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[ICU Management & Practice]: ICU中的虚拟与增强现实已关闭评论
Virtual and Augmented Reality in the ICU Virtual reality (VR) and augmented reality (AR) are emerging technologies with diverse applications, from entertainment and education to medical care. VR immerses users in a virtual three-dimensional environment, while AR retains connection to the real world while increasing information through the use of virtual elements. Both require specialised VR/AR glasses. These technologies have already found extensive use in healt...
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[ICU Management & Practice]: 顽固性感染性休克使用血管加压素负荷剂量已关闭评论
Vasopressin Loading for Refractory Septic Shock Vasopressin is a potent vasopressor used to treat septic shock, acting via a different receptor than catecholamines. Previous randomised control trials have demonstrated its efficacy. However, its use can also lead to adverse effects such as ischaemia events. Therefore, it is recommended as a second-line agent after noradrenaline. Typically, vasopressin is given as a continuous infusion up to 0.03 U/min (1.8 U/h). ...
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[ICU Management & Practice]: 单平面与实时双平面超声指导中心静脉置管已关闭评论
Single-Plane vs Real-Time Biplane Approaches for Ultrasound-Guided CVC Central venous catheterisation (CVC) is a lifesaving procedure for critically ill patients, commonly used during fluid resuscitation, safe intravenous administration of medication, and to facilitate haemodialysis and monitor haemodynamic variables in the ICU. Over 15 million CVCs are performed annually in the United States, and nearly 70 CVCs per 100 patient-days are performed in European I...
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[JAMA Intern Med发表述评]:临床试验领导者的性别平等已关闭评论
Editor's Note  October 30, 2023 Gender Equity in Clinical Trial Leadership—A Win-Win for Everyone Grace Y. Zhang, Ishani Ganguli, Tracy Y. Wang JAMA Intern Med. Published online October 30, 2023. doi:10.1001/jamainternmed.2023.5091 Gender disparity in clinical trial leadership has been described previously in fields such as cardiology.1 In this issue of JAMA Internal Medicine, Waldhorn et al2 demonstrate that this issue is more...
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[ICU Management & Practice]: 呼吸机诱导肺损伤与生物钟已关闭评论
Ventilator-Induced Lung Injury and the Circadian Clock Patients diagnosed with acute respiratory distress syndrome (ARDS) often require mechanical ventilation (MV) as a life-saving intervention. However, mechanical ventilation can aggravate lung injury, leading to a condition known as ventilator-induced lung injury (VILI). Although using low tidal volume (VT) ventilation has become the standard in clinical practice for patients with ARDS, lung-protective ventila...
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[ICU Management & Practice]: 皮质激素治疗重症社区获得性肺炎已关闭评论
Corticosteroids in Severe CAP Corticosteroid use in the care of critically ill patients has been the subject of ongoing research with conflicting findings. There is a growing interest in understanding their role in treating a common source of sepsis: community-acquired pneumonia (CAP). Some studies have focused on determining whether corticosteroids provide clinical benefits to patients with the most severe clinical presentation and highest mortality rate of C...
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[ICU Management & Practice]: 重症监护水平与脓毒症患者住院病死率已关闭评论
Levels of Intensive Care and In-Hospital Mortality in Sepsis Sepsis is a life-threatening condition caused by a dysfunctional response to infection. It is a significant global health issue, with approximately 48.9 million cases and 11 million deaths annually. Sepsis accounts for nearly 30% of all ICU admissions worldwide. Previous studies have reported varying prevalence rates of ICU-treated sepsis, ranging from 58 to 80 cases per 100,000 person-years, highlighting...
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[ICU Management & Practice]: 重症医学中的性别差异已关闭评论
Sex and Gender Differences in Intensive Care In recent years, there has been a growing focus on recognising sex and gender differences in diagnosis, clinical care, and outcomes. Several landmark publications have highlighted how women often receive unequal treatment compared to men, leading to worse outcomes. Historically, there has been a significant oversight in research when it comes to considering sex differences. Women have been underrepresented in clinical...
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[ICU Management & Practice]: 针对重症资源的检诊步骤已关闭评论
Triage Procedures for Critical Care Resources During the COVID-19 pandemic, several states in the U.S. used pandemic preparedness plans to guide the allocation of critical resources in times of crisis. These state-specific plans varied in the factors used to triage patients. Some encountered significant scrutiny from advocacy groups due to concerns about potential discrimination. A study assessed the role of comorbidities and long-term prognosis in state triage ...
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[ICU Management & Practice]: 维生素B对感染性休克患者的肾脏保护已关闭评论
Thiamine for Renal Protection in Septic Shock Kidney injury frequently occurs in patients with septic shock and is linked to worse clinical outcomes. Administering thiamine (vitamin B1) as part of a mitochondrial resuscitation strategy might help mitigate septic kidney injury. Thiamine is crucial for aerobic respiration, and thiamine can lead to organ dysfunction. Because the kidney contains a high concentration of mitochondria and relies on thiamine for mitocho...
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