Xue-zhong Xing

Chinese Academy of Medical Sciences & Peking Union Medical College

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Chulin Huang

Chinese Academy of Medical Sciences & Peking Union Medical College

Shi-ning Qu

Chinese Academy of Medical Sciences & Peking Union Medical College

Haijun Wang

Peking University

Zhennan Yuan

Chinese Academy of Medical Sciences & Peking Union Medical College

Yong Gao

Guangzhou University of Chinese Medicine

Kelin Sun

Institute of Deep-Sea Science and Engineering

Quan-hui Yang

Chinese Academy of Medical Sciences & Peking Union Medical College

Hao Wang

Qilu Hospital of Shandong University

Hao Zhang

NYU Langone Health

Hao Zhang

Taian City Central Hospital

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Chinese Academy of Medical Sciences & Peking Union Medical College

Capital Medical University

Peking Union Medical College Hospital

Shanghai Jiao Tong University

Sun Yat-sen University

Zhejiang University

Chinese Academy of Sciences

Peking University

Central South University

National Clinical Research

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Combining Therapy of Octreotide and Glucocorticoid in the Treatment of a Lung Adenocarcinoma Patient with Acute Respiratory Distress Syndrome

Journal of Translational Critical Care Medicine (2019)

Xue-zhong Xing Hai‐Jun Wang Shi-ning Qu Chulin Huang

A 63-year-old male who was diagnosed with adenocarcinoma of the right lower lobe presented with 1 week of fever, cough, and progressive dyspnea and admitted to the Intensive Care Unit (ICU). After intubation, physical examination revealed copious, light bloody sputum and diffuse crackles and rales on lung auscultation. The patient was diagnosed as Stage IV adenocarcinoma, septic shock (lung infection), and acute respiratory distress syndrome. His oxygenation failed to improve despite sedation, restrictive fluid therapy, and methylprednisolone, antimicrobials therapy, protective ventilation, plasma supplement, and anticoagulation. Respiratory secretions suctioned from her endotracheal tube averaged 1.0 L daily. On day 2 after admission, octreotide was infused to control sputum volume. The patient's respiratory secretions decreased significantly, and on day 8, the ventilator mode was changed to pressure support ventilation, and the patient was extubated and dismissed from ICU.

Crackles

10.4103/jtccm.jtccm_8_18

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Prognosis of patients with shock receiving vasopressors

World Journal of Emergency Medicine (2013)

Xue-zhong Xing Haijun Wang Chulin Huang Quan-hui Yang Shi-ning Qu

Consensus guidelines suggested that both dopamine and norepinephrine may be used, but specific doses are not recommended. The aim of this study is to determine the predictive role of vasopressors in patients with shock in intensive care unit.One hundred and twenty-two patients, who had received vasopressors for 1 hour or more in intensive care unit (ICU) between October 2008 and October 2011, were included. There were 85 men and 37 women, with a median age of 65 years (55-73 years). Their clinical data were retrospectively collected and analyzed.The median simplified acute physiological score 3 (SAPS 3) was 50 (42-55). Multivariate analysis showed that septic shock (P=0.018, relative risk: 4.094; 95% confidential interval: 1.274-13.156), SAPS 3 score at ICU admission (P=0.028, relative risk: 1.079; 95% confidential interval: 1.008-1.155), and norepinephrine administration (P<0.001, relative risk: 9.353; 95% confidential interval: 2.667-32.807) were independent predictors of ICU death. Receiver operating characteristic curve analysis demonstrated that administration of norepinephrine ≥0.7 μg/kg per minute resulted in a sensitivity of 75.9% and a specificity of 90.3% for the likelihood of ICU death. In patients who received norepinephrine ≥0.7 μg/kg per minute there was more ICU death (71.4% vs. 44.8%) and in-hospital death (76.2% vs. 48.3%) than in those who received norepinephrine <0.7 μg/kg per minute. These patients had also a decreased 510-day survival rate compared with those who received norepinephrine <0.7 μg/kg per minute (19.2% vs. 64.2%).Septic shock, SAPS 3 score at ICU admission, and norepinephrine administration were independent predictors of ICU death for patients with shock. Patients who received norepinephrine ≥0.7 μg/kg per minute had an increased ICU mortality, an increased in-hospital mortality, and a decreased 510-day survival rate.

