世界危重病急救学杂志(英文版)最新文献

{"title":"Psychological first aid in the intensive care unit.","authors":"Traci N Adams, Carol S North","doi":"10.5492/wjccm.v14.i2.98939","DOIUrl":"10.5492/wjccm.v14.i2.98939","url":null,"abstract":"<p><p>The intensive care unit (ICU) is a stressful environment for patients and their families as well as healthcare workers (HCWs). Distress, which is a negative emotional or physical response to a stressor is common in the ICU. Psychological first aid (PFA) is a form of mental health assistance provided in the immediate aftermath of disasters or other critical incidents to address acute distress and re-establish effective coping and functioning. The aim of this narrative review is to inform the development and utilization of PFA by HCWs in the ICU to reduce the burden of distress among patients, caregivers, and HCWs. This is the first such review to apply PFA to the ICU setting.</p>","PeriodicalId":66959,"journal":{"name":"世界危重病急救学杂志(英文版)","volume":"14 2","pages":"98939"},"PeriodicalIF":0.0,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11891850/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259489","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":"Thrombolysis in dysfunctional valve and stroke.","authors":"Dormar David Barrios-Martínez, Yuri Valentina Pinzon, Veronica Giraldo, Gina Gonzalez","doi":"10.5492/wjccm.v14.i2.96624","DOIUrl":"10.5492/wjccm.v14.i2.96624","url":null,"abstract":"<p><strong>Background: </strong>Valvular heart disease affects more than 100 million people worldwide and is associated with significant morbidity and mortality. The prevalence of at least moderate valvular heart disease is 2.5% across all age groups, but its prevalence increases with age. Mitral regurgitation and aortic stenosis are the most frequent types of valvular heart disease in the community and hospital context, respectively. Surgical valve replacement (or mitral valve repair) is the standard of care for treating heart valve disease. However, the replacement of a prosthetic heart valve can lead to complications, either in the peri-procedural phase or in the long-term follow-up period.</p><p><strong>Case summary: </strong>We present a case of a 71-year-old female patient with a history of mitral valve replacement and warfarin anti-coagulation therapy. She was admitted to the intensive care unit due to spontaneously reperfused ischemic stroke of probable cardioembolic etiology. A dysfunctional mitral prosthesis was identified due to malfunction of one of the fixed discs. Furthermore, a possible microthrombotic lesion was suspected. Therefore, systemic thrombolysis was performed with subsequent normalization of mitral disc opening and closing.</p><p><strong>Conclusion: </strong>This case underscores the critical importance of a multidisciplinary approach for timely decision-making in critically ill patients with prosthetic valve complications.</p>","PeriodicalId":66959,"journal":{"name":"世界危重病急救学杂志(英文版)","volume":"14 2","pages":"96624"},"PeriodicalIF":0.0,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11891847/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259493","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":"Transformative impact of point-of-care testing in critical care.","authors":"Pradeep K Dabla, Aashima Dabas","doi":"10.5492/wjccm.v14.i2.100623","DOIUrl":"10.5492/wjccm.v14.i2.100623","url":null,"abstract":"<p><p>The advent of point-of-care testing (POCT) has revolutionized the approach to patient management, especially for pediatric care. POCT provides rapid, on-the-spot biochemical and microbiological evaluations, bypassing delays typically associated with central laboratory testing, enabling swift clinical decision-making. Additionally, POCT has proven to be a valuable prognostic tool for monitoring electrolyte, lactate, creatinine levels, often a marker of severe illness and poor outcomes. POCT enables its faster identification, allowing for prompt interventions. This capability is essential in managing conditions like sepsis, where timely treatment can significantly impact survival rates. However, the implementation of POCT is not without its challenges. Variability in sample handling, particularly with heparinized syringes, can affect the accuracy of certain measurements, such as potassium levels. The absence of comprehensive follow-up data and cost-effectiveness analyses in some studies indicate the need for continued research to optimize the use of POCT. In conclusion, POCT is a transformative tool in critical care, offering prompt and reliable assessments that significantly enhance patient management. As technology advances, the integration of POCT into emergency departments and intensive critical care units holds great promise for improving the quality of healthcare and patient survival rates.