Pub Date : 2019-07-01DOI: 10.4103/jtccm.jtccm_17_20
Yuanfang Zhu, Z. Peng
Therefore, we are glad to do our part to facilitate the dissemination of the up-to-date information and better serve the community. In the following issues, we will take more studies on the biology, epidemiology, pathophysiology, and treatment of COVID-19, as well as reviews and perspectives. We are also interested in the studies associated with the long‐term influence of COVID-19 and are eager to hear constructive suggestions to help improve the current situation. We sincerely appreciate the work all researchers have done to curb the spread of COVID‐19 and help people fight against it.
{"title":"Editorial - Focus on the Study of Coronavirus Disease 2019","authors":"Yuanfang Zhu, Z. Peng","doi":"10.4103/jtccm.jtccm_17_20","DOIUrl":"https://doi.org/10.4103/jtccm.jtccm_17_20","url":null,"abstract":"Therefore, we are glad to do our part to facilitate the dissemination of the up-to-date information and better serve the community. In the following issues, we will take more studies on the biology, epidemiology, pathophysiology, and treatment of COVID-19, as well as reviews and perspectives. We are also interested in the studies associated with the long‐term influence of COVID-19 and are eager to hear constructive suggestions to help improve the current situation. We sincerely appreciate the work all researchers have done to curb the spread of COVID‐19 and help people fight against it.","PeriodicalId":93326,"journal":{"name":"Journal of Translational Critical Care Medicine","volume":"41 5 1","pages":"75 - 75"},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72777538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-07-01DOI: 10.4103/jtccm.jtccm_14_19
N. Jayaprakash, C. Daniels, C. Bennett, K. Kashani
Introduction: Rotating shift patterns and night shifts are associated with fatigue and sleep deprivation, which in turn contribute to burnout. The aim of this quality improvement initiative at Mayo Clinic Rochester critical care fellowship programs was to implement a new critical care fellow shift schedule in the medical intensive care unit while evaluating the impact on self-reported burnout scores. Materials and Methods: Focus groups of fellows weighed pros and cons of the existing schedule and selected a revision of the schedule in which night shifts were grouped into blocks with limited frequency and incorporated a recovery period. Baseline self-reported burnout amongst critical care fellows was assessed using an abbreviated Maslach burnout inventory (MBI) screening questionnaire and re-evaluated at the end of the implementation period. Results: At baseline, 33 of 45 (73%) fellows responded to a survey with the abbreviated Maslach Burnout Index questionnaire. Median (IQR) scores for each of the domains were 10 (6-12) emotional exhaustion, 3 (1-9) depersonalization, and 15 (13-17) personal accomplishment. For the post-intervention survey, 17 out of 24 (71%) responded. The median (IQR) score for critical care internal medicine and pulmonary and critical care fellows was 7 (4-11), P=.06 and 9 (7-11), P=0.5 for emotional exhaustion; 3 (0-6), P=.07 and 5 (0-11), P=1.0 for depersonalization score; and 16 (11-17), P=.31 and 15 (12-17), P=.75 for personal accomplishment score. Discussion: Reducing the number of day-night rotations, incorporating a scheduled recovery period, and limiting the number of recurrent consecutive nights resulted in a trend towards improvement of self-reported burnout amongst critical care fellows.
