Reflections and countermeasures on the construction of critical care medicine and critical care capacity in China / 中华医院管理杂志

Critical care medicine is the last line of defense for people′s lives and health, and it is necessary to attach great importance to the development of critical care medicine and the construction of treatment capabilities. This study analyzed the development effect of critical care medicine and critical care capacity in China, analyzed the shortcomings of the current shortage of talent and treatment capacity reserves in the field of critical care medicine, combed the experience of foreign countries in attaching importance to the reserve of critical care resources, the mechanism of combining peacetime and wartime, and the construction of critical care database. Targeted suggestions were proposed to strengthen development planning, optimize investment mechanism, improve talent cultivation and growth, and build critical care database, so as to provide reference for promoting the development of critical care medicine and improving the ability of critical care in China.

Prognosis-related factors of severe trauma in intensive care unit / 中华急诊医学杂志

Objective To evaluate the prognosis-related factors of severe trauma in Intensive Care Unit,and to provide clinical reference for the diagnosis and treatment of severe trauma.Methods The clinical data of all 408 patients with severe trauma and ISS score ≥ 25 admitting to our ICU and from January 2011 to December 2015 were retrospectively analyzed.To summarize the epidemiological characteristics and compare gender,age,site of injury,cause of injury,duration,complications,treatment,ISS score and APACHE Ⅱ score between the improved group and the death or deterioration group.Results There were 332 people who were improved and 76 people who died or deteriorated.The patients of death and deterioration groups were older,has a higher proportion of self falls,environment disorder,shock,ARF,ARDS and MODS,more complications,and are more likely to accept mechanical ventilation,blood purification,CPR and lower GCS score and higher APACHE Ⅱ score.The improvement group has more sites of injury higher proportion of chest,limbs and pelvis injury,and is more likely to accept surgical operation and the longer hospital stay.Binary Logistic regression analysis shows that age ＞ 55,self falls,MODS,APACHE Ⅱ ＞ 20 and CPR are risk factors of death and deterioration for the severe trauma in ICU.Conclusion It's essential to pay more attention to the overall situation of patients,preventing complications,and protecting the function of organs during the treatment of severe trauma in ICU.