首页 > 最新文献

Intensive Care Medicine最新文献

英文 中文
Beyond borders: the impact of international fellowships on professional and personal development 超越国界:国际研究金对专业和个人发展的影响
IF 38.9 1区 医学 Q1 CRITICAL CARE MEDICINE Pub Date : 2024-10-23 DOI: 10.1007/s00134-024-07684-1
Stephan von Düring, Damian Ratano, Brian Cuthbertson
Intensive Care Medicine (ICM) is a specialized field that has evolved significantly from its origins, where critically ill patients were managed by general hospital physicians [1]. Over time, ICM has developed into a distinct discipline requiring intensivists to possess a deep understanding of human pathophysiology, critical illness, and the management of life-threatening conditions, while also leading interprofessional teams [2, 3]. The coronavirus disease 2019 (COVID-19) pandemic highlighted the importance of skilled intensivists, and the increasing demand for intensive care unit (ICU) beds globally indicates a growing need for these specialists [4].
重症监护医学(ICM)是一门专业学科,与最初由普通医院医生管理危重病人相比,已经有了长足的发展[1]。随着时间的推移,重症医学已发展成为一门独特的学科,要求重症医学专家对人体病理生理学、危重病和危及生命的病情管理有深入的了解,同时还要领导跨专业团队[2, 3]。2019 年冠状病毒病(COVID-19)大流行凸显了技术娴熟的重症监护医生的重要性,而全球对重症监护病房(ICU)床位的需求不断增加也表明对这些专家的需求日益增长[4]。
{"title":"Beyond borders: the impact of international fellowships on professional and personal development","authors":"Stephan von Düring, Damian Ratano, Brian Cuthbertson","doi":"10.1007/s00134-024-07684-1","DOIUrl":"https://doi.org/10.1007/s00134-024-07684-1","url":null,"abstract":"Intensive Care Medicine (ICM) is a specialized field that has evolved significantly from its origins, where critically ill patients were managed by general hospital physicians [1]. Over time, ICM has developed into a distinct discipline requiring intensivists to possess a deep understanding of human pathophysiology, critical illness, and the management of life-threatening conditions, while also leading interprofessional teams [2, 3]. The coronavirus disease 2019 (COVID-19) pandemic highlighted the importance of skilled intensivists, and the increasing demand for intensive care unit (ICU) beds globally indicates a growing need for these specialists [4].","PeriodicalId":13665,"journal":{"name":"Intensive Care Medicine","volume":null,"pages":null},"PeriodicalIF":38.9,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142487081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Terlipressin use in hepatorenal syndrome-acute kidney injury in cirrhosis 肝肾综合征-肝硬化急性肾损伤中使用特利加压素
IF 38.9 1区 医学 Q1 CRITICAL CARE MEDICINE Pub Date : 2024-10-23 DOI: 10.1007/s00134-024-07681-4
Florence Wong, Stephen C. Pappas
No Abstract
无摘要
{"title":"Terlipressin use in hepatorenal syndrome-acute kidney injury in cirrhosis","authors":"Florence Wong, Stephen C. Pappas","doi":"10.1007/s00134-024-07681-4","DOIUrl":"https://doi.org/10.1007/s00134-024-07681-4","url":null,"abstract":"No Abstract","PeriodicalId":13665,"journal":{"name":"Intensive Care Medicine","volume":null,"pages":null},"PeriodicalIF":38.9,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142487156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Causal inference can lead us to modifiable mechanisms and informative archetypes in sepsis 因果推论可引导我们找到败血症的可调节机制和信息原型
IF 38.9 1区 医学 Q1 CRITICAL CARE MEDICINE Pub Date : 2024-10-21 DOI: 10.1007/s00134-024-07665-4
J. Kenneth Baillie, Derek Angus, Katie Burnham, Thierry Calandra, Carolyn Calfee, Alex Gutteridge, Nir Hacohen, Purvesh Khatri, Raymond Langley, Avi Ma’ayan, John Marshall, David Maslove, Hallie C. Prescott, Kathy Rowan, Brendon P. Scicluna, Christopher Seymour, Manu Shankar-Hari, Nathan Shapiro, W. Joost Wiersinga, Mervyn Singer, Adrienne G. Randolph

