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Objective:To investigate the risk factors of bronchopulmonary dysplasia (BPD) in very low birth weight (VLBW) infants with gestational age ≤32 weeks within 28 days after birth and to establish and validate the nomogram model for BPD prediction.Methods:We retrospectively chose VLBW infants with gestational age ≤32 weeks who survived to postmenstrual age (PMA) 36 weeks and were admitted to the neonatal intensive care unit of Peking University Third Hospital from January 2016 to April 2020 as the training cohort. BPD was diagnosed in accordance with the 2018 criteria. The clinical data of these infants were collected, and the risk factors of BPD were analyzed by Chi-square test, Mann-Whitney U test, and multivariate logistic regression, and a nomogram model was established. The area under the curve (AUC) of the receiver operating characteristic (ROC) curve was used to assess the predictive performance. Decision curve analysis (DCA) was constructed for differentiation evaluation, and the calibration chart and Hosmer-Lemeshow goodness of fit test were used for the calibration evaluation. Bootstrap was used for internal validation. VLBW infants with gestational age ≤32 weeks survived to PMA 36 weeks and admitted to Hebei Chengde Maternal and Child Health Hospital from October 2017 to February 2022 were included as the validation cohort. ROC curve and calibration plot were conducted in the validation cohort for external validation. Results:Of the 467 premature infants included in the training cohort, 104 were in the BPD group; of the 101 patients in the external validation cohort, 16 were in the BPD group. Multivariate logistic regression analysis showed that low birth weight ( OR=0.03, 95% CI: 0.01-0.13), nosocomial pneumonia ( OR=2.40, 95% CI: 1.41-4.09), late-onset sepsis ( OR=2.18, 95% CI: 1.18-4.02), and prolonged duration of endotracheal intubation ( OR=1.61, 95% CI: 1.26-2.04) were risk factors for BPD in these groups of infants (all P<0.05). According to the multivariate logistic regression analysis results, a nomogram model for predicting BPD risk was established. The AUC of the training cohort was 0.827 (95% CI: 0.783-0.872), and the ideal cut-off value for predicted probability was 0.206, with a sensitivity of 0.788 (95% CI: 0.697-0.862) and specificity of 0.744 (95% CI: 0.696-0.788). The AUC of the validation cohort was 0.951 (95% CI:0.904-0.999). Taking the prediction probability of 0.206 as the high-risk threshold, the sensitivity and specificity corresponding to this value were 0.812 (95% CI: 0.537-0.950) and 0.882 (95% CI: 0.790-0.939). The Hosmer-Lemeshow goodness-of-fit test in the training and validation cohort showed a good fit ( P>0.05). DCA results showed a high net benefit of clinical intervention in very preterm infants when the threshold probability was 5%~80% for the training cohort. Conclusion:Low birth weight, nosocomial pneumonia, late-onset sepsis, and prolonged tracheal intubation duration are risk factors for BPD. The established nomogram model has a certain value in predicting the risk of BPD in VLBW less than 32 weeks.
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This article elaborates the key points of the updated recommendations and the latest evidence of the important steps in China neonatal resuscitation guideline (revised in 2021), aiming to help clinicians better understand the guideline and guide training to achieve a standardized and efficient resuscitation and further to improve neonatal outcomes.
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Correct neonatal resuscitation is the primary way to reduce perinatal mortality and neurological sequelae, and adequate preparation is essential. This article introduces the details for preparing neonatal resuscitation (including antenatal consultation) and ways to optimize the practice, aiming to improve the success rate of neonatal resuscitation.
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Objective:To analyze the factors influencing pH value in umbilical arterial blood gas (UABG) analysis in preterm infants.Methods:A retrospective study was conducted on live singleton preterm infants ( n=573) who received UABG analysis in Peking University Third Hospital from January 2017 to February 2019. Analysis of variance, independent sample t-test, Spearman's or Pearson's correlation analysis, or linear regression analysis was used to analyze the influencing factors. Results:There was no significant difference in UABG pH value between preterm infants of different gestational ages (F=1.74, P=0.077). Spearman's correlation analysis found no correlation between gestational age and UABG pH value in premature infants ( r=0.003, P=0.940), and neither did Pearson's correlation between birth weight and pH value ( r=0.025, P=0.548). UABG pH value in preterm infants was linearly correlated with vaginal delivery ( t=－5.72, P<0.001), gestational hypertension ( t=－3.99, P<0.001) and placental abruption ( t=－4.52, P<0.001). Conclusions:Preterm infants at different gestational ages show a similar pH value in UABG. For those born to mothers with gestational hypertension or placental abruption, when vaginal delivery is pending, close monitoring and full preparation for resuscitation are necessary.
