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1、重症医学进展 -2014-2015,Advance of Critical Care in 2014-2015,Big Data and MIMIC II Database,Advance of Critical Care in 2014-2015,屌丝的福音,The Age of Big Data,Advance of Critical Care in 2014-2015,Volume-大量Velocity-快速Variety-多样Value-价值,Advance of Critical Care in 2014-2015,Big Data,NOT-Randomization非随机化抽样,A
2、dvance of Critical Care in 2014-2015,Big Data and Traditional Medicine,MIMIC DatabaseMultiparameter Intelligent Monitoring in Intensive Care,Advance of Critical Care in 2014-2015,Big Data and Critical Care Medicine,MIMIC,Advance of Critical Care in 2014-2015,Advance of Critical Care in 2014-2015,MIM
3、IC II Database,流行病学统计临床决策监护设备的研发,Advance of Critical Care in 2014-2015,MIMIC II Database,http:/mimic.physionet.org/database.html,Advance of Critical Care in 2014-2015,MIMIC II Database,Dejam, et al. Critical care,2014,18:487.,Advance of Critical Care in 2014-2015,MIMIC II Database,Fuchs, et al. Plos
4、 one.2014, 9(4):e93234,Advance of Critical Care in 2014-2015,MIMIC II Database,Moskowitz, et al. J Intensive Care Med,2014,Advance of Critical Care in 2014-2015,MIMIC II Database,Zhang, et al. Plos one, 2014,Advance of Critical Care in 2014-2015,MIMIC II Database,EnglishComputerStatistics,Ability,Fa
5、ir,Advance of Critical Care in 2014-2015,Big Data,AustraliaChina,Sepsis,Advance of Critical Care in 2014-2015,Definition DiagnosisClassificationEGDT(Early-Goal Directed Therapy)China guidelines for SepsisSepsis-associated AKI,Advance of Critical Care in 2014-2015,Sepsis 3.0定义更新,再见，SIRS！你好，SOFA！,Adva
6、nce of Critical Care in 2014-2015,Sepsis 1.0-2.0 Definition,Sepsis is a systemic, deleterious host response to infection leading to systemic inflammatory response syndrome (SIRS).,脓毒症是感染引起的全身炎症反应综合征。,Advance of Critical Care in 2014-2015,Sepsis 1.0-2.0 Diagnosis,Hypothermia or fever (body temperatur
7、e 38.5C)Tachycardia (90 beats/min)Tachypnea (20 breaths/min or PaCO2 12 000/mm3), leukopenia (10%).,Advance of Critical Care in 2014-2015,Kaukonen, et al. JAMA,2014,311(13):2637,Background,Advance of Critical Care in 2014-2015,Sepsis 1.0-2.0 Definition,缺陷,Specificity,Morbidity Mortality,Advance of C
8、ritical Care in 2014-2015,Sepsis 3.0 Definition,Sepsis is defined as life-threatening organ dysfunction due to a dysregulated host response to infection.,脓毒症是机体对于感染引起的失控的炎症反应所导致威胁生命的器官功能障碍。（安友仲）,Advance of Critical Care in 2014-2015,Sepsis Shock 3.0 Definition,1.0-2.0: 感染导致的积极液体复苏无法纠正的低血压及组织低灌注状态（La
9、c，尿量、神志）。,3.0: Sepsis 基础上出现的补液无法纠正的低血压及Lac2mmol/L。,Advance of Critical Care in 2014-2015,Sepsis 3.0 Definition,SIRS-CARS-MARSOrgan dysfunction (OD)-,SOFA,Advance of Critical Care in 2014-2015,Sepsis 3.0 Definition,Advance of Critical Care in 2014-2015,Sepsis 3.0诊断更新,THRRWBC,SBPGCSR,Advance of Critic
10、al Care in 2014-2015,Sepsis 3.0分型更新,SepsisSevere SepsisSeptic Shock,Severe SepsisSeptic Shock,精准医疗的前奏,Advance of Critical Care in 2014-2015,Sepsis 3.0治疗更新,EGDT走下神坛？,Advance of Critical Care in 2014-2015,EGDT (Early-Goal Directed Therapy),Rivers, et al. N Engl J Med 2001,370(18):1368-1377,Advance of
11、Critical Care in 2014-2015,EGDT (Early-Goal Directed Therapy),Rivers, et al. N Engl J Med 2001,370(18):1368-1388,Advance of Critical Care in 2014-2015,EGDT (Early-Goal Directed Therapy),Advance of Critical Care in 2014-2015,EGDT (Early-Goal Directed Therapy),Advance of Critical Care in 2014-2015,EGD
12、T (Early-Goal Directed Therapy),The ProCESS Investigators .N Engl J Med 2014; 370:1683-1693,Advance of Critical Care in 2014-2015,EGDT (Early-Goal Directed Therapy),The ProCESS Investigators .N Engl J Med 2014; 370:1683-1693,Advance of Critical Care in 2014-2015,EGDT (Early-Goal Directed Therapy),Mo
13、uncey.N Engl J Med 2015; 372,(14):1301-1311,Advance of Critical Care in 2014-2015,EGDT (Early-Goal Directed Therapy),Mouncey.N Engl J Med 2015; 372,(14):1301-1311,Advance of Critical Care in 2014-2015,EGDT (Early-Goal Directed Therapy),The ARISE investigators and the ANZICS clinics trail groups.N En
14、gl J Med ,2014,371(16):1496-1507,Advance of Critical Care in 2014-2015,EGDT (Early-Goal Directed Therapy),The ARISE investigators and the ANZICS clinics trail groups.N Engl J Med ,2014,371(16):1496-1507,Advance of Critical Care in 2014-2015,EGDT (Early-Goal Directed Therapy),http:/www.survivingsepsi
15、s.org/About-SSC/Pages/default.aspx,Advance of Critical Care in 2014-2015,EGDT (Early-Goal Directed Therapy),http:/www.survivingsepsis.org/SiteCollectionDocuments/SSC_Bundle.pdf,Advance of Critical Care in 2014-2015,EGDT (Early-Goal Directed Therapy),http:/www.survivingsepsis.org/SiteCollectionDocuments/SSC_Bundle.pdf,Advance of Critical Care in 2014-2015,Sepsis and Albumin,Caironi et al. N Engl J Med.2014,370(15):1412-1421,Advance of Critical Care in 2014-2015,Sepsis and Albumin,Caironi et al. N Engl J Med.2014,370(15):1412-1421,
