世界危重病急救学杂志(英文版)最新文献

筛选
英文 中文
Sleep during and following critical illness: A narrative review. 危重疾病期间和之后的睡眠:叙述性回顾。
世界危重病急救学杂志(英文版) Pub Date : 2023-06-09 DOI: 10.5492/wjccm.v12.i3.92
Laurie Showler, Yasmine Ali Abdelhamid, Jeremy Goldin, Adam M Deane
{"title":"Sleep during and following critical illness: A narrative review.","authors":"Laurie Showler,&nbsp;Yasmine Ali Abdelhamid,&nbsp;Jeremy Goldin,&nbsp;Adam M Deane","doi":"10.5492/wjccm.v12.i3.92","DOIUrl":"https://doi.org/10.5492/wjccm.v12.i3.92","url":null,"abstract":"<p><p>Sleep is a complex process influenced by biological and environmental factors. Disturbances of sleep quantity and quality occur frequently in the critically ill and remain prevalent in survivors for at least 12 mo. Sleep disturbances are associated with adverse outcomes across multiple organ systems but are most strongly linked to delirium and cognitive impairment. This review will outline the predisposing and precipitating factors for sleep disturbance, categorised into patient, environmental and treatment-related factors. The objective and subjective methodologies used to quantify sleep during critical illness will be reviewed. While polysomnography remains the gold-standard, its use in the critical care setting still presents many barriers. Other methodologies are needed to better understand the pathophysiology, epidemiology and treatment of sleep disturbance in this population. Subjective outcome measures, including the Richards-Campbell Sleep Questionnaire, are still required for trials involving a greater number of patients and provide valuable insight into patients' experiences of disturbed sleep. Finally, sleep optimisation strategies are reviewed, including intervention bundles, ambient noise and light reduction, quiet time, and the use of ear plugs and eye masks. While drugs to improve sleep are frequently prescribed to patients in the ICU, evidence supporting their effectiveness is lacking.</p>","PeriodicalId":66959,"journal":{"name":"世界危重病急救学杂志(英文版)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/7d/3e/WJCCM-12-92.PMC10308338.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9743467","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}
引用次数: 0
Causative bacteria of ventilator-associated pneumonia in intensive care unit in Bahrain: Prevalence and antibiotics susceptibility pattern. 巴林重症监护病房呼吸机相关肺炎的致病菌:患病率和抗生素敏感性模式
世界危重病急救学杂志(英文版) Pub Date : 2023-06-09 DOI: 10.5492/wjccm.v12.i3.165
Mohamed Eliwa Hassan, Safaa Abdulaziz Al-Khawaja, Nermin Kamal Saeed, Sana Abdulaziz Al-Khawaja, Mahmood Al-Awainati, Sara Salah Yusuf Radhi, Mohamed Hameed Alsaffar, Mohammed Al-Beltagi
{"title":"Causative bacteria of ventilator-associated pneumonia in intensive care unit in Bahrain: Prevalence and antibiotics susceptibility pattern.","authors":"Mohamed Eliwa Hassan,&nbsp;Safaa Abdulaziz Al-Khawaja,&nbsp;Nermin Kamal Saeed,&nbsp;Sana Abdulaziz Al-Khawaja,&nbsp;Mahmood Al-Awainati,&nbsp;Sara Salah Yusuf Radhi,&nbsp;Mohamed Hameed Alsaffar,&nbsp;Mohammed Al-Beltagi","doi":"10.5492/wjccm.v12.i3.165","DOIUrl":"https://doi.org/10.5492/wjccm.v12.i3.165","url":null,"abstract":"<p><strong>Background: </strong>Ventilator-associated pneumonia (VAP) is defined as pneumonia that occurs two calendar days following endotracheal intubation or after that. It is the most common infection encountered among intubated patients. VAP incidence showed wide variability between countries.</p><p><strong>Aim: </strong>To define the VAP incidence in the intensive care unit (ICU) in the central government hospital in Bahrain and review the risk factors and the predominant bacterial pathogens with their antimicrobial susceptibility pattern.