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Although wearable electrocardiograms (ECGs) are being increasingly applied in clinical settings, validation methods have not been standardized. As an exploratory evaluation, we performed a multicenter clinical trial implementing an approved wearable patch ECG. Healthy male adults were enrolled in 2 study centers. The approved ECGs were deployed for 6 hours, and pulse rates were measured independently with conventional pulse oximetry at selected time points for correlation analyses. The transmission status of the data was evaluated by heart rates and classified into valid, invalid, and missing. A total of 55 subjects (40 in center 1 and 15 in center 2) completed the study. Overall, 77.40% of heart rates were within the valid range. Invalid and missing data accounted for 1.42% and 21.23%, respectively. There were significant differences in valid and missing data between centers. The proportion of missing data in center 1 (24.77%) was more than twice center 2 (11.77%). Heart rates measured by the wearable ECG and conventional pulse oximetry showed a poor correlation (intraclass correlation coefficient = 0.0454). In conclusion, we evaluated the multicenter feasibility of implementing wearable ECGs. The results suggest that systems to mitigate multicenter discrepancies and remove artifacts should be implemented prior to performing a clinical trial.
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Consensus and guidelines regarding point-of-care ultrasound (POCUS) carried out by neonatologists in neonatal intensive care unit (NICU) have been published in many countries. This review summarizes the development, advantages, limitations, and current issues of POCUS in NICU, aiming to promote the establishment of systematic training courses, accelerate the development of POCUS in NICU in China, and ensure the effectiveness and safety of POCUS implementation.
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Objective:To investigate the prognosis of severe hyperbilirubinemia in full-term infants who met the exchange transfusion criteria and were treated by blood exchange transfusion and phototherapy.Methods:A total of 168 full-term infants with severe hyperbilirubinemia who met the criteria for exchange transfusion and were hospitalized in the Neonatology Department of seven tertiary hospitals in Hebei Province from June 2017 to December 2018 were retrospectively included. According to the treatment protocol, they were divided into two groups: exchange transfusion group (38 cases) and phototherapy group (130 cases). Two independent sample t-test and Chi-square test were used to compare the clinical manifestations and follow-up results between the two groups. Multivariate logistic regression was used to analyze the risk factors for poor prognosis. Results:Neonatal severe hyperbilirubinemia in the exchange transfusion and phototherapy group were both mainly caused by hemolytic disease [42.1%(16/38) and 29.2%(38/130)], sepsis [28.9%(11/38) and 11.5%(15/130)] and early-onset breastfeeding jaundice [15.8%(6/38) and 11.5%(15/130)]. Total serum bilirubin level on admission in the exchange transfusion group was significantly higher than that in the phototherapy group [(531.7±141.3) vs (440.0±67.4) μmol/L, t=3.870, P<0.001]. Moreover, the percentage of patients with mild, moderate and severe acute bilirubin encephalopathy in the exchange transfusion group were higher than those in the phototherapy group [15.8%(6/38) vs 3.8%(5/130), 7.9%(3/38) vs 0.8%(1/130), 13.2%(5/38) vs 0.0%(0/130); χ2=29.119, P<0.001]. Among the 168 patients, 135 were followed up to 18-36 months of age and 12 showed poor prognosis (developmental retardation or hearing impairment) with four in the exchange transfusion group (12.9%, 4/31) and eight in the phototherapy group (7.7%, 8/104). Multivariate logistic regression analysis showed that for full-term infants with severe hyperbilirubinemia who met the exchange transfusion criteria, phototherapy alone without blood exchange transfusion as well as severe ABE were risk factors for poor prognosis ( OR=14.407, 95% CI: 1.101-88.528, P=0.042; OR=16.561, 95% CI: 4.042-67.850, P<0.001). Conclusions:Full-term infants who have severe hyperbilirubinemia and meet the exchange transfusion criteria should be actively treated with blood exchange transfusion, especially for those with severe ABE, so as to improve the prognosis.
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Effective neonatal resuscitation is critical to reducing the mortality and morbidity of neonatal asphyxia. The standardized implementation of neonatal resuscitation is described and emphasized in this article from the three following aspects: neonatal resuscitation program from experience- to evidence-based, the unchanged sequence of each step in resuscitation, and reonatal resuscitation from theory to practice in order to achieve a highly effective and efficient resuscitation.
