ABSTRACT
Objective Using Doppler ultrasound measured in femoral artery flow velocity variation rate method to predict fluid responsiveness.Methods 80 patients were measured femoral artery flow velocity variation rate (△Vpeak)by mastering the ultrasound skills of the attending physician.Passive leg raising test (PLR)stroke vol-ume variation (△SV)was used to analyze the peak value of the femoral artery flow velocity,rate of femoral artery peak velocity of respiratory changes,and the results were compared with results of PICCO monitoring to predict patients with their response to the treatment capacity,to evaluate clinical feasibility.Results Reactive groups in the PLR test before the experiment and hemodynamic changes:PLR test reaction group in before the test and test process, HR,MAP,CAP index changes were not obvious (P >0.05),but ultrasonic detection and PICCO detection showed SV and CO varied significantly (t =15.24,P =0.00;t =13.64,P =0.00),the two kinds of methods to forecast results was consistent.In the absence of the anti should patients in PLR test before the experiment and hemodynamic chan-ges:PLR test unreacted group in before the test and test process,HR,MAP,CAP,SV and CO index change were not obvious (all P >0.05).Conclusion By ultrasonic method for measuring femoral artery flow speed variation rate can exactly evaluate the capacity status of critically ill patients,and effectively predict fluid responsiveness,the prediction results and PICOO monitoring results are highly consistent.It is a safe and efficient prediction method,which is worthy of promotion in clinical intensive observation.
ABSTRACT
OBJECTIVE:To provide reference for imipenem-resistant Pseudomonas aeruginosa infection control. METHODS:114 patients infected with imipenem-resistant P. aeruginosa were selected from 3 tertiary hospitals in Zhoushan during Feb. 2013 to Feb. 2014. 114 strains of P. aeruginosa were isolated from clinical specimens,and drug resistance characteristics and carbapene-mase-producing gene diversity were analyzed. 101 inpatients with imipenem-resistant P. aeruginosa infection were included in con-trol group;univariate and multivariate Logistic regression analysis were adopted to explore the risk factors of imipenem-resistant P. aeruginosa infection. RESULTS:114 strains were sensitive to polymyxin B,and had different levels of resistance to other 9 kinds of antibiotics. Carbapenemase-producing gene were mainly IMP and VIM type gene. Long-term hospitalization,mechanical ventila-tion,used imipenem and early combined use of antibiotics were risk factors of imipenem-resistant P. aeruginosa infection. CON-CLUSIONS:In Zhoushan area,imipenem-resistant P. aeruginosa shows serious drug resistance. To avoid long-term hospitalization and early combined use of antibiotics can reduce imipenem-resistant P. aeruginosa infection.