ABSTRACT
ABSTRACT BACKGROUND: For critically ill patients, physicians tend to administer sufficient or even excessive oxygen to maintain oxygen saturation at a high level. However, the credibility of the evidence for this practice is unclear. OBJECTIVE: To determine the effects of different oxygen therapy strategies on the outcomes of mechanically ventilated intensive care unit (ICU) patients. DESIGN AND SETTING: Systematic review of the literature and meta-analysis conducted at Jiangxi Provincial People's Hospital, Affiliated to Nanchang University, Nanchang, China. METHODS: We systematically searched electronic databases such as PubMed and Embase for relevant articles and performed meta-analyses on the effects of different oxygen therapy strategies on the outcomes of mechanically ventilated ICU patients. RESULTS: A total of 1802 patients from five studies were included. There were equal numbers of patients in the conservative and liberal groups (n = 910 in each group). There was no significant difference between the conservative and liberal groups with regard to 28-day mortality (risk ratio, RR = 0.88; 95% confidence interval, CI = 0.59-1.32; P = 0.55; I2 = 63%). Ninety-day mortality, infection rates, ICU length of stay, mechanical ventilation-free days up to day 28 and vasopressor-free days up to day 28 were comparable between the two strategies. CONCLUSIONS: It is not necessary to use liberal oxygen therapy strategies to pursue a higher level of peripheral oxygen saturation for mechanically ventilated ICU patients. Conservative oxygen therapy was not associated with any statistically significant reduction in mortality.
Subject(s)
Humans , Oxygen , Respiration, Artificial , Oxygen Inhalation Therapy , Prognosis , Critical Illness/therapy , Intensive Care Units , Length of StayABSTRACT
·AIM:To study the effects of phacoemulsification on ocular surface and corneal endothelial cells in cataract patients with diabetes mellitus.·METHODS:This study used a retrospective analysis of the clinical data to compare curative effect, the research object was 98 cases ( 98 eyes ) of cataract patients with phacoemulsification from January 2016 to December 2016 in our hospital. Patients were divided into the observation group and the control group according to whether diabetes merged. The observation group had 50 cases of cataract patients with diabetes, the control group had 48 cases of pure cataract patients. Two groups of patients underwent phacoemulsification surgery and transparent corneal incision, surgeries were completed by the same doctor, no xeroma before surgery. Preoperative glycemic control was normal for diabetic patients, no changes in eye fundus. Observation of ocular surface at postoperative 1, 3, 7d and 1mo was taken. Dry eye symptoms, lacrimal film breakup time ( BUT ) , corneal fluorescein staining ( FL ) score, SchirmerⅠtest ( SⅠt ) and corneal endothelial cell density were compared.·RESULTS: Dry eye symptom score of the two groups before and after operation had significant difference;data of the observation group at postoperative 7d and 1mo was significantly higher than that of the control group, there was statistical significance (P<0. 05), there was no significant difference at 1 and 3d after operation (P>0. 05 ). BUT of the two groups before and after surgery showed significant difference; data of the observation group at 7d and 1mo after operation was significantly lower than that of the control group, there was statistical significance ( P<0. 05 ); at 1 and 3d after operation there was no significant difference (P>0. 05). The FL score of the two groups before and after surgery had significant difference, and at 3, 7d and 1mo after operation, data of the observation group was significantly higher than that of the control group, there was statistical significance ( P< 0. 05 ); there was no significant difference at postoperative 1d (P>0. 05). The two groups' before and after surgery SⅠt had significant difference, at 1, 3, 7d and 1mo after operation, data of the observation group was significantly higher than that of the control group, there was statistical significance (P< 0. 05 ). Corneal endothelial cell density showed apparent difference of the two groups before and after surgery;at 1, 3, 7d and 1mo after operation, data of the observation group was significantly lower than that of the control group, there was statistical significance ( P<0. 05).· CONCLUSION: Phacoemulsification has significant effects on tear film break-up time, SⅠt and dry eye symptoms in patients with diabetes mellitus, which may be related to the impaired repair ability of diabetic patients.