导读:轮班模式和夜班与疲劳和睡眠剥夺有关，这反过来又会导致倦怠。梅奥诊所罗切斯特重症监护奖学金项目的质量改进倡议的目的是在医学重症监护病房实施新的重症监护轮班时间表，同时评估对自我报告的倦怠评分的影响。材料和方法:研究人员的焦点小组权衡了现有时间表的利弊，并选择了一个修订的时间表，在该时间表中，夜班被分成有限频率的块，并纳入了恢复期。使用简略的Maslach倦怠量表(MBI)筛选问卷对危重病护理人员的基线自我报告倦怠进行评估，并在实施期结束时重新评估。结果:在基线时，45名研究员中有33名(73%)回答了一份简短的马斯拉克倦怠指数问卷调查。每个领域的中位数(IQR)得分分别为10分(6-12分)、3分(1-9分)和15分(13-17分)。对于干预后的调查，24人中有17人(71%)做出了回应。危重内科、肺科及危重科研究员的IQR评分中位数为7分(4-11分)，P=。情绪衰竭6、9 (7-11)，P=0.5;3 (0-6)， p =。07和5(0-11)，人格解体得分P=1.0;和16 (11-17)，P=。31和15 (12-17)，P=。个人成就75分。讨论:减少日夜轮转的次数，纳入预定的恢复期，并限制重复连续夜的次数，导致重症监护研究员自我报告的倦怠改善的趋势。
{"title":"An Approach to Addressing Trainee Burnout: Revising Fellow Shift Scheduling in the Intensive Care Unit","authors":"N. Jayaprakash, C. Daniels, C. Bennett, K. Kashani","doi":"10.4103/jtccm.jtccm_14_19","DOIUrl":"https://doi.org/10.4103/jtccm.jtccm_14_19","url":null,"abstract":"Introduction: Rotating shift patterns and night shifts are associated with fatigue and sleep deprivation, which in turn contribute to burnout. The aim of this quality improvement initiative at Mayo Clinic Rochester critical care fellowship programs was to implement a new critical care fellow shift schedule in the medical intensive care unit while evaluating the impact on self-reported burnout scores. Materials and Methods: Focus groups of fellows weighed pros and cons of the existing schedule and selected a revision of the schedule in which night shifts were grouped into blocks with limited frequency and incorporated a recovery period. Baseline self-reported burnout amongst critical care fellows was assessed using an abbreviated Maslach burnout inventory (MBI) screening questionnaire and re-evaluated at the end of the implementation period. Results: At baseline, 33 of 45 (73%) fellows responded to a survey with the abbreviated Maslach Burnout Index questionnaire. Median (IQR) scores for each of the domains were 10 (6-12) emotional exhaustion, 3 (1-9) depersonalization, and 15 (13-17) personal accomplishment. For the post-intervention survey, 17 out of 24 (71%) responded. The median (IQR) score for critical care internal medicine and pulmonary and critical care fellows was 7 (4-11), P=.06 and 9 (7-11), P=0.5 for emotional exhaustion; 3 (0-6), P=.07 and 5 (0-11), P=1.0 for depersonalization score; and 16 (11-17), P=.31 and 15 (12-17), P=.75 for personal accomplishment score. Discussion: Reducing the number of day-night rotations, incorporating a scheduled recovery period, and limiting the number of recurrent consecutive nights resulted in a trend towards improvement of self-reported burnout amongst critical care fellows.","PeriodicalId":93326,"journal":{"name":"Journal of Translational Critical Care Medicine","volume":"79 1","pages":"103 - 108"},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78570603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-07-01DOI: 10.4103/jtccm.jtccm_4_19
L. Moscote-Salazar, Eduardo Barciela, Y. Ramos, L. Quintana-Pájaro, A. Agrawal
{"title":"Self-Knotting of a Nasogastric Tube","authors":"L. Moscote-Salazar, Eduardo Barciela, Y. Ramos, L. Quintana-Pájaro, A. Agrawal","doi":"10.4103/jtccm.jtccm_4_19","DOIUrl":"https://doi.org/10.4103/jtccm.jtccm_4_19","url":null,"abstract":"","PeriodicalId":93326,"journal":{"name":"Journal of Translational Critical Care Medicine","volume":"1 1","pages":"111 - 112"},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84144403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-04-01DOI: 10.4103/jtccm.jtccm_10_18
R. Murugan, H. Qiu, T. Rimmele, Jianguo Li, Z. Peng, Kaijiang Yu, J. Kellum, C. Ronco
How fluid resuscitation clinical trials should be conducted for either prevention or treatment of acute kidney injury among patients admitted to the intensive care unit is unclear. In 2017, a group of experts in fluid resuscitation and acute kidney injury met at the Acute Disease Quality Initiative (ADQI) XIX consensus conference on “Pragmatic Studies for AKI”, Wuhan, China and developed a research framework. In this report, we summarize the consensus recommendations on the topic of fluid resuscitation in the peri-AKI period based on existing clinical evidence. We also discuss the gaps in our knowledge and identify future research questions. Finally, we examine the feasibility of conducting a pragmatic fluid resuscitation trial to improve outcomes from acute kidney injury.
