Critical Care and Resuscitation最新文献

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Unravelling the paradox of vitamin C research in sepsis 揭示败血症中维生素C研究的悖论

IF 1.7 4区医学 Q3 CRITICAL CARE MEDICINE

Critical Care and Resuscitation

Pub Date : 2025-09-01 Epub Date: 2025-10-14 DOI: 10.1016/j.ccrj.2025.100134

Tomoko Fujii MD, PhD , Clive N. May PhD , Yugeesh R. Lankadeva PhD

Professor Rinaldo Bellomo’s lasting impact on critical care research stems from his commitment to structured, biologically grounded research programs over isolated studies. His work on vitamin C in sepsis exemplifies this approach. While early enthusiasm grew around combination therapies involving vitamin C, Rinaldo championed a cautious, rigorous, and methodical investigation. He worked closely with collaborators to address key methodological issues, including dosing, stability, and the design of appropriate control groups, which ultimately led to the international VITAMINS trial. This landmark study compared vitamin C, hydrocortisone, and thiamine to hydrocortisone alone in septic shock and found no clinical benefit. Rinaldo embedded a pharmacokinetic substudy to confirm supraphysiological serum vitamin C levels, ensuring biological plausibility of the trial design. Beyond clinical research, he fostered translational research with the Florey Institute using a preclinical sheep model of sepsis. This collaboration uncovered critical mechanisms of septic acute kidney injury and led to the development of mega-dose sodium ascorbate therapy. The program progressed from proof-of-concept to a double-blind pilot randomised trial in septic shock and now underpins a national multicentre phase Ib and II clinical trials. Rinaldo’s legacy is defined by scientific rigour, mentorship, and humility. His visionary, disciplined approach remains a model for impactful research and continues to guide ongoing efforts to advance care for critically ill patients.

教授里纳尔多·贝洛莫对重症监护研究的持久影响源于他对结构化的、基于生物学的研究项目的承诺，而不是孤立的研究。他关于维生素C在败血症中的作用的研究就是这种方法的例证。虽然早期人们对含维生素C的联合疗法热情高涨，但里纳尔多主张进行谨慎、严格和有条不紊的研究。他与合作者密切合作，解决了关键的方法学问题，包括剂量、稳定性和适当对照组的设计，这最终导致了国际维生素试验。这项具有里程碑意义的研究将维生素C、氢化可的松和硫胺素与单用氢化可的松治疗感染性休克进行了比较，发现没有临床益处。Rinaldo嵌入了一项药代动力学亚研究，以确认超生理血清维生素C水平，确保试验设计的生物学合理性。除了临床研究之外，他还与弗洛里研究所（Florey Institute）合作，使用临床前绵羊败血症模型进行转化研究。这项合作揭示了脓毒性急性肾损伤的关键机制，并导致了大剂量抗坏血酸钠治疗的发展。该项目从概念验证发展到脓毒性休克的双盲随机试验，目前正在进行国家多中心Ib期和II期临床试验。雷纳尔多的遗产是由严谨的科学、指导和谦逊来定义的。他富有远见的、严谨的方法仍然是有影响力的研究的典范，并继续指导正在进行的努力，以提高对危重病人的护理。

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引用次数: 0

A gardener lost in spring 一个迷失在春天的园丁

IF 1.7 4区医学 Q3 CRITICAL CARE MEDICINE

Critical Care and Resuscitation

Pub Date : 2025-09-01 Epub Date: 2025-10-14 DOI: 10.1016/j.ccrj.2025.100125

Neil R. Orford MBBS, FCICM, FANZCA, PGDipEcho, PhD

引用次数: 0

Critical care nutrition and the legacy of Rinaldo Bellomo 重症监护营养和里纳尔多·贝洛莫的遗产

IF 1.7 4区医学 Q3 CRITICAL CARE MEDICINE

Critical Care and Resuscitation

Pub Date : 2025-09-01 Epub Date: 2025-10-14 DOI: 10.1016/j.ccrj.2025.100147

Adam M. Deane MBBS, PhD , Sandra L. Peake BMBS, PhD , Andrew R. Davies MBBS , Yasmine Ali Abdelhamid MBBS, PhD , Moritoki Egi MD, PhD , Marianne J. Chapman BMBS, PhD , Emma J. Ridley APD, PhD

We provide an overview of the monumental impact that Professor Rinaldo Bellomo made in the field of critical illness nutrition and metabolism. We reflect on research he conducted into energy delivery, refeeding hypophosphataemia, carbohydrate metabolism and glycaemia, protein delivery and impact of renal perfusion and nitrogen metabolism, and bowel management during nutritional therapy.