</p>","PeriodicalId":66959,"journal":{"name":"世界危重病急救学杂志(英文版)","volume":"14 2","pages":"100623"},"PeriodicalIF":0.0,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11891844/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259494","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":"Novel flangeless video laryngoscope for limited mouth opening.","authors":"Mohd Mustahsin, Harshita Singh","doi":"10.5492/wjccm.v14.i1.98938","DOIUrl":"10.5492/wjccm.v14.i1.98938","url":null,"abstract":"<p><p>Airway management plays a crucial role in providing adequate oxygenation and ventilation to patients during various medical procedures and emergencies. When patients have a limited mouth opening due to factors such as trauma, inflammation, or anatomical abnormalities airway management becomes challenging. A commonly utilized method to overcome this challenge is the use of video laryngoscopy (VL), which employs a specialized device equipped with a camera and a light source to allow a clear view of the larynx and vocal cords. VL overcomes the limitations of direct laryngoscopy in patients with limited mouth opening, enabling better visualization and successful intubation. Various types of VL blades are available. We devised a novel flangeless video laryngoscope for use in patients with a limited mouth opening and then tested it on a manikin.</p>","PeriodicalId":66959,"journal":{"name":"世界危重病急救学杂志(英文版)","volume":"14 1","pages":"98938"},"PeriodicalIF":0.0,"publicationDate":"2025-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11671836/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588009","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":"Healthcare providers' perspectives on factors influencing their critical care decision-making during the COVID-19 pandemic: An international pilot survey.","authors":"Sonali Vadi, Neha Sanwalka, Pramod Thaker","doi":"10.5492/wjccm.v14.i1.97006","DOIUrl":"10.5492/wjccm.v14.i1.97006","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Understanding a patient's clinical status and setting priorities for their care are two aspects of the constantly changing process of clinical decision-making. One analytical technique that can be helpful in uncertain situations is clinical judgment. Clinicians must deal with contradictory information, lack of time to make decisions, and long-term factors when emergencies occur.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;To examine the ethical issues healthcare professionals faced during the coronavirus disease 2019 (COVID-19) pandemic and the factors affecting clinical decision-making.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This pilot study, which means it was a preliminary investigation to gather information and test the feasibility of a larger investigation was conducted over 6 months and we invited responses from clinicians worldwide who managed patients with COVID-19. The survey focused on topics related to their professional roles and personal relationships. We examined five core areas influencing critical care decision-making: Patients' personal factors, family-related factors, informed consent, communication and media, and hospital administrative policies on clinical decision-making. The collected data were analyzed using the &lt;i&gt;χ&lt;/i&gt; &lt;sup&gt;2&lt;/sup&gt; test for categorical variables.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 102 clinicians from 23 specialties and 17 countries responded to the survey. Age was a significant factor in treatment planning (&lt;i&gt;n&lt;/i&gt; = 88) and ventilator access (&lt;i&gt;n&lt;/i&gt; = 78). Sex had no bearing on how decisions were made. Most doctors reported maintaining patient confidentiality regarding privacy and informed consent. Approximately 50% of clinicians reported a moderate influence of clinical work, with many citing it as one of the most important factors affecting their health and relationships. Clinicians from developing countries had a significantly higher score for considering a patient's financial status when creating a treatment plan than their counterparts from developed countries. Regarding personal experiences, some respondents noted that treatment plans and preferences changed from wave to wave, and that there was a rapid turnover of studies and evidence. Hospital and government policies also played a role in critical decision-making. Rather than assessing the appropriateness of treatment, some doctors observed that hospital policies regarding medications were driven by patient demand.