Objective:To summarize the clinical experience in the treatment of fulminant myocarditis with multiple organ dysfunction using extracorporeal life support in the ICU.Methods:Clinical data of 9 adult cases of fulminant myocarditis complicated with multiple organ dysfunction admitted in ICU from January 2019 to October 2020 were retrospectively analyzed.Results:All patients received immunoregulatory and antiviral therapy; mechanical ventilation and renal replacement treatment were performed. Extracorporeal life support was also applied, including 1 case receiving intra-aortic balloon pump (IABP) support, and 6 cases receiving IABP and venous-arterial extracorporeal membrane oxygenation (VA-ECMO). In 6 cases with ECMO, the SpO 2(100.0±0)%, ScvO 2(78.7±3.9)%, hsTnI [10.0(2.2,31.8)mg/ml], oxygenation index[437.0(326.5,450.8)], lactic acid [(1.5±0.5)mmol/L], BE(-1.1±1.9)and LVEF(53.5±12.6)% were significantly improved 5 days after treatment compared with before [(98.0±1.4)%,(61.9±4.3)%,27.1(16.6,50.0)mg/ml,159.7(70.3,190.9),(6.4±3.4)mmol/L,(-10.3±4.6),(29.0±11.1)%]( t=-3.46, -9.74; Z=-1.99, -4.89; t=3.63, -5.84, -3.33; P<0.05). Eight patients were discovered and discharged, and one patient died. Conclusion:Fulminant myocarditis develops rapidly, integrated treatment based on extracorporeal mechanical life support and immunomodulatory therapy can improve the outcome of patients in the ICU.

Objective:To investigate the incidence and risk factors of AKI in intensive care unit patients .Methods :Datum of 1443 patients admitted to Intensive Care Unit (ICU) from February 2010 to December 2012 were collected and analyzed retro-spectively .AKI patients were screened according to the clinical diagnostic criteria of AKI .The etiological diseases ,laboratory indicators ,urine output ,length of ICU stay were analyzed ,and logistic regression analysis was performed to investigate the risk factors for the prognosis of AKI .Results:AKI occurred in 98 of all patients (6 .7% ) under KDIGO-AKI criteria .Among the AKI patients ,32 cases(32 .65% ) died ,and 50 cases (51 .02% ) need renal replacement therapy .The mortality rate in-creased with AKI stage and age .According to the individual etiological disease ,48 cases (48 .98% ) were septic AKI and 50 ca-ses (51 .02% ) were non-septic AKI .Septic AKI patients had longer ICU stay and hospital stay than non-septic AKI patients(t=2 .292 ,P=0 .024 ;t=2 .083 ,P=0 .040 ,respectively )as well as higher rates of renal replacement therapy (χ2 =4 .083 ,P=0 .043) .On logistic regression ,elderly ,oliguria ,shock ,metabolic acidosis ,stage 3 of AKI ,vasopressors ,infection and need of renal replacement therapy were independent predictors of mortality in AKI .Conclusions :AKI patients have high incidence and mortality in ICU .A variety of factors are related to the prognosis of AKI .Early detection and effective therapeutic meas-ures are important to reduce the mortality of AKI patients in ICU .