</p><p><strong>Methods: </strong>The research was a prospective cross-sectional observational study over six months from November 2019 to June 2020. It included adult and adolescent patients (> 14 years old) admitted to the ICU and required intubation and mechanical ventilation. VAP was diagnosed when it occurred after 48 h after endotracheal intubation using the clinical pulmonary infection score, which considers the clinical, laboratory, microbiological, and radiographic evidence.</p><p><strong>Results: </strong>The total number of adult patients admitted to the ICU who required intubation and mechanical ventilation during the study period was 155. Forty-six patients developed VAP during their ICU stay (29.7%). The calculated VAP rate was 22.14 events per 1000 ventilator days during the study period, with a mean age of 52 years ± 20. Most VAP cases had late-onset VAP with a mean number of ICU days before the development of VAP of 9.96 ± 6.55. Gram-negative contributed to most VAP cases in our unit, with multidrug-resistant Acinetobacter being the most identified pathogen.</p><p><strong>Conclusion: </strong>The reported VAP rate in our ICU was relatively high compared to the international benchmark, which should trigger a vital action plan for reinforcing the implementation of the VAP prevention bundle.</p>","PeriodicalId":66959,"journal":{"name":"世界危重病急救学杂志(英文版)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/77/e8/WJCCM-12-165.PMC10308340.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9801328","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}
引用次数: 0
Knowledge and awareness of infection control practices among nursing professionals: A cross-sectional survey from South Asia and the Middle East. 护理专业人员感染控制实践的知识和意识:来自南亚和中东的横断面调查。
世界危重病急救学杂志(英文版) Pub Date : 2023-06-09 DOI: 10.5492/wjccm.v12.i3.176
Kanwalpreet Sodhi, Gunjan Chanchalani, Muktanjali Arya, Gentle S Shrestha, Juhi N Chandwani, Manender Kumar, Monika G Kansal, Mohammad Ashrafuzzaman, Anushka D Mudalige, Ashraf Al Tayar, Bassam Mansour, Hasan M Saeed, Madiha Hashmi, Mitul Das, Nehad N Al Shirawi, Ranjan Mathias, Wagih O Ahmed, Amandeep Sharma, Diptimala Agarwal, Prashant Nasa
{"title":"Knowledge and awareness of infection control practices among nursing professionals: A cross-sectional survey from South Asia and the Middle East.","authors":"Kanwalpreet Sodhi,&nbsp;Gunjan Chanchalani,&nbsp;Muktanjali Arya,&nbsp;Gentle S Shrestha,&nbsp;Juhi N Chandwani,&nbsp;Manender Kumar,&nbsp;Monika G Kansal,&nbsp;Mohammad Ashrafuzzaman,&nbsp;Anushka D Mudalige,&nbsp;Ashraf Al Tayar,&nbsp;Bassam Mansour,&nbsp;Hasan M Saeed,&nbsp;Madiha Hashmi,&nbsp;Mitul Das,&nbsp;Nehad N Al Shirawi,&nbsp;Ranjan Mathias,&nbsp;Wagih O Ahmed,&nbsp;Amandeep Sharma,&nbsp;Diptimala Agarwal,&nbsp;Prashant Nasa","doi":"10.5492/wjccm.v12.i3.176","DOIUrl":"https://doi.org/10.5492/wjccm.v12.i3.176","url":null,"abstract":"<p><strong>Background: </strong>The proficiency of nursing professionals in the infection prevention and control (IPC) practices is a core component of the strategy to mitigate the challenge of healthcare associated infections.</p><p><strong>Aim: </strong>To test knowledge of nurses working in intensive care units (ICU) in South Asia and Middle East countries on IPC practices.</p><p><strong>Methods: </strong>An online self-assessment questionnaire based on various aspects of IPC practices was conducted among nurses over three weeks.</p><p><strong>Results: </strong>A total of 1333 nurses from 13 countries completed the survey. The average score was 72.8% and 36% of nurses were proficient (mean score > 80%). 43% and 68.3% of respondents were from government and teaching hospitals, respectively. 79.2% of respondents worked in < 25 bedded ICUs and 46.5% in closed ICUs. Statistically, a significant association was found between the knowledge and expertise of nurses, the country's per-capita income, type of hospitals, accreditation and teaching status of hospitals and type of ICUs. Working in high- and upper-middle-income countries (β = 4.89, 95%CI: 3.55 to 6.22) was positively associated, and the teaching status of the hospital (β = -4.58, 95%CI: -6.81 to -2.36) was negatively associated with the knowledge score among respondents.