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Objective:To explore the feasibility and application effect of Mini-CEX in pediatric clinical practice.Methods:Residents who received standardized residency training in pediatrics department of Peking University Third Hospital from March 2016 to September 2017 were selected as research objects. The clinical ability of the residents were evaluated by application of the Mini-CEX structured form. Its effectiveness as a training guide and assessment method was also evaluated. SPSS 25.0 was used for t test. Results:The Mini-CEX scale was refined according to the characteristics of pediatrics. In this study, a total of 36 residents participated in the evaluation and 110 cases were completed by introducing Mini-CEX structured form in 7 examinations. Compared with 2016, the Mini-CEX scores of the residents in the 2017 showed different degrees of improvement in information gathering [(7.4±0.9) vs. (7.7±0.7)], clinical examination [(7.5±1.1) vs. (7.6±0.9)], clinical judgment [(7.5±0.9) vs. (7.6±0.9)], organizational effectiveness [(7.4±0.9) vs. (7.7±0.9)], and overall clinical competency [(7.5±0.9) vs. (7.7±0.9)], without significant differences ( P > 0.05). A total of 17 residents completed the assessments more than or equal to 3 times. Compared with 2016, the mean scores of the 17 individuals' Mini-CEX scales in 2017 were significantly improved in terms of information gathering, organizational effectiveness, and overall clinical competency. Conclusion:The results have shown that the Mini-CEX scale is simple and easy to operate, it maybe helpful to improve the clinical ability of pediatric residents, and it can be used as a method to evaluate the clinical ability of pediatric residents.
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Objective:To investigate the application of umbilical vein catheterization in neonates.Methods:The patients who underwent umbilical vein catheterization from November 2007 to September 2019 in neonatal intensive care unit (NICU) at Peking University Third Hospital were selected consecutively.Clinical data were collected retrospectively to investigate the application time of umbilical vein catheterization in neonates, the incidence of catheter-related bloodstream infection, pathogenic bacteria and the causes of extubation.Results:A total of 835 newborns were enrolled, including 435 males (52.1%) and 400 females (47.9%). The average gestational age was (30.6±2.4) weeks.The median birth weight was 1 310(1 080, 1 520)g.The average indwelling time of umbilical vein catheterization was (4.850±1.893) days.Catheter related bloodstream infection occurred in ten (1.2%) neonates.The main pathogens were Staphylococcus epidermidis, Staphylococcus wallichi, Staphylococcus haemolyticus and Enterococcus faecium.A total of 770 (92.2%) newborns were extubated in a planned manner, and 65 (7.8%) were unplanned extubation.The top three causes of unplanned extubation were umbilical wheel swelling, clinical diagnosis of sepsis, catheter-related bloodstream infection and tube blockage.Conclusion:Umbilical vein catheterization is simple, high success rate, safe and can be used in NICU for a short time.If possible, abdominal B-ultrasound and echocardiography should be monitored and catheter related complications should be noted.
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Objectives@#It is crucial to find ways to fit regular exercise into the daily lives of office workers. Non-exercise activity thermogenesis has been introduced as an effective form of daily exercise. This study aimed to develop a healthy lifestyle coaching program for office workers, to be delivered using a messenger application. @*Methods@#The interface was developed using KakaoTalk and Plus Friend. Performance feedback was developed using the IBM Watson conversation program. Twenty office workers used the application for three weeks. Afterward, a survey was conducted to assess the usability of and participants’ satisfaction with the application. @*Results@#The application delivered customized push alarms, provided information related to habit formation, allowed for one-on-one chats, and delivered rewards. The satisfaction measurement results for the application showed that extrinsic reward factors contributed the most to the performance of the activity, followed by reminders and intrinsic rewards. Regarding the usability test, the perceived usefulness of the Healthy Lifestyle Coaching Chatbot was highest, followed by the usage intent and the perceived ease of use. @*Conclusions@#This study found that coaching programs using chatbots can improve the effectiveness of performing simple, repetitive exercises.