Medical progress is reflected in the advance from broad clinical syndromes to mechanistically coherent diagnoses. By this metric, research in sepsis is far behind other areas of medicine—the word itself conflates multiple different disease mechanisms, whilst excluding noninfectious syndromes (e.g., trauma, pancreatitis) with similar pathogenesis. New technologies, both for deep phenotyping and data analysis, offer the capability to define biological states with extreme depth. Progress is limited by a fundamental problem: observed groupings of patients lacking shared causal mechanisms are very poor predictors of response to treatment. Here, we discuss concrete steps to identify groups of patients reflecting archetypes of disease with shared underlying mechanisms of pathogenesis. Recent evidence demonstrates the role of causal inference from host genetics and randomised clinical trials to inform stratification analyses. Genetic studies can directly illuminate drug targets, but in addition they create a reservoir of statistical power that can be divided many times among potential patient subgroups to test for mechanistic coherence, accelerating discovery of modifiable mechanisms for testing in trials. Novel approaches, such as subgroup identification in-flight in clinical trials, will improve efficiency. Within the next decade, we expect ongoing large-scale collaborative projects to discover and test therapeutically relevant sepsis archetypes.

医学的进步体现在从广泛的临床综合症到机理上一致的诊断。根据这一标准,败血症的研究远远落后于其他医学领域--这个词本身就混淆了多种不同的疾病机制,同时排除了具有类似发病机制的非感染性综合征(如创伤、胰腺炎)。用于深度表型和数据分析的新技术提供了以极高深度定义生物状态的能力。但进展受限于一个基本问题:观察到的患者分组缺乏共同的因果机制,对治疗反应的预测性很差。在此,我们将讨论如何采取具体步骤来确定反映具有共同潜在发病机制的疾病原型的患者群体。最近的证据表明,从宿主遗传学和随机临床试验中得出的因果推论可为分层分析提供依据。遗传学研究可直接揭示药物靶点,此外还能产生统计能力,可在潜在的患者亚组中进行多次分配,以测试机理的一致性,从而加快发现可在试验中测试的可改变机理。临床试验中的亚组识别等新方法将提高效率。在未来十年内,我们期待正在进行的大规模合作项目能发现并测试与治疗相关的败血症原型。
{"title":"Causal inference can lead us to modifiable mechanisms and informative archetypes in sepsis","authors":"J. Kenneth Baillie, Derek Angus, Katie Burnham, Thierry Calandra, Carolyn Calfee, Alex Gutteridge, Nir Hacohen, Purvesh Khatri, Raymond Langley, Avi Ma’ayan, John Marshall, David Maslove, Hallie C. Prescott, Kathy Rowan, Brendon P. Scicluna, Christopher Seymour, Manu Shankar-Hari, Nathan Shapiro, W. Joost Wiersinga, Mervyn Singer, Adrienne G. Randolph","doi":"10.1007/s00134-024-07665-4","DOIUrl":"https://doi.org/10.1007/s00134-024-07665-4","url":null,"abstract":"<p>Medical progress is reflected in the advance from broad clinical syndromes to mechanistically coherent diagnoses. By this metric, research in sepsis is far behind other areas of medicine—the word itself conflates multiple different disease mechanisms, whilst excluding noninfectious syndromes (e.g., trauma, pancreatitis) with similar pathogenesis. New technologies, both for deep phenotyping and data analysis, offer the capability to define biological states with extreme depth. Progress is limited by a fundamental problem: observed groupings of patients lacking shared causal mechanisms are very poor predictors of response to treatment. Here, we discuss concrete steps to identify groups of patients reflecting archetypes of disease with shared underlying mechanisms of pathogenesis. Recent evidence demonstrates the role of causal inference from host genetics and randomised clinical trials to inform stratification analyses. Genetic studies can directly illuminate drug targets, but in addition they create a reservoir of statistical power that can be divided many times among potential patient subgroups to test for mechanistic coherence, accelerating discovery of modifiable mechanisms for testing in trials. Novel approaches, such as subgroup identification in-flight in clinical trials, will improve efficiency. Within the next decade, we expect ongoing large-scale collaborative projects to discover and test therapeutically relevant sepsis archetypes.