</p><p><strong>Conclusion: </strong>There is considerable variation in knowledge among nurses working in ICU. Factors like income status of countries, public <i>vs</i> private and teaching status of hospitals and experience are independently associated with nurses' knowledge of IPC practices.</p>","PeriodicalId":66959,"journal":{"name":"世界危重病急救学杂志(英文版)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f9/9a/WJCCM-12-176.PMC10308336.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9748556","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}
引用次数: 0
Approaches to neuroprotection in pediatric neurocritical care. 小儿神经危重症护理中的神经保护方法。
世界危重病急救学杂志(英文版) Pub Date : 2023-06-09 DOI: 10.5492/wjccm.v12.i3.116
Angad Kochar, Kara Hildebrandt, Rebecca Silverstein, Brian Appavu
{"title":"Approaches to neuroprotection in pediatric neurocritical care.","authors":"Angad Kochar,&nbsp;Kara Hildebrandt,&nbsp;Rebecca Silverstein,&nbsp;Brian Appavu","doi":"10.5492/wjccm.v12.i3.116","DOIUrl":"https://doi.org/10.5492/wjccm.v12.i3.116","url":null,"abstract":"<p><p>Acute neurologic injuries represent a common cause of morbidity and mortality in children presenting to the pediatric intensive care unit. After primary neurologic insults, there may be cerebral brain tissue that remains at risk of secondary insults, which can lead to worsening neurologic injury and unfavorable outcomes. A fundamental goal of pediatric neurocritical care is to mitigate the impact of secondary neurologic injury and improve neurologic outcomes for critically ill children. This review describes the physiologic framework by which strategies in pediatric neurocritical care are designed to reduce the impact of secondary brain injury and improve functional outcomes. Here, we present current and emerging strategies for optimizing neuroprotective strategies in critically ill children.</p>","PeriodicalId":66959,"journal":{"name":"世界危重病急救学杂志(英文版)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b1/04/WJCCM-12-116.PMC10308339.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9746556","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}
引用次数: 0
The artificial intelligence evidence-based medicine pyramid. 人工智能循证医学金字塔。
世界危重病急救学杂志(英文版) Pub Date : 2023-03-09 DOI: 10.5492/wjccm.v12.i2.89
Valentina Bellini, Federico Coccolini, Francesco Forfori, Elena Bignami
{"title":"The artificial intelligence evidence-based medicine pyramid.","authors":"Valentina Bellini,&nbsp;Federico Coccolini,&nbsp;Francesco Forfori,&nbsp;Elena Bignami","doi":"10.5492/wjccm.v12.i2.89","DOIUrl":"https://doi.org/10.5492/wjccm.v12.i2.89","url":null,"abstract":"<p><p>Several studies exist in the literature regarding the exploitation of artificial intelligence in intensive care. However, an important gap between clinical research and daily clinical practice still exists that can only be bridged by robust validation studies carried out by multidisciplinary teams.</p>","PeriodicalId":66959,"journal":{"name":"世界危重病急救学杂志(英文版)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f2/9f/WJCCM-12-89.PMC10075045.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9278451","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}
引用次数: 0
Elevated soluble fas blood concentrations in patients dying from spontaneous intracerebral hemorrhage. 自发性脑出血死亡患者可溶性fas血药浓度升高。
世界危重病急救学杂志(英文版) Pub Date : 2023-03-09 DOI: 10.5492/wjccm.v12.i2.63
Leonardo Lorente, María M Martín, Antonia Pérez-Cejas, Luis Ramos-Gómez, Jordi Solé-Violan, Juan J Cáceres, Alejandro Jiménez, Agustín F González-Rivero
