Acid–BaseDisordersintheICU

NEPHROLOGY-CASE REPORTCentral pontine and extrapontine myelinolysis secondary to fast correction of severe hyponatremia and hypokalemia in an alcoholic patientAhmad Ghaith Tarakji•Ahmad Raed Tarakji•Uzma ShaheenReceived:2May2011/Accepted:4November2012ÓSpringer Science+Business Media Dordrecht2012ObjectiveTo confirm the importance of slow correction of serum sodium and potassium by describing a case of a woman with chronic alcoholism and malnutrition who developed central pontine and extrapontine myelinol-ysis(CPM)after fast correction of severe hyponatre-mia and hypokalemia.Case reportA59-year-old white alcoholic female was transferred to ER by ambulance at04:52 a.m.for lethargy, disorientation,weakness,falls,and headache for few days.She was only drinking alcohol for few days but not eating.She had history of hypertension,and she was taking Lorazepam2mg thrice daily,Ramipril 2.5mg once daily and Hydrochlorothiazide12.5mg once daily.Her initial vital signs by paramedics revealed BP of124/56mmHg,pulse of75bpm,and temperature of36.7°C.Her weight was60kg,and her height was161cm.Her Glasgow Coma Scale was13/15.On examination,the patient was con-fused,only oriented to place and had slurred speech and multiple bruises of different ages.Her pupils were5mm,equal and reactive to light.No other significantfindings were found.Initial laboratory results are shown in Table1.Intravenousfluids were started asfirst line of1L of Normal Saline with40mEq of KCl at100mL/h and second line of250mL of Normal Saline with40mEq of KCl at50mL/h.Head CT scan was negative for acute hemorrhage,infarct,or edema.Thiamine 100mg IVP was given,and third IV line was then initiated with1L of Saline with40mEq of KCl at 100mL/h.Her blood pressure suddenly dropped to 82/44mmHg,so a bolus of Normal Saline500mL was given,and her blood pressure improved to 152/87mmHg within15min.She was transferred to ICU where she additionally received IV magnesium sulfate,oral potassium chloride,and oral sodium phosphate replacements.Serial blood chemistry tests were done,and IVfluid types and rates were adjusted accordingly.During thefirst day,she excreted a large amount of diluted urine which could be secondary to a quick decrease in serum vasopressin level when herA.G.TarakjiAleppo University,Aleppo,SyriaA.R.TarakjiDepartment of Medicine,Yarmouth Regional Hospital, Yarmouth,NS,CanadaA.R.Tarakji(&)Nephrology and Hypertension Maritime Clinic, Yarmouth Regional Hospital,60Vancouver Street, Suite405,Yarmouth,NS B5A2P5,Canadae-mail:dartmo@U.ShaheenDepartment of Diagnostic Imaging,Yarmouth Regional Hospital,Yarmouth,NS,Canada DOI10.1007/s11255-012-0329-3volume status had improved(Table2).Therefore,her serum sodium and potassium were corrected so fast over the next48h as in Fig.1.However,her serum phosphorus was corrected slowly over the next5days (Day2:0.18(nadir),Day3:0.35,Day4:0.76,and Day 5:1.20mmol/L).Over the next3days,she had improved with no alcohol withdrawal symptoms but she was still weak requiring physiotherapy.On8th hospital day,she started with slurred speech again with difficulty swallowing and drooling.MRI study of the brain was ordered,and thefindings were consistent with CPM as in Fig.2.She received continuous rehabili-tation and supportive care by interdisciplinary team with slow recovery and improvement.A repeat MRI study of the brain after3months showed a degree of improvement of the CPMfindings,and she was eventually discharged home after5months. DiscussionOur case is a typical one for CPM in an alcoholic mp and Yazdi[1]found that chronic alcoholism and correction of hyponatremia are com-mon with an incidence of39.4and21.5%,respec-tively,in442documented cases of CPM between1986 and2001.The literature suggests that‘‘increases of10–12mEq/L within24h and increases ofTable1Blood and urine tests resultsBloodTest(normal range)Result Test(normal range)ResultNa?(136–145mmol/L)100INR(0.8–1.3)0.9 K?(3.6–5.2mmol/L) 1.7CPK(21–215U/L)3,895 Cl-(98–107mmol/L)57Alb(35–47g/L)38 Total CO2(21–32mmol/L)29Etoh(0.0–0.0mmol/L)0.4 Urea(3.0–7.9mmol/L) 3.7TSH(0.465–4.680mIU/L)0.448 Creatinine(53–115l mol/L)40FT4(10.0–28.2pmol/L)14.4 Random glucose(3.9–6.0mmol/L) 5.2Osmolality(266–298mmol/Kg)200 Mg(0.74–0.99mmol/L)0.69Phos(0.81–1.58mmol/L)0.36 Ca(2.10–2.70mmol/L) 2.08Arterial blood gasPH(7.35–7.45)7.57PO2(83–108mmHg)63.5 PCO2(32–45mmHg)35.3O2sat(95.0–99.0%)95% Lactate(0.5–1.6mmol/L)0.8FIO2RA Urine(random sample)Specific gravity(\1.005–1.025) 1.015Osmolality(50–1,400mmol/Kg)416 PH(5–8.5) 6.5Na?(mmol/L)15 Protein(\0.1g/L)0.3K?