我们提供了一个巨大的影响，教授里纳尔多贝洛莫在危重疾病营养和代谢领域的概述。我们回顾了他在营养治疗期间的能量输送、再喂养低磷血症、碳水化合物代谢和血糖、蛋白质输送和肾灌注和氮代谢的影响、肠道管理等方面的研究。

引用次数: 0

The Australian and New Zealand Intensive Care Research Centre and Rinaldo Bellomo 澳大利亚和新西兰重症监护研究中心和里纳尔多·贝洛莫

IF 1.7 4区医学 Q3 CRITICAL CARE MEDICINE

Critical Care and Resuscitation

Pub Date : 2025-09-01 Epub Date: 2025-10-14 DOI: 10.1016/j.ccrj.2025.100129

D. Jamie Cooper AO, MD

引用次数: 0

A tribute to Rinaldo Bellomo: Why randomised behaviour is better than random behaviour 向Rinaldo Bellomo致敬：为什么随机行为比随机行为更好

IF 1.7 4区医学 Q3 CRITICAL CARE MEDICINE

Critical Care and Resuscitation

Pub Date : 2025-09-01 Epub Date: 2025-10-14 DOI: 10.1016/j.ccrj.2025.100123

John A. Myburgh MBBCh PhD DSc, FCICM, Balasubramanian Venkatesh MD, FCICM

引用次数: 0

Sedation Practice in Intensive Care Evaluation, SPICE and beyond, Rinaldo’s legacy in sedation and delirium research 重症监护评估中的镇静实践，SPICE及其他，Rinaldo在镇静和谵妄研究中的遗产

IF 1.7 4区医学 Q3 CRITICAL CARE MEDICINE

Critical Care and Resuscitation

Pub Date : 2025-09-01 Epub Date: 2025-10-14 DOI: 10.1016/j.ccrj.2025.100142

Yahya Shehabi MBBS, PhD, EMBA, FCICM, FANZCA, Michael C. Reade MBBS, MPH, DPhil, DMedSc, GAICD, AFRACMA, FHEA, FCCM, FANZCA, FCICM

引用次数: 0

Rinaldo Bellomo and the ‘Dark Arts’ of clinical trials 里纳尔多·贝洛莫和临床试验的“黑魔法”

IF 1.7 4区医学 Q3 CRITICAL CARE MEDICINE

Critical Care and Resuscitation

Pub Date : 2025-09-01 Epub Date: 2025-10-14 DOI: 10.1016/j.ccrj.2025.100146

Steve A. Webb MBBS, PhD, Alisa M. Higgins BPhysio(Hons), PhD

引用次数: 0

Rinaldo Bellomo: A clinician with a passion for preclinical research 里纳尔多·贝洛莫：一位对临床前研究充满热情的临床医生

IF 1.7 4区医学 Q3 CRITICAL CARE MEDICINE

Critical Care and Resuscitation

Pub Date : 2025-09-01 Epub Date: 2025-10-14 DOI: 10.1016/j.ccrj.2025.100128

Clive N. May PhD , Yugeesh R. Lankadeva PhD , Shailesh Bihari PhD

Professor Rinaldo Bellomo was a pioneer in intensive care medicine whose influence extended beyond clinical trials to preclinical and translational research. His long-standing collaboration with the Florey Institute established ovine sepsis models that overturned dogma, demonstrating that septic acute kidney injury can occur despite increased renal blood flow, and clarifying the effects of fluids, noradrenaline, vasopressin, and angiotensin II. These studies advanced understanding of renal medullary hypoperfusion and hypoxia, guided antioxidant strategies, and inspired clinical investigation of megadose sodium ascorbate. Rinaldo also championed integration of preclinical science into the ANZICS Clinical Trials Group, legitimising dedicated sessions, fostering collaboration, and ensuring basic discoveries informed hypothesis-driven clinical trials. A gifted mentor and communicator, he inspired generations of researchers with his curiosity, humility, and passion for physiology. His legacy as both clinician and scientist underscores the enduring value of discovery research in advancing critical care.

