CRITICAL CARE MEDICINE重症医学
CRITICAL CARE MEDICINE(英文缩写 CRIT CARE MED),ISSN 0090-3493,eISSN 1530-0293,中文译名:重症医学 是一本学术期刊。本页汇总该期刊的最新影响因子、分区信息以及最新收录于 PubMed 的文献,帮助您快速了解期刊全貌。
发文量统计区间：2025-11-01 至 2026-10-31，按本站收录文献的发表日期统计。
期刊介绍
历年影响因子趋势
| JCR 数据年份 | 影响因子 | JCR 分区 |
|---|---|---|
| 2021 | 9.296 | Q1 |
| 2022 | 8.800 | Q1 |
| 2023 | 7.700 | Q1 |
| 2024 | 6.000 | Q1 |
| 2025 | 7.500 | Q1 |
CRITICAL CARE MEDICINE 最新收录文献
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1. Derivation and Validation of Operational Definitions From Claims Data for Identifying Cardiogenic Shock.
1. 从理赔数据中推导和验证用于识别心源性休克的操作性定义PMID:日期:2026-10-05To derive and validate a claims-based operational definition for cardiogenic shock (CS) using administrative data against clinically adjudicated reference standards. Diagnostic accuracy study. Two independent clinical cohorts, a single-center cardiac ICU (CICU) registry and a multicenter CS registry (REtrospective and prospective observational Study to investigate Clinical oUtcomes and Efficacy of left ventricular assist device for Korean patients with cardiogenic shock [RESCUE]), and a nationwide administrative database from the Korean National Health Insurance Service. A total of 10,156 patients from the CICU registry and 1,247 patients from the RESCUE registry. For population-level application, 207,419 patients were identified from the national claims database. None. A claims-based algorithm defined CS using the International Classification of Diseases, 10th Revision code R57.0 or cardiac disease codes combined with treatment-based criteria reflecting hemodynamic support, including mechanical circulatory support or vasoactive therapy. In the CICU cohort, the algorithm demonstrated a sensitivity of 0.89 and specificity of 0.90, with an overall accuracy of 0.90. In the RESCUE cohort, sensitivity was 0.95. When applied to the nationwide database, 207,419 patients with CS were identified. The cumulative mortality rates were 37.9% at 12 months, 49.9% at 5 years, and 61.7% at 10 years. A claims-based definition combining diagnostic codes with treatment-based criteria demonstrated high diagnostic performance for identifying CS. This approach enables reliable large-scale epidemiologic studies and long-term outcome assessments using administrative data and may facilitate system-level evaluation of critical care delivery in patients with CS.
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2. Diabetes and Atherosclerotic Cardiovascular Disease Modify the Association Between Soluble Tumor Necrosis Factor Receptor 1 and Sepsis Mortality: A Secondary Cohort Analysis.
2. 糖尿病和动脉粥样硬化性心血管疾病对可溶性肿瘤坏死因子受体1与脓毒症死亡率之间关联的修饰作用：一项二次队列分析PMID:日期:2026-09-30To determine whether diabetes mellitus or atherosclerotic cardiovascular disease (ASCVD) modify the association between soluble tumor necrosis factor receptor 1 (sTNFR1) and mortality in sepsis. Secondary cohort analysis using the Acetaminophen and Ascorbate in Sepsis: Targeted Therapy to Enhance Recovery Research Materials. Academic hospitals in the United States. A total of 466 adults with sepsis and respiratory failure or vasopressor-dependent shock with available baseline sTNFR1 measurements. None. We tested the interaction between sTNFR1 and diabetes or ASCVD (defined by Charlson comorbidity categories) on 90-day mortality using Cox regression with restricted cubic splines, adjusted for illness severity, age (in tertiles), and sex. Of 466 patients, 243 patients (52.1%) had diabetes or ASCVD. Despite similar illness severity and mortality between groups, sTNFR1 was higher among patients with diabetes or ASCVD (median, 6547 vs. 4883 pg/mL). Among patients without diabetes or ASCVD, higher sTNFR1 was associated with 90-day mortality (hazard ratio [HR], 2.25 per sd; 95% CI, 1.76-2.88). The association was attenuated among those with diabetes or ASCVD, with a plateau in mortality risk above approximately 12,000 pg/mL (overall HR, 1.04; 95% CI, 0.83-1.30; interaction p < 0.001). This interaction was specific to sTNFR1 and was not observed for interleukin-6 or angiopoietin-2. No effect modification was present among patients with obesity or hypertension without diabetes or ASCVD. Diabetes or ASCVD attenuated the association between sTNFR1 and sepsis mortality. These findings suggest that comorbid conditions may alter the biological relationship between a biomarker and outcome, with implications for biomarker-guided risk stratification and disease mechanisms in sepsis.