{"title":"Elevated soluble fas blood concentrations in patients dying from spontaneous intracerebral hemorrhage.","authors":"Leonardo Lorente,&nbsp;María M Martín,&nbsp;Antonia Pérez-Cejas,&nbsp;Luis Ramos-Gómez,&nbsp;Jordi Solé-Violan,&nbsp;Juan J Cáceres,&nbsp;Alejandro Jiménez,&nbsp;Agustín F González-Rivero","doi":"10.5492/wjccm.v12.i2.63","DOIUrl":"https://doi.org/10.5492/wjccm.v12.i2.63","url":null,"abstract":"<p><strong>Background: </strong>Several studies of spontaneous intracerebral hemorrhage (SICH) patients have shown apoptotic changes in brain samples after hematoma evacuation. However, there have been no data on the association between blood concentrations of soluble fas (sFas) (the main surface death receptor of the extrinsic apoptosis pathway) and the prognosis of spontaneous intracranial hypotension (SIH) patients.</p><p><strong>Aim: </strong>To determine whether there is an association between blood sFas concentrations and SICH patient mortality.</p><p><strong>Methods: </strong>We included patients with <b>s</b>evere and supratentorial SIH. Severe was defined as having Glasgow Coma Scale < 9. We determined serum sFas concentrations at the time of severe SICH diagnosis.</p><p><strong>Results: </strong>We found that non-surviving patients (<i>n</i> = 36) compared to surviving patients (<i>n</i> = 39) had higher ICH score (<i>P</i> = 0.001), higher midline shift (<i>P</i> = 0.004), higher serum sFas concentrations (<i>P <</i> 0.001), and lower rate of early hematoma evacuation (<i>P</i> = 0.04). Multiple logistic regression analysis showed an association between serum sFas concentrations and 30-d mortality (odds ratio = 1.070; 95% confidence interval = 1.014-1.129; <i>P</i> = 0.01) controlling for ICH score, midline shift, and early hematoma evacuation.</p><p><strong>Conclusion: </strong>The association of blood sFas concentrations and SICH patient mortality is a novel finding in our study.</p>","PeriodicalId":66959,"journal":{"name":"世界危重病急救学杂志(英文版)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ea/d7/WJCCM-12-63.PMC10075047.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9278453","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}
引用次数: 0
Point-of-care ultrasound in diagnosis and management of congestive nephropathy. 充血性肾病的即时超声诊断和治疗。
世界危重病急救学杂志(英文版) Pub Date : 2023-03-09 DOI: 10.5492/wjccm.v12.i2.53
Michael Turk, Thomas Robertson, Abhilash Koratala
{"title":"Point-of-care ultrasound in diagnosis and management of congestive nephropathy.","authors":"Michael Turk,&nbsp;Thomas Robertson,&nbsp;Abhilash Koratala","doi":"10.5492/wjccm.v12.i2.53","DOIUrl":"https://doi.org/10.5492/wjccm.v12.i2.53","url":null,"abstract":"<p><p>Congestive nephropathy is kidney dysfunction caused by the impact of elevated venous pressures on renal hemodynamics. As a part of cardiorenal syndrome, the diagnosis is usually made based on history and physical examination, with findings such as jugular venous distension, a third heart sound, and vital signs as supporting findings. More recently, however, these once though objective measures have come under scrutiny for their accuracy. At the same time, bedside ultrasound has increased in popularity and is routinely being used by clinicians to take some of the guess work out of making the diagnosis of volume overload and venous congestion. In this mini-review, we will discuss some of the traditional methods used to measure venous congestion, describe the role of point-of-care ultrasound and how it can ameliorate a clinician's evaluation, and offer a description of venous excess ultrasound score, a relatively novel scoring technique used to objectively quantify congestion. While there is a paucity of published large scale clinical trials evaluating the potential benefit of ultrasonography in venous congestion compared to gold standard invasive measurements, more study is underway to solidify the role of this objective measure in daily clinical practice.</p>","PeriodicalId":66959,"journal":{"name":"世界危重病急救学杂志(英文版)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/dd/dc/WJCCM-12-53.PMC10075049.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9278455","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}