</p>","PeriodicalId":13665,"journal":{"name":"Intensive Care Medicine","volume":null,"pages":null},"PeriodicalIF":38.9,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142451804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Effect of albumin bolus therapy on vasopressor requirement after cardiac surgery? Author’s reply 白蛋白栓塞疗法对心脏手术后血管加压素需求的影响?作者回复
IF 38.9 1区 医学 Q1 CRITICAL CARE MEDICINE Pub Date : 2024-10-21 DOI: 10.1007/s00134-024-07685-0
Geoffrey J. Wigmore, Adam M. Deane, Jeffrey J. Presneill, Rinaldo Bellomo
No Abstract
无摘要
{"title":"Effect of albumin bolus therapy on vasopressor requirement after cardiac surgery? Author’s reply","authors":"Geoffrey J. Wigmore, Adam M. Deane, Jeffrey J. Presneill, Rinaldo Bellomo","doi":"10.1007/s00134-024-07685-0","DOIUrl":"https://doi.org/10.1007/s00134-024-07685-0","url":null,"abstract":"No Abstract","PeriodicalId":13665,"journal":{"name":"Intensive Care Medicine","volume":null,"pages":null},"PeriodicalIF":38.9,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142451805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Set reliable hypothesis when using ICEMAN to assess credibility of subgroup analysis. Authors’ reply 使用 ICEMAN 评估亚组分析可信度时设置可靠的假设。作者回复
IF 38.9 1区 医学 Q1 CRITICAL CARE MEDICINE Pub Date : 2024-10-21 DOI: 10.1007/s00134-024-07678-z
Frederik M. Nielsen, Thomas L. Klitgaard, Morten H. Møller, Olav L. Schjørring, Bodil S. Rasmussen
No Abstract
无摘要
{"title":"Set reliable hypothesis when using ICEMAN to assess credibility of subgroup analysis. Authors’ reply","authors":"Frederik M. Nielsen, Thomas L. Klitgaard, Morten H. Møller, Olav L. Schjørring, Bodil S. Rasmussen","doi":"10.1007/s00134-024-07678-z","DOIUrl":"https://doi.org/10.1007/s00134-024-07678-z","url":null,"abstract":"No Abstract","PeriodicalId":13665,"journal":{"name":"Intensive Care Medicine","volume":null,"pages":null},"PeriodicalIF":38.9,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142451807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Invasive fungal infections in non-neutropenic patients 非中性卫生患者的侵袭性真菌感染
IF 38.9 1区 医学 Q1 CRITICAL CARE MEDICINE Pub Date : 2024-10-21 DOI: 10.1007/s00134-024-07683-2
Louis Kreitmann, Stijn Blot, Saad Nseir
Critically ill patients, particularly those with features of immunosuppression, are susceptible to invasive fungal infections (IFI), which pose significant diagnostic and therapeutic challenges [1]. Candida and Aspergillus, the two most prominent fungal pathogens in this population, will be the focus of this short review.
重症患者,尤其是具有免疫抑制特征的患者,很容易发生侵袭性真菌感染(IFI),这给诊断和治疗带来了巨大挑战[1]。白色念珠菌和曲霉菌是这类人群中最常见的两种真菌病原体,将是本短文的重点。
