ABSTRACT
The studies done on lung protective strategies in medical ventilators have shown that tidal volume of 6-ml/ kg predicted body weight protects the lungs of a patient during the invasive ventilation for acute respiratory distress syndrome (ARDS) patients in intensive care unit. Corona virus disease 2019 has increased the need for mechanical ventilation, which are operated manually, in changing the settings on the mechanical ventilators. In this study, fuzzy logic method is used to develop a computer-aided decision-making to improve on the accuracy of the reasoning done during the ventilator setting adjustment, by adding the fuzzy reasoning concept into the ARDS Berlin definition. The ARDS positive end-expiratory pressure (PEEP) values were used in building the fuzzy rules of the fuzzy algorithm. From the experimental results, the algorithm mimics the recommended ARDS PEEP values with respect to the values of fraction of inspired oxygen (FiO2);the algorithm as well increases the respiratory rate and tidal volume for potential of Hydrogen (pH) less than 7.2;maintains the respiratory rate and tidal volume for pH between 7.2 and 7.4;decreases the respiratory rate;and maintains the tidal volume for pH greater than 7.4. The developed fuzzy system can therefore be applied as a physician–ventilator interface to guide the clinician/physician during the ventilation, so as, to reduce the human errors and ensure lung protection. © 2023, The Author(s) under exclusive licence to Taiwan Fuzzy Systems Association.
ABSTRACT
An introduction is presented in which the author discusses articles within the issue on topics including environmental contamination by SARS-CoV-2 from COVID-19 19 subjects receiving noninvasive ventilation, SARS-CoV-2 aerosols during noninvasive respiratory support of COVID-19 patients, and response of positive airway pressure devices during treatment of sleep-disordered breathing.
ABSTRACT
An introduction is presented in which the author discusses articles within the issue on topics including environmental contamination by SARS-CoV-2 from COVID-19 19 subjects receiving noninvasive ventilation, SARS-CoV-2 aerosols during noninvasive respiratory support of COVID-19 patients, and response of positive airway pressure devices during treatment of sleep-disordered breathing.
ABSTRACT
The author reviews the use of enteral nutrition in critically ill patients during prone positioning.
ABSTRACT
Objective: To analyze the epidemiological and clinical characteristics, and imaging features of patients with COVID-19 in Henan Province People's Hospital. Methods: The epidemiology, clinical symptoms, laboratory and radiologic data of 49 patients with COVID-19 infection admitted to the department of infectious disease in our hospital from January 23, 2020 to February 22, 2020 were retrospectively analyzed. All analyses were performed with SPSS software, version 22.0. Results: A total of 49 patients with COVID-19 were enrolled, of which 28 were ordinary, 16 were severe, and 5 were critical in disease severity. The average ages of the 3 groups were (46±19) , (60±16) and (68±20) years, with statistical differences (P=0.015). Common symptoms at the onset were fever (41 patients), dry cough (35 patients), and fatigue (21 patients). Epidemiological investigations found that 31 (63%) patients had direct or indirect contact with confirmed cases, and 14 cases were family clustered. Laboratory test results showed that the lymphocyte counts progressively decreased [0.85 (0.5-1.6) ×10(9)/L,0.51 (0.4-0.9) ×10(9)/L and 0.43 (0.47-0.61) ×10(9)/L, respectively], while LDH [162 (145.1-203.5) U/L,265 (195.3-288.4) U/L and 387 (312.3-415.5) U/L, respectively] and D-dimer [0.15 (0.09-0.40) mg/L,0.4 (0.2-0.6) mg/L and 0.9 (0.5-1.4) mg/L, respectively] were significantly increased (P<0.05), in all the 3 groups. The levels of IL-6 [(43.2±15.4) µg/L, (78.5±31.2) µg/L and (132.4±47.9) µg/L, respectively] and IL-10 [(3.5±3.2) µg/L, (7.6±6.4) µg/L and (9.4±7.2) µg/L respectively] increased significantly with disease severity. Pulmonary imaging of ordinary patients mainly showed unilateral or bilateral multiple infiltrates, while severe and critically ill patients showed diffuse exudation and consolidation of both lungs, and a few patients showed signs of "white lungs". Conclusions: Patients with COVID-19 has a definite history of contact with diagnosed patients, and has family aggregation. The clinical symptoms were mainly fever and dry cough. Laboratory results showed that lymphocyte count, LDH, D-dimer, interleukin-6 and interleukin-10 levels had a significant correlation with the severity of the disease, which could be used as markers for disease progression and prognosis. Pulmonary imaging showed unilateral or bilateral ground glass infiltration. In severe and critically ill patients, diffuse infiltration and consolidation or even "white lung" were present.