Microcirculation and Mitochondria: The Critical Unit

Wang, Guangjian; Lian, Hui; Zhang, Hongmin; Wang, Xiaoting

doi:10.3390/jcm12206453

Cited by 4 publications

(4 citation statements)

References 103 publications

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“…The critical unit covers the structural integrity and function of mitochondria and endothelial cells and plays an important role in critical diseases. 2 Mitochondrial fission and mitophagy can eliminate damaged mitochondria. 13 Fission 1 and Parkin are the signature proteins of mitochondrial fission and mitophagy, respectively.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, we use it as an indirect index for the critical unit. 2 Wang G and Lian H extracted the data independently and cross-checked the extracted data. Data were confirmed by Wang X and Zhang H.…”

Section: Methodsmentioning

confidence: 99%

“…On the basis of the inseparable relationship between endothelium and mitochondria and their significant impact on critical diseases, we integrated them into the “critical unit”. 2 The critical unit covers the structural and function of mitochondria and endothelium, which is also a key link in critical illness. 2 …”

Section: Introductionmentioning

confidence: 99%

“… 2 The critical unit covers the structural and function of mitochondria and endothelium, which is also a key link in critical illness. 2 …”

Section: Introductionmentioning

confidence: 99%

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A Prospective Study of the Association of IL6 with the Critical Unit and Their Effect on in-Hospital Mortality in Critically Ill Patients

Wang,

Lian,

Guo

et al. 2024

IJGM

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Purpose We previously proposed a new concept, the “critical unit”, which covers the structural integrity and function of mitochondria and endothelium. Injury of the critical unit plays a key role in the development of critical illnesses. High levels of inflammation may lead to abnormalities of the critical unit, which is an important mechanism for critical illnesses, and both inflammation and critical unit dysfunction may affect patient prognosis. Here we evaluated the correlation between interleukin-6 (IL6) and the critical unit biomarkers in critically ill patients and the impact of both on prognosis. Patients and Methods This study included adult patients admitted to the intensive care unit for various reasons from January 1st to May 31st, 2023. Baseline characteristics, intensive care unit parameters, and laboratory test and outcome data were obtained from the electronic medical records system. Critical unit parameters were measured using polymerase chain reaction and enzyme-linked immunosorbent assay methods. Correlations were examined between IL6, critical unit parameters, and various outcomes. Results In critically ill patients, IL6 was closely associated with all the critical unit biomarkers (activated partial thromboplastin time, sphingosine 1-phosphate, mitochondrial DNA, mitochondrial fission 1, and Parkin) and the prognoses of patients. A nomogram was constructed using the critical unit biomarkers to predict the in-hospital mortality of critically ill patients. The area under the curve for the mortality prediction model was 0.708. In sensitivity analyses, the predictive effect was better in the non-surgery and tumor groups compared with the surgery and non-tumor groups, with area under the curve values of 0.885 and 0.891, respectively. Conclusion Our study innovatively integrated mitochondrial and endothelial markers in the critical unit to comprehensively evaluate patient prognosis, which may be a trend in the future assessment of critically ill patients. There are few such studies, and ours may promote the progress of related research.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“… 2 The critical unit covers the structural and function of mitochondria and endothelium, which is also a key link in critical illness. 2 …”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

A Prospective Study of the Association of IL6 with the Critical Unit and Their Effect on in-Hospital Mortality in Critically Ill Patients

Wang,

Lian,

Guo

et al. 2024

IJGM

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What every intensivist should know about…Systolic arterial pressure targets in shock

Yuriditsky,

Bakker

2024

Journal of Critical Care

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Construction and validation of a clinical prediction model for sepsis using peripheral perfusion index to predict in-hospital and 28-day mortality risk

Guo,

Li,

Wang

et al. 2024

Sci Rep

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Sepsis is a clinical syndrome caused by infection, leading to organ dysfunction due to a dysregulated host response. In recent years, its high mortality rate has made it a significant cause of death and disability worldwide. The pathophysiological process of sepsis is related to the body’s dysregulated response to infection, with microcirculatory changes serving as early warning signals that guide clinical treatment. The Peripheral Perfusion Index (PI), as an indicator of peripheral microcirculation, can effectively evaluate patient prognosis. This study aims to develop two new prediction models using PI and other common clinical indicators to assess the mortality risk of sepsis patients during hospitalization and within 28 days post-ICU admission. This retrospective study analyzed data from sepsis patients treated in the Intensive Care Unit of Peking Union Medical College Hospital between December 2019 and June 2023, ultimately including 645 patients. LASSO regression and logistic regression analyses were used to select predictive factors from 35 clinical indicators, and two clinical prediction models were constructed to predict in-hospital mortality and 28-day mortality. The models’ performance was then evaluated using ROC curve, calibration curve, and decision curve analyses. The two prediction models performed excellently in distinguishing patient mortality risk. The AUC for the in-hospital mortality prediction model was 0.82 in the training set and 0.73 in the validation set; for the 28-day mortality prediction model, the AUC was 0.79 in the training set and 0.73 in the validation set. The calibration curves closely aligned with the ideal line, indicating consistency between predicted and actual outcomes. Decision curve analysis also demonstrated high net benefits for the clinical utility of both models. The study shows that these two prediction models not only perform excellently statistically but also hold high practical value in clinical applications. The models can help physicians accurately assess the mortality risk of sepsis patients, providing a scientific basis for personalized treatment. Supplementary Information The online version contains supplementary material available at 10.1038/s41598-024-78408-0.

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Microcirculation and Mitochondria: The Critical Unit

Cited by 4 publications

References 103 publications

A Prospective Study of the Association of IL6 with the Critical Unit and Their Effect on in-Hospital Mortality in Critically Ill Patients

A Prospective Study of the Association of IL6 with the Critical Unit and Their Effect on in-Hospital Mortality in Critically Ill Patients

What every intensivist should know about…Systolic arterial pressure targets in shock

Construction and validation of a clinical prediction model for sepsis using peripheral perfusion index to predict in-hospital and 28-day mortality risk

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