引用次数: 4
Enhancing the awakening to family engagement bundle with music therapy. 加强与音乐疗法捆绑家庭参与的觉醒。
世界危重病急救学杂志(英文版) Pub Date : 2023-03-09 DOI: 10.5492/wjccm.v12.i2.41
Ariel M Modrykamien
{"title":"Enhancing the awakening to family engagement bundle with music therapy.","authors":"Ariel M Modrykamien","doi":"10.5492/wjccm.v12.i2.41","DOIUrl":"https://doi.org/10.5492/wjccm.v12.i2.41","url":null,"abstract":"<p><p>Survivors of prolonged intensive care unit (ICU) admissions may present undesirable long-term outcomes. In particular, physical impairment and cognitive dysfunction have both been described in patients surviving episodes requiring mechanical ventilation and sedation. One of the strategies to prevent the aforementioned outcomes involves the implementation of a bundle composed by: (1) Spontaneous awakening trial; (2) Spontaneous breathing trial; (3) Choosing proper sedation strategies; (4) Delirium detection and management; (5) Early ICU mobility; and (6) Family engagement (ABCDEF bundle). The components of this bundle contribute in shortening length of stay on mechanical ventilation and reducing incidence of delirium. Since the first description of the ABCDEF bundle, other relevant therapeutic factors have been proposed, such as introducing music therapy. This mini-review describes the current evidence supporting the use of the ABCDEF bundle, as well as current knowledge on the implementation of music therapy.</p>","PeriodicalId":66959,"journal":{"name":"世界危重病急救学杂志(英文版)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f0/45/WJCCM-12-41.PMC10075048.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9278452","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}
引用次数: 0
Extracorporeal blood purification strategies in sepsis and septic shock: An insight into recent advancements. 脓毒症和感染性休克的体外血液净化策略:对最近进展的洞察。
世界危重病急救学杂志(英文版) Pub Date : 2023-03-09 DOI: 10.5492/wjccm.v12.i2.71
Yatin Mehta, Rajib Paul, Abdul Samad Ansari, Tanmay Banerjee, Serdar Gunaydin, Amir Ahmad Nassiri, Federico Pappalardo, Vedran Premužić, Prachee Sathe, Vinod Singh, Emilio Rey Vela
{"title":"Extracorporeal blood purification strategies in sepsis and septic shock: An insight into recent advancements.","authors":"Yatin Mehta,&nbsp;Rajib Paul,&nbsp;Abdul Samad Ansari,&nbsp;Tanmay Banerjee,&nbsp;Serdar Gunaydin,&nbsp;Amir Ahmad Nassiri,&nbsp;Federico Pappalardo,&nbsp;Vedran Premužić,&nbsp;Prachee Sathe,&nbsp;Vinod Singh,&nbsp;Emilio Rey Vela","doi":"10.5492/wjccm.v12.i2.71","DOIUrl":"https://doi.org/10.5492/wjccm.v12.i2.71","url":null,"abstract":"<p><strong>Background: </strong>Despite various therapies to treat sepsis, it is one of the leading causes of mortality in the intensive care unit patients globally. Knowledge about the pathophysiology of sepsis has sparked interest in extracorporeal therapies (ECT) which are intended to balance the dysregulation of the immune system by removing excessive levels of inflammatory mediators.</p><p><strong>Aim: </strong>To review recent data on the use of ECT in sepsis and to assess their effects on various inflammatory and clinical outcomes.</p><p><strong>Methods: </strong>In this review, an extensive English literature search was conducted from the last two decades to identify the use of ECT in sepsis. A total of 68 articles from peer-reviewed and indexed journals were selected excluding publications with only abstracts.</p><p><strong>Results: </strong>Results showed that ECT techniques such as high-volume hemofiltration, coupled plasma adsorption/filtration, resin or polymer adsorbers, and CytoSorb<sup>®</sup> are emerging as adjunct therapies to improve hemodynamic stability in sepsis. CytoSorb<sup>®</sup> has the most published data in regard to the use in the field of septic shock with reports on improved survival rates and lowered sequential organ failure assessment scores, lactate levels, total leucocyte count, platelet count, interleukin- IL-6, IL-10, and TNF levels.