SAPS II

10.5847/wjem.j.issn.1920-8642.2013.01.011

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Expert Consensus on Acute Respiratory Failure in Critically Ill Cancer Patients (2023)

Chinese Medical Sciences Journal (2019)

Hai‐Jun Wang Wei Chen Hongzhi Wang Heling Zhao Donghao Wang

Objective This consensus aims to provide evidence-based recommendations on common questions in the diagnosis and treatment of acute respiratory failure (ARF) for critically ill cancer patients.Methods We developed six clinical questions using the PICO (Population, Intervention, Comparison, and Outcome) principle in diagnosis and treatment for critical ill cancer patients with ARF. Based on literature searching and meta-analyses, recommendations were devised. The GRADE (Grading of Recommendation Assessment, Development and Evaluation) method was applied to each question to reach consensus in the expert panel. Results The panel makes strong recommendations in favor of (1) metagenomic next-generation sequencing (mNGS) tests may aid clinicians in rapid diagnosis in critically ill cancer patients suspected of pulmonary infections; (2) extracorporeal membrane oxygenation (ECMO) therapy should not be used as a routine rescue therapy for acute respiratory distress syndrome in critically ill cancer patients but may benefit highly selected patients after multi-disciplinary consultations; (3) cancer patients who have received immune checkpoint inhibitor therapy have an increased incidence of pneumonitis compared with standard chemotherapy; (4) critically ill cancer patients who are on invasive mechanical ventilation and estimated to be extubated after 14 days may benefit from early tracheotomy; and (5) high-flow nasal oxygen and noninvasive ventilation therapy can be used as a first-line oxygen strategy for critically ill cancer patients with ARFs. A weak recommendation is: (6) for critically ill cancer patients with ARF caused by tumor compression, urgent chemotherapy may be considered as a rescue therapy only in patients determined to be potentially sensitive to the anticancer therapy after multidisciplinary consultations. Conclusions The recommendations based on the available evidence can guide diagnosis and treatment in critically ill cancer patients with acute respiratory failure and improve outcomes.

10.24920/004203

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Effects of carrimycin on biomarkers of inflammation and immune function in tumor patients with sepsis: A multicenter double-blind randomized controlled trial

Pharmacological Research (2023)

Chuanchuan Nan Xiaowu Zhang Wei Huang Biao Zhu Jianghong Zhao

Carrimycin is a potential immune-regulating agent for sepsis in patients with tumors. In this study, we investigated its effects on inflammation and immune function in tumor patients with sepsis. In total, 120 participants were randomized to receive either carrimycin treatment (400 mg/day) (n = 62) or placebo (n = 58) for 7 days. The primary outcomes were immune-related indicators. Subsequently, patients were stratified into two subgroups (CD4 < 38.25% and CD8 < 25.195%). Ninety-nine participants were analyzed: 47 and 52 in the carrimycin and placebo groups, respectively. HLA-DR levels were rapidly increased in the carrimycin group; however, the placebo group initially experienced a decline in HLA-DR level at 1 day after administration. In the subgroup with CD4 < 38.25%, the carrimycin group exhibited significantly higher HLA-DR levels than the placebo group (2.270, P = 0.023) 1 day after administration and the degree of increase in HLA-DR in the carrimycin group was higher than that in the placebo group (2.057, P = 0.040). In the CD8 < 25.195% subgroup, the carrimycin group demonstrated significantly higher levels of CD8+ T cells than the placebo group at 3 (2.300,P = 0.027) and 5 (2.106, P = 0.035) days after administration. Carrimycin intervention led to significant reductions in the SOFA, APACHE II, PCT, and CRP levels. No adverse events were observed. In tumor patients with sepsis, particularly in those experiencing immunological suppression, carrimycin effectively regulates immune responses by increasing HLA-DR and CD8+ T cell levels and plays an anti-infective role, reducing disease severity. (Chictr.org.cn, ID Number: ChiCTR2000032339).