{"title":"Pragmatic Studies for Acute Kidney Injury: Fluid Resuscitation in the Peri-Acute Kidney Injury Period","authors":"R. Murugan, H. Qiu, T. Rimmele, Jianguo Li, Z. Peng, Kaijiang Yu, J. Kellum, C. Ronco","doi":"10.4103/jtccm.jtccm_10_18","DOIUrl":"https://doi.org/10.4103/jtccm.jtccm_10_18","url":null,"abstract":"How fluid resuscitation clinical trials should be conducted for either prevention or treatment of acute kidney injury among patients admitted to the intensive care unit is unclear. In 2017, a group of experts in fluid resuscitation and acute kidney injury met at the Acute Disease Quality Initiative (ADQI) XIX consensus conference on “Pragmatic Studies for AKI”, Wuhan, China and developed a research framework. In this report, we summarize the consensus recommendations on the topic of fluid resuscitation in the peri-AKI period based on existing clinical evidence. We also discuss the gaps in our knowledge and identify future research questions. Finally, we examine the feasibility of conducting a pragmatic fluid resuscitation trial to improve outcomes from acute kidney injury.","PeriodicalId":93326,"journal":{"name":"Journal of Translational Critical Care Medicine","volume":"71 1","pages":"52 - 56"},"PeriodicalIF":0.0,"publicationDate":"2019-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75053148","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Acute kidney injury (AKI) is a common and serious complication in critically ill patients. Patients who require renal replacement therapy (RRT) face a high mortality rate. Questions concerning the intensity of RRT in AKI patients led us to integrate direct and indirect evidence using a network meta-analysis to determine the optimal intensity and mode. Materials and Methods: We searched the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, CINAHL, and Web of Science databases from 1990 to 2017 that included randomized controlled trials (RCTs) comparing different intensities of RRT to treat AKI in adults (18 years or older). Data regarding study characteristics, methods, and outcomes were extracted. We assessed the studies for eligibility, extracted the data, pooled the data, and used the GeMTC package in R to combine direct comparisons with indirect evidence. Results: Ten RCTs including 3354 participants were included in the network meta-analysis. The higher intensity continuous renal replacement treatment (CRRT) (to exceed 35 mL/kg/h) and the higher intensity IRRT (to exceed six times per week) both showed no statistical significance. Further analysis for higher intensity CRRT, lower intensity CRRT, higher intensity IRRT, and lower intensity IRRT also revealed no significance. Conclusions: This meta-analysis showed that increasing the intensity of CRRT to exceed 35 mL/kg/h and six times per week for intermittent RRT (IRRT) did not reduce mortality or the rate of dependence on dialysis among AKI patients.
