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59 Articles
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  • 1.
    Experts consensus on extended infusion of β-lactam antibiotics in adult sepsis patients
    Force on Experts Consensus on Extended Infusion of β-Lactam Task
    Chinese Journal of Critical Care & Intensive Care Medicine(Electronic Edition) 2024, 10 (04): 313-324. DOI: 10.3877/cma.j.issn.2096-1537.2024.04.001
    Abstract (559) HTML (100) PDF (1217 KB) (547)

    Sepsis is a pathologic syndrome of life-threatening organ dysfunction caused by a dysregulated host immune response to infection.Early and appropriate anti-infection treatment can improve the prognosis.β-lactam antibiotics are common antibiotics for the treatment of sepsis.Extended infusion of β-lactam antibiotics is a simple and effective method to optimize pharmacokinetic/pharmacodynamics and improve the efficiency.In the experts consensus, we discuss the basic theory, efficiency, safety, and clinical application on extended infusion of β-lactam antibiotics in adult sepsis patients, and summarize the evidence-based medicine for reference.

  • 2.
    Interpretation of the guidelines for the management of adult acute and acute-on-chronic liver failure in the ICU: neurology, peri-transplant medicine, infectious disease, and gastroenterology considerations
    Yishan Zheng, Jun Yan, Jun Liu
    Chinese Journal of Critical Care & Intensive Care Medicine(Electronic Edition) 2024, 10 (03): 214-217. DOI: 10.3877/cma.j.issn.2096-1537.2024.03.002
    Abstract (345) HTML (20) PDF (786 KB) (36)

    In May 2023, the American Society of Critical Care evaluated the neurology, peritransplant, infectious and gastrointestinal disease of acute liver failure (ALF) and acute-on-chronic liver failure (ACLF) in ICU, integrated the latest clinical relevant studies, issued clinical management guidelines, put forward 28 recommendations and core points with clinical practice value, which has important clinical value in guiding the diagnosis and treatment practice of ALF and ACLF in ICU. By interpreting the guide, this paper encourages clinicians, especially critical care physicians, to deeply understand and apply the guide scientifically.

  • 3.
    Expert consensus on the application of single-use flexible bronchoscopes in intensive care units
    Beijing Association of Critical Care Physicians, Beijing Society of Critical Care Medicine, Beijing Center for Quality Control and Improvement of Critical Care Medicine
    Chinese Journal of Critical Care & Intensive Care Medicine(Electronic Edition) 2024, 10 (01): 1-5. DOI: 10.3877/cma.j.issn.2096-1537.2024.01.001
    Abstract (739) HTML (16) PDF (507 KB) (96)

    软性支气管镜自20世纪60年代在临床应用以来,其迅速成为诊断和治疗气道和肺实质疾病至关重要的方法,并在支气管镜检查室和ICU得以广泛应用。2009年,一次性软性支气管镜(single-use flexible bronchoscopes,SUFB)开始应用于困难气道气管插管。10余年来,SUFB的图像质量、可操作性及功能不断改进,与可重复使用软性支气管镜(reusable flexible bronchoscopes,RFB)相比,其性能和成本均达到可接受的水平,并极大地减少了支气管镜检查相关的交叉感染,显著提高了患者的安全性,且便于携带、易于获取,在紧急情况下可立即使用,使用后不需再处理,降低了清洁和存储成本。SUFB已经在ICU、手术室、支气管镜室等环境中不断应用,尤其在新型冠状病毒感染(corona virus disease 2019,COVID-19)大流行初期,考虑到使用RFB存在病毒传播风险,SUFB受到重视,包括美国支气管病学和介入肺病学会(American Association for Bronchology and Interventional Pulmonology,AABIP)、西班牙肺病学和胸外科学会(Spanish Society of Pneumology and Thoracic Surgery,SEPAR)和阿根廷支气管病学会(Argentine Society of Bronchchiopathy,AABE)等均推荐SUFB在已知或疑似感染严重急性呼吸综合征冠状病毒2(severe acute respiratory syndrome coronavirus 2,SARS-CoV-2)的患者中使用。

  • 4.
    Clinical practice guidelines of nutrition assessment and monitoring for adult patients in the ICU of China
    Chinese Society of Critical Care Medicine, Chinese Medical Association
    Chinese Journal of Critical Care & Intensive Care Medicine(Electronic Edition) 2023, 09 (04): 321-348. DOI: 10.3877/cma.j.issn.2096-1537.2023.04.001
    Abstract (2036) HTML (313) PDF (1316 KB) (1039)