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3. Time-Dependent Effects of Inotropic Exposure During Venoarterial Extracorporeal Membrane Oxygenation Support on the Probability of Extracorporeal Membrane Oxygenation Weaning Failure.
3. 静脉-动脉体外膜氧合支持期间正性肌力药物暴露对体外膜氧合撤机失败概率的时间依赖性效应PMID:日期:2026-09-25During venoarterial extracorporeal membrane oxygenation (VA ECMO), organ perfusion no longer entirely depends on native cardiac output, which may reduce the therapeutic advantage of inotropic drugs relative to their risks. We hypothesized that, in this setting, higher cumulative inotropic exposure would be associated with impaired cardiac recovery. Observational cohort study on the effects of longitudinal inotropic exposure during VA ECMO support. Temporal changes in inotropic support during VA ECMO support were evaluated. Cumulative inotropic exposure per day during VA ECMO support was calculated using the area under the curve of a standardized inotropic score. These cumulative inotropic scores were associated with the risk of ECMO weaning failure up to 30 days (a composite of death, ongoing need for ECMO support, or the need for heart replacement therapy), mortality, and complications, using joint modeling techniques. Six hospitals in the Netherlands. Adult patients with severe cardiogenic shock (CS) receiving VA ECMO support between 2018 and 2024. None. Out of 440 patients with various causes of CS, 235 patients (53.4%) developed ECMO weaning failure. Inotropic support remained largely unchanged in the days following VA ECMO initiation. Adjusted joint models showed that a higher cumulative inotropic exposure during VA ECMO support was associated with an increased risk for ECMO weaning failure (hazard ratio [HR], 1.04; 95% CI, 1.00-1.07), 30-day mortality (HR, 1.04; 95% CI, 1.01-1.08), arrhythmias (HR, 1.05; 95% CI, 1.01-1.08), and protracted lactate clearance (HR, 0.96; 95% CI, 0.92-0.99). In patients requiring VA ECMO support for refractory CS, inotropic support is often maintained at similar levels after ECMO initiation. Higher cumulative inotropic exposure was associated with an increased risk for ECMO weaning failure. Prospective studies are needed to investigate whether inotropes can be tapered or even stopped and whether such a strategy could improve cardiac recovery.
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4. Epilepsy After Antipsychotic Prescription in Survivors of Traumatic Brain Injury: A Population-Based Cohort Study.