{"title":"Invasive fungal infections in non-neutropenic patients","authors":"Louis Kreitmann, Stijn Blot, Saad Nseir","doi":"10.1007/s00134-024-07683-2","DOIUrl":"https://doi.org/10.1007/s00134-024-07683-2","url":null,"abstract":"Critically ill patients, particularly those with features of immunosuppression, are susceptible to invasive fungal infections (IFI), which pose significant diagnostic and therapeutic challenges [1]. Candida and Aspergillus, the two most prominent fungal pathogens in this population, will be the focus of this short review.","PeriodicalId":13665,"journal":{"name":"Intensive Care Medicine","volume":null,"pages":null},"PeriodicalIF":38.9,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142451806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The choice of resuscitation fluids—Ionic composition matters. Author’s reply 复苏液的选择--离子成分很重要。作者回复
IF 38.9 1区 医学 Q1 CRITICAL CARE MEDICINE Pub Date : 2024-10-17 DOI: 10.1007/s00134-024-07666-3
Yaseen M. Arabi, Emilie Belley-Cote, Daniel De Backer, Morten H. Møller, Fayez AlShamsi
We would like to thank Mertzlufft for raising the issue of importance of the physiological composition of crystalloid fluids [1]. In the process of guideline generation, we selected questions with sufficient clinical evidence to support a recommendation [2]. In that regard, we have addressed the question of the balanced crystalloids versus saline, for which multiple randomized clinical trials have been conducted. As highlighted in the guideline document and the article by Mertzlufft et al., there is limited clinical evidence to support other questions about the composition of different balanced crystalloids [3]. This point has been highlighted in the guidelines as an area for further research [2].
感谢 Mertzlufft 提出晶体液生理成分的重要性问题[1]。在制定指南的过程中,我们选择了有足够临床证据支持建议的问题[2]。在这方面,我们讨论了平衡晶体液与生理盐水的对比问题,对此已进行了多项随机临床试验。正如指南文件和 Mertzlufft 等人的文章所强调的,支持有关不同平衡晶体液成分的其他问题的临床证据有限[3]。这一点已在指南中强调为需要进一步研究的领域[2]。
{"title":"The choice of resuscitation fluids—Ionic composition matters. Author’s reply","authors":"Yaseen M. Arabi, Emilie Belley-Cote, Daniel De Backer, Morten H. Møller, Fayez AlShamsi","doi":"10.1007/s00134-024-07666-3","DOIUrl":"https://doi.org/10.1007/s00134-024-07666-3","url":null,"abstract":"We would like to thank Mertzlufft for raising the issue of importance of the physiological composition of crystalloid fluids [1]. In the process of guideline generation, we selected questions with sufficient clinical evidence to support a recommendation [2]. In that regard, we have addressed the question of the balanced crystalloids versus saline, for which multiple randomized clinical trials have been conducted. As highlighted in the guideline document and the article by Mertzlufft et al., there is limited clinical evidence to support other questions about the composition of different balanced crystalloids [3]. This point has been highlighted in the guidelines as an area for further research [2].","PeriodicalId":13665,"journal":{"name":"Intensive Care Medicine","volume":null,"pages":null},"PeriodicalIF":38.9,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142440822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
EFFECT of daily antiseptic bathing with octenidine on ICU-acquired bacteremia and ICU-acquired multidrug-resistant organisms: a multicenter, cluster-randomized, double-blind, placebo-controlled, cross-over study 用辛烯胺每天消毒洗澡对重症监护室获得性菌血症和重症监护室获得性多重耐药菌的影响:一项多中心、分组随机、双盲、安慰剂对照、交叉研究
IF 38.9 1区 医学 Q1 CRITICAL CARE MEDICINE Pub Date : 2024-10-17 DOI: 10.1007/s00134-024-07667-2
Tiffany Schaumburg, Norbert Köhler, Yasmine Breitenstein, Susanne Kolbe-Busch, Dirk Hasenclever, Iris F. Chaberny

