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Objective:To investigate the clinical effect of setting proportional pressure support (PPS) parameters by target tidal volume (VT) method.Methods:The study was conducted retrospectively on acute exacerbation of chronic obstructive pulmonary disease (AECOPD) patients admitted to Tianjin Third Central Hospital from January 2016 to December 2020. According to the PPS parameter setting method, the patients were divided into the airway blocking group and target VT group. The baseline characteristics, initial setting values of flow assist (FA) and volume assist (VA), respiratory system parameters, and clinical outcomes were collected and compared between the two groups.Results:Fifty-nine patients were enrolled, 29 patients in the airway blocking group, and 30 in the target VT group. There was no statistically significant difference in baseline characteristics, compliance, resistance, and initial settings of FA and VA between the two groups. Compared with the target VT group, the respiratory rate (RR), mean arterial pressure (MAP), VT, and arterial partial pressure of oxygen (PaO 2) recorded 1 hour after the initial setting of the PPS parameters in the airway block method group were significantly reduced [RR (times/minute): 21.0 (18.5, 22.5) vs. 23.0 (21.0, 25.0), MAP (mmHg, 1 mmHg = 0.133 kPa): 84.0 (79.0, 90.5) vs. 90.0 (87.0, 96.2), VT (mL): 305.24±41.07 vs. 330.87±46.84, PaO 2 (mmHg): 68.0 (66.0, 73.5) vs. 74.0 (69.8, 82.5), all P < 0.05], while arterial partial pressure of carbon dioxide (PaCO 2) and oral closure pressure (P0.1) were both increased significantly [PaCO 2 (mmHg): 41.0 (39.0, 46.0) vs. 37.5 (35.0, 42.2), P0.1 (cmH 2O, 1 cmH 2O = 0.098 kPa): 1.42±0.78 vs. 0.90±0.67, both P < 0.05]. Compared with airway blocking group, the duration of weaning, ICU stay, and hospital stay in the target VT group were significantly shorter [duration of weaning (hours): 42.0 (24.0, 70.5) vs. 64.0 (30.5, 97.5), ICU stay: 10.00±3.38 to 13.28±5.41, hospital stay (days): 12.07±3.40 vs. 15.41±5.60, all P < 0.05]. There was no statistically significant difference in the invasive mechanical ventilation time, weaning failure rate, ICU mortality and in-hospital mortality between the two groups. Conclusion:This study suggested that the target TV method has the advantages of practicality, safety, convenience, and rapid to set PPS parameters than the airway block method, which shortens the duration of weaning and ICU stay, and has a good clinical prospect.
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The utilization of temporary circulatory support in the form of extracorporeal membrane oxygenation (ECMO) has increased and its indications are expanding. Anesthesiologists may be involved in the care of these patients during the initiation of and weaning off from ECMO, surgical procedures with an ECMO in situ, and transfer of patients on ECMO between the operating theater and intensive care unit. This article addresses the anesthetic considerations and management for explant of veno-arterial ECMO in adults.
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Nasal continuous positive airway pressure (nCPAP) has been widely used in neonatal respiratory support, but how to successfully withdraw nCPAP has not been further studied, and there is no unified standard of timing and mode of nCPAP weaning.This paper reviews the research progress of nCPAP weaning in premature infants.
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Nasal continuous positive airway pressure (nCPAP) has been widely used in neonatal respiratory support,but how to successfully withdraw nCPAP has not been further studied,and there is no unified standard of timing and mode of nCPAP weaning.This paper reviews the research progress of nCPAP weaning in premature infants.
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@#Objective To investigate the changes of hemodynamics in patients weaning intra-aortic balloon pump (IABP) by using progressive volume deflation followed by rate reduction. Methods We retrospectively analyzed the clinical data of 36 patients aged 68.9±4.7 years, 22 males and 14 females, who underwent progressive volume deflation followed by rate reduction for IABP weaning in Xinhua Hospital between September 2006 and January 2016. Progressive volume deflation followed by rate reduction was used to wean IABP and collect hemodynamics parameters of each time point. Results All the patients successfully weaned IABP. One patient got re-IABP assistant 36 hours after the first successful weaning. One early death and three patients (8%) with postoperative IABP-related complications were embolization of the toe artery. One was in ipsilateral limb, and two of contralateral limb. One patient with acute hepatic insufficiency and one patient with acute renal insufficiency cured after treatment. Conclusion Intra-aortic balloon pump weaning is successful by using volume deflation followed by rate reduction which allowed better hemodynamic parameters.