背景:急性肾损伤(AKI)是危重症患者常见且严重的并发症。需要肾替代治疗(RRT)的患者面临高死亡率。关于AKI患者RRT强度的问题使我们使用网络荟萃分析整合直接和间接证据，以确定最佳强度和模式。材料和方法:我们检索了1990年至2017年Cochrane中央对照试验注册库、MEDLINE、EMBASE、CINAHL和Web of Science数据库，其中包括比较不同强度RRT治疗成人(18岁及以上)AKI的随机对照试验(rct)。提取有关研究特征、方法和结果的数据。我们评估研究的合格性，提取数据，汇总数据，并使用R中的GeMTC包将直接比较与间接证据结合起来。结果:网络荟萃分析纳入10项随机对照试验，共3354名受试者。高强度连续肾替代治疗(CRRT)(超过35 mL/kg/h)和高强度连续肾替代治疗(超过每周6次)均无统计学意义。进一步分析高强度CRRT、低强度CRRT、高强度IRRT和低强度IRRT也无显著性。结论:本荟萃分析显示，间歇性RRT (IRRT)增加CRRT强度至35 mL/kg/h以上，每周6次，并不能降低AKI患者的死亡率或透析依赖性。
{"title":"The Intensity of Renal Replacement Treatment for Acute Kidney Injury: A Systematic Review and Network Meta-Analysis","authors":"Hongliang Wang, Haitao Liu, Yue Wang, Hongshuang Tong, Pulin Yu, Shuangshuang Chen, Guiyue Wang, Miao Liu, Yuhang Li, Nana Guo, Changsong Wang, Kaijiang Yu","doi":"10.4103/jtccm.jtccm_11_19","DOIUrl":"https://doi.org/10.4103/jtccm.jtccm_11_19","url":null,"abstract":"Background: Acute kidney injury (AKI) is a common and serious complication in critically ill patients. Patients who require renal replacement therapy (RRT) face a high mortality rate. Questions concerning the intensity of RRT in AKI patients led us to integrate direct and indirect evidence using a network meta-analysis to determine the optimal intensity and mode. Materials and Methods: We searched the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, CINAHL, and Web of Science databases from 1990 to 2017 that included randomized controlled trials (RCTs) comparing different intensities of RRT to treat AKI in adults (18 years or older). Data regarding study characteristics, methods, and outcomes were extracted. We assessed the studies for eligibility, extracted the data, pooled the data, and used the GeMTC package in R to combine direct comparisons with indirect evidence. Results: Ten RCTs including 3354 participants were included in the network meta-analysis. The higher intensity continuous renal replacement treatment (CRRT) (to exceed 35 mL/kg/h) and the higher intensity IRRT (to exceed six times per week) both showed no statistical significance. Further analysis for higher intensity CRRT, lower intensity CRRT, higher intensity IRRT, and lower intensity IRRT also revealed no significance. Conclusions: This meta-analysis showed that increasing the intensity of CRRT to exceed 35 mL/kg/h and six times per week for intermittent RRT (IRRT) did not reduce mortality or the rate of dependence on dialysis among AKI patients.","PeriodicalId":93326,"journal":{"name":"Journal of Translational Critical Care Medicine","volume":"9 4 1","pages":"61 - 68"},"PeriodicalIF":0.0,"publicationDate":"2019-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82196860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-04-01DOI: 10.4103/jtccm.jtccm_15_18
J. Kesecioglu
{"title":"Ethics and End-of-Life Care","authors":"J. Kesecioglu","doi":"10.4103/jtccm.jtccm_15_18","DOIUrl":"https://doi.org/10.4103/jtccm.jtccm_15_18","url":null,"abstract":"","PeriodicalId":93326,"journal":{"name":"Journal of Translational Critical Care Medicine","volume":"44 1","pages":"45 - 47"},"PeriodicalIF":0.0,"publicationDate":"2019-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74744420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-04-01DOI: 10.4103/jtccm.jtccm_9_18
M. Ostermann, X. Xi, J. Vincent, Raymond K. Hsu
Acute kidney injury (AKI) occurs in approximately 20% of hospitalized patients and is associated with increased morbidity and mortality. The care of hospitalized patients with AKI has been shown to be variable in clinical practices. Systematic tools including checklists, care bundles and medical algorithms have been developed and implemented to improve the care and outcomes of AKI patients. However, whether these systematic tools can improve the quality of care and outcomes of AKI patients is still unknown. The committee of the 19th Acute Disease Quality Initiative (ADQI) conference dedicated a workgroup with the task of developing a study protocol to investigate this question. A comprehensive literature search was performed using PubMed and Embase. Key questions and feasibility of potential study proposals were discussed during the conference. Then a two-step Delphi process was used to reach consensus regarding several aspects of the study protocol. The group suggested that patient risk assessment be included in the study protocol and the choice of systematic tool be depending on different clinical contexts. The group also proposed a two-phase study with the use of oliguria and systematic tool to investigate the quality of care and outcomes of AKI patients. Consensus was reached on a study protocol regarding the efficacy of using systematic tools to improve clinical management and outcomes of AKI patients.