Purpose

Antiseptic bathing has garnered attention in an effort to reduce hospital-acquired infections. Previous studies have shown the efficacy of antiseptic bathing in high-risk environments, such as intensive care units (ICUs), using chlorhexidine. In this study we aimed to evaluate the effectiveness of octenidine as a potential alternative due to its established popularity and widespread use in Europe.

Methods

We compared the rates of ICU-acquired primary bacteremia and ICU-acquired multidrug-resistant organisms (MDROs) in a multicenter, cluster-randomized, double-blind, placebo-controlled, cross-over study using octenidine-impregnated and placebo washcloths. On 44 ICUs in 23 hospitals throughout Germany, we compared individual ICUs with themselves over two 12-month time periods. All data were obtained digitally via hospital information systems as individual ward-movement data and microbiological test results; both endpoints were algorithmically derived.

Results

104,039 ICU episodes from 93,438 patients with 712,784 microbiological test results were analyzed, thereby detecting 1508 cases of ICU-acquired primary bacteremia and 1871 cases of ICU-acquired MDRO. Bathing with octenidine-impregnated washcloths prevented ICU-acquired primary bacteremia; a risk reduction of 17% was seen homogeneously across all participating ICUs (adjusted hazard ratio (HR) 0.83, 95% confidence interval (CI) [0.75; 0.92], p = 0.0003). This reduction affected predominantly coagulase-negative staphylococci (53%) and enterococci (17%). However, no intervention effect was seen for ICU-acquired MDROs (adjusted HR 0.98, 95% CI [0.83; 1.15]). Heterogeneity among intra-ICU intervention effects on MDRO acquisition was substantial.

Conclusions

Antiseptic bathing with octenidine may be effective in preventing ICU-acquired primary bacteremia, particularly due to Gram-positive bacteria and common skin commensals.

目的 为减少医院感染,消毒沐浴备受关注。以往的研究表明,在重症监护室(ICU)等高风险环境中使用洗必泰进行消毒沐浴效果显著。我们在一项多中心、群组随机、双盲、安慰剂对照、交叉研究中,使用辛替尼定浸渍过的毛巾和安慰剂毛巾,比较了 ICU 获得性原发性菌血症和 ICU 获得性多重耐药菌 (MDRO) 的发病率。在全德国 23 家医院的 44 个重症监护室中,我们对各个重症监护室在两个 12 个月期间的情况进行了比较。所有数据都是通过医院信息系统以数字形式获得的,包括个人病房移动数据和微生物检测结果;两个终点都是通过算法得出的。结果分析了来自 93438 名患者的 14039 个 ICU 病例和 712784 个微生物检测结果,从而发现了 1508 例 ICU 获得性原发性菌血症和 1871 例 ICU 获得性 MDRO。用浸过辛烯胺的浴巾洗澡可预防 ICU 获得性原发性菌血症;所有参与研究的 ICU 的风险均降低了 17%(调整后危险比 (HR) 0.83,95% 置信区间 (CI) [0.75; 0.92],p = 0.0003)。这种减少主要影响凝固酶阴性葡萄球菌(53%)和肠球菌(17%)。但是,对 ICU 获得性 MDROs 没有干预效果(调整 HR 0.98,95% CI [0.83; 1.15])。结论使用辛烯胺进行消毒沐浴可有效预防ICU获得性原发性菌血症,尤其是革兰氏阳性菌和常见皮肤共生菌引起的菌血症。
{"title":"EFFECT of daily antiseptic bathing with octenidine on ICU-acquired bacteremia and ICU-acquired multidrug-resistant organisms: a multicenter, cluster-randomized, double-blind, placebo-controlled, cross-over study","authors":"Tiffany Schaumburg, Norbert Köhler, Yasmine Breitenstein, Susanne Kolbe-Busch, Dirk Hasenclever, Iris F. Chaberny","doi":"10.1007/s00134-024-07667-2","DOIUrl":"https://doi.org/10.1007/s00134-024-07667-2","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Purpose</h3><p>Antiseptic bathing has garnered attention in an effort to reduce hospital-acquired infections. Previous studies have shown the efficacy of antiseptic bathing in high-risk environments, such as intensive care units (ICUs), using chlorhexidine. In this study we aimed to evaluate the effectiveness of octenidine as a potential alternative due to its established popularity and widespread use in Europe.