RESUMO
Small-bore flexible feeding tubes decrease the risk of ulceration of the nose, pharynx, and stomach compared with large-bore and more rigid tubes. However, small-bore feeding tubes have more respiratory system complications, such as pneumothorax, hydropneumothorax, bronchopleural fistula, and pneumonia, which are associated with significant morbidity and mortality. Thus, it is important to confirm the correct position of feeding tubes. Chest X-ray is the gold standard to detect tracheal malpositioning of the feeding tube. We present three cases in which intubated patients exhibited an altered mental state. An assistant guide wire was used at the insertion of small-bore feeding tubes. These conditions are thought to be potential risk factors for tracheobronchial malpositioning of feeding tubes.
Assuntos
Humanos , Cuidados Críticos , Estado Terminal , Nutrição Enteral , Fístula , Hidropneumotórax , Mortalidade , Nariz , Faringe , Pneumonia , Pneumotórax , Sistema Respiratório , Fatores de Risco , Estômago , Tórax , ÚlceraRESUMO
BACKGROUND: Percutaneous dilatational tracheostomy (PDT) performed by an intensivist in critically ill patients is currently popular. Many studies support the safety and feasibility of PDT. However, there is limited data on the safety and feasibility of PDT performed by intensive care trainees. METHODS: To evaluate the safety and feasibility of PDT performed by intensive care trainees and to compare these with those performed by intensivists, we retrospectively analyzed the clinical characteristics and adverse events of all prospectively registered patients who underwent PDT by ICT or intensivists in intensive care units (ICUs) from August 2010 to August 2013. RESULTS: In the study period, 203 patients underwent PDT in ICUs; 139 (68%) by trainees and 64 (32%) by intensivists. There were no statistically significant differences in clinical characteristics including demographics, laboratory findings, and parameters of mechanical ventilation between the two groups. Procedure times and outcomes of the patients were not different between the two groups. The majority of complications observed in 24 hours after PDT were bleeding; however, there was no significant difference between the two groups (trainee 10.8% vs. intensivist 9.4%, p = 0.758). There was no procedure-related death in the two groups. CONCLUSIONS: PDT performed by intensive care trainees was safe and feasible. However, further well-designed studies should be conducted to confirm our results.
Assuntos
Humanos , Estado Terminal , Demografia , Educação , Bolsas de Estudo , Hemorragia , Unidades de Terapia Intensiva , Cuidados Críticos , Estudos Prospectivos , Respiração Artificial , Estudos Retrospectivos , Procedimentos Cirúrgicos Minimamente Invasivos , TraqueostomiaRESUMO
We have constructed the Rice Genome Information Service System (RGISS), which is an information service system of the Oryza sativa L. ssp. japonica (rice) genome, using the released version of rice Build 3.0 pseudomolecules based on the Ensembl architecture. The nonredundant library, composed of 3,360 clones of BACs, PACs, and fosmids, was used to construct supercontigs. RGISS contains 50,717 annotated genes from GenBank, 56,161 predicted genes from FgeneSH, and information on 9,587 markers, which includes STS, SSR, and EST-based RFLP. The 20,180 ESTs sequenced by the Korea National Institute of Agricultural Biotechnology (NIAB) were aligned and mapped into 168,792 exons. By gene ontology analysis, the classified protein numbers in the rice genome were 6158, 4531, and 12,364 proteins, which were mapped to molecular function, cellular component, and biological process, respectively.