[Clinical update in critical care of pulmonary medicine 2023]

This article reviewed the clinical progress in the field of pulmonary and critial care medicine, both domestically and internationally during the year 2023 (from October 1, 2022 to September 30, 2023). In 2023, there have been significant modifications to the global definition of Acute Respiratory Distress Syndrome (ARDS). These include the inclusion of SpO₂/FiO₂ as a diagnostic criterion for ARDS, the addition of parameters for high-flow nasal cannula humidified oxygen therapy as a basis for diagnosing ARDS in non-intubated patients, clarification of the need to diagnose ARDS in non-intubated patients with PEEP≥5 cmH₂O under non-invasive positive pressure ventilation, and the increased diagnostic value of ultrasound. Bedside electrical impedance, transpulmonary pressure and severe ultrasound provide effective means for for individualized assessment of critically ill patients. End-tidal alveolar dead space fraction, intestinal microecological imbalance, and ICU-acquired weakness are important warning indicators for the prognosis of critically ill patients. Machine learning models based on big data can effectively predict the prognosis of critically ill patients, and ECMO combined with prone positioning can improve patient outcomes. Cognition and fatigue were the most common persistent symptoms in critically ill patients after discharge. Intervention on specific cellular subtypes of lung injury receptors may be a future target for personalized treatment of lung injury tissue repair.