4. 创伤性脑损伤幸存者接受抗精神病药物处方后的癫痫风险：一项基于人群的队列研究PMID:日期:2026-09-21To evaluate whether the choice of antipsychotic treatment following traumatic brain injury (TBI) hospitalization is associated with the risk of post-traumatic epilepsy in older adults. Retrospective cohort study. Population-based cohort in Ontario, Canada (2009-2021). We included adults 66 years or older without epilepsy who survived a first TBI admission and filled new prescriptions for antipsychotics within 30 days after discharge. None. The exposure groups included patients who were prescribed haloperidol or risperidone, compared separately to quetiapine. The primary outcome was a new diagnosis of epilepsy up to 5 years following discharge. We used inverse probability of treatment weighting of cause-specific Cox models to calculate adjusted hazard ratios (aHR) and 95% CIs based on a robust variance estimator. Of 1204 TBI survivors included, 202 (17%) filled prescriptions for haloperidol, 300 (25%) for risperidone, and 702 (58%) for quetiapine; epilepsy was diagnosed in 6%, 13%, and 14% of these groups, respectively. Mortality by 5 years of follow-up was 89% for haloperidol, 66% for risperidone, and 62% for quetiapine. Compared with quetiapine, a new prescription for haloperidol (aHR = 0.73; 95% CI, 0.39-1.34) or risperidone (aHR = 0.94; 95% CI, 0.65-1.36) was not associated with higher epilepsy risk. We found no clear signal of a differential risk of epilepsy when comparing new prescriptions for haloperidol or risperidone with quetiapine among survivors of TBI. Nonetheless, high mortality limited comparability across groups, CIs were wide, and additional studies should confirm our findings.
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5. Epidemiology of Critically Ill Patients With Cirrhosis Undergoing Continuous Renal Replacement Therapy: A Contemporaneous Parallel Analysis of the HRS-HARMONY and CRRTnet Registries.
5. 接受连续性肾脏替代治疗的危重肝硬化患者的流行病学：HRS-HARMONY与CRRTnet登记数据库的同期平行分析PMID:日期:2026-09-17Describe the epidemiology of patients with cirrhosis/acute-on-chronic liver failure (ACLF) receiving continuous renal replacement therapy (CRRT) pertaining to process factors including renal replacement dose, modality, and circuit anticoagulation. Academic tertiary care hospitals in the United States and Canada. We performed a parallel study of contemporaneous data from the HARMONY and CRRT network (CRRTnet) databases to describe the epidemiology and process of CRRT care of cirrhosis/ACLF patients receiving CRRT in the ICU. We evaluated clinical and CRRT process factors (dialysis dose, anticoagulation) with the primary outcome of in-hospital mortality. None. The HARMONY cohort (n = 245; median age, 57 yr; 41% female) and CRRTnet cohort (n = 206; 58 yr; 39% female) demonstrated similar overall survival to hospital discharge (HARMONY, 34%; CRRTnet, 30%). In HARMONY, the two most common causes of acute kidney injury (AKI) requiring CRRT were acute tubular necrosis (73%) and hepatorenal syndrome-AKI (13%), with no significant difference between survivors and nonsurvivors (p = 0.24). In HARMONY, higher chronic liver failure-C ACLF scores (hazard ratio, 1.03 [95% CI, 1.01-1.05]; p < 0.001) were independently associated with increased in-hospital mortality. In CRRTnet, the most common CRRT modality was continuous venovenous hemodiafiltration (83.8%), and the most common anticoagulation strategy was regional citrate anticoagulation (58.0%) or no anticoagulation (35.8%). CRRT prescribed dose greater than 30 mL/kg/hr was independently associated with higher in-hospital mortality (multivariable regression; odds ratio, 2.69; 95% CI, 1.3-5.64; p = 0.01). Of survivors in CRRTnet, 64% were transitioned to intermittent hemodialysis (IHD) before hospital discharge. Critically ill cirrhosis/ACLF patients initiated on CRRT in the absence of liver transplantation had high in-hospital mortality. These patients were prescribed higher initial CRRT doses (median total effluent > 30 mL/kg/hr), with higher CRRT dose independently associated with increased in-hospital mortality. Of ICU survivors, 64% were transitioned to IHD at ICU discharge. Despite concerns for citrate toxicity, citrate regional anticoagulation was commonly employed in these patients.
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6. Returning to Driving: Developing a Roadmap to Inform Decision-Making After Critical Illness.
6. 重返驾驶：制定路线图以指导危重疾病后的决策PMID:日期:2026-09-11该文献暂无摘要。
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7. Operationalizing Alternatives to Prospective Consent in Critical Care Trials.
