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Objective To investigate the correlations of short-term prognosis and B-type natriuretic peptide(BNP) of no heart disease patients in ICU.Methods Sixty patients of critically ill in our ICU ward from March 2010 to March 2012 were taken scores of acute physiology and chronic health Ⅱ scoring system (APACHE Ⅱ score) and determination serum BNP level in 24 hours of admission and analysis mortality in hospital time,mechanical ventilation time and other major prognostic indicators.Results Forty-two cases were living,18 cases were dead in the 60 cases (mortality rate 30％).APACHE Ⅱ score (26.46 ± 11.6) and serum BNP concentrations(2154.26 ± 1126.49) ng/L were significantly higher in death cases than in living cases (13.45 ± 4.20) vs.(1058.16 ± 857.83) ng/L (t =6.4055,4.1190,P ＜ 0.001),mechanical ventilation time mortality rate both also increase with BNP levels (F =49.089,22.754,36.398 respectively,P ＜ 0.001).Conclusion BNP level and APACHE Ⅱ score rise of survival of critically ill patients have important prognostic significance with duration of mechanical ventilation,length of hospital stay prognostic indicators forecast.
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Objective To provide an effective basis for clinical control methods of multi-drug-resistant bacterial (MDRB) infections by analyzing the distribution and antimicrobial resistance of MDRB.Methods The French Merieux ATB Expression Automated Analysis System was used for bacterial identification,whereas a drug susceptibility testing was performed by K-B methods.Drug-resistance rate was calculated,and the predisposing factors were analyzed.Results Altogether 811(8.1％) strains were isolated from 9 954 specimens,and the majority of multiply antimircobial-resistant bacteria were Escherichia coli,Coagulase-negative staphylococci,Klebsiella Pneumoniae Staphylococcus aureus,Acinetobacter Baumannii,Pseudommonas aeruginosa,whereas the last two appeared pan resistant strains.Specimen source was mainly from respiratory specimens,accounted for 47.8％,and was mainly distributed in the ICU unit,atout41.8％ ;MDRB enterobacter was highly sensitive to Carbapenems with resistance rates less than 1.5％ and to Amikacin and other inhibitor drugs that rate was less than 30.0％.The resistance rates of MDRB nonfermentative bacteria was ＞ 77.0％ to Carbapenem antibacterial drugs whereas to non-resistance was found to polymyxin and only 20.0％ resistance rate to Cefoperazone/sulbactam.MDRB staphylococcus was 100.0％ sensitive to Vancomyci,Teicoplanin and Linezolid and less sensitive (＜ 30.0％) to chloramphenicol and rifampicin.MDRB showed high resistance rate to other antibacterial drugs.The predisposing factors included age,other disease,hospitalization over two weeks,the usage of multiply antimicrobial especially cephalosporins overtoppinh 7 days,and invasive operations.Conclusion The major MDRBs are resistant to common-used antimicrobial drugs.It is nesessary to pay attention to the differences.
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Objective To study the clinical value of PgCO_2 measurement on the patients in ICU.Methods PgCO_2 were continuous measured 24 hours by using air-automated tonometry for 50 cases admitted in ICU.The heart rate,blood pressure,MAP,CVP,SpO_2,artery blood gas were measured at the same time.According to acute physiologic and chronic health evaluation(APACH Ⅱ) and MODS mark,the patients were divided into 2 groups,high-risk group and light-risk group.20 cases suffered from malignant tumour without functional failure of the organs were looked on as compared group.The results of measurement of every group were compared.Results Comparing with the three groups,the results of PgCO_2,Pg-aCO_2,Pg-etCO_2 were significantly different,but the Pg-aCO_2 and Pg-etCO_2 were the same.Conclusion PgCO_2 is an effective index for observing the conditional change of the high-risk cases.PgCO_2≥45mmHg,Pg-aCO_2≥15mmHg may be considered as a predictive signal that the patient well appears functional failure or death.Pg-etCO_2 may substitute Pg-aCO_2 as a continuous measurement index.