    The Chinese Society of Critical Care Medicine (CSCCM) has developed the clinical practice guidelines of nutrition assessment and monitoring for patients in adult intensive care unit (ICU) of China. This guideline focuses on nutrition assessment and metabolic monitoring to achieve the optimal and individualized nutrition therapy for critical ill patients. This guideline was made by experts in critical care medicine and evidence-based medicine methodology and was developed after a thorough system review and summary of relevant trials or studies published from 2000 to July 2023. A total of 18 recommendations were formed and consensus was reached through discussions and review by expert groups in critical care medicine, parenteral and enteral nutrition, and surgery. The recommendations are based on the currently available evidence and cover several key fields, including nutrition risk screening and assessment, evaluation and assessment of enteral feeding intolerance, metabolic and nutritional measurement and monitoring during nutrition therapy, and organ function evaluation related to nutrition supply. Each question was analyzed according to the PICO principle. In addition, interpretations were provided for four questions that did not reach a consensus but may have potential clinical and research value. The plan is to update this nutrition assessment and monitoring guideline using the international guideline update method within 3 to 5 years.

  • 5.
    Chinese expert consensus on the clinical diagnosis and treatment of sepsis induced thrombocytopenia
    Task Force on Chinese expert consensus on the clinical diagnosis and treatment of sepsis induced thrombocytopenia
    Chinese Journal of Critical Care & Intensive Care Medicine(Electronic Edition) 2023, 09 (03): 225-240. DOI: 10.3877/cma.j.issn.2096-1537.2023.03.001
    Abstract (1319) HTML (171) PDF (1599 KB) (780)

    血小板减少症是指外周血中血小板计数(platelet,PLT)<100×109/L而引起的临床综合征。据报道有13.0%~44.1%的重症患者可能发生血小板减少症,且血小板减少的程度是重症患者预后的重要预测指标之一。重症患者发生血小板减少症的原因众多,其中脓毒症相关的血小板减少症(sepsis induced thrombocytopenia,SIT)最为常见,约占50%。SIT的发生不仅延长重症患者ICU住院时间、机械通气时间及血管活性药物使用时间,同时可能导致出血相关性不良事件及全因病死率增加。目前尚缺乏SIT的监测、诊断及治疗规范,因此中华医学会重症医学分会专家制定《脓毒症相关的血小板减少症临床诊疗中国专家共识》,以期对此疾病进行规范化管理。

  • 6.
    Guidelines on clinical application of ciprofol (2023)
    Task Force on Guidelines on Clinical Application of Ciprofol
    Chinese Journal of Critical Care & Intensive Care Medicine(Electronic Edition) 2023, 09 (03): 241-244. DOI: 10.3877/cma.j.issn.2096-1537.2023.03.002
    Abstract (1813) HTML (282) PDF (535 KB) (688)

    环泊酚是中国自主研发且具有全球自主知识产权的1类创新药。为规范和优化环泊酚的临床应用,2021年国内专家组曾撰写《环泊酚临床应用指导意见》。该指导意见对帮助临床医师了解环泊酚的药理学特性及其临床应用起到了一定作用。近年来,环泊酚在麻醉学和重症医学领域得到广泛应用,积累了大量的临床经验和临床研究资料。因此有必要对《环泊酚临床应用指导意见》进行补充和修订,以更好地指导临床应用。

  • 7.
    Expert consensus on analgesic management in severe adult patients in China
    Subgroup of Critical Respiratory Diseases, China Clinical Practice Guideline Alliance
    Chinese Journal of Critical Care & Intensive Care Medicine(Electronic Edition) 2023, 09 (02): 97-115. DOI: 10.3877/cma.j.issn.2096-1537.2023.02.001
    Abstract (3299) HTML (742) PDF (1449 KB) (3548)
  • 8.
    Expert consensus on analgesic sedation data element and definition in severe adult patients
    Chinese Society of Critical Care Medicine, Chinese Association of Pathophysiology
    Chinese Journal of Critical Care & Intensive Care Medicine(Electronic Edition) 2023, 09 (02): 116-134. DOI: 10.3877/cma.j.issn.2096-1537.2023.02.002
  • 9.
    Protocolized diagnosis and treatment for pain and agitation in critically ill adults
    Shuai Liu, Shanshan Xu, Shuya Wang, Mengxue Hou, Mingyue Miao, Ying Tian, Linlin Zhang, Jianxin Zhou
    Chinese Journal of Critical Care & Intensive Care Medicine(Electronic Edition) 2023, 09 (02): 135-142. DOI: 10.3877/cma.j.issn.2096-1537.2023.02.003
    Abstract (1507) HTML (296) PDF (1025 KB) (1546)

    Analgesia and sedation are crucial for critically ill patients. In recent years, a comprehensive strategy featuring prioritized analgesia, light sedation, delirium screening and prevention, early mobility and sleep improvement has been formed. However, a concise and easy-to-operate flow chart still needs to be improved. We have developed a protocolized process for pain and agitation management for critically ill patients to provide a hands-on tool in clinical practice.