(mmol/L)27 Glucose(\5.5mmol/L)Neg Cl-(mmol/L)64 Ketones(\0.5mmol/L) 3.9Urea(mmol/L)226Abnormal values in italicizedTable2Fluid balance in thefirst two days1st Day2nd DayTotalfluid intake5,010mL3,503mLPO850mL1,100mLIV NS?40mEq KCl/L2,329mL1,422mLIV NS?40mEq KCl/L590mL–IV NS?40mEq KCl/250mL250mL–IV D5W991mL981mLTotalfluid output4,830mL2,600mLAverage blood pressure111/64117/7318–25mEq/L within48h are sufficient to cause this syndrome’’[2]as happened with our patient.Recently,it has been recognized that correction of hypokalemia is similarly important as discussed by Berl and Rastegar[3]in their teaching case.Because sodium is mainly an extracellular cation and potas-sium is mainly an intracellular cation,loss of either one of these cations without water loss can lead to hypoosmolality.So,replacing serum potassium can play a significant role in correcting serum sodium as they showed with their calculation.Therefore,they recommended to modify the above rule as‘‘in chronic hyponatremia(duration[48h),the increase in serum sodium plus potassium levels should not exceed 12mEq/L in thefirst24h and18mEq/L in thefirst 48h’’[3].Even though that our patient had initially received Normal Saline(0.9%),instead of3%saline,then almost1L of5%dextrose in water(D5W) (Table2),her serum sodium was corrected quickly partially due to large urine output in thefirst day (almost5L).Unfortunately,repeated urine electro-lytes and osmolality measurements were not done serially to guide herfluid administration.However, she was not given Desmopressin as was recom-mended by Sterns and Hix[4].They stressed that ‘‘fear of osmotic demyelination does not justify therapeutic inaction(and)fear of complications from hyponatremic encephalopathy does not justify ther-apeutic excess’’[4].Our case is a good example of their strong recommendation that‘‘overcorrection of hyponatremia should be viewed as a medical emer-gency’’[4]since there is some animal evidence that intervening might decrease mortality[5].Furthermore,although it was corrected slowly in our case,severe hypophosphatemia probably contrib-uted to the development of CPM as suggested from cases report of CPM associated with isolated severely low serum phosphorus[6].Pontine myelinolysis usually affects corticobulbar fibers and corticospinal tracts causing dysarthria, dysphagia,andflaccid quadraparesis.Extrapontine involvement causes tremor and ataxia and can lead to movement disorders[7].It was reported that the initial lesions and the duration of these lesions on MRI do not correlate with severity of clinicalfindings or their improvement and the survival depends on the second-ary complications of this disease[8].ConclusionThis case is typical for central pontine and extrapon-tine myelinolysis secondary to rapid correction of serum sodium,potassium,and osmolality.Extreme caution with vigilance in correcting these serumcations together as suggested above is strongly recommended to avoid this disastrous,and sometimes fatal [9],complication.Conflict of interest The authors declare that they have no conflict of interest.Referencesmp C,Yazdi K (2002)Central pontine myelinolysis.Eur Neurol 47:3–102.Palmer BF,Sterns RH (2009)Fluid,electrolytes,and acid-base disturbances.Nephrol Self Assess Progr8:117–121Fig.2Head MRI.a Axial T2image shows central pontine hyperintensity with relative sparing ofcorticospinal tracts.b This lesion is hypointense on Sagittal T1-weighted image.c ,d On DWI axial images,restricted diffusion is noted at the periphery of this lesion and at the posterior and lateral aspects of thalami while the central part of this lesion is isointense on DWI sequence.e ,f No thalamic abnormality is present on FLAIR or T2-weighted sequences.This signifies that the central portion of this lesion has run a chronic course while the peripheral portion and thalamic components are acute3.Berl T,Rastegar A(2010)A patient with severe hyponatre-mia and hypokalemia:osmotic demyelination following potassium repletion.Am J Kid Dis55(4):742–7484.Sterns RH,Hix JK(2009)Overcorrection of hyponatremia isa medical emergency.Kidney Int76(6):587–5895.Gankam Kengne F,Soupart A,Pochet R,Brion JP,Decaux G(2009)Re-induction of hyponatremia after rapid overcor-rection of hyponatremia reduces mortality in rats.Kidney Int 76(6):614–6216.Michell AW,Burn DJ,Reading PJ(2003)Central pontinemyelinolysis temporally related to hypophosphataemia.J Neurol Neurosurg Psychiatry74:820–8267.Abbott R,Silber E,Felber J,Ekpo E(2005)Osmotic demy-elination syndrome.BMJ331:829–8308.Menger H,Jorg J(1999)Outcome of central pontine andextrapontine myelinolysis.J Neurol246:700–7059.Martin RJ(2004)Central pontine and extrapontine myeli-nolysis:the osmotic demyelination syndromes.J Neurol Neurosurg Psychiatry75(Suppl III):iii22–iii28。

