ABSTRACT
Objective:To analyze the participation of clinical pharmacist in the process of diagnose and treatment of typical critical patients and summarize the clinical and pharmaceutical thoughts of clinical pharmacist in pharmaceutical care in order to provide better service for clinics .Methods:Through the participation of clinical pharmacist in the process of diagnose and treatment of one patient with hypernatronemia complicated with demyelination after liver abscess drainage , and combined with the results of laboratory tests and imaging examination and drug treatment regimen , clinical pharmacists analyzed the radical causes of apostasies and feasible therapeutic measures, and then provided the reasonable suggestions for the medication .Results: Clinical pharmacist paid close attention to the medication history and disease evolution of the patient , assessed the therapeutic efficacy timely , communicated and discussed with clin-ical doctors actively , and then made out individualized treatment schedule for the patient , which obtained promising effects .Conclu-sion:Clinical pharmacist should grasp the principal contradictions and pay attention to details , which can play an important role in the treatment course of severe patients .
ABSTRACT
Objective To study the effects of sodium bicarbonate (SB) on resuscitation in swine model of asphyxiation cardiac arrest (CA).Methods Thirty-two healthy miniature pigs were randomized (ramdom number) into two groups,the SB group (n =16) and the control group (n =16).Animals in both groups underwent endotracheal tube clamping to induce CA.Once induced,CA left untreated for a period of 8 minutes.At the beginning of initiation of cardiopulmonary resuscitation (CPR),SB (1.0 mEq/kg,diluted to 40 mL) was injected in central venous in SB group and isopyknic normal saline solution was injected in control group.Two minutes following initiation of CPR,defibrillation was attempted until return of spontaneous circulation (ROSC) was achieved or animals died.To assess the SB effects on myocardial metabolism,positron emission tomography (PET) was performed at baseline and 6 after ROSC.To analyze 18F-FDG myocardial uptake identified in PET,the maximum standardized uptake value (SUV) was measured.Results ROSC was 10/16 successful in SB group and only 8/16 successful in control group.The average survival time of SB group was (3.63 ± 0.76) h and that of control group was (2.45 0.70) h.Myocardial metabolism imaging using PET demonstrated that myocardial metabolism injuries in control group were more severe than in SB group at 6 h after ROSC and SUVmax was more higher in SB group than in control group (6 hrs after ROSC:1.32 ± 0.20 vs.1.10 ± 0.14,P =0.035).Conclusions In swine model of asphyxiation CA,SB improve the myocardial metabolism and might raise the possibility of ROSC and have no hypernatronemia.