  • 10.
    Core competences of neurocritical care: consensus of chinese experts based on Delphi method and nominal group method
    the Working Group from Neuro-Critical Care Committee Affiliated to the Chinese Association of Critical Care Physicians, the National Center for Healthcare Quality Management in Neurological Diseases
    Chinese Journal of Critical Care & Intensive Care Medicine(Electronic Edition) 2023, 09 (01): 1-8. DOI: 10.3877/cma.j.issn.2096-1537.2023.01.001
    Abstract (655) HTML (116) PDF (909 KB) (278)

    Neurocritical care is an emerging specialty integrating critical care medicine and neuroscience. Neurocritical care specialty in China started late, due to lack of data on medical resources, and complex professional background of specialists in Neuro-critical care unit. Without standardized neurocritical care specialist training in China, there is an urgent need for neurocritical care specialist training. According to successful experience of previous specialized training in China and foreign countries, before establishing a standardized specialized training, priority should be given to core competencies in this specialty. A working Group from Neuro-Critical Care Committee affiliated to the Chinese Association of Critical Care Physicians and the National Center for Healthcare Quality Management in Neurological Diseases established the consensus through formal consensus methods (modified Delphi method and nominal group method). The working group first compiled the previous guidelines and then issued an online questionnaire. 1094 respondents from 33 provinces in China participated in the online survey. A formal list containing 329 statements was generated for rating by a nominal group. After five rounds of nominal group meetings and one round of comments and iterative review, 198 core competencies (54 on neurological diseases, 64 on general medical diseases, 42 on monitoring of practical procedures, 20 on professionalism and system management, 5 on ethical and legal aspects, 3 on the principles of research and certification, and 10 on scoring systems) formed the final list. The list can be used as a reference for neurocritical care training in the future.

  • 11.
    Talk about the timing of prone position ventilation again
    Chengfen Yin, Lei Xu
    Chinese Journal of Critical Care & Intensive Care Medicine(Electronic Edition) 2023, 09 (01): 9-13. DOI: 10.3877/cma.j.issn.2096-1537.2023.01.002
    Abstract (629) HTML (31) PDF (683 KB) (272)

    Prone position ventilation (PPV) is a technique of respiratory support for patients under a prone position. PPV has the advantages of promoting collapsed alveolar recruitment, enhancing ventilation/perfusion ratio, improving respiratory system compliance, facilitating secretion drainage, and reducing ventilator-associated lung injury. However, there is no unified recommendations for the timing of PPV initiation. For patients with moderate and severe ARDS, PPV is now recommended by guidelines for mechanical ventilation of acute respiratory distress syndrome (ARDS). Considering that ventilator-associated lung injury complicates ARDS, PPV should be implemented as soon as possible for patients with traditional ARDS. For those receiving extracorporeal membrane oxygenation (ECMO), it is recommended to start PPV at the early stage of ECMO support in ECMO centers. The timing of PPV for intubated COVID-19 patients with poor respiratory compliance can refer to patients with traditional ARDS. The timing for awake PPV in COVID-19 gradually moves forward. Even if oxygenation does not dramatically drop, PPV can be started in COVID-19 patients as long as they are tolerable and have no contraindications.

  • 12.
    Surviving sepsis campaign guidelines 2021: “eight pitfalls” in early resuscitation
    Zongsheng Wu, Jianfeng Xie, Haibo Qiu
    Chinese Journal of Critical Care & Intensive Care Medicine(Electronic Edition) 2023, 09 (01): 14-18. DOI: 10.3877/cma.j.issn.2096-1537.2023.01.003
    Abstract (900) HTML (91) PDF (675 KB) (355)

    The surviving sepsis campaign (SSC) guidelines has been updated five editions nowadays since it first published in 2004. SSC guidelines promote knowledge about sepsis constantly, which also improve management of sepsis to a certain extent, and become an important basis for guiding diagnosis and therapy in patients with sepsis. However, there are still several obvious defects in early resuscitation of septic shock in the SSC guidelines 2021, and the relevant recommendations may lead to misinterpretation or misuse. Therefore, "eight pitfalls" and relevant clinical evidence in SSC guidelines 2021 are discussed in present commentary.

