(英文版)","volume":"14 3","pages":"104778"},"PeriodicalIF":0.0,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12305033/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144980446","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":"Correct sepsis classification-A must for antimicrobial stewardship: A longitudinal observational study.","authors":"Jaideep Pilania, Prasan Kumar Panda, Udit Chauhan, Ravi Kant","doi":"10.5492/wjccm.v14.i3.101864","DOIUrl":"10.5492/wjccm.v14.i3.101864","url":null,"abstract":"<p><strong>Background: </strong>Sepsis is a critical medical condition, and poses a substantial global health burden, with significant morbidity, mortality, and economic costs, particularly pronounced in low- and middle-income countries. Effective management of sepsis relies on early recognition and appropriate intervention, underscoring the importance of accurate classification to guide treatment decisions. The correct diagnosis will lead to effective antimicrobial stewardship practices.</p><p><strong>Aim: </strong>To assess the distribution of sepsis categories and the use of empirical antibiotics classified by the World Health Organization (WHO) Access, Watch, and Reserve (AWaRe) system in a tertiary care hospital in Northern India and to correlate antibiotic usage with sepsis classifications.</p><p><strong>Methods: </strong>This longitudinal observational study in the Department of General Medicine, in a tertiary care hospital in Northern India, from 2023 to 2024, aimed to assess the use of empirical antibiotics classified by the WHO AWaRe system. The study also aimed to correlate antibiotic usage. Patients were categorized into sepsis classes (Asepsis, Possible Sepsis, Probable Sepsis, Confirmed Sepsis) and followed until discharge or Day-28. Descriptive and inferential statistical analyses were employed to assess sepsis categories and empirical antibiotic usage classified by the WHO AWaRe system.</p><p><strong>Results: </strong>A total of 1867 patients admitted with suspected sepsis were screened, with 230 meeting the inclusion criteria. Among the study cohort (mean age 40.70 ± 14.49 years, 50.9% female), initial sepsis classification predominantly included probable sepsis (51.3%) and possible sepsis (35.7%), evolving to asepsis (57.8%) upon final classification, but all received antibiotics. Empirical antibiotic use showed a predominance of Watch group antibiotics (72.2%), with ceftriaxone and piperacillin-tazobactam being the most commonly prescribed; however, no statistical association could be established among the different classes of sepsis with the AWaRe groups.</p><p><strong>Conclusion: </strong>Accurate sepsis classification is pivotal for clinical decision-making, optimizing antibiotic use, and combating antimicrobial resistance. The majority of the asepsis category was labelled as probable or possible sepsis and given antibiotics at initial hospitalization. The high reliance on Watch group antibiotics in empirical therapy signals a need for enhanced diagnostic strategies to refine treatment initiation, potentially reducing unnecessary antibiotic exposure. Future efforts should focus on establishing sepsis classification checklists as in this study and promoting adherence to antimicrobial stewardship principles to mitigate the global threat of antimicrobial resistance.</p>","PeriodicalId":66959,"journal":{"name":"世界危重病急救学杂志(英文版)","volume":"14 3","pages":"101864"},"PeriodicalIF":0.0,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12304903/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144980413","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":"Energy expenditure measurement in critical care: Implications for personalized nutrition support.","authors":"Jiayang Chen, Kay Choong See","doi":"10.5492/wjccm.v14.i3.105299","DOIUrl":"10.5492/wjccm.v14.i3.105299","url":null,"abstract":"<p><strong>Background: </strong>Accurate measurement of energy expenditure (EE) is critical for optimizing nutritional support in critically ill patients. Indirect calorimetry (IC) is the reference method used, but its availability at the bedside is limited. As a result, numerous predictive equations have been devised to estimate EE in critically ill patients, along with other more novel methods recently proposed.</p><p><strong>Aim: </strong>To evaluate current methods of measuring EE in critical care, focusing on practical challenges, accuracy, feasibility, and limitations. We will also discuss how these methods contribute to improving nutrition support strategies for intensive care unit patients for a more personalised and effective solution.</p><p><strong>Methods: </strong>A comprehensive search was conducted in PubMed and EMBASE for studies published from December 2014 to December 2024<b>.</b> Eligible studies compared EE measurement methods in critically ill populations. Data extraction and quality assessment followed PRISMA guidelines. Adherence to reporting standards was assessed using the TRIPOD questionnaire and risk of bias was evaluated using the PROBAST tool.</p><p><strong>Results: </strong>Twenty five original studies met the inclusion criteria and were analysed.</p><p><strong>Conclusion: </strong>Each method has unique strengths and limitations. We found that while IC remains the reference standard, less accurate predictive equations have greater accessibility and ease of implementation. Emerging technologies show promise for bedside applicability. Future research should address practical barriers and validate newer approaches.</p>","PeriodicalId":66959,"journal":{"name":"世界危重病急救学杂志(英文版)","volume":"14 3","pages":"105299"},"PeriodicalIF":0.0,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12305103/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144980432","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}