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Importance of timely and adequate source control in sepsis and septic shock 及时、充分地控制败血症和脓毒性休克病源的重要性
Journal of intensive medicine Pub Date : 2024-02-27 DOI: 10.1016/j.jointm.2024.01.002
Jan J. De Waele
{"title":"Importance of timely and adequate source control in sepsis and septic shock","authors":"Jan J. De Waele","doi":"10.1016/j.jointm.2024.01.002","DOIUrl":"10.1016/j.jointm.2024.01.002","url":null,"abstract":"<div><p>Source control is defined as the physical measures undertaken to eliminate the source of infection and control ongoing contamination, as well as restore anatomy and function at the site of infection. It is a key component of the management of patients with sepsis and septic shock and one of the main determinants of the outcome of infections that require source control. While not all infections may require source control, it should be considered in every patient presenting with sepsis; it is applicable and necessary in numerous infections, not only those occurring in the abdominal cavity. Although the biological rationale is clear, several aspects of source control remain under debate. The timing of source control may impact outcome; early source control is particularly relevant for patients with abdominal infections or necrotizing skin and soft tissue infections, as well as for those with more severe disease. Percutaneous procedures are increasingly used for source control; nevertheless, surgery—tailored to the patient and infection—remains a valid option for source control. For outcome optimization, adequate source control is more important than the strategy used. It should be acknowledged that source control interventions may often fail, posing a challenge in this setting. Thus, an individualized, multidisciplinary approach tailored to the infection and patient is preferable.</p></div>","PeriodicalId":73799,"journal":{"name":"Journal of intensive medicine","volume":"4 3","pages":"Pages 281-286"},"PeriodicalIF":0.0,"publicationDate":"2024-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667100X24000070/pdfft?md5=ffbb1b073bf9cca19274d820812937bb&pid=1-s2.0-S2667100X24000070-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140465223","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
Cerebral autoregulation-directed optimal blood pressure management reduced the risk of delirium in patients with septic shock 以大脑自动调节为导向的最佳血压管理降低了脓毒性休克患者出现谵妄的风险
Journal of intensive medicine Pub Date : 2024-02-02 DOI: 10.1016/j.jointm.2023.12.003
Qianyi Peng , Xia Liu , Meilin Ai , Li Huang , Li Li , Wei Liu , Chunguang Zhao , Chenghuan Hu , Lina Zhang
{"title":"Cerebral autoregulation-directed optimal blood pressure management reduced the risk of delirium in patients with septic shock","authors":"Qianyi Peng ,&nbsp;Xia Liu ,&nbsp;Meilin Ai ,&nbsp;Li Huang ,&nbsp;Li Li ,&nbsp;Wei Liu ,&nbsp;Chunguang Zhao ,&nbsp;Chenghuan Hu ,&nbsp;Lina Zhang","doi":"10.1016/j.jointm.2023.12.003","DOIUrl":"10.1016/j.jointm.2023.12.003","url":null,"abstract":"<div><h3>Background</h3><p>When resuscitating patients with septic shock, cerebrovascular reactivity parameters are calculated by monitoring regional cerebral oxygen saturation (rSO<sub>2</sub>) using near-infrared spectroscopy to determine the optimal blood pressure. Here, we aimed to analyze the impact of cerebral autoregulation-directed optimal blood pressure management on the incidence of delirium and the prognosis of patients with septic shock.</p></div><div><h3>Methods</h3><p>This prospective randomized controlled clinical study was conducted in the Xiangya Hospital of Central South University, China. Fifty-one patients with septic shock (December 2020–May 2022) were enrolled and randomly allocated to the experimental (<em>n</em>=26) or control group (<em>n</em>=25). Using the ICM<sup>+</sup> software, we monitored the dynamic changes in rSO<sub>2</sub> and mean arterial pressure (MAP) and calculated the cerebrovascular reactivity parameter tissue oxygen reactivity index to determine the optimal blood pressure to maintain normal cerebral autoregulation function during resuscitation in the experimental group. The control group was treated according to the Surviving Sepsis Campaign Guidelines. Differences in the incidence of delirium and 28-day mortality between the two groups were compared, and the risk factors were analyzed.