  • 13.
    Expert consensus on the diagnosis and treatment of critically ill patients with COVID-19 at high altitudes in China
    Ling Liu, Xuyan Li, Yonghao Xu, Huiying Zhao, Qiaoxia Luo, Xiaofeng Ou, Lei Song, Yuan Cheng, Juan Zhou, Yiping Zeng, Aihua Liu, Bianbaqiongda, Shuo Zhang, Jie Lyu, Xi Wang, Yanyun Lu, Baixu Chen, zhen Da, Yun Yu, Jia Shao, Critical Care Respiratory Group, Chinese Society of Critical Care Medicine, Chinese Medical Association, Tibet Medical Association for High Altitude Medicine and Cardiology, Chinese Association of Critical Care Physicians
    Chinese Journal of Critical Care & Intensive Care Medicine(Electronic Edition) 2022, 08 (04): 340-346. DOI: 10.3877/cma.j.issn.2096-1537.2022.04.011
    Abstract (265) HTML (22) PDF (1155 KB) (67)

    Critically ill patients with COVID-19 at high altitudes were difficult to recognize and diagnose, due to hypoxemia associated with high altitudes and various chronic co-morbidities. In order to standardize the diagnostic and treatment practice, the present expert consensus was established by the method of consensus meeting, according to the Diagnostic and Treatment Regimen of COVID-19 (version 9), investigation advances abroad and domestic, and expert opinions, focusing on the common and important issues of diagnosis and treatment practice of critically ill patients with COVID-19 at high altitudes. This consensus will provide a reference for the standardized treatment of critically ill patients with COVID-19 at high altitudes in China.

  • 14.
    The development of critical care medicine in the post-pandemic era
    Xiangdong Guan
    Chinese Journal of Critical Care & Intensive Care Medicine(Electronic Edition) 2022, 08 (02): 97-100. DOI: 10.3877/cma.j.issn.2096-1537.2022.02.001
    Abstract (317) HTML (141) PDF (633 KB) (213)
  • 15.
    Post-graduation education of intensivists-residential training and specialized training of Chinese Association of Critical Care Physicians
    Xiaoyun Hu, Li Jiang, Bin Du
    Chinese Journal of Critical Care & Intensive Care Medicine(Electronic Edition) 2022, 08 (02): 101-102. DOI: 10.3877/cma.j.issn.2096-1537.2022.02.002
    Abstract (339) HTML (71) PDF (515 KB) (183)

    Chinese Association of Critical Care Physicians has been devoted to development of standardized critical care training program in the past three years. An integrated postgraduate training system including resident and specialist standardized training protocol has been forming. Short-run working scheme is to refine the program in all aspects, including further standardization of training curriculum, training center supervision, training faculty qualification and web-based supporting system.

  • 16.
    Review and prospect of critical care medical research in 2021
    Linlin Zhang, Jianxin Zhou
    Chinese Journal of Critical Care & Intensive Care Medicine(Electronic Edition) 2022, 08 (02): 103-104. DOI: 10.3877/cma.j.issn.2096-1537.2022.02.003
  • 17.
    Expert consensus on early standardized management of post-cardiac arrest syndrome
    Critical Neurology Group of Critical Care Medicine Branch of Jiangsu Medical Association
    Chinese Journal of Critical Care & Intensive Care Medicine(Electronic Edition) 2022, 08 (01): 1-15. DOI: 10.3877/cma.j.issn.2096-1537.2022.01.001
  • 18.
    Atomization treatment guidelines for mechanical ventilation patients
    Subgroup of Critical Respiratory Diseases of Chinese Medical Association
    Chinese Journal of Critical Care & Intensive Care Medicine(Electronic Edition) 2021, 07 (03): 193-203. DOI: 10.3877/cma.j.issn.2096-1537.2021.03.001
    Abstract (2341) HTML (191) PDF (1206 KB) (760)

    雾化治疗是机械通气时常同步应用的集束化气道管理方法之一。为规范临床机械通气患者雾化治疗行为,中华医学会重症医学分会依据国内外最新的研究进展及专家意见,归纳和构建了10个在机械通气患者雾化治疗临床实践中常见的重要问题,采用GRADE方法制定了本指南。

  • 19.
    Free
    Chinese Journal of Critical Care & Intensive Care Medicine(Electronic Edition) DOI: 10.3877/cma.j.issn.2096-1537.2021.00067
  • 20.
    Free
    Chinese Journal of Critical Care & Intensive Care Medicine(Electronic Edition) DOI: 10.3877/cma.j.issn.2096-1537.2021.00074
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