The European Society of Intensive Care Medicine (ESICM) issued the second consensus on the assessment of sublingual microcirculation in critically ill patients. This paper interprets the consensus for clinicians about: what is microcirculation, how to observe microcirculation, and the details of microcirculation images collection and parameters analysis. Besides, this paper illustrates the relationship between microcirculation alternation and shock, it also evaluates the present situation and future development of microcirculation monitoring.

Sudden cardiac arrest survivors are a special group of patients, often with unique and complex needs that are not adequately addressed by current treatments. In May 2020, the American Heart Association (AHA) developed a scientific statement on sudden cardiac arrest survivorship based on relevant research developments, which emphasized the importance of a unified patient-centered assessment and resources. This article attempts to interpret the key content of the scientific statement, hoping to provide reference and help for domestic medical staff to understand and apply it.

To investigate the association between red blood cell volume distribution width (RDW) and osteophytes.
 Methods: This cross-sectional study was conducted in the Department of Health Examination Center of Xiangya Hospital, Central South University in Changsha, Hunan Province, China. A total of 8 334 subjects were included in this study. The severity of osteophytes was graded using the criteria of the Osteoarthritis Research Society International (OARSI). Osteophytes incident was defined as at least one side of the knee had a osteophytes grade ≥1. According to the quartiles of the RDW level, the subjects were divided into 4 groups. Multivariate logistic regression analysis was used to calculate the odds ratio (OR) and the 95% confidence interval (CI) of the knee osteophytes incidence between each RDW group and the lowest level group. Tests for linear trends were conducted based on logistic regression using a median variable of RDW level in each category.
 Results: Quartile 1 (Q1), RDW≤9.78; Q2, 9.7813.10. The multivariable adjusted ORs (95%CI) of the prevalence of osteophytes were 1.38 (1.06 to 1.79) in the second percentile interval, and 1.27 (0.97 to 1.66) and 1.50 (1.15 to 1.94) in the third and fourth percentile interval, respectively. Test for linear trends suggested that there was a positive association between the RDW level and the risk of knee osteophytes incidence (P=0.019).
 Conclusion: The risk of osteophytes incidence increases with the increasing RDW levels.
China ; Confidence Intervals ; Cross-Sectional Studies ; Erythrocyte Volume ; Humans ; Incidence ; Odds Ratio ; Osteophyte ; blood ; epidemiology ; Risk Factors ; Severity of Illness Index

Objective: To evaluate the left ventricular systolic synchrony and investigate the early diagnostic value of left ventricular systolic dyssynchrony on cardiotoxicity caused by anthracyclines in patients with diffuse large B-cell lymphoma (DLBCL). Methods: Thirty-two patients (22 males, 10 females, age: 22-73(54.4±14.2) years) from June 2016 to January 2019 with confirmed DLBCL and normal gated myocardial perfusion imaging (GMPI) before anthracyclines chemotherapy were enrolled prospectively. GMPI was performed after 6 cycles or more of chemotherapy. Changes of myocardial markers, electrocardiogram (ECG) indicators, left ventricular function indicators including left ventricular ejection fraction (LVEF), left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV), peak filling rate (PFR), summed motion score (SMS) and summed thickening score (STS) as well as left ventricular systolic synchrony indicators including phase bandwidth (BW), phase standard deviation (SD) and entropy before and after anthracyclines chemotherapy were analyzed. Paired t test, Wilcoxon signed rank test and χ² test were used for data analysis. Results: Compared with pre-chemotherapy, the left ventricular systolic synchrony indicators were significantly higher than those before chemotherapy (BW: (42.81±11.37)° vs (29.28±8.68)°; SD: (11.65±4.64)° vs (8.79±3.14)°; entropy: (39.84±5.51)% vs (36.19±5.94)%; t values: -9.132 to -3.173, all P<0.05). There were no significant differences in other indicators (t values: -1.161 to 1.750, z values: -1.633 to -0.096, all P>0.05). Of 32 patients, 13 patients (40.62%) had left ventricular systolic dyssynchrony, and the rate of chemotherapy-induced left ventricular systolic dyssynchrony was significantly higher than that of left ventricular dysfunction (15.62%, 5/32; χ²=4.947, P=0.025). All 5 patients with left ventricular dysfunction caused by chemotherapy had left ventricular systolic dyssynchrony. The LVEF of the chemotherapy-induced left ventricular systolic dyssynchrony group was significantly lower than that of the left ventricular systolic synchronization group ((54.54±9.25)% vs (66.79±7.65)%; t=4.087, P<0.01). Conclusion Left ventricular systolic dyssynchrony can be appeared in DLBCL patients after chemotherapy and is significantly earlier than left ventricular dysfunction, which can be an early indicator of cardiotoxicity caused by anthracycline chemotherapy.