Implication of cognitive-behavioral stress management on anxiety, depression, and quality of life in acute myocardial infarction patients after percutaneous coronary intervention: a multicenter, randomized, controlled study.

OBJECTIVE: Cognitive-behavioral stress management (CBSM) intervention enhances the psychological status and quality of life in patients with various diseases, such as cancer, human immunodeficiency virus infection, chronic fatigue syndrome, and multiple sclerosis. This multicenter, randomized, controlled study intended to explore the potential benefit of CBSM in ameliorating the anxiety, depression, and quality of life (QoL) in acute myocardial infarction (AMI) patients after percutaneous coronary intervention (PCI). METHODS: A total of 250 AMI patients who received PCI were randomly allocated to the CBSM (N = 125) and control care (CC) (N = 125) groups, and underwent weekly corresponding interventions for 12 weeks. The hospital anxiety and depression scale (HADS), EuroQol 5D (EQ-5D), and EuroQol visual analogue scale (EQ-VAS) scores were evaluated at baseline (M0), month (M)1, M3, and M6. Major adverse cardiovascular events (MACE) were recorded during follow-up. RESULTS: HADS-anxiety score at M1 (P = 0.036), M3 (P = 0.002), and M6 (P = 0.001), as well as anxiety rate at M6 (P = 0.026), was reduced in the CBSM group versus the CC group. HADS-depression score at M3 (P = 0.027) and M6 (P = 0.002), as well as depression rate at M6 (P = 0.013), was decreased in the CBSM group versus the CC group. EQ-5D score at M3 (P = 0.046) and M6 (P = 0.001) was reduced, while EQ-VAS score at M1 (P = 0.037), M3 (P = 0.010), and M6 (P = 0.003) was raised, in the CBSM group versus the CC group. However, accumulating MACE rate did not differ between the two groups (P = 0.360). CONCLUSION: CBSM ameliorates anxiety, depression, and QoL but does not affect MACE in AMI patients after PCI.

[Experimental study of the monitoring bias of pressure in intubation balloon using handheld pressure gauge].

OBJECTIVE: To explore the bias between the real pressure and the measured values when handheld pressure gauge (HPG) was used to monitor intermittently the pressure in the intubation balloon, so as to provide some measures for the correct use of HPG. METHODS: In the first part of the study, HPG was used to measure the pressure with the balloon connected with a three-way tube with which to control the inflation and deflation in a laboratory to measure the pressure in the air bag. After gaining the deviation in this in vitro experiment, it was tested and verified in vivo in adult patients undergoing endotracheal intubation. RESULTS: After 132 times of measurements, it was found that measurement with a HPG might result in an "inherent loss" (3.928±0.291) cmH2O (1 cmH2O=0.098 kPa, t=155.273, P=0.000) between inflation value [(30.000±0.000) cmH2O] and measured value [(26.072±0.291) cmH2O]. In addition, after 214 times repeated measurements, the pressure "loss" during disconnection of the gauge was as high as (1.196±0.954) cmH2O (t=18.348, P=0.000) between filled values [(30.000±0.000) cmH2O] and measured values [(28.804±0.954) cmH2O] and it was named as "error loss". At last, the total error was verified by clinical test, and it was (5.270±2.583) cmH2O (t=29.632, P=0.000) between pressure of filled value [(30.000±0.000) cmH2O] and measured value [(24.730±2.583) cmH2O]. CONCLUSIONS: When the balloon pressure was monitored intermittently with HPG, the real value should be the measured value plus the "error". In addition, subglottic aspiration should be done before the connection of the balloon to the gauge to prevent the secretions on the cuff falls into the deeper airway, and to maintain the cuff pressure at 30 cmH2O.