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Objective:To investigate the relationship of umbilical arterial blood pH with Apgar score and its perinatal influencing factors as well as effects on short-term neonatal outcomes.Methods:This study retrospectively collected the clinical data of 7 183 singleton newborns who were born at ≥35 gestational weeks with umbilical artery blood gas analysis in Peking University Third Hospital from January 2017 to February 2019. All cases were divided into two groups according to their Apgar scores at 1 min: low Apgar group (≤7 scores, n=42) and normal Apgar group (>7 scores, n=7 141). Moreover, according to the pH value of umbilical artery blood they were also allocated into acidosis group (pH<7.2, n=379 ) and normal pH group (pH≥7.2, n=6 804). Independent sample t test, Chi-square test, Fisher's exact test, Pearson's correlation analysis and multivariate logistic regression analysis were used to analyze the correlation between umbilical arterial blood pH and Apgar score, effects of perinatal complications on umbilical arterial blood pH, and influences of acidosis on early neonatal outcomes. Results:The umbilical arterial blood pH in the low Apgar group was significantly lower than that in the normal Apgar group (7.19±0.13 vs 7.32±0.07, t=-6.011, P<0.001). There was a positive correlation between the umbilical arterial blood pH and Apgar score at 1 min ( r=0.217, P<0.001). Fetal distress was an independent risk factor for low Apgar score ( OR=20.553, 95% CI: 4.380-96.443, P<0.001). Premature rupture of membranes was an independent risk factor for acidosis ( OR=1.316, 95% CI: 1.035-1.673, P=0.025). The incidence of low Apgar score [6.33% (24/379) vs 0.26% (18/6 804), χ2=217.075], respiratory distress [6.60% (25/379) vs 2.62% (178/6 804), χ2=21.205] and intracranial hemorrhage [1.06% (4/379) vs 0.04% (3/6 804), Fisher's exact test] was significantly higher in the acidosis group than in the normal pH group (all P<0.001). Conclusions:Neonates with lower umbilical arterial blood pH value should be closely monitored after birth as they are more likely to have respiratory distress and intracranial hemorrhage. Umbilical arterial blood pH value may be effective and is recommended in predicting neonatal early outcome.
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OBJECTIVES: This study analyzed the health technology trends and sentiments of users using Twitter data in an attempt to examine the public's opinions and identify their needs. METHODS: Twitter data related to health technology, from January 2010 to October 2016, were collected. An ontology related to health technology was developed. Frequently occurring keywords were analyzed and visualized with the word cloud technique. The keywords were then reclassified and analyzed using the developed ontology and sentiment dictionary. Python and the R program were used for crawling, natural language processing, and sentiment analysis. RESULTS: In the developed ontology, the keywords are divided into ‘health technology‘ and ‘health information‘. Under health technology, there are are six subcategories, namely, health technology, wearable technology, biotechnology, mobile health, medical technology, and telemedicine. Under health information, there are four subcategories, namely, health information, privacy, clinical informatics, and consumer health informatics. The number of tweets about health technology has consistently increased since 2010; the number of posts in 2014 was double that in 2010, which was about 150 thousand posts. Posts about mHealth accounted for the majority, and the dominant words were ‘care‘, ‘new‘, ‘mental‘, and ‘fitness‘. Sentiment analysis by subcategory showed that most of the posts in nearly all subcategories had a positive tone with a positive score. CONCLUSIONS: Interests in mHealth have risen recently, and consequently, posts about mHealth were the most frequent. Examining social media users' responses to new health technology can be a useful method to understand the trends in rapidly evolving fields.
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Biomedical Technology , Biotechnology , Boidae , Data Mining , Informatics , Medical Informatics , Methods , Natural Language Processing , Privacy , Public Opinion , Social Media , TelemedicineABSTRACT
Objective@#To investigate the pregnancy and neonatal outcomes in twin pregnancies and the association with chorionicity and modes of conception in order to provide evidence for early prevention and reduction of complications and life quality improvement of twin neonates.@*Methods@#This study retrospectively enrolled 756 women with twin pregnancies who gave birth at Peking University Third Hospital from January 1, 2014 to December 31, 2015. Clinical features of the mothers and newborns were collected, the pregnancy and neonatal outcomes were analyzed. Impacts of chorionicity and different modes of conception on the outcomes were also evaluated. Two independent-sample t test and Chi-square test were used as statistical methods.