</p></div><div><h3>Results</h3><p>The 51 patients, including 39 male and 12 female, had a mean age of (57.0±14.9) years. The incidence of delirium was 40.1% (23/51), and the 28-day mortality rate was 29.4% (15/51). The mean MAP during the first 24 h of intensive care unit (ICU) admission was higher ([84.5±12.2] mmHg <em>vs.</em> [77.4±11.8] mmHg, <em>P</em>=0.040), and the incidence of delirium was lower (30.8% <em>vs.</em> 60.0%, <em>P</em>=0.036) in the experimental group than in the control group. The use of cerebral autoregulation-directed optimal blood pressure (odds ratio [OR]=0.090, 95% confidence interval [CI]: 0.009 to 0.923, <em>P</em>=0.043) and length of ICU stay (OR=1.473, 95% CI: 1.093 to 1.985, <em>P</em>=0.011) were risk factors for delirium during septic shock. Vasoactive drug dose (OR=8.445, 95% CI: 1.26 to 56.576, <em>P</em>=0.028) and partial pressure of oxygen (PaO<sub>2</sub>) (OR=0.958, 95% CI: 0.921 to 0.996, <em>P</em>=0.032) were the risk factors for 28-day mortality.</p></div><div><h3>Conclusions</h3><p>The use of cerebral autoregulation-directed optimal blood pressure management during shock resuscitation reduces the incidence of delirium in patients with septic shock.</p></div><div><h3><strong>Trial Registration</strong></h3><p>ClinicalTrials.gov ldentifer: NCT03879317</p></div>","PeriodicalId":73799,"journal":{"name":"Journal of intensive medicine","volume":"4 3","pages":"Pages 376-383"},"PeriodicalIF":0.0,"publicationDate":"2024-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667100X24000033/pdfft?md5=36e2277329e7a6cc912306adadac723d&pid=1-s2.0-S2667100X24000033-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139881780","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
Risk factors and mortality rates of carbapenem-resistant Gram-negative bacterial infections in intensive care units 重症监护病房耐碳青霉烯类革兰氏阴性菌感染的风险因素和死亡率
Journal of intensive medicine Pub Date : 2024-01-09 DOI: 10.1016/j.jointm.2023.11.007
Tulay Orhan Kuloglu , Gamze Kalin Unuvar , Fatma Cevahir , Aysegul Ulu Kilic , Emine Alp
{"title":"Risk factors and mortality rates of carbapenem-resistant Gram-negative bacterial infections in intensive care units","authors":"Tulay Orhan Kuloglu ,&nbsp;Gamze Kalin Unuvar ,&nbsp;Fatma Cevahir ,&nbsp;Aysegul Ulu Kilic ,&nbsp;Emine Alp","doi":"10.1016/j.jointm.2023.11.007","DOIUrl":"10.1016/j.jointm.2023.11.007","url":null,"abstract":"<div><h3>Background</h3><p>The prevalence of hospital-acquired infections caused by carbapenem-resistant gram-negative bacteria (CRGNB) is increasing worldwide. Several risk factors have been associated with such infections. The present study aimed to identify risk factors and determine the mortality rates associated with CRGNB infections in intensive care units.</p></div><div><h3>Methods</h3><p>This retrospective case-control study was conducted at Erciyes University Hospital (Kayseri, Turkey) between January 2017 and December 2021. Demographic and laboratory data were obtained from the Infection Control Committee data and record system. Patients who had CRGNB infection 48–72 h after hospitalization were assigned to the case group, while those who were not infected with CRGNB during hospitalization formed the control group. Risk factors, comorbidity, demographic data, and mortality rates were compared between the two groups.