.综述.氨基酸代谢与肾脏疾病王佳佳（综述）鲍华英（审校）南京医科大学附属儿童医院肾内科210008通信作者：鲍华英，Email:baohy67@【摘要】氨基酸是所有生物活细胞和生物体所必需的生物活性物质,其水平受到严格控制，肾脏在氨基酸代谢中发挥重要作用，包括氨基酸的合成、转运、排泄及重吸收等,其中任何一个环节出现问题都会导致体内氨基酸水平异常。

氨基酸代谢异常可作为某些肾脏疾病的特征性改变，对疾病的早期诊断具有重要意义。

该文就氨基酸代谢与肾脏的关系及氨基酸代谢在肾脏疾病中的作用进行综述。

【关键词】氨基酸；氨基酸代谢；肾脏疾病DOI：10.3760/cma.j.issn.1673-4408.2020.12.012Amino acid metabolism in kidney diseasesWang Jiajia,Bao HuayingDepartment of Nephrology,Children's Hospital of Nanjing Medical University,Nanjing210008,ChinaCorresponding author-Bao Huaying,Email：baohy67@hotmaiL com[Abstract]Amino acid is a necessary for all living cells and organisms,and its level is in a state ofstrict regulation.The kidney plays an important role in amino acid metabolism,including amino acid synthesis,transport,excretion,and reabsorption.Dysfunction in any of these stages will cause abnormal amino acid lev・els in the body.Abnormal amino acid metabolism can be used as a characteristic change of certain kidney disea­ses,which is of great significance to the early diagnosis of the diseases.This review describes the correlationbetween amino acid metabolism and kidney as well as the role of amino acid metabolism in kidney diseases.[Key words】Amino acid；Amino acid metabolism；Kidney diseasesDOI:10.3760/cma.j.issn.1673-4408.2020.12.012氨基酸是构成人体营养所需蛋白质的基本物质，是拔酸碳原子上的氢原子被氨基取代后的化合物。

SCCMASPEN成年危重病患者营养支持治疗实施与评估指南(36)Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Adult Critically Ill Patient: Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.)成年危重病患者营养支持治疗的实施与评估指南：美国危重病医学会(SCCM)与美国肠外肠内营养学会(ASPEN)Taylor BE, McClave SA, Martindale RG, et al. Crit Care Med 2016; 44: 390-438翻译：清华大学长庚医院周华许媛F. ADJUNCTIVE THERAPY 辅助治疗Question: Should a fiber additive be used routinely in all hemodynamically stable ICU patients on standard enteral formulas? Should a soluble fiber supplement be provided as adjunctive therapy in the critically ill patient who develops diarrhea and is receiving a standardnon-fiber-containing enteral formula?问题：是否血流动力学稳定的ICU患者均需在标准肠内营养配方基础上添加纤维素？合并腹泻的重症患者，是否应在标准配方基础上添加纤维素作为辅助治疗？F1. Based on expert consensus, we suggest that a fermentable soluble fiber (e.g.,fructo-oligossaccharides [FOSs], inulin) additive be consideredfor routine use in all hemodynamically stable medical and surgical ICU patients placed on a standard enteral formulation. We suggest that 10–20 grams of a fermentable soluble fiber supplement be given in divided doses over 24 hours as adjunctive therapy if there is evidence of diarrhea.根据专家共识，建议血流动力学稳定的内科与外科ICU患者，可考虑添加发酵性可溶性纤维（如低聚果糖[FOSs], 菊粉）。