</p><p><strong>Conclusion: </strong>Clinical acceptance of ECT in sepsis and septic shock is currently still limited due to a lack of large random clinical trials. In addition to patient-tailored therapies, future research developments with therapies targeting the cellular level of the immune response are expected.</p>","PeriodicalId":66959,"journal":{"name":"世界危重病急救学杂志(英文版)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c4/c5/WJCCM-12-71.PMC10075046.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9278454","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}
引用次数: 1
Role of cerebrospinal fluid lactate in diagnosing meningitis in critically ill patients. 脑脊液乳酸盐在诊断重症患者脑膜炎中的作用。
世界危重病急救学杂志(英文版) Pub Date : 2023-01-09 DOI: 10.5492/wjccm.v12.i1.1
Devraj Yadav, Omender Singh, Deven Juneja, Amit Goel, Sahil Kataria, Anisha Beniwal
{"title":"Role of cerebrospinal fluid lactate in diagnosing meningitis in critically ill patients.","authors":"Devraj Yadav, Omender Singh, Deven Juneja, Amit Goel, Sahil Kataria, Anisha Beniwal","doi":"10.5492/wjccm.v12.i1.1","DOIUrl":"10.5492/wjccm.v12.i1.1","url":null,"abstract":"<p><strong>Background: </strong>Meningitis is a life-threatening clinical condition associated with high mortality and morbidity. Early diagnosis and specific treatment may improve outcomes. Lack of specific clinical signs or tests make the diagnosis challenging.</p><p><strong>Aim: </strong>To assess the efficacy of cerebrospinal fluid (CSF) lactate in diagnosing meningitis in critically ill patients.</p><p><strong>Methods: </strong>A prospective, observational cohort study was carried out in a neuro-medical intensive care unit (ICU) over a 22 mo period. Adult patients, with suspected meningitis admitted in ICU, were serially recruited. Patients who refused consent, those with peripheral sensorineural deficit, or with any contraindication to lumber puncture were excluded. CSF cytology, bio-chemistry, lactates, culture and polymerase chain reaction based meningo-encephalitis panel were evaluated. Patients were divided in two groups based on clinical diagnosis of meningitis. The efficacy of CSF lactate in diagnosing meningitis was evaluated and compared with other tests.</p><p><strong>Results: </strong>Seventy-one patients were included and 23 were diagnosed with meningitis. The mean values of CSF total leucocyte count (TLC), proteins and lactates were significantly higher in meningitis group. There was a significant correlation of CSF lactate levels with CSF cultures and meningo-encephalitis panel. CSF lactate (> 2.72 mmol/L) showed good accuracy in diagnosing meningitis with an area under the curve of 0.81 (95% confidence interval: 0.69-0.93), sensitivity of 82.6%, and specificity 72.9%. These values were comparable to those of CSF TLC and protein. Twelve patients with bacterial meningitis had significantly higher CSF lactate (8.9 ± 4.7 mmol/L) than those with non-bacterial meningitis (4.2 ± 3.8 mmol/L), <i>P</i> = 0.006.</p><p><strong>Conclusion: </strong>CSF lactate may be used to aid in our diagnosis of meningitis in ICU patients. CSF lactate (> 2.72 mmol/L) showed good accuracy, sensitivity, and specificity in diagnosing meningitis and may also help to differentiate between bacterial and non-bacterial meningitis.</p>","PeriodicalId":66959,"journal":{"name":"世界危重病急救学杂志(英文版)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d8/50/WJCCM-12-1.PMC9846869.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10571856","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}
引用次数: 0
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
相关产品
×
本文献相关产品
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信