</p></div><div><h3>Results</h3><p>Approximately 1449 patients (8.97%) were monitored during the active follow-up period; of those, 1171 patients were included in this analysis. CRGNB infection developed in 14 patients (70.00%) who had CRGNB colonization at admission; in 162 (78.26%) were colonized during hospitalization, whereas 515 (54.56%) were not colonized. There was no significant difference in age, sex (male/female) or comorbidities. The total length of hospital stay was statistically significantly longer (<em>P</em>=0.001) in the case group (median: 24 [interquartile range: 3–378] days) than the control group (median: 16 [interquartile range: 3–135] days). The rates of colonization at admission (25.5%; <em>vs.</em> 10.6%, <em>P</em>=0.001) and mortality (64.4% <em>vs.</em> 45.8%, <em>P</em>=0.001) were also significantly higher in the cases than in the control group, respectively. In the univariate analysis, prolonged hospitalization, the time from intensive care unit admission to the development of infection, presence of CRGNB colonization at admission, transfer from other hospitals, previous antibiotic use, enteral nutrition, transfusion, hemodialysis, mechanical ventilation, tracheostomy, reintubation, central venous catheter, arterial catheterization, chest tube, total parenteral nutrition, nasogastric tube use, and bronchoscopy procedures were significantly associated with CRGNB infections (<em>P</em> &lt;0<em>.</em>05). Multivariate analysis identified the total length of stay in the hospital (odds ratio [OR]=1.02; 95% confidence interval [CI]: 1.01 to 1.03; <em>P</em>=0.001), colonization (OR=2.19; 95% CI: 1.53 to 3.13; <em>P</em>=0.001), previous antibiotic use (OR=2.36; 95% CI: 1.53 to 3.62; <em>P</em>=0.001), intubation (OR=1.59; 95% CI: 1.14 to 2.20; <em>P</em>=0.006), tracheostomy (OR=1.42; 95% CI: 1.01 to 1.99; <em>P</em>=0.047), and central venous catheter use (OR=1.62; 95% CI: 1.20 to 2.19; <em>P</em>=0.002) as the most important risk factors for CRGNB infection.</p></div><div><h3>Conclusions</h3><p>Colo","PeriodicalId":73799,"journal":{"name":"Journal of intensive medicine","volume":"4 3","pages":"Pages 347-354"},"PeriodicalIF":0.0,"publicationDate":"2024-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667100X23000944/pdfft?md5=26c3611d22f92d86944a7bf9cb6ec976&pid=1-s2.0-S2667100X23000944-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139455544","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
Genetic causal association between gut microbiota and sepsis: Evidence from a two-sample bidirectional Mendelian randomization analysis 肠道微生物群与败血症之间的遗传因果关系:来自双样本双向孟德尔随机分析的证据
Journal of intensive medicine Pub Date : 2024-01-08 DOI: 10.1016/j.jointm.2023.11.006
Jungen Tang, Man Huang
{"title":"Genetic causal association between gut microbiota and sepsis: Evidence from a two-sample bidirectional Mendelian randomization analysis","authors":"Jungen Tang,&nbsp;Man Huang","doi":"10.1016/j.jointm.2023.11.006","DOIUrl":"10.1016/j.jointm.2023.11.006","url":null,"abstract":"<div><h3>Background</h3><p>Sepsis is a severe and potentially life-threatening condition characterized by a dysregulated host response and organ dysfunction. The causal relationship between intestinal microbiota and sepsis is unclear.</p></div><div><h3>Methods</h3><p>A two-sample Mendelian randomization (MR) study was performed to proxy the causal association between gut microbiota and sepsis. The genome-wide association study (GWAS) data of sepsis and gut microbiome were collected from the Integrative Epidemiology Unit (IEU) OpenGWAS, with summary-level data obtained from the UK Biobank. Five traditional methods were used to estimate the potential causal relationships between gut microbiota and sepsis, including the inverse-variance weighted method, weighted median method, MR-Egger regression, simple mode, and weighted mode. Reverse MR analysis was performed on the bacteria that were found to be causally associated with sepsis in forward MR analysis. Cochran's <em>Q</em> statistic was used to quantify the heterogeneity of instrumental variables.