《中外医学研究》第17卷 第18期（总第422期）2019年6月 现代护理 Xiandaihuli*基金项目：福州市临床重点专科经费资助项目(项目编号：201710271)①福州神经精神病防治院　福建　福州　350008个案护理在双相情感障碍出院患者中的应用分析*林吓妹①　商丽虹①【摘要】　目的：分析双相情感障碍出院患者应用个案护理的效果。

方法：随机抽取82例2017年3月-2018年8月在笔者所在医院接受双相情感障碍治疗的患者，按照随机抽签法将其分为对照组(n =41)和研究组(n =41)。

两组患者出院前均给予饮食指导等常规护理，定期进行随访，同时为研究组患者提供个案护理。

比较两组生活质量及自护能力。

结果：护理后研究组健康知识水平、自护责任感等自护能力评分均明显高于对照组，差异有统计学意义(P <0.05)。

护理后研究组患者营养状况、压力调节、人际关系等生活质量评分均明显高于对照组，差异有统计学意义(P <0.05)。

结论：双相情感障碍出院患者应用个案护理有利于提高自护能力及生活质量。

【关键词】　个案护理；　双相情感障碍；　出院患者；　应用效果 doi：10.14033/ki.cfmr.2019.18.046文献标识码　B文章编号　1674-6805(2019)18-0111-02 Application of Case Nursing in Discharged Patients with Bipolar Disorder/LIN Xiamei，SHANG Lihong.//Chinese and Foreign Medical Research，2019，17(18)：111-112 【Abstract】　Objective：To analyze the effect of case nursing in discharged patients with bipolar disorder.Method：A total of 82 patients who underwent bipolar disorder treatment in our hospital from March 2017 to August 2018 were randomly selected.They were randomly divided into the control group(n =41) and the study group(n =41).The patients in both groups received routine nursing such as diet guidance before discharge，followed up regularly，and provided case nursing for the study group.The quality of life and self-care ability were compared between the two groups.Result：After nursing，the scores of self-care ability such as health knowledge level and self-care responsibility of the study group were significantly higher than those of the control group，the differences were statistically significant(P <0.05).After nursing，the life quality scores such as nutritional status，stress regulation，interpersonal relationship of the study group were significantly higher than those of the control group，the differences were statistically significant(P <0.05).Conclusion：The application of case nursing in discharged patients with bipolar disorder is beneficial to improve their self-care ability and quality of life. 【Key words】　Case nursing；　Bipolar disorder；　Discharged patients；　Application effect First-author ’s address：Fuzhou Neuropsychological Hospital，Fuzhou 350008，China 作为临床常见慢性精神性疾病，双相情感障碍包括抑郁发作和躁狂发作，该病具有反复发作、自杀率及自残率高等特点，患者需要长期接受治疗以控制病情进展并改善其身心健康[1]。