PMID:日期:2026-09-11该文献暂无摘要。
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8. Landscape of Biomarker Use in Critically Ill Patients: Systematic Evidence Map of Acute Kidney Injury and Implications for Practice.
8. 危重症患者生物标志物应用全景：急性肾损伤的系统证据图谱及实践意义PMID:日期:2026-09-11Create systematic evidence maps of novel biomarkers of kidney injury from a mapping review to guide future implementation in patient care. PubMed/MEDLINE and Embase. Systematic evidence maps included clinical trials and observational studies in critically ill patients, investigating novel kidney biomarkers for acute kidney injury (AKI). Six thousand eight hundred five records were screened, and 1116 studies were included that related to one or more novel biomarkers and AKI. Adult populations accounted for 78.6% of the studies, and 93.3% used a cohort design to investigate AKI biomarkers. Mixed critically ill populations, cardiac surgery, and sepsis were identified as the most frequently studied clinical contexts in 69.5% of the studies. Systematic evidence maps were synthesized for biomarker studies to predict AKI (n = 944), prognosticate clinical outcomes (n = 647), diagnose AKI etiology (n = 109), enrich clinical trials (n = 6), and manage AKI (n = 12). Implementation strategies for patient care included surveilling patients at risk of AKI, including patients undergoing surgery and those exposed to multiple nephrotoxic drugs. Substantial clinical evidence assessing the accuracy of biomarkers compared with diagnosis of AKI exists, with fewer practical trials in clinical use. Still, guidance on implementation approaches can be gleaned from evaluations using biomarkers for the management of critically ill patients, particularly in surgical and nephrotoxin-exposed populations where evidence is available. This review identifies the landscape of current evidence and highlights priorities for future management and enrichment trials needed to bridge the gap between predictive accuracy and clinical decision-making.
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10. Comprehensive Driving Assessment to Enable Driving Resumption in Adults Recovering From Critical Illness: A Prospective Cohort Study.
10. 危重疾病康复期成年人恢复驾驶能力的综合驾驶评估：一项前瞻性队列研究PMID:日期:2026-09-11Primary objective: To determine the driving ability of adult ICU survivors 2 months after hospital discharge. Secondary objectives: Evaluate driving resumption at 3, 6, and 12 months; factors associated with driving resumption; and acceptability of a comprehensive driving assessment. Observational cohort study. Certified driving assessment center in the United Kingdom. Adult ICU survivors who received mechanical ventilation (minimum 72 hr) and/or extracorporeal membrane oxygenation. A Driver Vehicle Licensing Agency-approved, driving ability assessment comprising physical and cognitive evaluation, and practical driving skills using a driving simulator, private track in-car assessment, and on-road in-car assessment. We recruited 40 participants (median age, 53 yr [interquartile range (IQR), 46-64 yr]; 13 [32%] female) from six hospitals. Of these, 33 completed the driving assessment at a median of 12.5 weeks following hospital discharge. Twenty-six participants (79%) were assessed as capable of driving a standard vehicle; however, only 15 (45%) had resumed driving. Seven participants (7/33, 21%) were deemed unable to drive a standard vehicle due to either physical (n = 4/7, 57%), psychological (n = 2/7, 29%), or cognitive impairment (n = 1/7, 14%). Driving resumption following adaptations, retraining, or refresher lessons occurred in four participants (n = 4/7, 57%) in the 12-month study period. Self-reported driving resumption at 3, 6, and 12 months was observed in 21 (62%), 28 (82%), and 30 (91%) participants, respectively. Time to driving resumption ranged from 7 to 274 days following hospital discharge. Median (IQR) driving confidence (10-point Likert scale) increased from 7 (5-8) pre-assessment to 9 (7-10) post assessment (p < 0.05). Driving assessment acceptability was rated very good or excellent by 32 participants (97%). Using a comprehensive driving assessment 3 months following hospital discharge, approximately three quarters of this cohort were deemed able to drive a standard vehicle, yet less than half had resumed driving. Of those with a driving-related impairment, most could resume driving following intervention.