Zhonghua wei zhong bing ji jiu yi xue最新文献

Patients with new-onset atrial fibrillation in sepsis have a high mortality rate and poor prognosis. At present, the pathogenesis of new-onset atrial fibrillation in sepsis has not been fully elucidated. Studies have shown that both sepsis and atrial fibrillation are closely related to NOD-like receptor protein 3 (NLRP3). NLRP3 inflammasome can not only induce the activation of caspase-1 and the subsequent release of cellular pro-inflammatory factors, but also participate in the occurrence and development of sepsis and promote the occurrence and development of atrial fibrillation. It is concluded that the NLRP3 inflammasome may play an important role in the occurrence and development of new-onset atrial fibrillation in sepsis. This paper summarized the current research progress on the structure and function of the NLRP3 inflammasome, its role in sepsis, its mechanism in promoting atrial fibrillation, the relationship between the NLRP3 inflammasome and new-onset atrial fibrillation in sepsis, the feasibility of studying new-onset atrial fibrillation in sepsis, and potential therapeutic targets for new-onset atrial fibrillation in sepsis. This review aims to provide a theoretical basis for future research on the mechanisms by which the NLRP3 inflammasome promotes new-onset atrial fibrillation in sepsis and possible therapeutic targets.

Invasive mechanical ventilation stands as a principal therapeutic intervention in the intensive care unit (ICU), yet there exists a lack of standardized data management protocols. To address this, the Chinese Society of Critical Care Medicine organized a working group from disciplines including critical care medicine, respiratory and critical care medicine, respiratory therapy, and health informatics. This group formulated the Expert consensus on core data elements and definitions for adult invasive mechanical ventilation (2024). This consensus established a standardized framework comprising 246 key data elements through a comprehensive literature review. The elements cover patient demographic information, clinical data, ICU admission details, parameters of invasive mechanical ventilation therapy, vital signs, and blood gas analysis, aiming to standardize data management in both clinical practice and research. Moreover, the consensus accentuates the necessity for continuous updates to the data element standards in line with advancements in mechanical ventilation technology, ensuring that they reflect the latest clinical practices and technological progress.

Sepsis is a life-threatening organ dysfunction caused by the host's uncontrolled response to infection, and is one of the main causes of death in critically ill patients. Sepsis-associated acute kidney injury (SA-AKI) is associated with the poor prognosis of sepsis patients, and its pathogenesis is complex and still unclear to this day. Mitochondrial dynamics is crucial for maintaining the normal morphology, quantity, number and function of mitochondria, which is a new research hotspot in recent years. Mitochondrial dynamics disorder is involved in the occurrence and development of SA-AKI by regulating renal tubular dysfunction, which is expected to become new therapeutic targets. Deeply exploring the role of mitochondrial dynamic disorders in the pathogenesis of SA-AKI will help to find more effective treatment methods, thereby improving the success rate of rescue in SA-AKI patients.

Objective: To comprehensively search the relevant literature on prone position-cardiopulmonary resuscitation (PP-CPR) in adults at home and abroad, analyze the content, summarize the evidence, and provide reference for clinical health care professionals.

Methods: Systematic search of CNKI, China Biomedical Literature Service System (SinoMed), Wanfang Data, VIP database, PubMed, Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochran Library, Web of Science, Scopus literature database and other Chinese and English databases was conducted. The search period was from inception to June 15 in 2024. The contents of PP-CPR from randomized controlled trial (RCT), non-RCT (prospective or retrospective), cohort studies and case reports were extracted and systematically analyzed. The search results were standardized by the method of scoping review.

Results: A total of 523 articles were obtained through preliminary search, and 14 references and gray literature were retrieved, totaling 537 articles. After strict screening by two researchers, a total of 26 literatures were included, 3 were non-RCT and 23 were case reports, involving 12 countries, including 3 in Chinese, 19 in English, 2 in French, 1 in German, and 1 in Korean. Three non-RCT demonstrated that compared with standard cardiopulmonary resuscitation (CPR), PP-CPR could produce higher pressure, and provide good respiratory and circulatory support. A total of 25 adult patients were included in the 23 case reports, of which 17 reported total recovery time and 13 reported PP-CPR time ≤ 5 minutes, all of which recovered spontaneous circulation, indicating the effectiveness of PP-CPR technology. In terms of final outcome, 4 patients (16.0%) died and 21 patients (84.0%) survived, indicating that PP-CPR technology could provide timely blood circulation and improve clinical outcomes for prone cardiac arrest patients. Among the 11 patients who reported complications after resuscitation, no neurological damage was found in the short-term outcomes, indicating that PP-CPR technology had a certain level of safety.

Conclusions: PP-CPR can provide timely blood circulation for patients with cardiac arrest who are unable to lie supine quickly, and win "golden time" for defibrillation and further treatment. In clinical practice, medical staff need to evaluate the emergency environment, the number of rescuers and the specific condition of the patient, and implement first aid as soon as possible, so as to reduce the time of no blood flow in the vital organs of patients with cardiac arrest in prone position, and improve the clinical prognosis.