@*Results@#Twin pregnancies accounted for 6.7% (756/11 169) of all deliveries in the hospital during the study period and the preterm birth rate was 59.4% (449/756). Twenty five women underwent fetal reduction (3.3%, 25/756) and intrauterine death occurred in 85 pregnancies (11.2%, 85/756). Eventually 1 400 babies were born alive (92.6%, 1 400/1 512). Subgroup analysis suggested that compared with dichorionic diamniotic (DCDA) pregnancies, monochorionic diamniotic (MCDA) cases showed younger maternal age at conception [(30.5±4.2) vs (32.9±4.0) years, t=-7.412], smaller gestational age at delivery [(34.1±3.1) vs (35.7±2.2) weeks, t=-7.325] and higher preterm birth rate [78.4% (174/222) vs 51.5% (263/511), χ2=46.554], all P<0.05. Moreover, the incidence of neonatal complications, including respiratory distress syndrome [18.3% (40/219) vs 8.0% (21/261), χ2=11.210], neonatal pneumonia [18.3% (40/219) vs 8.8% (23/261), χ2=9.331] and sepsis [6.8% (15/219) vs 1.5% (4/261), χ2=8.854], etc. was higher in the MCDA group than those in the DCDA group, resulting in a higher mortality rate [7.8% (17/219) vs 1.1% (3/261), χ2=13.042] in the MCDA pregnancies, all P<0.05. Compared with spontaneously conceived twin pregnancies, women underwent in vitro fertilization-embryo transfer were older at conception [(33.4±3.8) vs (30.6±4.4) years, t=-6.095], delivered at a greater gestational age [(35.8±2.1) vs (35.2±2.6) weeks, t=-2.452] and had a lower preterm birth rate [49.2% (206/419) vs 63.5% (54/85), χ2=5.838] in the DCDA group, all P<0.05. No significant differences in the incidence of neonatal diseases were observed between the two subgroups.@*Conclusions@#The incidence of preterm birth is high in twin pregnancies. Compared with DCDA twin pregnancies, MCDA twin pregnancies are associated with more adverse outcomes due to higher incidence of neonatal diseases. In vitro fertilization-embryo transfer does not increase the incidence of preterm birth and the neonatal outcomes were comparable to those of spontaneously conceived ones.
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This is a case report of preterm female neonate with Raynaud's phenomenon, who was born at 30+3 weeks of gestation. Her right upper limb completely turned pale from wrist to fingers with undetermined cause five days after birth, with weakened radial artery pulsation and lower skin temperature than the other side. After several treatment steps including right upper limb massage, keeping warm, intravenous infusion of Alprostadil and application of tropical mucopolysaccharide polysulfate cream, the affected limb gradually turned to purple and then ruddy. No abnormality was detected in the examinations for secondary Raynaud's phenomenon, therefore a primary Raynaud's phenomenon was considered. No similar symptoms recurred during hospitalization or follow-ups. Though rare, Raynaud's phenomenon should be considered if patients' hands suddenly turn to pale and then purple. The main treatments involve removing the causative factors, keeping warm and massage of the affected limb. Medications can be used to improve peripheral circulation if necessary. Long-term follow-up is needed for neonates suffered from Raynaud's phenomenon.
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Objective To investigate the pregnancy and neonatal outcomes in twin pregnancies and the association with chorionicity and modes of conception in order to provide evidence for early prevention and reduction of complications and life quality improvement of twin neonates.Methods This study retrospectively enrolled 756 women with twin pregnancies who gave birth at Peking University Third Hospital from January 1,2014 to December 31,2015.Clinical features of the mothers and newborns were collected,the pregnancy and neonatal outcomes were analyzed.Impacts of chorionicity and different modes of conception on the outcomes were also evaluated.Two independent-sample t test and Chi-square test were used as statistical methods.Results Twin pregnancies accounted for 6.7％ (756/11 169) of all deliveries in the hospital during the study period and the preterm birth rate was 59.4％ (449/756).Twenty five women underwent fetal reduction (3.3％,25/756) and intrauterine death occurred in 85 pregnancies (11.2％,85/756).Eventually 1 400 babies were born alive (92.6％,1 400/1 512).Subgroup analysis suggested that compared with dichorionic diamniotic (DCDA) pregnancies,monochorionic diamniotic (MCDA) cases showed younger maternal age at conception [(30.5 ±4.2) vs (32.9±4.0) years,t=-7.412],smaller gestational age at delivery [(34.1±3.1) vs (35.7±2.2) weeks,t=-7.325] and higher preterm birth rate [78.4％ (174/222) vs 51.5％ (263/511),x2=46.554],all P＜0.05.Moreover,the incidence of neonatal complications,including respiratory distress syndrome [1 8.3％ (40/219) vs 8.0％ (21/261),x2=11.210],neonatal pneumonia [18.3％ (40/219) vs 8.8％ (23/261),x2=9.331] and sepsis [6.8％ (15/219) vs 1.5％ (4/261),~=8.854],etc.was higher in the MCDA group than those in the DCDA group,resulting in a higher mortality rate [7.8％ (17/219) vs 1.1％ (3/261),x2=13.042] in the MCDA pregnancies,all P＜0.05.Compared with spontaneously conceived twin pregnancies,women underwent in vitro fertilization-embryo transfer were older at conception [(33.4±3.8) vs (30.6±4.4) years,t=-6.095],delivered at a greater gestational age [(35.8±2.1) vs (35.2±2.6) weeks,t=-2.452] and had a lower preterm birth rate [49.2％(206/419) vs 63.5％ (54/85),x2=5.838] in the DCDA group,all P＜0.05.No significant differences in the incidence of neonatal diseases were observed between the two subgroups.Conclusions The incidence of preterm birth is high in twin pregnancies.Compared with DCDA twin pregnancies,MCDA twin pregnancies are associated with more adverse outcomes due to higher incidence of neonatal diseases.In vitro fertilization-embryo transfer does not increase the incidence of preterm birth and the neonatal outcomes were comparable to those of spontaneously conceived ones.
