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21世纪危重症医学概述

21st century critical care medicine: An overview.

作者信息

Padte Smitesh, Samala Venkata Vikramaditya, Mehta Priyal, Tawfeeq Sawsan, Kashyap Rahul, Surani Salim

机构信息

Department of Research, Global Remote Research Scholars Program, St. Paul, MN 55104, United States.

Department of Hospital Medicine, Cheshire Medical Center/Dartmouth Health, Keene, NH 03431, United States.

出版信息

World J Crit Care Med. 2024 Mar 9;13(1):90176. doi: 10.5492/wjccm.v13.i1.90176.

Abstract

Critical care medicine in the 21st century has witnessed remarkable advancements that have significantly improved patient outcomes in intensive care units (ICUs). This abstract provides a concise summary of the latest developments in critical care, highlighting key areas of innovation. Recent advancements in critical care include Precision Medicine: Tailoring treatments based on individual patient characteristics, genomics, and biomarkers to enhance the effectiveness of therapies. The objective is to describe the recent advancements in Critical Care Medicine. Telemedicine: The integration of telehealth technologies for remote patient monitoring and consultation, facilitating timely interventions. Artificial intelligence (AI): AI-driven tools for early disease detection, predictive analytics, and treatment optimization, enhancing clinical decision-making. Organ Support: Advanced life support systems, such as Extracorporeal Membrane Oxygenation and Continuous Renal Replacement Therapy provide better organ support. Infection Control: Innovative infection control measures to combat emerging pathogens and reduce healthcare-associated infections. Ventilation Strategies: Precision ventilation modes and lung-protective strategies to minimize ventilator-induced lung injury. Sepsis Management: Early recognition and aggressive management of sepsis with tailored interventions. Patient-Centered Care: A shift towards patient-centered care focusing on psychological and emotional well-being in addition to medical needs. We conducted a thorough literature search on PubMed, EMBASE, and Scopus using our tailored strategy, incorporating keywords such as critical care, telemedicine, and sepsis management. A total of 125 articles meeting our criteria were included for qualitative synthesis. To ensure reliability, we focused only on articles published in the English language within the last two decades, excluding animal studies, /molecular studies, and non-original data like editorials, letters, protocols, and conference abstracts. These advancements reflect a dynamic landscape in critical care medicine, where technology, research, and patient-centered approaches converge to improve the quality of care and save lives in ICUs. The future of critical care promises even more innovative solutions to meet the evolving challenges of modern medicine.

摘要

21世纪的重症医学取得了显著进展,极大地改善了重症监护病房(ICU)患者的治疗效果。本摘要简要总结了重症医学的最新发展,突出了关键创新领域。重症医学的近期进展包括:精准医学:根据个体患者特征、基因组学和生物标志物量身定制治疗方案,以提高治疗效果。目的是描述重症医学的近期进展。远程医疗:整合远程健康技术进行远程患者监测和会诊,促进及时干预。人工智能(AI):用于早期疾病检测、预测分析和治疗优化的人工智能驱动工具,增强临床决策。器官支持:体外膜肺氧合和连续性肾脏替代治疗等先进生命支持系统提供更好的器官支持。感染控制:创新的感染控制措施,以对抗新出现的病原体并减少医疗相关感染。通气策略:精准通气模式和肺保护策略,以尽量减少呼吸机相关性肺损伤。脓毒症管理:早期识别并积极管理脓毒症,采取量身定制的干预措施。以患者为中心的护理:转向以患者为中心的护理,除了关注医疗需求外,还注重心理和情感健康。我们使用量身定制的策略在PubMed、EMBASE和Scopus上进行了全面的文献检索,纳入了重症监护、远程医疗和脓毒症管理等关键词。共有125篇符合我们标准的文章被纳入定性综合分析。为确保可靠性,我们仅关注过去二十年发表的英文文章,排除动物研究、分子研究以及社论、信件、方案和会议摘要等非原始数据。这些进展反映了重症医学领域的动态发展,技术、研究和以患者为中心的方法相互融合,以提高ICU的护理质量并挽救生命。重症医学的未来有望出现更多创新解决方案,以应对现代医学不断演变的挑战。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/026e/11019625/a2a65016517d/90176-g001.jpg

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