10.1016/j.phrs.2023.106991

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Two acute kidney injury risk scores for critically ill cancer patients undergoing non-cardiac surgery

World Journal of Emergency Medicine (2012)

Xue-zhong Xing Haijun Wang Chulin Huang Quan-hui Yang Shi-ning Qu

BACKGROUND: Several risk scoures have been used in predicting acute kidney injury (AKI) of patients undergoing general or specifi c operations such as cardiac surgery.This study aimed to evaluate the use of two AKI risk scores in patients who underwent non-cardiac surgery but required intensive care. METHODS:The clinical data of patients who had been admitted to ICU during the fi rst 24 hours of ICU stay between September 2009 and August 2010 at the Cancer Institute, Chinese Academy of Medical Sciences & Peking Union Medical College were retrospectively collected and analyzed.AKI was diagnosed based on the acute kidney injury network (AKIN) criteria.Two AKI risk scores were calculated: Kheterpal and Abelha factors.

10.5847/wjem.j.issn.1920-8642.2012.04.007

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Performance of two prediction scores in predicting postoperative morbidities after colorectal surgery

Chin J Colorec Dis (Electronic Edition) (2020)

Xue-zhong Xing Haijun Wang Shi-ning Qu Chulin Huang Hao Wang

Objective To investigate the value of two prediction scores in predicting postoperative morbidities after colorectal surgery. Methods Data of patients who underwent colorectal surgery between September 2017 and September 2018 were retrospectively collected and reviewed. There were 177 patients in total. Surgical Apgar Score (SAS) and colorectal physiological and operative severity score for the enumeration of mortality and morbidity(CR-POSSUM) were calculated for each patient. Patients were grouped as morbidity group and normal group. And patients were grouped as major complication group and no or minor complication group. Major complication was defined as complications grade 3 and upper according to the definition of Clavien-Dindo grading. Results Univariable analysis demonstrated that neither SAS nor CR-POSSUM was predictive of the occurrence of major complication. And Univariable analysis demonstrated that only SAS was predictive of the occurrence of postoperative complication (χ2=6.127, P=0.013), while CR-POSSUM was not. Receiver operation curve (ROC) demonstrated that area under the curve of intraoperative SAS in predicting the occurrence of complication after colorectal surgery was 0.605±0.043 (95% CI: 0.521~0.689, P=0.017). Sensitivity and specificity of SAS was 58.8% and 60.0% respectively in predicting the occurrence of complication when the cutoff was set as 9. Conclusion Intraoperative Surgical Apgar Score was predictive of the occurrence of complication after colorectal surgery with moderate discrimination. It should be in combination with other prediction tools. Key words: Colorectal neoplasms; Surgery; Complication; Prediction scores

Colorectal Surgery

Grading (engineering)

10.3877/cma.j.issn.2095-3224.2020.01.006

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Correlation of fluid balance and postoperative pulmonary complications in patients after esophagectomy for cancer.

PubMed (2015)

Xue-zhong Xing Yong Gao Haijun Wang Shi-ning Qu Chulin Huang

To investigate the association between fluid balance and postoperative pulmonary complications in patients after esophagectomy for cancer in a high volume cancer center.Data of patients who admitted to intensive care unit (ICU) after esophagectomy at Cancer Hospital of Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC) between September 2008 and October 2010 were retrospectively collected and reviewed.There were 85 males and 15 females. Among them, 39 patients developed postoperative pulmonary complications and hospital death was observed in 3 patients (3.0%). Univariable analysis showed that patients who developed postoperative pulmonary complications had more cumulative fluid balance in day 1 to 2 (2,669±1,315 vs. 3,815±1,353 mL, P<0.001; and 4,307±1,627 vs. 5,397±2,040 mL, P=0.014, respectively) compared with patients who did not have postoperative pulmonary complications. Multivariable regression analysis demonstrated that only more cumulative fluid balance in day 1 (P=0.008; OR =1.001; 95% CI, 1.000-1.002) was independent risk factor for postoperative pulmonary complications.Positive fluid balance in postoperative day 1 is predictive of pulmonary complications in patients after esophagectomy for cancer.

Esophagectomy

10.3978/j.issn.2072-1439.2015.11.24

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