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INTRODUCCIÓN: El abandono progresivo de la lactancia materna se ha considerado una nueva enfermedad propia de los siglos XX y XXI, en la cual han influido una serie de factores de muy diversa Índole. OBJETIVO: Caracterizar el comportamiento de los factores biosociales en la lactancia materna en los menores de un año. MÉTODOS: Se realizó un estudio descriptivo de corte transversal, en un universo de 158 nacimientos ocurridos en el 2008 del Área de salud Aleida Fernández Chardiet . Se empleó el estudio bibliográfico, documental y la contrastación de criterios de diferentes autores como procedimiento teórico, además de procedimientos empíricos. RESULTADOS: Solo en el 55,7 por ciento de los lactantes estudiados, se logró una lactancia materna exitosa, cifras por debajo de las recomendaciones internacionales. El destete precoz ocurrió en el 44,3 por ciento y el motivo más frecuente fue la hipogalactia materna. CONCLUSIONES: El motivo más frecuente del destete precoz, fue sustentado por el criterio de las madres de que era insuficiente la producción y obtención de leche
INTRODUCTION: The progressive neglect of breastfeeding has been considered a new disease own of XX and XXI centuries where a series of very diverse factors have been influenced. OBJECTIVE: To characterize the behavior of biosocial factors related to breastfeeding in babies aged less than 1 year. METHODS: A cross-sectional and descriptive study was conducted in 158 births occurred in 2008 in Aleida Chardiet health area. Authors used the bibliographic, documentary study and the criteria contrast from different authors as a theoretical procedure, in addition to the empirical ones. RESULTS: Only in the 55.7 percent of study infants it was possible to achieve a successful breastfeeding, figures under the international recommendations. The early wean occurred in the 44.3 percent and the more frequent reason was the mother hypogalactia. CONCLUSIONS: The more frequent reason for the early wean was supported by the mother criterion related to a insufficient milk production and obtaining
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Humans , Male , Female , Infant , Breast Feeding/epidemiology , Weaning , Cross-Sectional Studies , Epidemiology, DescriptiveABSTRACT
Conduziu-se este trabalho, com o objetivo de verificar o efeito do uso de probiótico e/ou prebiótico na alimentação de matrizes suínas. Foi utilizado um delineamento inteiramente casualizado com 4 tratamentos e 6 repetições (T1= controle; T2= prebiótico; T3= probiótico; e T4= prebiótico + probiótico), sendo cada fêmea considerada uma parcela. A adição de probiótico e/ou prebiótico diminuiu o número de leitões mumificados. A adição de prebiótico na ração das matrizes adicionado ou não de probiótico, elevou a concentração de proteína no leite no 21º dia de lactação. No 14º dia de lactação, as concentrações de Clostridium perfringens foram menores nas fezes de matrizes que se alimentaram de probiótico. No 21º dia de lactação, as concentrações de Bifidobacterium nas fezes das matrizes foram estatisticamente menores no tratamento com prebiótico (T2). As concentrações de Enterobacteriaceae foram maiores nas fezes de matrizes que receberam a adição de probiótico (T3).
The objective of the present study was to in determine the effect of probiotic and/or prebiotic added to feed for sows. An entirely randomized design with 24 sows, 4 treatments and 6 replicates (T1 = control; T2 = prebiotic; T3 = probiotic; and T4 = prebiotic + probiotic) was used. The addition of probiotic and/or prebiotic decreased the number of mummified piglets. The addition of prebiotic to sow´s feed, with or without probiotic, increased the concentration of milk protein on the 21st day of lactation. On the14th day of lactation, the of Clostridium perfringens was smaller in the faeces of sows fed with probiotic (T3 and T4). On the 21st day of lactation, the concentration of Bifidobacterium in the faeces was statistically lower in sow food with prebiotic (T2). Concentrations of Enterobacteriaceae were higher in the faeces of sows that received probiotic (T3).