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Objective To analyze the pathogenic factors, clinical features and treatment measures of critically ill pregnant women so as to provide experience for improving the success rate of treatment. Methods The clinical data of 167 cases of critically ill pregnant women who admitted to intensive care unit (ICU) of the Affiliated Hospital of Guizhou Medical University from January 2013 to December 2017 were collected, and the disease distribution of patients, the causes of postpartum hemorrhage, the treatment situation and the results. Patients were divided into obstetrical complications group, pregnancy complicated with basic diseases group and other complicated diseases group according to disease types, and the treatment status of each group was analyzed. Results Among 167 critically ill pregnant women, 118 cases (70.6%) were in the obstetric complications group, 26 cases (15.6%) were in the pregnancy complicated with basic diseases group, and 23 cases (13.8%) were in the other complicated diseases group. Nine cases died in 167 critically ill pregnant women, with a mortality rate of 5.4%. Postpartum hemorrhage was the major obstetric complication (35.3%), and the coagulation function of 59 patients with postpartum hemorrhage was significantly improved 48 hours after active hemostasis and reasonable blood transfusion [compared to entering the ICU, prothrombin time (PT, s): 14.49±4.66 vs. 23.39±8.11, activated partial thromboplastin time (APTT, s): 52.94±36.36 vs. 87.35±74.69, fibrinogen (Fib, g/L): 2.91±1.03 vs. 1.03±0.65, platelet count (PLT, ×109/L): 94.85±30.09 vs. 43.15±24.07, all P < 0.01]. Compared with pregnancy complicated basic diseases group and other complicated diseases group, the acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) scores was reduced significantly in obstetrical complications group (10.41±4.85 vs. 16.46±13.87, 16.90±8.82, both P < 0.05), the length of ICU stay was significantly reduced (hours: 57.83±34.67 vs. 79.64±36.01, 278.30±83.72, both P < 0.05). Compared with other complicated diseases group, the mechanical ventilation time [hours :14 (6, 38) vs. 43 (12, 396)] and mortality (0.8% vs. 13.0%) were significantly decreased in obstetrical complications group (both P < 0.05). Conclusions Observe the changes of the condition closely, necessary hemodynamic treatment, respiratory support, and organ function support with critically ill pregnant women can improve the rescue success rate and prognosis.
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Objective To analyze the value of serum procalcitonin (PCT) in patients with community acquired pneumonia (CAP),and to evaluate the role of PCT in the therapeutic effect,severity and prognosis.Methods A retrospective analysis of data and laboratory tests of 50 patients with CAP admitted from November 15,2011 to November 15,2012 in GICU was carried out.Patients with infection of other parts of body,surgical treatment and trauma were ruled out.The level of PCT (ng/mL) before and during treatment,and the relationships between PCT and respiratory failure,mechanical ventilation,treatment results were analyzed respectively.Results According to the occurrence of sepsis,50 patients were divided into sepsis group and non-sepsis group.In the non-sepsis group,the PCT level before treatment,the highest and average PCT levels during the treatment were 0.1125 (0.078,0.269),0.1235 (0.078,0.494),and 0.1355 (0.08,0.245) respectively.Correspondingly,the PCT levels in the sepsis group were 8.92 (2.715,16.33),13.53 (6.305,25.625),and 4.26 (2.1415,8.2455),and there were statistically significant differences in three values of PCT between groups (ZIst =-4.743,PIST ＜ 0.05 ; ZMax =-5.783,PMax ＜ 0.05 ; ZMean =-5.644,PMean ＜ 0.05).According to the emergence of respiratory failure during treatment,average PCT level in the patients with respiratory failure was 1.7375 (0.224,5.092),and that in the patients without respiratory failure was 0.081 ng/mL (0.049,0.146),presenting the statistically significant difference between two groups (Z =4.472,P ＜ 0.05).In case of using mechanical ventilation (MV),the average PCT level of the patients with mechanical ventilation was 1.618 ng/mL (0.224,5.092),and that in the patients without MV was 0.086 ng/mL (0.061,0.465),producing a significant difference between the two groups (Z =-3.788,P ＜ 0.05).Grouped according to the outcome of patients,the mean value of PCT level in death group was 7.4585 ng/mL (2.392,16.25),and that in the survival group was 0.1965 ng/mL (0.885,0.618),showing statistically significant difference between two groups (Z =3.857,P ＜ 0.05).The first PCT level in the GICU within 24 h after admission was used to make the receiver operating characteristic curve (ROC),and the area under the curve (AUC) was 0.9867,cutoff point was 1.25 ng/mL.Conclusions In case of CAP,the PCT level in patients with sepsis is significantly higher than that in patients without sepsis,and PCT can distinguish sepsis from pneumonia precisely.In addition,PCT is an important biomarker to judge the severity and outcomes of CAP at early stage.
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Objective To assess the risk of emergent endotracheal intubations in pediatric intensive care unite (PICU ) and to de-termine the risk factors of complications .Methods A prospective study was conducted with unified tables to collected data of all e-mergent intubations occurring in PICU between November 2011 and May 2012 .All the children were divided into group of any com-plication and group of no complication .Results (1)69 .1% children of emergent intubations had complications including desatura-tion(67 .9% ) ,bradycardia(29 .8% ) ,vomiting (16 .7% ) .(2)Emergent endotracheal intubations were 1 .7 times more likely to occur off-hours .Off-hours intubations were associated with 2 .7 times the risk of complications as on-hours intubations .(3)In a multivari-ate logistic regression analysis ,the nasal tracheal intubation ,two or more attempts at intubation ,and off-hours intubation were asso-ciated with complications .Conclusion Emergent endotracheal intubation are 1 .7 times more likely to occur off-hours .off-hours in-tubations ,the nasal tracheal intubation ,two or more attempts at intubation ,are associated with complications .
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Objective:To investigate the perceptions of ICU patients on nurse caring behaviors and related factors,then raise nursing straties. Methods:101 ICU patient samples were selected from two tertiary general hospital(sGrdae A)in Fuzhou.The mod- ified caring behavior assessmen(tCBA)scale was used to interview the subjects. Results:The most important caring behaviors were to help patients satisfy their basical requiments. There were statistically significant differences in the perceptions of importance of nurse caring behaviors among the patients’demographic data such as marriage and length stayed in ICU.Conclusion:ICU patients need nurse caring behaviors. Nurses should provide patients with individual caring behaviors to satisfy their requi-ments. So nursing quality and patient satisfaction would be improved.