ABSTRACT
Objective To study the applied value of modified poisoning severity score (PSS) for early prognostic evaluation in acute paraquat poisoning.Methods Thirty-seven patients with acute paraquat poisoning from June 2013 to June 2016 were enrolled.The PSS score,the modified PSS score,the acute physiology and the chronic health status Ⅱ score (APACHE Ⅱ) of the patients were calculated.The relationship between modified PSS and APACHE Ⅱ was analyzed.Also the factors that affect outcome were analyzed by logistic regression analysis.The work characteristic curve (ROC curve) of the PSS,the modified PSS and the APECH Ⅱ were drawn and compared.Results There was a positive correlation between the risk of death and admission time,poisonous dose,the concentration of urine paraquat,and white blood cell count (P＜0.05).There was a significant correlation between the modified PSS and the APACHE Ⅱ (P＜0.0001).The immediate PSS score,the modified PSS score,and the APACHE Ⅱ score were significant for the prognosis of patients with acute paraquat poisoning.The area under the curve (AUC) was in turn 0.774,0.788,0.799.Among them,the best bound of the modified PSS score was 6.5 (when the score is greater than 6.5,the risk of death is higher).Further comparison of the area under the three curves showed that there was no significant difference in the area under the ROC curve between the three scores in predicting the prognosis of death [P=0.7633(PSS-DPSS),P=0.7791 (PSS-APACHE Ⅱ),P=0.8918(DPSS-APACHE Ⅱ)].Conclusion Modified PSS is helpful in early predicting the prognosis of acute paraquat poisoning.
ABSTRACT
OBJECTIVE@#To review the indications and effect of the intra-aortic balloon pump (IABP) in 38 patients during the cardiac surgery.@*METHODS@#From June 2004 to August 2007, 38 patients were performed IABP in the cardiac surgery, including 28 coronary artery bypass grafting (CABG) and 10 valve replacements. The intra-operation prophylactic use of IABP was in 5 cases, the use of IABP for weaning from cardiopulmonary bypass (CPB) during the cardiac surgery was in 22 cases, and the rest use of IABP was after the operation in the intensive care unit. Low molecular weight heparin was used for IABP anticoagulation.@*RESULTS@#Thirteen died out of the 38 IABP patients. The total IABP success rate was 66%.The IABP success rate in CABG was 82%, and 20% in the valve replacement. The patients with intra-operation prophylactic use of IABP all recovered, and 16 recovered out of the 22 patients with IABP uses for weaning from CPB, and 6 recovered out of the 11 patients with post-operation IABP application. No severe complications related to IABP occurred.@*CONCLUSION@#IABP has better effect in CABG patients than in valve replacements. Effect of the prophylactic use of IABP is better than both the IABP use for weaning from CPB or the post-operation IABP application. For IABP anticoagulation, low molecular weight heparin is the better alternative than routine heparin, and the proper ACT is controlled at 150-170 s.