2050年的重症医学：未来的ICU治疗
10月4日， 《Intensive Care Medicine》贴春联习俗在线发表了一篇有趣的短文：Intensive care medicine in 2050: the future of ICU treatments（2050年的重症医学：未来的ICU治疗），作者是Jean-Louis Vincent与Arthur S. Slutsky及Luciano Gattinoni 平抛运动实验三位最大牌的老教授。
在这篇只有10个自然段的文章中，开篇是这么说的：It’s unlikely that any of the three of us will still be around, but we can imagine how our children would describe their experience if they were admitted to the ICU in 2050. Here is what they might say:
2050年的时候我们老哥仨已不可能在了，不过我们倒是能够想象那个时候我们的孩子将如何描述他们入住ICU的体验，他们可能会这样说：...
石油大王哈默
第二自然段：“The hospital is definitely smaller than in the past with lots of ICU beds, but very few other beds. And, it looks more like a five-star hotel than a hospital, with nice shops and restaurants in the lobby—it makes you forget you’re in hospital. My ICU room is fantastic! Really spacious, with a comfortable sofa for my family who can
说的是ICU的环境如同五星酒店般宽松，室内有巨大的电子屏，可以显示包含生命体征、检验、影像等一切的信息，包括将患者与世界各地同样病况的患者进行联结，当然还有醒目的红键， 能够及时联系护士。
第三自然段：In the past, I remember the phlebotomist ud to visit regularly to take blood for various tests, but now I’ve got a percutaneous nsor that measures almost every lab test. Everything ems to be non-invasive. I remember all the tubes and lines that patients ud to have to monitor their heart rate and function—...
无创检验以及大量对呼吸、循环、微循环、代谢的传感器监测以及基于闭环监测的持续液体反应的监测系统以便于缩血管与正性肌力药物的持续滴定治疗。
微信邮箱注册第四自然段I remember lots of my dad’s patients ud to have tubes in their trachea to help them breath, but they hardly u tho anymore! I need help breathing, but just have a special helmet, which is very comfortable. In really vere, acute cas, there’s an intubating robot that can inrt an endotracheal tube already connected to the respirator, which sits out of the way in the clot! I’m also receiving extracorporeal lung/renal/metabolic support—this is an impressive system that, by passing my blood through an external system, oxygenates it and cleans it of CO2, urea, potassium, inflammatory mediators, and other products that my failing kidneys can no longer eliminate, and replaces them with a caloric mixture including specialized nutrients, all in one smooth passage.
湖心亭看雪翻译嘉应学院梅州师范分院
气管插管已经很少应用，取而代之的是特殊的头罩式（Helmet）吸氧装置，只有极少的重型病人可经机器人进行插管，插管本身已经与呼吸器连接。当然还有各种体外肺、肾、代谢支持装置...
第五、六自然段：A weird-looking machine just scanned my chest for about a minute and then showed the amazing pictures and videos of my lungs on that huge screen. ...
They do quite a lot of surgical procedures here, but there are hardly any surgeons: all surgery is done remotely with surgeons only prent in ca of exceptional technical breakdown. ...There are also fewer nurs than in the past, but they are very well trained; they follow protocols and regularly practice and rehear on simulators.
能够替代过去笨重的CT、MRI的新型3D的肺部床旁扫描...关于外科治疗，几乎均由远程手术取代，气管镜以及血管内操作也是由机器人完成。感染科医生将监测治疗规程，计算机负责抗菌药物及其剂量的选择，如愿的第一步治疗常常是针对耐药病原的疫苗接种。貌似医生和护士大量减少，不过这些家伙都是受过极佳训练的家伙——他们能依从规程、规矩行医并且常先模拟排练...(危通注：我有点搞不清楚，这种情况是否真的代表受过良好训练——ICU有排演的机会吗？)兰考县委书记
继续前行
第七自然段：You might think this all sounds a bit inhuman, but it’s not at all. Although there are fewer doctors doing procedures and interventions, the ones that are prent are much more available to talk to you, to explain, answer questions, and reassure me and my family. After all, they tell us that the word “doctor” comes from the Latin word docere that means “to teach” and that is now their primary role. In fact, one of the doctors explained to me how my treatment was specifically tailored precily for me. Somehow they match the therapies I receive to my genetic code so that I get the optimal therapy with the minimal side effects. And apparently, they have this huge databa of all the patients’ results and outcomes for the past 25 years, so that they can e if anyone el had the weird syndrome I had, and then figure out the best way to treat it. I was also happy to sign a form that all patients sign, agreeing that virtually any treatment I get will be part of a clinical trial, and that all major hospitals are linked as part of a clinical trials network. Apparently, this approach has really advanced medical care. Clinical trials that ud to take years are now done in the matter of a few weeks, and the results can be better individualized. They call this large network-bad medicine and it replaced the old evidence-bad medicine.