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PURPOSE: This study was done to estimate supply and demand for nursing workforce to provide community-based primary healthcare in the North Korean region to cost-efficiently narrow the health gap between the two Koreas in case of a Korean reunification. METHODS: To understand the nursing education system and current state of nursing workforce in North Korea, the authors interviewed six North Korean defectors who had worked as nurses in North Korea. Based on the interview results and literature review, the supply and demand for the primary healthcare nursing workforce that would be needed after Korean reunification were estimated RESULTS: Currently, a total of 2,100 to 2,700 North Korean nurses were estimated to have graduated from nursing schools with a 2 year curriculum or completed 6-month military nurse training courses every year. The projected number of nurses in demand to provide primary health care ranged from 84,160 to 105,200 and the shortage would be between 31,586 and 52,626. CONCLUSION: An active utilization of the North Korean nursing workforce to improve the health of North Koreans after reunification will be the best way to reduce the reunification cost which will be inflicted mainly on South Korea.
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Humans , Curriculum , Democratic People's Republic of Korea , Education, Nursing , Korea , Military Personnel , Nursing , Primary Health Care , Schools, NursingABSTRACT
This is a case report of preterm female neonate with Raynaud's phenomenon, who was born at 30+3 weeks of gestation. Her right upper limb completely turned pale from wrist to fingers with undetermined cause five days after birth, with weakened radial artery pulsation and lower skin temperature than the other side. After several treatment steps including right upper limb massage, keeping warm, intravenous infusion of Alprostadil and application of tropical mucopolysaccharide polysulfate cream, the affected limb gradually turned to purple and then ruddy. No abnormality was detected in the examinations for secondary Raynaud's phenomenon, therefore a primary Raynaud's phenomenon was considered. No similar symptoms recurred during hospitalization or follow-ups. Though rare, Raynaud's phenomenon should be considered if patients' hands suddenly turn to pale and then purple. The main treatments involve removing the causative factors, keeping warm and massage of the affected limb. Medications can be used to improve peripheral circulation if necessary. Long-term follow-up is needed for neonates suffered from Raynaud's phenomenon.
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Multidisciplinary team cooperation was highlighted in Neonatal Resuscitation Program (7th edition), which combining with effective team communication were considered as the essential skills during neonatal resuscitation. The key points of the multidisciplinary team cooperation were the identification of the team leader, mutual support, communication, correct records, and reports after resuscitation. It is of great importance to master the crucial skills, emphasize simulation training of the team cooperation, and strengthen the multidisciplinary team cooperation in decreasing the incidence of neonatal asphyxia.
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Objective:To study the pathogenesis and the risk factors of eye injury after non-ocular surgery in the patients underwent general anesthesia, and to provide the reference for its prevention, diagnosis and treatment.Methods:The clinical materials of two patients with eye injury after non-ocular surgery underwent general anesthesia were analyzed and the related literatures were reviewed.Results:A young woman patient underwent laparoscopic hysterectomy with general anesthesia while positioned Trendelenburg, the eyes were being closed naturally without protection, and corneal abrasion of both eyes occurred after operation.The lesion had completely resolved with no sequelae after treatment.An old man underwent cervical posterior laminoplasty with general anesthesia in prone position developed ischemic optic neuropathy (ION) after operation.The vision of the patients partly recovered after symptomatic treatment.Conclusion:Corneal abrasion is the most frequent ophthalmologic complication during general anesthesia, most of the patients have good prognosis.Postoperative visual loss (POVL) is the most severe ophthalmologic complication without effective treatment available, the delicate reasons and mechanisms are not totally clear, prevention outweighs treatment.