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Factors other than medical considerations frequently affect management choices. The disparity in treatment choices, became more apparent during the pandemic. We highlight the difficulties and contradictions between moral standards and the realities physicians encountered during this medical emergency. False information, large patient populations, and limited resources caused problems for clinicians. These factors impacted decision-making, which, in turn, affected patient care and h","PeriodicalId":66959,"journal":{"name":"世界危重病急救学杂志(英文版)","volume":"14 1","pages":"97006"},"PeriodicalIF":0.0,"publicationDate":"2025-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11671838/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588638","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":"Forging an easier path through graduation: Improving the patient transition from paediatric to adult critical care.","authors":"Stephen Warrillow, Ben Gelbart, Jess Stevens, Gordon Baikie, Mark E Howard","doi":"10.5492/wjccm.v14.i1.101835","DOIUrl":"10.5492/wjccm.v14.i1.101835","url":null,"abstract":"<p><p>Adolescence and the journey to adulthood involves exciting opportunities as well as psychosocial stress for young people growing up. These normal experiences are potentially magnified for teenagers living with chronic illness or disability and their families. Advances in care have improved survival for children with a variety of serious chronic medical conditions such that many who may once have died in childhood now survive well into adulthood with ongoing morbidity. For those with highly complex needs, care is often provided at major paediatric hospitals with expertise, specially trained personnel, and resources to support young people and their families for the first decades of life. At the end of adolescence, however, it is generally appropriate and necessary for young adults and their caregivers to transition to the care of clinicians trained in the care of adults at general hospitals. While there are some well-managed models to support this journey of transition, these are often specific to certain conditions and usually do not involve intensive care. Many patients may encounter considerable challenges during this period. Difficulties may include the loss of established therapeutic relationships, a perception of austerity and reduced amenity in facilities oriented to caring for adult patients, and care by clinicians with less experience with more common paediatric conditions. In addition, there is a risk of potential conflict between clinicians and families regarding goals of care in the event of a critical illness when it occurs in a young adult with major disability and long-term health issues. These challenges present genuine opportunities to better understand the transition from paediatric to adult-based care and to improve processes that assist clinicians who support patients and families as they shift between healthcare settings.</p>","PeriodicalId":66959,"journal":{"name":"世界危重病急救学杂志(英文版)","volume":"14 1","pages":"101835"},"PeriodicalIF":0.0,"publicationDate":"2025-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11671834/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588631","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":"Effect of dietary fibre on the gastrointestinal microbiota during critical illness: A scoping review.","authors":"Angajendra N Ghosh, Calum J Walsh, Matthew J Maiden, Tim P Stinear, Adam M Deane","doi":"10.5492/wjccm.v14.i1.98241","DOIUrl":"10.5492/wjccm.v14.i1.98241","url":null,"abstract":"<p><p>The systemic effects of gastrointestinal (GI) microbiota in health and during chronic diseases is increasingly recognised. Dietary strategies to modulate the GI microbiota during chronic diseases have demonstrated promise. While changes in dietary intake can rapidly change the GI microbiota, the impact of dietary changes during acute critical illness on the microbiota remain uncertain. Dietary fibre is metabolised by carbohydrate-active enzymes and, in health, can alter GI microbiota. The aim of this scoping review was to describe the effects of dietary fibre supplementation in health and disease states, specifically during critical illness. Randomised controlled trials and prospective cohort studies that include adults (> 18 years age) and reported changes to GI microbiota as one of the study outcomes using non-culture methods, were identified. Studies show dietary fibres have an impact on faecal microbiota in health and disease. The fibre, inulin, has a marked and specific effect on increasing the abundance of faecal Bifidobacteria. Short chain fatty acids produced by <i>Bifidobacteria</i> have been shown to be beneficial in other patient populations. Very few trials have evaluated the effect of dietary fibre on the GI microbiota during critical illness. More research is necessary to establish optimal fibre type, doses, duration of intervention in critical illness.</p>","PeriodicalId":66959,"journal":{"name":"世界危重病急救学杂志(英文版)","volume":"14 1","pages":"98241"},"PeriodicalIF":0.0,"publicationDate":"2025-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11671841/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588626","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":"Management of gastrointestinal bleed in the intensive care setting, an updated literature review.","authors":"Vignesh K Nagesh, Sai Priyanka Pulipaka, Ruchi Bhuju, Emelyn Martinez, Shruthi Badam, Gomathy Aarthy Nageswaran, Hadrian Hoang-Vu Tran, Daniel Elias, Charlene Mansour, Jaber Musalli, Sanket Bhattarai, Lokeash Subramani Shobana, Tannishtha Sethi, Ritvik Sethi, Namrata Nikum, Chinmay Trivedi, Amer Jarri, Colin Westman, Nazir Ahmed, Shawn Philip, Simcha Weissman, Jonathan