</p></div><div><h3>Results</h3><p>The inverse-variance weighted estimate suggested that class Lentisphaeria (odds ratio [OR]=0.86, 95% confidence interval [CI]: 0.78 to 0.94, <em>P</em>=0.0017, <em>q</em>=0.1596) and order Victivallales (OR=0.86, 95% CI: 0.78 to 0.94, <em>P</em>=0.0017, <em>q</em>=0.1596) have a protective effect on sepsis. The genus <em>Eubacterium eligens</em> group (OR=1.34, 95% CI: 1.11 to 1.63, <em>P</em>=0.0029, <em>q</em>=0.1881) was positively associated with the risk of sepsis. Sepsis may be a significant risk factor for genus <em>Odoribacter</em> (OR=1.18, 95% CI: 1.10 to 1.39, <em>P</em>=0.0415, <em>q</em>=0.9849) and <em>Phascolarctobacterium</em> (OR=1.21, 95% CI: 1.00 to 1.46, <em>P</em>=0.0471, <em>q</em>=0.9849), but this effect was not statistically significant after false discovery rate correction. There was a suggestive association between sepsis and <em>Faecalibacterium</em> (OR=0.85, 95% CI: 0.73 to 0.98, <em>P</em>=0.0278) and <em>Ruminococcus</em> 1 (OR=0.85, 95% CI: 0.73 to 1.00, <em>P</em>=0.0439), which were not significant after false discovery rate correction (<em>q</em>&gt;0.2).</p></div><div><h3>Conclusions</h3><p>This study found that class Lentisphaeria, order Victivallales, and genus <em>Eubacterium eligens</em> group may have a causal relationship with the risk of sepsis.</p></div>","PeriodicalId":73799,"journal":{"name":"Journal of intensive medicine","volume":"4 3","pages":"Pages 362-367"},"PeriodicalIF":0.0,"publicationDate":"2024-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667100X23000932/pdfft?md5=90e584504586b97ba93b9b4a49b08027&pid=1-s2.0-S2667100X23000932-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139458436","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
Late-onset Very long-chain acyl-CoA dehydrogenase deficiency diagnosis complicated by fulminant myocarditis in adult patient 成年患者晚发性极长链酰基-CoA脱氢酶缺乏诊断并发暴发性心肌炎
Journal of intensive medicine Pub Date : 2024-01-05 DOI: 10.1016/j.jointm.2023.11.003
Martin Gérard , Clair Douillard , Julien Poissy , Mehdi Marzouk , Christophe Vinsonneau
{"title":"Late-onset Very long-chain acyl-CoA dehydrogenase deficiency diagnosis complicated by fulminant myocarditis in adult patient","authors":"Martin Gérard ,&nbsp;Clair Douillard ,&nbsp;Julien Poissy ,&nbsp;Mehdi Marzouk ,&nbsp;Christophe Vinsonneau","doi":"10.1016/j.jointm.2023.11.003","DOIUrl":"10.1016/j.jointm.2023.11.003","url":null,"abstract":"","PeriodicalId":73799,"journal":{"name":"Journal of intensive medicine","volume":"4 3","pages":"Pages 400-402"},"PeriodicalIF":0.0,"publicationDate":"2024-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667100X23000890/pdfft?md5=b623cfc56f30021085b578fc6b101771&pid=1-s2.0-S2667100X23000890-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139394517","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
Prevention of urinary tract infection using a silver alloy hydrogel-coated catheter in critically ill patients: A single-center prospective randomized controlled study 危重患者使用银合金水凝胶包覆导尿管预防尿路感染:一项单中心前瞻性随机对照研究
Journal of intensive medicine Pub Date : 2024-01-01 DOI: 10.1016/j.jointm.2023.06.003
Menglong Zhao , Shike Geng , Lei Zhang, Xiaoqin Fan, Fei Tong, Xianlin Meng, Tianfeng Wang, Xiaowei Fang, Qing Mei, Aijun Pan
{"title":"Prevention of urinary tract infection using a silver alloy hydrogel-coated catheter in critically ill patients: A single-center prospective randomized controlled study","authors":"Menglong Zhao ,&nbsp;Shike Geng ,&nbsp;Lei Zhang,&nbsp;Xiaoqin Fan,&nbsp;Fei Tong,&nbsp;Xianlin Meng,&nbsp;Tianfeng Wang,&nbsp;Xiaowei Fang,&nbsp;Qing Mei,&nbsp;Aijun Pan","doi":"10.1016/j.jointm.2023.06.003","DOIUrl":"10.1016/j.jointm.2023.06.003","url":null,"abstract":"<div><h3>Background</h3><p>A new type of silver alloy hydrogel-coated (SAH) catheter has been shown to prevent bacterial adhesion and colonization by generating a microcurrent, and to block the retrograde infection pathway. However, these have only been confirmed in ordinary patients. This study aims to evaluate the effectiveness of a SAH catheter for preventing urinary tract infections in critically ill patients.