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>We compared the rates of ICU-acquired primary bacteremia and ICU-acquired multidrug-resistant organisms (MDROs) in a multicenter, cluster-randomized, double-blind, placebo-controlled, cross-over study using octenidine-impregnated and placebo washcloths. On 44 ICUs in 23 hospitals throughout Germany, we compared individual ICUs with themselves over two 12-month time periods. All data were obtained digitally via hospital information systems as individual ward-movement data and microbiological test results; both endpoints were algorithmically derived.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>104,039 ICU episodes from 93,438 patients with 712,784 microbiological test results were analyzed, thereby detecting 1508 cases of ICU-acquired primary bacteremia and 1871 cases of ICU-acquired MDRO. Bathing with octenidine-impregnated washcloths prevented ICU-acquired primary bacteremia; a risk reduction of 17% was seen homogeneously across all participating ICUs (adjusted hazard ratio (HR) 0.83, 95% confidence interval (CI) [0.75; 0.92], <i>p</i> = 0.0003). This reduction affected predominantly coagulase-negative staphylococci (53%) and enterococci (17%). However, no intervention effect was seen for ICU-acquired MDROs (adjusted HR 0.98, 95% CI [0.83; 1.15]). Heterogeneity among intra-ICU intervention effects on MDRO acquisition was substantial.</p><h3 data-test=\"abstract-sub-heading\">Conclusions</h3><p>Antiseptic bathing with octenidine may be effective in preventing ICU-acquired primary bacteremia, particularly due to Gram-positive bacteria and common skin commensals.</p>","PeriodicalId":13665,"journal":{"name":"Intensive Care Medicine","volume":null,"pages":null},"PeriodicalIF":38.9,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142440843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Adjusting risk of acute kidney injury for time on controlled mechanical ventilation in acute respiratory distress syndrome: victim or partner in crime? Authors’ reply 根据急性呼吸窘迫综合征患者接受控制性机械通气的时间调整急性肾损伤风险:受害者还是犯罪同伙?作者回复
IF 38.9 1区 医学 Q1 CRITICAL CARE MEDICINE Pub Date : 2024-10-17 DOI: 10.1007/s00134-024-07661-8
Edoardo Antonucci, David Chen, Matthieu Legrand
No Abstract
无摘要
{"title":"Adjusting risk of acute kidney injury for time on controlled mechanical ventilation in acute respiratory distress syndrome: victim or partner in crime? Authors’ reply","authors":"Edoardo Antonucci, David Chen, Matthieu Legrand","doi":"10.1007/s00134-024-07661-8","DOIUrl":"https://doi.org/10.1007/s00134-024-07661-8","url":null,"abstract":"No Abstract","PeriodicalId":13665,"journal":{"name":"Intensive Care Medicine","volume":null,"pages":null},"PeriodicalIF":38.9,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142440819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Accuracy of continuous glucose monitoring systems in intensive care unit patients: a scoping review 重症监护室患者持续葡萄糖监测系统的准确性:范围界定综述
IF 38.9 1区 医学 Q1 CRITICAL CARE MEDICINE Pub Date : 2024-10-17 DOI: 10.1007/s00134-024-07663-6
Christian G. Nielsen, Milda Grigonyte-Daraskeviciene, Mikkel T. Olsen, Morten H. Møller, Kirsten Nørgaard, Anders Perner, Johan Mårtensson, Ulrik Pedersen-Bjergaard, Peter L. Kristensen, Morten H. Bestle

