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Objective To analyze the blood gas analysis before extubation related to early withdraw venti-lator in infants with congenital heart disease.Methods Collecting the blood gas analysis datas before extubation of infants with congenital heart disease who were treated with CICU in our hospital from 2014. 01.01 to 2017.01.01, To analyze the relationship between early withdraw ventialtor and the blood gas analysis before extubation. Re-sults 1.Univariate analysis showed that infants with congenital heart disease early postoperative rate of weaning were related to blood gas analysis before extubation with PH,HCO3-,Lac-,SaO2,A-aDO2,respiratory index and oxygenation index(P<0.05).2.The results of non conditional logisitic regression analysis showed that PH,HCO3-and Lac- were independent factors,the value of OR(95%CI) were 50.1(80-311),1.51(1.12-2.02) and 0.18 (0.05-0.65). Conclusion In infants with congenital heart disease before extubation SaO2high,A-aDO2≤ 100 mmHg,respiratory index low and oxygenation index high were the important factors of postoperative early weaning;The PH,HCO3-and Lac-were independent factors,even though early withdrawal unit blood gas analysis before ex-tubation the index is inferior to late withdrawal unit's,it can also achieve early weaning in the basic normal value range.
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Objective To analyze the preoperative related factors of early weaning of infants with congenital heart disease after operation. Methods From January ,2014 to January ,2017 in Pediatric Cardiology CICU , infants with congenital heart disease were selected as research objects. The clinical data were retrospectively collect ed and the relationship between preoperative influencing factors and postoperative early weaning were analyzed. Early weaning meant mechanical ventilation time was shorter than 24 h and late weaning meant longer than 24 h. Results Single factor analysis showed that early weaning success rate was related to preoperative cardiac function grade 1,NNIS grade 0~1,ASA grade 1,no lung infection and no or mild pulmonary hypertension(average P<0.05). Non conditional logistic regression analysis showed that preoperative heart function grade 1 was an indepen-dent influencing factor,with OR value(95%CI)of 3.9(1.9~7.7). Conclusions In infants with congenital heart disease,preoperative heart function grade 1,NNIS grade 0 ~ 1 ,ASA grade 1,no lung infection and no or mild pulmonary hypertension benefit early withdrawing of ventilator and preoperative cardiac function grade 1 is an inde-pendent factor for early weaning.
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Objective To explore the development and interaction of left and right ventricular function in healthy children using tissue Doppler imaging.Methods Healthy children aged 0-15 years and adolescents were recruited,then children were divided into 6 groups:0-1 year,＞ 1-3 years,＞ 3-6 years,＞ 6-9 years,＞ 9-12 years,＞ 12-15 years.Healthy adolescents aged ＞ 15-25 years were also recruited.Every subject underwent echocardiography including cardiac dimension measurements,atrio-ventricular valvular velocity and early-diastolic flow velocity(E)/late-diastolic flow evlocity(A) ratio measured by pulsed color Doppler,atrio-ventricular annular myocardial velocity (including systolic velocity (s),early diastolic velocity (e) and late diastolic velocity (a)),time intervals (including isovolumic contraction time,ejection time and isovolumic relaxation time),isovolumic acceleration (ⅣA) and Tei index measured by tissue Doppler imaging.Results were compared among different groups,the correlations with age and other factors were explored.Furthermore,comparison was done between left and right ventricular functional parameters.Results Left ventricular Tei index and isovolumic contraction time were significantly lower during puberty.From infancy to pre-school stage,left ventricular E/A (flow velocity) and e/a(tissue velocity) increased accordingly,then presented with no significant changes among the following age groups(P ＞ 0.05).There were no significant differences in right ventricular Tei index,ⅣA,E/A (flow velocity) and e/a (tissue velocity) among the 6 groups (P ＞ 0.05).Left ventricular systolic myocardial velocity (s) and ⅣA were significantly lower than right ventricle (all P ＜ 0.001).However,left ventricular E/e(flow velocity) and e/a(tissue velocity) were significantly greater than right ventricle (all P ＜0.001).Conclusions In healthy children,left ventricular systolic function enhances during puberty,diastolic function increases from infancy to pre-school stage,then keeps stable till adolescents.Right ventricular systolic and diastolic function present with no significant changes during growth.Left ventricular diastolic function is greater than right one,however,right ventricular longitudinal systolic function is greater than left one.
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AIM:To observe the effect of motilium on bronchial asthma associated with gastroesophageal reflux(GER BA). METHODS:50 cases of GER BA, were treated with routine anti asthma and motilium 20 mg tid,ranitidine 0.3 g,amoxicillin 0.5 g and metronidazolum 0.2 g tid for chronic gastritis cases, and losec 20 mg for the gastric acid rdflux at night. The treatment lasted for 1-4 wk, and then stopped to observe the response of the treatmeat. The recurrent cases would be treated as the above again. RESULTS:45 cases were cured in the 4 wk,no case recrudesced in 6 mon. 5 cases needed another the treatment for 1-4 wk since the recurrence, and 4 of the 5 cases were cured. CONCLUSION: Motilium has a good curative effect in preventing and curing bronchial asthma associated with gastroesophageal reflux.entfor1 -4wksin
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AIM: To analyze the relation of hypoglycemic coma and xiaoke pills. METHODS: The relation of hypoglycemic coma and xiaoke pills were analyzed retrospectively from the five cases of old patients. RESULTS: All the five old patients with diabetes died of hypoglycemic coma on the seventh day to the thirteenth day, after taking xiaoke pills. CONCLUSION: It must be cautious for xiaoke pills to treat diabetes in elderly patients.