{"title":"Is there a Role for Systematic Tools to Improve the Clinical Management of Patients with Acute Kidney Injury? Consensus Report of Acute Disease Quality Initiative XIX","authors":"M. Ostermann, X. Xi, J. Vincent, Raymond K. Hsu","doi":"10.4103/jtccm.jtccm_9_18","DOIUrl":"https://doi.org/10.4103/jtccm.jtccm_9_18","url":null,"abstract":"Acute kidney injury (AKI) occurs in approximately 20% of hospitalized patients and is associated with increased morbidity and mortality. The care of hospitalized patients with AKI has been shown to be variable in clinical practices. Systematic tools including checklists, care bundles and medical algorithms have been developed and implemented to improve the care and outcomes of AKI patients. However, whether these systematic tools can improve the quality of care and outcomes of AKI patients is still unknown. The committee of the 19th Acute Disease Quality Initiative (ADQI) conference dedicated a workgroup with the task of developing a study protocol to investigate this question. A comprehensive literature search was performed using PubMed and Embase. Key questions and feasibility of potential study proposals were discussed during the conference. Then a two-step Delphi process was used to reach consensus regarding several aspects of the study protocol. The group suggested that patient risk assessment be included in the study protocol and the choice of systematic tool be depending on different clinical contexts. The group also proposed a two-phase study with the use of oliguria and systematic tool to investigate the quality of care and outcomes of AKI patients. Consensus was reached on a study protocol regarding the efficacy of using systematic tools to improve clinical management and outcomes of AKI patients.","PeriodicalId":93326,"journal":{"name":"Journal of Translational Critical Care Medicine","volume":"1 1","pages":"57 - 60"},"PeriodicalIF":0.0,"publicationDate":"2019-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88909071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-04-01DOI: 10.4103/jtccm.jtccm_12_18
J. Prowle, B. Du, Changsong Wang, M. Gallagher
In this article, we report consensus of 19th Acute Disease Quality Initiative (ADQI) conference and pragmatic trial proposals on renal replacement therapy (RRT) for acute kidney injury (AKI)and sepsis. The committee develop a list of key questions for the pragmatic trials. Then a systematic literature search was performed using PubMed and Embase. Finally the group summarized the proposed trials using PICO(Patient, Intervention, Comparator, Outcome). The groups recommended the first step would be a prospective observational study to document the current clinical practice of RRT in ICUs. Then the second stage would be to develop a quality improvement (QI) tools to improve and standardize the RRT practice in ICUs. The committee also proposed the primary outcome and secondary outcomes of the trial. Consensus had been reached for the pragmatic trial of RRT for AKI and sepsis in Chinese ICUs.
{"title":"Pragmatic Studies for Acute Kidney Injury in China: Renal Replacement Therapy for Acute Kidney Injury and Sepsis Consensus Report of Acute Disease Quality Initiative XIX","authors":"J. Prowle, B. Du, Changsong Wang, M. Gallagher","doi":"10.4103/jtccm.jtccm_12_18","DOIUrl":"https://doi.org/10.4103/jtccm.jtccm_12_18","url":null,"abstract":"In this article, we report consensus of 19th Acute Disease Quality Initiative (ADQI) conference and pragmatic trial proposals on renal replacement therapy (RRT) for acute kidney injury (AKI)and sepsis. The committee develop a list of key questions for the pragmatic trials. Then a systematic literature search was performed using PubMed and Embase. Finally the group summarized the proposed trials using PICO(Patient, Intervention, Comparator, Outcome). The groups recommended the first step would be a prospective observational study to document the current clinical practice of RRT in ICUs. Then the second stage would be to develop a quality improvement (QI) tools to improve and standardize the RRT practice in ICUs. The committee also proposed the primary outcome and secondary outcomes of the trial. Consensus had been reached for the pragmatic trial of RRT for AKI and sepsis in Chinese ICUs.","PeriodicalId":93326,"journal":{"name":"Journal of Translational Critical Care Medicine","volume":"103 1","pages":"48 - 51"},"PeriodicalIF":0.0,"publicationDate":"2019-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81000636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-01-01DOI: 10.4103/JTCCM.JTCCM_1_18
E. Ahmadnia, Anna Hall, M. Ostermann
Interest in the use of angiotensin (AT) (particularly in the context of shock) had been rekindled by recent randomized trial data (notably the AT II for the Treatment of High-Output Shock-3 study). This review article outlines the renin–AT system in health and during sepsis as well as the proposed clinical uses of AT II. The potential for wider application within critical care is also considered.
