Current Problems in Diagnostic RadiologyIIMB Management ReviewJournal of Cardiac FailureJournal of Exotic Pet MedicineBiology of Blood and Marrow TransplantationSeminars in Spine SurgerySeminars in Arthritis & RheumatismCurrent Problems in Pediatric and Adolescent Helath CareSolid State Electronics
Current Problems in Diagnostic RadiologyIIMB Management ReviewJournal of Cardiac FailureJournal of Exotic Pet MedicineBiology of Blood and Marrow TransplantationSeminars in Spine SurgerySeminars in Arthritis & RheumatismCurrent Problems in Pediatric and Adolescent Helath CareSolid State Electronics
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诊断放射学的当前问题IIMB 管理评论心力衰竭杂志外来宠物医学杂志血液和骨髓移植生物学脊柱外科研讨会关节炎研讨会
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发表时间：
2018
期刊：
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通讯作者：
G. Whitman
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文献类型：
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作者：
Cecillia Lui;G. Whitman
自20世纪60年代早期重症监护室创建以来，如何操作和配备重症监护室的核心问题一直是一个持续讨论的问题。早期的研究表明，当人员配置从远程提供者改为全职现场提供者时，道德水平会下降。除了转向全职的现场提供者，日常护理的结构也发生了重大的范式变化。几项研究揭示了多学科轮次的重要性和益处，直接和公开地交流日常目标。特别是对于休克的心脏病患者，最近的两项研究提供了确凿的数据，证明有全职现场服务人员的重症监护病房死亡率显著降低。对于体外膜氧合的患者，这种益处更加明显。这些数据支持重症监护的实践：1)配备全职现场医护人员；2)设置多学科查房；3)团队成员之间开放沟通的安全环境。中心信息：心脏病患者的标准护理应该由全职重症监护医师，包括心脏外科医生。多学科查房和合作文化对于提供高质量护理至关重要。图1：韩国CICU的高强度重症监护显著降低了总体患者的心血管死亡率，在体外膜氧合（ECMO）[10]支持的患者中甚至更显著。虽然重症监护室在20世纪60年代初就出现了，但如何适当地配备重症监护室的概念在20世纪80年代初才开始形成。1984年，针对这一问题的首批研究之一
Since the creation of intensive care units in the early 1960s, the central question of how to operate and staff them has continued to be an ongoing discussion. Early studies demonstrated decreased morality when staffing was altered from remote providers to full-time on-site providers. In addition to the shift towards full-time onsite providers, the structure of daily care has also undergone significant paradigm changes. Several studies have revealed the importance and benefit of multidisciplinary rounds with direct and open communication of daily goals. Particularly for cardiac patients in shock, two recent studies have provided hard data demonstrating a significant decrease in mortality in ICUs with full-time onsite providers. This benefit was even more pronounced for patients supported with extracorporeal membrane oxygenation. These data support the practice of intensive care with a) full-time onsite provider staffing, b) in the setting of multidisciplinary rounds, and c) a safe environment with open communication between team members. Central Message: The standard of care for the cardiac patient should be by full time intensivists, including cardiac surgeons. Multidisciplinary rounds and a culture of collaboration are crucial to providing high quality care. Figure 1: High intensity critical care in a Korean CICU significantly decreases cardiovascular mortality in overall patients, and even more dramatically in patients supported with extracorporeal membrane oxygenation (ECMO) [10]. Although intensive care units came into being in the early 1960s, the concept of how to appropriately staff them started to take form in the early 1980s. One of the first studies addressing this issue in 1984