Weinberger, Ayrton I Bangolo","doi":"10.5492/wjccm.v14.i1.101639","DOIUrl":"10.5492/wjccm.v14.i1.101639","url":null,"abstract":"<p><p>Gastrointestinal (GI) bleeding is a critical and potentially life-threatening condition frequently observed in the intensive care unit (ICU). This literature review consolidates current insights on the epidemiology, etiology, management, and outcomes of GI bleeding in critically ill patients. GI bleeding remains a significant concern, especially among patients with underlying risk factors such as coagulopathy, mechanical ventilation, and renal failure. Managing GI bleeding in the ICU requires a multidisciplinary approach, including resuscitation, endoscopic intervention, pharmacologic therapy, and sometimes surgical procedures. Even with enhanced management strategies, GI bleeding in the ICU is associated with considerable morbidity and mortality, particularly when complicated by multi-organ failure. This review reiterates the need for adequate resuscitation and interventions in managing GI bleeding in critically ill patients, aiming to enhance survival rates and improve the quality of care within the ICU setting.</p>","PeriodicalId":66959,"journal":{"name":"世界危重病急救学杂志(英文版)","volume":"14 1","pages":"101639"},"PeriodicalIF":0.0,"publicationDate":"2025-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11671843/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588006","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":"Anaesthesia in chronic dialysis patients: A narrative review.","authors":"Julian Yaxley","doi":"10.5492/wjccm.v14.i1.100503","DOIUrl":"10.5492/wjccm.v14.i1.100503","url":null,"abstract":"<p><p>The provision of anaesthesia for individuals receiving chronic dialysis can be challenging. Sedation and anaesthesia are frequently managed by critical care clinicians in the intensive care unit or operating room. This narrative review summarizes the important principles of sedation and anaesthesia for individuals on long-term dialysis, with reference to the best available evidence. Topics covered include the pharmacology of anaesthetic agents, the impacts of patient characteristics upon the pre-anaesthetic assessment and critical illness, and the fundamentals of dialysis access procedures.</p>","PeriodicalId":66959,"journal":{"name":"世界危重病急救学杂志(英文版)","volume":"14 1","pages":"100503"},"PeriodicalIF":0.0,"publicationDate":"2025-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11671837/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588614","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":"Current role of extracorporeal membrane oxygenation for the management of trauma patients: Indications and results.","authors":"Mohammed Abdulrahman, Maryam Makki, Malak Bentaleb, Dana Khamis Altamimi, Marcelo Af Ribeiro Junior","doi":"10.5492/wjccm.v14.i1.96694","DOIUrl":"10.5492/wjccm.v14.i1.96694","url":null,"abstract":"<p><p>Extracorporeal membrane oxygenation (ECMO) has emerged as a vital circulatory life support measure for patients with critical cardiac or pulmonary conditions unresponsive to conventional therapies. ECMO allows blood to be extracted from a patient and introduced to a machine that oxygenates blood and removes carbon dioxide. This blood is then reintroduced into the patient's circulatory system. This process makes ECMO essential for treating various medical conditions, both as a standalone therapy and as adjuvant therapy. Veno-venous (VV) ECMO primarily supports respiratory function and indicates respiratory distress. Simultaneously, veno-arterial (VA) ECMO provides hemodynamic and respiratory support and is suitable for cardiac-related complications. This study reviews recent literature to elucidate the evolving role of ECMO in trauma care, considering its procedural intricacies, indications, contraindications, and associated complications. Notably, the use of ECMO in trauma patients, particularly for acute respiratory distress syndrome and cardiogenic shock, has demonstrated promising outcomes despite challenges such as anticoagulation management and complications such as acute kidney injury, bleeding, thrombosis, and hemolysis. Some studies have shown that VV ECMO was associated with significantly higher survival rates than conventional mechanical ventilation, whereas other studies have reported that VA ECMO was associated with lower survival rates than VV ECMO. ECMO plays a critical role in managing trauma patients, particularly those with acute respiratory failure. Further research is necessary to explore the full potential of ECMO in trauma care. Clinicians should have a clear understanding of the indications and contraindications for the use of ECMO to maximize its benefits in treating trauma patients.</p>","PeriodicalId":66959,"journal":{"name":"世界危重病急救学杂志(英文版)","volume":"14 1","pages":"96694"},"PeriodicalIF":0.0,"publicationDate":"2025-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11671839/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588618","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}