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Objective To study the airway patency during sitting position and supine position in bronchoscopy during anesthesia. Method Forty-eight patients underwent bronchoscopy during Non-intubation anesthesia were randomly allocated to two groups.There were 24 cases in each group by observeing the airway patency and vital signs of the two groups during the procedure. Result Sitting position in bronchoscopy during anesthesia have the shorter average time to reach the carina, on securing a clear airway. The incidence of desaturation, hypertension and agitation were lower in sitting position during bronchoscopy. Conclusion Bronchoscopy anesthesia can reduce discomfort and fear, but traditional supine bronchoscopy anesthesia can cause displacement of the tongue, collapse of the upper airway in the oropharynx, soft palate and vocal cord related to gravity may seriously obstruct the upper airway, not only brings inconvenience to the inspection, but also increases the risk of airway correlation and hemodynamic instability, Sitting bronchoscopy ensure the airway patency and maintain a more stable hemodynamic state, so that sitting position in the sedation of bronchoscopy anesthesia is safer and more convenient.
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Objective To analyze the clinical application of double tube laryngeal mask airway in endoscopic retrograde cholangiopancreatography under total intravenous anesthesia. Method 60 patients between the ages of 60 and 80 years who were scheduled for elective ERCP were enrolled. The patients were randomly assigned to two groups: groups A and B. Those in group A underwent the procedure with sedation without any airway instruments and those in group B underwent procedure after sedation and airway management with double tube laryngeal mask airway. Intraoperative and postoperative vital signs as well as the satisfaction of the endoscopists were recorded. Result The time of successful insertion of esophagus in group B was shorter than that in group A, and the visual analogue score of pain in group B was lower than that in group A, and the satisfaction degree of endoscopic physicians in group B was higher than that in group A. The incidence of desaturation during ERCP was significantly higher in group A than in group B. Conclusion In conclusion, ERCP should be performed under optimal conditions to avoid the occurrence of unwanted complications, such as aspiration-related disorders. Therefore, according to the structural properties of double tube laryngeal mask airway, sedation anesthesia application with double tube laryngeal mask airway in ERCP will be safer, more comfortable, and more effective.
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<p><b>OBJECTIVE</b>To investigate the values of combination of urinary liver-type fatty acid-binding protein (L-FABP) and neutrophil gelatinase-associated lipocalin (NGAL) in early diagnosis of acute kidney injury (AKI) after cardiac surgery in children.</p><p><b>METHODS</b>A total of 97 children with congenital heart disease undergoing cardiopulmonary bypass surgery were enrolled. Serum and urine samples were collected before and after surgery. Levels of serum creatinine (Scr), urinary L-FABP, and urinary NGAL from AKI group (n=18) and non-AKI group (n=79) were measured, and the postoperative dynamic changes in these markers were compared between the two groups. The receiver operating characteristic (ROC) curve and the area under ROC curve (AUC) were used to assess the values of these markers alone or in combination in the prediction of postoperative AKI.</p><p><b>RESULTS</b>The levels of urinary L-FABP and NGAL in the AKI group were significantly higher than those in the non-AKI group at 2 and 6 hours after surgery, and the changes in their concentrations were earlier than Scr. The AUCs of urinary L-FABP alone in predicting AKI at 2 and 6 hours after surgery were 0.921 and 0.896 respectively, and those of urinary NGAL alone were 0.908 and 0.928 respectively. Those of their combination were 0.942 and 0.929 respectively.</p><p><b>CONCLUSIONS</b>Urinary L-FABP and NGAL significantly increase in the early stage of AKI after cardiac surgery in children, which are significantly earlier than the changes in Scr. They can be used to predict the occurrence of AKI in the early stage. A combination of the two biomarkers can further improve the accuracy of diagnosis.</p>
Subject(s)
Child , Child, Preschool , Female , Humans , Infant , Male , Acute Kidney Injury , Diagnosis , Urine , Cardiac Surgical Procedures , Cardiopulmonary Bypass , Creatinine , Blood , Fatty Acid-Binding Proteins , Urine , Lipocalin-2 , UrineABSTRACT
<p><b>OBJECTIVE</b>To investigate the effect of enhanced nutritional therapy on wound healing after endoscopic therapy in patients with liver cirrhosis and esophageal varices.</p><p><b>METHODS</b>Fifty patients with liver cirrhosis and esophageal varices were randomly divided into an enhanced nutritional therapy group (n = 25) and a control group (n = 25). The enhanced nutritional therapy group received one week of enhanced nutritional supplementation, including liver nutritional elements, prior to routine endoscopic therapy. The routine without any change to their diet. The rate of transformation and status of wound healing of esophageal varices were compared between the two groups.</p><p><b>RESULTS</b>The ratio of ulcers occurring at the injection site was lower in the enhanced nutrition group than in the control group (16/25 vs. 23/25; x2 = 5.711, P = 0.017). The enhanced nutrition group had only one case of minimal bleeding occurring during endoscopy as compared to the seven cases of bleeding in the control group (x2 = 5.357, P = 0.021). On average, the enhanced nutrition group required less sessions of endoscopic treatment to achieve eradication of esophageal varices than the control group (3.8 vs. 4.1; t = 2.069, P = 0.044).</p><p><b>CONCLUSION</b>Pre-endoscopic enhanced nutritional therapy may benefit patients with liver cirrhosis and esophageal varices by promoting recovery of procedure-related local tissue injury and occlusion of varices.</p>