医学博士英语试题及答案一、选择题（每题2分，共20分）1. Which of the following is the most common cause of death in patients with heart failure?A. Heart attackB. Kidney failureC. Respiratory failureD. Sepsis答案：C2. The primary function of the liver is to:A. Produce bileB. Regulate blood sugar levelsC. Filter bloodD. Produce hormones答案：A3. In medical terminology, "icterus" refers to:A. JaundiceB. HematuriaC. DyspneaD. Edema答案：A4. The term "neuropathy" is most closely associated withwhich system of the body?A. Musculoskeletal systemB. Nervous systemC. Cardiovascular systemD. Respiratory system答案：B5. Which of the following is a risk factor for developing diabetes?A. High blood pressureB. Family history of diabetesC. Both A and BD. Neither A nor B答案：C6. The abbreviation "MRI" stands for:A. Magnetic Resonance ImagingB. Myocardial Reperfusion ImagingC. Metabolic Rate ImagingD. Mitochondrial Respiratory Index答案：A7. A patient with a diagnosis of "pneumonia" is most likely to exhibit which symptom?A. CoughB. DiarrheaC. RashD. Headache答案：A8. The "HIV" in medical terminology stands for:A. Human Immunodeficiency VirusB. Hepatitis Infection VirusC. Hemophiliac Infection VirusD. Hypertension Infection Virus答案：A9. Which of the following is a type of cancer that originates in the blood?A. LeukemiaB. MelanomaC. Lung cancerD. Breast cancer答案：A10. The "ICU" in a hospital setting refers to:A. Intensive Care UnitB. Inpatient Care UnitC. Imaging Control UnitD. Infection Control Unit答案：A二、填空题（每题2分，共20分）1. The medical term for inflammation of the heart muscle is ________.答案：cardiomyopathy2. A(n) ________ is a medical professional who specializes in the diagnosis and treatment of diseases of the ear, nose, and throat.答案：otolaryngologist3. The process of removing waste products from the body is known as ________.答案：excretion4. A(n) ________ is a type of cancer that originates in the prostate gland.答案：prostate cancer5. The abbreviation "CT" stands for ________.答案：computed tomography6. A patient with a diagnosis of ________ is experiencing difficulty in breathing.答案：asthma7. The medical term for the surgical removal of the appendix is ________.答案：appendectomy8. A(n) ________ is a medical condition characterized by high blood pressure.答案：hypertension9. The abbreviation "MRI" stands for ________.答案：magnetic resonance imaging10. The term "diabetes" refers to a group of metabolic diseases characterized by high blood ________ levels.答案：glucose三、简答题（每题10分，共20分）1. Explain the difference between a "benign" tumor and a "malignant" tumor.答案：A benign tumor is a growth that does not invade nearby tissue or spread to other parts of the body. It is generally not life-threatening and can often be removed surgically. In contrast, a malignant tumor is cancerous, meaning it can invade and destroy surrounding tissues and spread to other parts of the body through the blood and lymph systems, posing a significant health risk.2. What is the role of the spleen in the human body?答案：The spleen is an important organ in the immune system, primarily responsible for filtering blood and removing damaged cells and bacteria. It also plays a role in the production of white blood cells and the storage of platelets and red blood cells. Additionally, the spleen helps in the recycling of iron from old red blood cells.四、论述题（每题15分，共30分）1. Discuss the importance of a balanced diet in maintaining good health.答案：A balanced diet is crucial for maintaining good health as it provides the body with the necessary nutrients, vitamins, and minerals required for optimal functioning. Ithelps in maintaining a healthy weight, supports the immune system, promotes proper growth and development, and reduces the risk of chronic diseases such as heart disease, diabetes, and certain types of cancer. A balanced diet typically includes a variety of fruits, vegetables, whole grains, lean proteins, and healthy fats, while。