Purpose

Glycemic control poses a challenge in intensive care unit (ICU) patients and dysglycemia is associated with poor outcomes. Continuous glucose monitoring (CGM) has been successfully implemented in the type 1 diabetes out-patient setting and renewed interest has been directed into the transition of CGM into the ICU. This scoping review aimed to provide an overview of CGM accuracy in ICU patients to inform future research and CGM implementation.

Methods

We systematically searched PubMed and EMBASE between 5th of December 2023 and 21st of May 2024 and reported findings in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline for scoping reviews (PRISMA-ScR). We assessed studies reporting the accuracy of CGM in the ICU and report study characteristics and accuracy outcomes.

Results

We identified 2133 studies, of which 96 were included. Most studies were observational (91.7%), conducted in adult patients (74%), in mixed ICUs (47.9%), from 2014 and onward, and assessed subcutaneous CGM systems (80%) using arterial blood samples as reference test (40.6%). Half of the studies (56.3%) mention the use of a prespecified reference test protocol. The mean absolute relative difference (MARD) ranged from 6.6 to 30.5% for all subcutaneous CGM studies. For newer factory calibrated CGM, MARD ranged from 9.7 to 20.6%. MARD for intravenous CGM was 5–14.2% and 6.4–13% for intraarterial CGM.

Conclusions

In this scoping review of CGM accuracy in the ICU, we found great diversity in accuracy reporting. Accuracy varied depending on CGM and comparator, and may be better for intravascular CGM and potentially lower during hypoglycemia.

目的 重症监护病房(ICU)患者的血糖控制是一项挑战,血糖异常与不良预后有关。连续血糖监测(CGM)已在 1 型糖尿病门诊环境中成功实施,人们对将 CGM 应用于重症监护病房再次产生了兴趣。方法我们在 2023 年 12 月 5 日至 2024 年 5 月 21 日期间系统地检索了 PubMed 和 EMBASE,并根据系统综述和荟萃分析首选报告项目 (PRISMA) 指南 (PRISMA-ScR) 报告了研究结果。我们评估了报告 ICU 中 CGM 准确性的研究,并报告了研究特征和准确性结果。大多数研究为观察性研究(91.7%),研究对象为成年患者(74%),研究地点为混合重症监护病房(47.9%),研究时间为 2014 年及以后,研究对象为皮下 CGM 系统(80%),使用动脉血样本作为参考测试(40.6%)。半数研究(56.3%)提到使用了预先指定的参考测试协议。所有皮下 CGM 研究的平均绝对相对差值(MARD)从 6.6% 到 30.5% 不等。对于较新的出厂校准 CGM,平均绝对相对差值介于 9.7% 到 20.6% 之间。静脉 CGM 的 MARD 为 5%-14.2%,动脉内 CGM 为 6.4%-13%。准确性因 CGM 和比较对象的不同而不同,血管内 CGM 的准确性可能更高,而低血糖时的准确性可能更低。
{"title":"Accuracy of continuous glucose monitoring systems in intensive care unit patients: a scoping review","authors":"Christian G. Nielsen, Milda Grigonyte-Daraskeviciene, Mikkel T. Olsen, Morten H. Møller, Kirsten Nørgaard, Anders Perner, Johan Mårtensson, Ulrik Pedersen-Bjergaard, Peter L. Kristensen, Morten H. Bestle","doi":"10.1007/s00134-024-07663-6","DOIUrl":"https://doi.org/10.1007/s00134-024-07663-6","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Purpose</h3><p>Glycemic control poses a challenge in intensive care unit (ICU) patients and dysglycemia is associated with poor outcomes. Continuous glucose monitoring (CGM) has been successfully implemented in the type 1 diabetes out-patient setting and renewed interest has been directed into the transition of CGM into the ICU. This scoping review aimed to provide an overview of CGM accuracy in ICU patients to inform future research and CGM implementation.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>We systematically searched PubMed and EMBASE between 5th of December 2023 and 21st of May 2024 and reported findings in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline for scoping reviews (PRISMA-ScR). We assessed studies reporting the accuracy of CGM in the ICU and report study characteristics and accuracy outcomes.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>We identified 2133 studies, of which 96 were included. Most studies were observational (91.7%), conducted in adult patients (74%), in mixed ICUs (47.9%), from 2014 and onward, and assessed subcutaneous CGM systems (80%) using arterial blood samples as reference test (40.6%). Half of the studies (56.3%) mention the use of a prespecified reference test protocol. The mean absolute relative difference (MARD) ranged from 6.6 to 30.5% for all subcutaneous CGM studies. For newer factory calibrated CGM, MARD ranged from 9.7 to 20.6%. MARD for intravenous CGM was 5–14.2% and 6.4–13% for intraarterial CGM.</p><h3 data-test=\"abstract-sub-heading\">Conclusions</h3><p>In this scoping review of CGM accuracy in the ICU, we found great diversity in accuracy reporting. Accuracy varied depending on CGM and comparator, and may be better for intravascular CGM and potentially lower during hypoglycemia.</p>","PeriodicalId":13665,"journal":{"name":"Intensive Care Medicine","volume":null,"pages":null},"PeriodicalIF":38.9,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142440842","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Intensive Care Medicine
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
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
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 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 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1