{"title":"Angiotensin in Clinical Practice","authors":"E. Ahmadnia, Anna Hall, M. Ostermann","doi":"10.4103/JTCCM.JTCCM_1_18","DOIUrl":"https://doi.org/10.4103/JTCCM.JTCCM_1_18","url":null,"abstract":"Interest in the use of angiotensin (AT) (particularly in the context of shock) had been rekindled by recent randomized trial data (notably the AT II for the Treatment of High-Output Shock-3 study). This review article outlines the renin–AT system in health and during sepsis as well as the proposed clinical uses of AT II. The potential for wider application within critical care is also considered.","PeriodicalId":93326,"journal":{"name":"Journal of Translational Critical Care Medicine","volume":"25 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84455694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-01-01Epub Date: 2019-01-04DOI: 10.4103/jtccm.jtccm_18_18
Xiaofeng Jia, Zhiyong Peng
With rapid development in the past few decades, critical care medicine and the intensive care unit (ICU) have become irreplaceable parts of the healthcare system. It is a multidisciplinary system that provides specialized and intensive medical care, advanced monitoring, organ function maintenance, and life support for critically ill patients. During the Crimean War in 1854, Florence Nightingale and a team of nurses provided intensive nursing care for critically injured soldiers, and her model of care was considered the precursor of contemporary ICUs. The first ICU was established in Denmark in 1953 when polio became epidemic and patients were centralized in a discrete department and mechanical ventilation was used to support the victims. Since then, critical care medicine continued embracing fast-developing technologies for organ maintenance and life support such as electrocardiogram monitoring, invasive mechanical ventilation, hemodialysis, bedside ultrasound, and extracorporeal membrane oxygenation. Nowadays, critical care medicine has become an integral element of the healthcare systems worldwide and has been evolved into a distinct medical subspecialty. To continue the advancement of critical care medicine, physicians and scientists must not only focus on developing novel medical technologies but also integrate knowledge from clinical and basic science research to further our treatment of critically ill patients.
{"title":"Translational Critical Care Medicine: Integrating State-of-the-Art Knowledge between Bench and Bedside.","authors":"Xiaofeng Jia, Zhiyong Peng","doi":"10.4103/jtccm.jtccm_18_18","DOIUrl":"https://doi.org/10.4103/jtccm.jtccm_18_18","url":null,"abstract":"With rapid development in the past few decades, critical care medicine and the intensive care unit (ICU) have become irreplaceable parts of the healthcare system. It is a multidisciplinary system that provides specialized and intensive medical care, advanced monitoring, organ function maintenance, and life support for critically ill patients. During the Crimean War in 1854, Florence Nightingale and a team of nurses provided intensive nursing care for critically injured soldiers, and her model of care was considered the precursor of contemporary ICUs. The first ICU was established in Denmark in 1953 when polio became epidemic and patients were centralized in a discrete department and mechanical ventilation was used to support the victims. Since then, critical care medicine continued embracing fast-developing technologies for organ maintenance and life support such as electrocardiogram monitoring, invasive mechanical ventilation, hemodialysis, bedside ultrasound, and extracorporeal membrane oxygenation. Nowadays, critical care medicine has become an integral element of the healthcare systems worldwide and has been evolved into a distinct medical subspecialty. To continue the advancement of critical care medicine, physicians and scientists must not only focus on developing novel medical technologies but also integrate knowledge from clinical and basic science research to further our treatment of critically ill patients.","PeriodicalId":93326,"journal":{"name":"Journal of Translational Critical Care Medicine","volume":"1 1","pages":"2-3"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/83/20/nihms-1705535.PMC8409177.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39380929","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}
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