ABSTRACT
OBJECTIVE: By analyzing the cases of accidental injuries among critically ill children in our hospital in recent years,we put forward feasible preventive measures to effectively reduce the occurrence of accidental injuries. METHODS: A retrospective analysis was performed on the clinical data of children who were admitted to the PICU in our hospital from May1,2015 to April 30,2018;the types of children with accidental injuries were analyzed,and the male-to-female ratio of the results was analyzed. Seasonal characteristics,age,and the proportion of deaths were analyzed. RESULTS: It was found that the top three causes of accidents in critically ill children were falling injuries(246,39.87%),traffic accidents(156,25.28%),and poisoning(57,9.23%). The incidence of accidental injuries for boys was significantly greater than that for girls;there were 375 boys and 242 girls,the ratio being 1.55∶1;severe accident injuries peaked in early childhood(1～4 years old);there was no significant difference between urban and rural areas. CONCLUSION: The accidental injuries in critically ill children have undergone tremendous changes. We should adopt preventive measures to reduce accidental injuries.
ABSTRACT
<p><b>OBJECTIVE</b>To evaluate dose response of inhaled nitric oxide (iNO) for surfactant-treated rabbits with meconium aspiration-induced acute lung injury (ALI) and hypoxemic respiratory failure (HRF), and variation of measured iNO by continuous NO delivery in pressure support ventilation (PSV).</p><p><b>METHODS</b>Adult rabbits (2.0 - 3.5 kg, n = 33) were randomized to receive intratracheal meconium instillation for 30 min and subjected to following treatment (n = 6 - 8). There were 4 groups: Control (C); NO, iNO at 1, 10, 20 and 40 x 10(-6) each for 60 min at 30 min interval of disconnection; Surf, intratracheal instillation of porcine lung surfactant phospholipids (100 mg/kg); SNO, both iNO and surfactant as in the NO and Surf groups; and a normal group (N), which did not undergo meconium aspiration but received sham deliveries of normal saline. All the animals were treated with PSV for 6 h. iNO levels at different input and sampling sites in the NO and SNO groups were detected by on-line chemiluminescent technique. The blood gas and lung mechanics were measured during the experiments every 2 h.</p><p><b>RESULTS</b>(1) Meconium aspiration induced ALI and severe HRF (PaO(2)/FiO(2) < 200 mmHg) and depressed dynamic compliance of respiratory system (Cdyn) and airway resistance (Raw). In both Surf and NO groups modestly improved oxygenation was observed. In the SNO, values for PaO(2)/FiO(2) were improved from (185 +/- 39) mmHg at baseline to (301 +/- 123) mmHg at 6 h, while moderate or transient improvement was observed in both Surf and NO groups. Cdyn and Raw were only improved for short time in the Surf, NO and SNO groups. iNO had a mild response at 1 x 10(-6) to good response at 10 and 20 x 10(-6), but no further improvement occurred at 40 x 10(-6). The response of iNO in NO group was relatively transient compared to the SNO group. (2) When iNO was connected to the ventilator circuit, the connected site should be placed before humidifier to minimize fluctuation of iNO concentration, and sampling site for iNO monitoring should be placed adequately to eliminate artifact.</p><p><b>CONCLUSIONS</b>iNO synergistically improved surfactant effects on oxygenation and lung mechanics. Continuous supply of iNO with non-continuous flow ventilator provided stable NO within accepted target range with least variation.</p>