</p></div><div><h3>Methods</h3><p>This was a prospective single-center, single-blind, randomized, controlled study. A total of 132 patients requiring indwelling catheterization in the intensive care unit (ICU) of the First Affiliated Hospital of the University of Science and Technology of China between October 2022 and February 2023 and who met the study inclusion/exclusion criteria were randomly divided into two groups. Patients in the SAH catheter group received a SAH catheter, while patients in the conventional catheter group received a conventional siliconized latex Foley catheter. The main outcome measure was the incidence of catheter-associated urinary tract infections (CAUTIs). Secondary outcome indicators included urine positivity for white blood cells and positive urine cultures on 3 days, 7 days, 10 days, and 14 days after catheterization, number of viable bacteria in the catheter biofilm on day 14, pathogenic characteristics of positive urine cultures, length of ICU stay, overall hospital stay, ICU mortality, and 28-day mortality. All the data were compared between the two groups.</p></div><div><h3>Results</h3><p>A total of 68 patients in the conventional catheter group and 64 patients in the SAH catheter group were included in the study. On day 7 after catheter placement, the positivity rate for urinary white blood cells was significantly higher in the conventional catheter group than in the SAH catheter group (33.8% <em>vs.</em> 15.6%, <em>P</em>=0.016). On day 10, the rates of positive urine cultures (27.9% <em>vs.</em> 10.9%, <em>P</em>=0.014) and CAUTIs (22.1% <em>vs.</em> 7.8%, <em>P</em>=0.023) were significantly higher in the conventional catheter group than in the SAH catheter group. On day 14, the numbers of viable bacteria isolated from the catheter tip ([3.21±1.91]×10<sup>6</sup> colony-forming units [cfu]/mL <em>vs.</em> [7.44±2.22]×10<sup>4</sup> cfu/mL, <em>P</em> &lt;0.001), balloon segment ([7.30±1.99]×10<sup>7</sup> cfu/mL <em>vs.</em> [3.48±2.38]×10<sup>5</sup> cfu/mL, <em>P</em> &lt;0.001), and tail section ([6.41±2.07]×10<sup>5</sup> cfu/mL <em>vs.</em> [8.50±1.46]×10<sup>3</sup> cfu/mL, <em>P</em> &lt;0.001) were significantly higher in the conventional catheter group than in the SAH catheter group. The most common bacteria in the urine of patients in both groups were <em>Escherichia coli</em> (<em>n</em>=13) and <em>Pseudomonas aeruginosa</em> (<em>n</em>=6), with only one case of <em>Candida</em> in each group. There were no significant differences between the two groups in terms of ICU hospitalization ","PeriodicalId":73799,"journal":{"name":"Journal of intensive medicine","volume":"4 1","pages":"Pages 118-124"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667100X23000348/pdfft?md5=2ff58f39b2a4314ae0a3d4983938d6a5&pid=1-s2.0-S2667100X23000348-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48078485","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
Massive abdominal muscle atrophy during prolonged mechanical ventilation: Implications for tracheostomy removal 长时间机械通气期间大量腹肌萎缩:气管造口术切除的意义
Journal of intensive medicine Pub Date : 2024-01-01 DOI: 10.1016/j.jointm.2023.06.005
Pascal Beuret, Florian Michelin, Audrey Tientcheu, Laurane Chalvet, Benedicte Philippon-Jouve, Jean-Charles Chakarian, Xavier Fabre
{"title":"Massive abdominal muscle atrophy during prolonged mechanical ventilation: Implications for tracheostomy removal","authors":"Pascal Beuret,&nbsp;Florian Michelin,&nbsp;Audrey Tientcheu,&nbsp;Laurane Chalvet,&nbsp;Benedicte Philippon-Jouve,&nbsp;Jean-Charles Chakarian,&nbsp;Xavier Fabre","doi":"10.1016/j.jointm.2023.06.005","DOIUrl":"10.1016/j.jointm.2023.06.005","url":null,"abstract":"","PeriodicalId":73799,"journal":{"name":"Journal of intensive medicine","volume":"4 1","pages":"Pages 133-135"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667100X23000476/pdfft?md5=7c4bc0d7427059184f098f3e6561d27f&pid=1-s2.0-S2667100X23000476-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43219123","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
