Critically ill patients are at high risk for hospital acquired infections, which can significantly increase the mortality rate and treatment costs for these patients. Therefore, in the process of treating the primary disease, strict prevention and control of new hospital infections is an essential component of the treatment for critically ill patients. The treatment of critically ill patients involves multiple steps and requires a concerted effort from various aspects such as theory, management, education, standards, and supervision to achieve effective prevention and control of hospital infections. However, there is currently a lack of unified understanding and standards for hospital infection prevention and control. To address this, in March 2024, a group of experts in critical care medicine, infectious diseases, and hospital infection from China discussed the current situation and issues of hospital infection control in the intensive care unit together. Based on a review of the latest evidence-based medical evidence from both domestic and international sources, 2024 Expert Consensus on Hospital Acquired Infection Control Principles in the Department of Critical Care Medicine was formed, aiming to provide a basis for the development of hospital infection prevention and control strategies in the field of critical care medicine.

The change of organ hemodynamics in critical patients is key to the impairment of organ function. Organ perfusion pressure is the direct power to ensure organ blood flow, which is affected by inlet organ pressure (arterial pressure) and outlet organ pressure (venous pressure). Different organs have unique perfusion pressure requirements and regulation systems for blood flow adjustment to match their physiological needs. As the supply side of organ perfusion, the blood flow of organs is influenced by mean arterial pressure (MAP)and autoregulation system. Organs with different autoregulatory abilities have different requirements for MAP, so the appropriate MAP should be decided according to the autoregulation range in clinical practice. However, organ blood flow perfusion is not only determined by the supply side, but also affected by venous reflux. Changes in arteriovenous gradient across important organs affect organ blood flow perfusion. Different organs have different tolerance levels for venous reflux disorders because their distance from the heart and the specificity of the organ itself. When conducting hemodynamic intervention, physicians should pay attention to the influence of different pressure changes on organ perfusion.

An important milestone in human cognition of severe diseases began with a refined understanding of the hemodynamics of shock. After decades of development, the concept of hemodynamic therapy has become more perfect. The treatment of shock involves not only guided group therapy, but also bedside individualized strategies. The leading effect of blood flow has long been well understood, and the oxygen flux in the blood flow is the target index of hemodynamic resuscitation of shock. In this paper, we aim to further explore blood flow and blood oxygen flux, separate the influence factors of blood flow and oxygen flux, monitoring and recovery-guided treatment, and propose four subtypes based on blood flow and oxygen flux shock, with the hope of ushering in an era of more precise hemodynamic treatment for organ hemodynamic therapy.

Although the shock has long and routinely been treated, right heart and pulmonary circulation used to be the forgotten corners in clinical management. Twenty years ago, my colleagues and I published the paper Right Ventricular Function of Patients with Septic Shock: Clinical Significance and proposed the strategy of "right heart priority", in which we took right heart as a starting point, completed whole circulation pathway of blood flow clinically with hemodynamic indicators, and performed treatment based on the hemodynamic changes at real locations, degrees and responses to therapeutic interventions. Over the past 20 years, this strategy has been confirmed by many others and practiced in many hospitals worldwide. The current treatment of shock is a continuous, dynamic, target directed quantitative hemodynamic therapy and is moving from individualized treatment towards organ targeted treatment.