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重症监护的最新进展:第二部分。

Recent advances in critical care: Part II.

作者信息

Gopal Palepu B, Sivapurapu Vijayalakshmi, Nag Deb Sanjay, Bhatia Nidhi, Tandon Ruchi, Bhavar Tushar

机构信息

Department of Critical Care Medicine, Citizens Specialty Hospitals, Hyderabad, Telangana, India.

Department of Anaesthesiology and Critical Care, Indira Gandhi Medical College and Research Institute, Puducherry, India.

出版信息

Indian J Anaesth. 2023 Jan;67(1):110-116. doi: 10.4103/ija.ija_1006_22. Epub 2023 Jan 21.

Abstract

With the increasing number of critically ill patients being admitted to intensive care units (ICUs), newer techniques and treatment modalities continue to evolve for their adequate management. Thus, it has become imperative to understand existing tools and resources, and utilise or repurpose them to achieve better results that can decrease morbidity and mortality. In this writeup, we chose five areas of interest, including analgosedation, role of colloids, recent advancements in the management of respiratory failure, the role of extracorporeal membrane oxygenation, and newer antimicrobials. The role of analgosedation in the critically ill has gained importance with focus on post-ICU syndromes, and albumin has re-entered the fray as a possible repairer of the injured glycocalyx. The coronavirus disease 2019 (COVID-19) pandemic forced us to relook at various ventilator strategies and mechanical support for the failing circulation has now become more common with clear end-points. Rising microbial antibiotic resistance has opened up the research on newer antibiotics.

摘要

随着重症监护病房(ICU)收治的重症患者数量不断增加,为了对他们进行充分管理,更新的技术和治疗方式持续发展。因此,了解现有的工具和资源,并利用或重新利用它们以取得能降低发病率和死亡率的更好结果变得至关重要。在本文章中,我们选择了五个感兴趣的领域,包括镇痛镇静、胶体的作用、呼吸衰竭管理的最新进展、体外膜肺氧合的作用以及新型抗菌药物。随着对ICU后综合征的关注,镇痛镇静在重症患者中的作用变得更加重要,白蛋白作为受损糖萼的可能修复剂重新进入人们的视野。2019冠状病毒病(COVID-19)大流行迫使我们重新审视各种通气策略,并且对于衰竭循环的机械支持现在变得更加普遍且有明确的终点。不断上升的微生物抗生素耐药性开启了对新型抗生素的研究。

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