Rinaldo Bellomo教授是重症监护医学的先驱，其影响从临床试验扩展到临床前和转化研究。他与弗洛里研究所的长期合作建立了羊脓毒症模型，推翻了以往的教条，证明尽管肾血流量增加，脓毒性急性肾损伤仍可能发生，并阐明了液体、去甲肾上腺素、血管加压素和血管紧张素II的作用。这些研究促进了对肾髓质灌注不足和缺氧的认识，指导了抗氧化策略，并启发了大剂量抗坏血酸钠的临床研究。Rinaldo还倡导将临床前科学纳入ANZICS临床试验小组，使专门会议合法化，促进合作，并确保基本发现为假设驱动的临床试验提供信息。他是一位天才导师和沟通者，他的好奇心、谦逊和对生理学的热情激励了一代又一代的研究人员。他作为临床医生和科学家的遗产强调了发现研究在推进重症监护方面的持久价值。

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引用次数: 0

Science-based fluid therapy in the intensive care unit: Professor Rinaldo Bellomo’s legacy 重症监护室的科学液体疗法：里纳尔多·贝洛莫教授的遗产

IF 1.7 4区医学 Q3 CRITICAL CARE MEDICINE

Critical Care and Resuscitation

Pub Date : 2025-09-01 Epub Date: 2025-10-14 DOI: 10.1016/j.ccrj.2025.100145

Simon R. Finfer DrMed , Naomi E. Hammond PhD , John A. Myburgh PhD

Research into the use of resuscitation and “maintenance” fluids in the intensive care unit was integral to the development of the Australian and New Zealand Intensive Care Society Clinical Trials Group (CTG) and the CTG being recognised as one of the most productive and influential trials groups in the world. Professor Rinaldo Bellomo (Rinaldo) played a central and critical role in this research and in this article; we focus on Rinaldo’s many roles and contributions to the key large clinical trials that changed the critical care research landscape in Australia and New Zealand and clinical practice worldwide. With a proposed recruitment of 7000 participants, the Saline versus Albumin Fluid Evaluation study was the first large pragmatic trial conducted in intensive care units anywhere in the world. Rinaldo brought the concept of the trial to the CTG and was critical to securing funding from multiple sources at a time when Australian National Health and Medical Research Council’s funding limits would cover only a fraction of the costs of such a trial. His personal contacts at CSL Ltd. and the Australian Red Cross Blood Service helped secure the supply of study fluids and made possible the seemingly impossible task of blinding a trial of two fluids that were macroscopically different with one supplied in glass bottles and the other in polyvinyl chloride bags. The successful conduct of the Saline versus Albumin Fluid Evaluation trial, the CTG’s first publication in The New England Journal of Medicine and presentation at the US Food and Drugs Administration, established the CTG on the global stage and served as a template for the Crystalloid versus Hydroxyethyl Starch Study and PlasmaLyte-148® versus Saline Study trials; we can only speculate what fraction of this could have been achieved without Rinaldo.

对在重症监护室使用复苏和“维持”液体的研究是澳大利亚和新西兰重症监护学会临床试验小组发展的组成部分，该小组被认为是世界上最有成效和最有影响力的试验小组之一。教授里纳尔多贝洛莫（里纳尔多）在这项研究和这篇文章中发挥了核心和关键作用；我们专注于Rinaldo在关键的大型临床试验中的许多角色和贡献，这些试验改变了澳大利亚和新西兰以及全球临床实践的重症监护研究格局。盐水与白蛋白液评估研究计划招募7000名参与者，是世界上第一个在重症监护病房进行的大型实用试验。Rinaldo向CTG提出了试验的概念，在澳大利亚国家卫生和医学研究委员会的资金限制只能支付此类试验费用的一小部分时，他对从多个来源获得资金至关重要。他在CSL有限公司和澳大利亚红十字会血液服务中心的个人联系帮助确保了研究液体的供应，并使一项看似不可能完成的任务成为可能，即对两种宏观上不同的液体进行盲化试验，一种用玻璃瓶供应，另一种用聚氯乙烯袋供应。CTG首次在《新英格兰医学杂志》（The New England Journal of Medicine）上发表，并在美国食品和药物管理局（US Food and drug Administration）上发表，CTG的成功开展使CTG登上了全球舞台，并成为Crystalloid与羟乙基淀粉研究和PlasmaLyte-148®与生理盐水研究试验的模板；我们只能推测，如果没有雷纳尔多，这一成绩能达到多少。

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Rinaldo Bellomo's contribution to trauma and traumatic brain injury research 雷纳多·贝洛莫对创伤和创伤性脑损伤研究的贡献

IF 1.7 4区医学 Q3 CRITICAL CARE MEDICINE

Critical Care and Resuscitation

Pub Date : 2025-09-01 Epub Date: 2025-10-14 DOI: 10.1016/j.ccrj.2025.100130

Craig French

引用次数: 0

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