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ABCDE bundle management is a comprehensive measure to prevent delirium in ICU patients and forms a standardized treatment model and process.This article summarizes the risk factors of delirium and the ABCDE bundle management in ICU patients and presents a reasonable and effective method to improve recognition of and also the ABCDE bundle management accuracy in ICU patients suffering from delirium,thus to reduce the incidence of delirium in ICU patients,reduce the suffering and improve the long-term survival of critically ill patients.
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Objective To evaluate the effect of mild hypothermia combined with hypbaric oxygen (HBO) treatment on secondary brain injury in patients with severe craniocerebral injury.Methods A prospective study was conducted in this study.Forty-two patients with severe craniocerebral injury admitted to hospital within 8 hours were randomly divided into sub-hypothermia combined with HBO treatment group and conventional HBO control group,21 cases in either group.Cerebral hemorrhage and brain edema were calculated by reviewed head CT on the 1st day,15th day and 30th day after injury.GCS (Glasgow Coma Scale) score was calculated at the same time.The number of cases of cerebral infarction was counted in the two groups.GOS (Glasgow Outcome Score) prognosis was scored for both groups of patients six months after injury.Two groups of sample rates were compared using a chi-square test with continuous correction,The intergroup comparisons were analyzed by independent sample t test by using SPSS version 13.0 software.Differences were considered statistically significant if P ＜ 0.05.Results (1) The amount of cerebral hemorrhage and edema in the treatment group were significantly lower than those in the control group on the 15th day and 30th day after injury [(21.71 ±4.3) vs.(26.33 ±5.23);(14.33 ± 1.93) vs.(16.86 ±2.86),P ＜0.05].(2) The GCS score of the treatment group was higher than that of the control group on the 15th day and 30th day after injury [(4.62 ±0.49) vs.(2.49 ±0.56);(9.76 ± 1.37) vs.(8.57 ± 0.92),P ＜ 0.05];(3) There were 2 cases of traumatic cerebral infarction in the treatment group and 9 cases in the control group (x2 =4.434,P =0.035).The GOS score in the treatment group was higher than that in the control group six months after injury [(4.29 ± 0.84) vs.(3.38 ± 0.74),P =0.001].Conclusions Mild hypothermia combined with hyperbaric oxygen treatment can reduce the secondary brain injury and improve the prognosis of patients with severe craniocerebral injury.It is worth further study,the mechanism of hypothermia remains to be further studied.
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Purpose To evaluate the value of imaging on the diagnosis and treatment of human-infected H10N8 virus. Materials and Methods The chest X-ray and CT features of one case of human infected H10N8 virus were retrospectively studied. Results A 73-year-old female patient was admitted to the third affiliated hospital of Nanchang University on November 30, 2013 due to cough, sputum for 3 days and fever for 1 day. The patient was diagnosed with severe pulmonary infection and underwent chest CT on December 1, which showed large opacities with air bronchograms were in the lower lobe of her right lung and ground-glass exudative lesions in the lower lobe of the left lung;the next 24 h, 48 h and 72 h review tracking chest X-ray showed the chest lesions developed rapidly which involved more lobes with more areas, integration of lesions and plenty of pleural effusion in a very short time. This was a typical white lung sign of acute respiratory distress syndrome. The patient died later on December 6, which was reported as the case of human-infected avian influenza (H10N8 virus) by Chinese Center for Disease Control and Prevention. Conclusion The chest imaging features found in human infected H10N8 virus present as progressive opacities and exudative lesions.