Intensive careIntensive care, also known as severe strengthen intensive care unit treatment ward (ICU), is severe, the clinical medical science for base, with its various causes of one or more organs and system function obstacle life-threatening or potentially high-risk factors patients, provide timely system, high quality medical monitoring and treatment technology, is the hospital centralized monitoring and treatment of professional department critically ill patients.ICU application of advanced diagnosis, monitoring and treatment equipment and technology, continuous and dynamic of the illness of the qualitative and quantitative observation, and through effective intervention measures for critically ill patients, provide standard, high quality life support, improve the quality of life. In severe cases life support technical level directly reflects the hospital comprehensive treatment ability, reflect the whole hospital medical strength, is an important symbol of modern hospital. Popularly say, strengthen treatment ward is critically ill patient special treatment of various places. Here, critically ill patients get better care, more effective treatment.Along with the progress of the society, the improvement of living standards, people on medical service level of demand is higher and higher. With the continuous development of medical level of disease know, unceasing enhancement, always in the intensive care ward in the model with a rescue critically ill patient show a lot of shortage, so every hospital has spawned critical intensive therapy ward (intensive care, ICU).In the world in the ICU has 30 years of history, has now become hospitals in the rescue center critically ill patient. How the monitoring level ICU, equipment is advanced, has become an important measure of a hospital level logo. China started late in the ICU, starting in the early 1980s, but development soon, at present domestic 3 armour hospital are equipped with the ICU, most of the county hospital has also set level a bottom's ICU ward. The ICU and divided into comprehensive intensie care unit (ICU GICU) and specialized subject. Comprehensive ICU mainly includes surgical intensie care unit (SICU), medicine intensie care unit (MICU), emergency intensie care unit (EICU), etc. ICU college mainly includes burns intensie care unit (BICU), breathing the neonatal intensie care unit (RICU), kidney disease intensie care unit (UICU), the neonatal intensie care unit (NICU), obstetrics intensie care unit (OICU), pediatric intensiecare unit (PICU), anesthesia intensie care unit (AICU) and transplantation intensie care unit (TICU), etc. Part of big hospitals will still high, even college in the ICU comprehensive ICU tutelar ward continue subdivision, such as cardiovascular intensive care will also is divided into: coronary heart disease intensive care ward (CCU), treatment of neonatal intensive care unit (heart-lung CPICU), heart surgery intensie care unit (CSICU), neurosurgery intensive care ward (NSICU) etc, in order to depth and accurate monitoring. Severe intensive therapy in equipment and personnel ward is the common ward all have very big advantage:1, in equipment: the guardianship, rescue equipment ICU 54%personnel are generally in the most advanced, the most complete, basic configuration has the bed multi-function monitors, oxygen supply facilities, sucking phlegm facilities, breathing machine, defibrillation meter, infusion pump, cardiopulmonary resuscitation rescue equipment car (the car have laryngoscope endotracheal tube, all kinds of joints, and emergency medicine and other rescue equipment), conditional hospitals are also equipped with electrocardiogram machine, flesh analyzer, blood purification meter, continuity with oxygen metabolism hemodynamic monitoring equipment, the external pacemaker, fiberoptic bronchoscopy, electronic litres of cooling equipment, etc.;2, personnel aspects: the ICU doctors and nurses all should is specially trained, master critical care medicine elementary knowledge and the basic operation technology, able to work independently full-time medical personnel, and to have enough quantity.ICU physicians should be master of critically ill patients important organ, system function monitoring and support theory and skills, such as recovery, shock, respiratory failure, cardiac insufficiency, serious arrhythmia, acute renal insufficiency, central nervous system function obstacle, serious liver dysfunction, gastrointestinal dysfunction and gastrointestinal hemorrhage, acute blood coagulation disorders, serious endocrine and metabolic disorders, water, electrolyte and acid-base disorders, intestinal and parenteral nutrition support, calm and analgesia, serious infection, multiple organ dysfunction syndrome, immune disorders.Physicians is divided have general clinical monitoring and treatment technology outside, should have independent completed the following monitoring and support technical capacity: cardiopulmonary resuscitation, artificial airwayestablishment and management, fiberoptic bronchoscopy deep vein and artery technology, catheter technique, hemodynamic monitoring technology, chest wear, pericardiac closed drainage of technic and chest, cardioerter and heart defibrillation art, bed side temporary defibrillators technology, continuous blood purification technology, disease critical degree evaluation method, etc.Only provided all sorts of rescue equipment, to the rescue when life guarantee patients. ICU equipped with a highly qualified and experienced staff, in rescue patient can not panic, not disorderly, improve rescue success. Medical researchers have multi-disciplinary knowledge, grasps various rescue technology, this is the most powerful rescue patients guarantee of success.Acute, reversible, have life-threatening organ dysfunction, through the strict monitoring and strengthen the ICU may recover short-term treatment of patients; Existing high-risk factors, potentially dangerous life, after the ICU at closely monitoring and effective treatment may reduce the risk of death patients; In chronic organ dysfunction, appear on the basis of acute exacerbations and life-threatening, after the strict monitoring and treatment ICU may be restored to the original state of patients; Chronic depleting diseases terminal state, irreversible illness and not from the ICU care treatment of patients, benefit is generally not the scope of ICU retrospectively. Popularly say, no matter what kind of disease with the patient, as long as a patient's life signs appeared apparently unusual, or appeared likely some viscera function obstacle recovery, or the patients have the potential life-threatening factors all can ICU admission.One of the ICU ward is hospital ward, the hospital clinical all need to abide by all rules, but also have a few different place with ordinary ward.1, ICU equipped with adequate medical personnel, for patient implement superfine (24 hours intensive care, including life care), don't need (also not allow) family chaperone. Family through the camera monitoring device interact with patients or stipulated in time for visiting;2, the ICU is seriously check-in, resistance are poorer, prone to secondary infection, so ward in the air disinfection. If the patient and family members in ICU or too, would increase the patient with patients, this is infection, do not allow the main cause of the patient's family accompanying;Three of the patients were in the ICU, very critical, the condition can occur at any time of change. In condition changes need to undertake specialrescue, when doctors shall have the right to some gen operation (that the family members in before), such as tracheal intubation, deep venipuncture, etc.重症监护室，又称重症加强治疗病房（intensive care unit,ICU），是重症医学学科的临床基地，它对因各种原因导致一个或多个器官与系统功能障碍危及生命或具有潜在高危因素的患者，及时提供系统的、高质量的医学监护和救治技术，是医院集中监护和救治重症患者的专业科室。