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Transient,reversible myocardium injury can occur in patients with brain injury.Several pathophysiological mechanisms are involved in the development of such neurogenic myocardium injury.Excess catecholamine release plays a major role during myocardial injury.The clinical features include abnormal electrocardiographic,echocardiographic features and elevated biomarkers.In some patients stunned myocardium can be observed which may lead to hemodynamic instability or even cardiogenic shock.Inotropic agents and mechanical support are useful in improving cardiac function.β-adrenergic blockade is likely to attenuate the catecholamine toxicity but its use remains controversial.
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BACKGROUND@#Increased right ventricle afterload during acute respiratory distress syndrome (ARDS) may induce acute cor pulmonale (ACP), which is associated with a poor clinical outcome. Echocardiography is now considered as a rapid and non-invasive tool for diagnosis of ACP. The aims of this study were to investigate the morbidity and mortality rates of ACP in ARDS patients in intensive care units (ICUs) across the mainland of China and to determine the severity and prognosis of ACP in ARDS patients through an ultrasound protocol (TRIP). And the association between ACP related factors and the ICU mortality will be revealed.@*METHODS@#This study is a multicenter and cross-sectional study in China which will include ICU participants when diagnosed as ARDS. The ultrasound protocol, known as the TRIP, is proposed as severity assessment for ACP, which includes tricuspid regurgitation velocity (T), right ventricular size (R), inferior vena cava diameter fluctuation (I), and pulmonary regurgitation velocity (P). The 28-day mortality, ICU/hospital mortality, the length of stay in ICU, mechanical ventilation days, hemodynamic parameters and lab parameters of liver function and kidney function are all recorded.@*DISCUSSION@#This large-scale study would give a sufficient epidemic investigation of ACP in ARDS patients in China. In addition, with the TRIP protocol, we expect that we could stratify ACP with more echocardiography parameters.@*TRIAL REGISTRATION@#NCT03827863, https://clinicaltrials.gov/ct2/show/NCT03827863.
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Objective To investigate the application of hypertension prevention knowledge and health education combined with Extended Release Nifedipine Tablets in the prevention and treatment of hypertension and its influence on blood pressure control. Methods 110 cases of hypertension patients in our hospital from March 2015 to April 2016 were randomly divided into two groups, the control group was treated with Extended Release Nifedipine Tablets, and the study group was combined with health education. Results The treatment effect of the study group was significantly better than that of the control group (P<0.05). Conclusion Combined Application of health education is beneficial to improve blood pressure control level in patients with hypertension.
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Objective To investigate the application of hypertension prevention knowledge and health education combined with Extended Release Nifedipine Tablets in the prevention and treatment of hypertension and its influence on blood pressure control. Methods 110 cases of hypertension patients in our hospital from March 2015 to April 2016 were randomly divided into two groups, the control group was treated with Extended Release Nifedipine Tablets, and the study group was combined with health education. Results The treatment effect of the study group was significantly better than that of the control group (P<0.05). Conclusion Combined Application of health education is beneficial to improve blood pressure control level in patients with hypertension.
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<p><b>OBJECTIVE</b>To explore the risk factors for acute respiratory distress syndrome (ARDS) in children receiving surgeries for critical and complex congenital heart disease (CCHD).</p><p><b>METHODS</b>According to the 2011's Berlin definition of ARDS, the clinical data were collected from 75 children without ARDS (group I) and 80 children with ARDS (group II) following surgeries for CCHD performed in the Department of Cardiac Surgery of our hospital from January, 2009 to May, 2014. Univariate analyses and logistic regression were used to analyze the risk factors contributing to the occurrence of ARDS following the surgeries.</p><p><b>RESULTS</b>In the 80 patients who developed ARDS postoperatively in group II, 27 had mild ARDS, 25 had moderate ARDS, and 28 had severe ARDS; death occurred in 17 (21%) cases. Univariate analyses showed that 23 parameters were significantly different between groups I and II (P<0.05), including weight; preoperative PCO2, left ventricular ejection fraction, pulmonary artery pressure, pulmonary infection, and coagulation abnormalities; early postoperative serum globulin; intraoperative aortic cross clamp (ACC) time; cardiopulmonary bypass (CPB) time; operation time; blood loss and blood transfusion amount intraoperatively and during the first 8 h after operation; lactic acid level immediately after the operation and its maximum increasing rate within 24 h postoperatively; postoperative serum levels of albumin and creatinine; serum levels of B-type natriuretic peptide, procalcitonin, C-reactive protein, and prealbumin 24 h after operation; and age. Logistic regression analyses showed that intraoperative ACC time, CPB time, the maximum increasing rate of lactic acid within 24 h after operation, serum procalcitonin 24 h after operation and intraoperative blood loss were independent risk factors for postoperative ARDS.</p><p><b>CONCLUSION</b>The risk factors of ARDS identified in these children can predict the occurrence of ARDS following the surgeries and timely interventions can improve the success rate in treatment of postoperative ARDS in children with CCHD.</p>