Latest Updates and Challenges in infections in intensive care medicine 重症监护医学中感染问题的最新进展与挑战
Journal of intensive medicine Pub Date : 2024-01-01 DOI: 10.1016/j.jointm.2023.11.001
Jordi Rello
{"title":"Latest Updates and Challenges in infections in intensive care medicine","authors":"Jordi Rello","doi":"10.1016/j.jointm.2023.11.001","DOIUrl":"10.1016/j.jointm.2023.11.001","url":null,"abstract":"","PeriodicalId":73799,"journal":{"name":"Journal of intensive medicine","volume":"4 1","pages":"Pages 1-2"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667100X23000865/pdfft?md5=32f6b43c3f87f94ee2d3feffd9e99be9&pid=1-s2.0-S2667100X23000865-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138625870","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
Optimizing artificial intelligence in sepsis management: Opportunities in the present and looking closely to the future 优化败血症管理中的人工智能:把握机遇,展望未来
Journal of intensive medicine Pub Date : 2024-01-01 DOI: 10.1016/j.jointm.2023.10.001
Darragh O'Reilly , Jennifer McGrath , Ignacio Martin-Loeches
{"title":"Optimizing artificial intelligence in sepsis management: Opportunities in the present and looking closely to the future","authors":"Darragh O'Reilly ,&nbsp;Jennifer McGrath ,&nbsp;Ignacio Martin-Loeches","doi":"10.1016/j.jointm.2023.10.001","DOIUrl":"10.1016/j.jointm.2023.10.001","url":null,"abstract":"<div><p>Sepsis remains a major challenge internationally for healthcare systems. Its incidence is rising due to poor public awareness and delays in its recognition and subsequent management. In sepsis, mortality increases with every hour left untreated. Artificial intelligence (AI) is transforming worldwide healthcare delivery at present. This review has outlined how AI can augment strategies to address this global disease burden. AI and machine learning (ML) algorithms can analyze vast quantities of increasingly complex clinical datasets from electronic medical records to assist clinicians in diagnosing and treating sepsis earlier than traditional methods. Our review highlights how these models can predict the risk of sepsis and organ failure even before it occurs. This gives providers additional time to plan and execute treatment plans, thereby avoiding increasing complications associated with delayed diagnosis of sepsis. The potential for cost savings with AI implementation is also discussed, including improving workflow efficiencies, reducing administrative costs, and improving healthcare outcomes. Despite these advantages, clinicians have been slow to adopt AI into clinical practice. Some of the limitations posed by AI solutions include the lack of diverse data sets for model building so that they are widely applicable for routine clinical use. Furthermore, the subsequent algorithms are often based on complex mathematics leading to clinician hesitancy to embrace such technologies. Finally, we highlight the need for robust political and regulatory frameworks in this area to achieve the trust and approval of clinicians and patients to implement this transformational technology.</p></div>","PeriodicalId":73799,"journal":{"name":"Journal of intensive medicine","volume":"4 1","pages":"Pages 34-45"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667100X23000816/pdfft?md5=f14061017e65ccf19b8b13fe0858f566&pid=1-s2.0-S2667100X23000816-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139299750","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
Erratum to “Relationship between PaO2/FiO2 and delirium in intensive care: A cross-sectional study” [Journal of Intensive Medicine volume 3 (2023) 73–78.] 重症监护中 PaO2/FiO2 与谵妄的关系:一项横断面研究"[《重症医学杂志》第 3 卷(2023 年)第 73-78 页]。
Journal of intensive medicine Pub Date : 2024-01-01 DOI: 10.1016/j.jointm.2023.12.001
Fang Gong , Yuhang Ai , Lina Zhang , Qianyi Peng , Quan Zhou , Chunmei Gui
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引用次数: 0
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