Diaphragm function in post-upper abdominal surgery: High-flow nasal cannula (HFNC) versus nasal cannula - a pilot study.

OBJECTIVE: This pilot study was performed to identify the differences between the effectiveness of HFNC and conventional oxygen therapy. METHODS: This study was a part of a more extensive ongoing study in a tertiary care hospital from January to April 2019. Criteria for inclusion were adult patients scheduled for upper-abdominal surgery. Patients were randomised into two groups: conventional oxygen therapy (n=10) and HFNC therapy (n=10). The differences in (clinical parameters;Mean Arterial Pressure (MAP), heart rate, respiratory rate), diaphragm thickening on ultrasound, air lung distribution on Electrical Impedance Tomography (EIT), and blood gas analysis data between both groups were assessed at specific times. Adverse events were recorded and treated during the study. The data collected was analysed using SPSS software version 23.0. RESULTS: During the recuritment of patients, no issues were indentified in this study. Therefore, no clinical or statistical differences in EIT and ultrasound diaphragm thickening between the two groups were observed; no clinical or statistical differences in patterns in clinical parameters were found. The mean arterial PO2 was particulary different at time 1: 137.10 mmHg for patients in the conventional therapy group and 93.95 mmHg in the HFNC group (p = 0.001). A patient in the HFNC group reported a feeling of discomfort. CONCLUSIONS: The aim of this study was to observe differences between HFNC and conventional oxygen therapy. Nonetheless, more data are needed in order to achieve a conclusive result.

A PROspective study on the Usage patterns of Doripenem in the Asia-Pacific region (PROUD study).

Doripenem is approved in the Asia-Pacific (APAC) region for treating nosocomial pneumonia (NP) including ventilator-associated pneumonia (VAP), complicated intra-abdominal infections (cIAIs) and complicated urinary tract infections (cUTIs). Clinical usage of doripenem (500mg intravenously, infused over 1h or 4h every 8h for 5-14 days) in APAC was evaluated in a prospective, open-label, non-comparative, multicentre study of inpatients (≥18 years) with NP, VAP, cIAI or cUTI. A total of 216 [intention-to-treat (ITT)] patients received doripenem: 53 NP (24.5%); 77 VAP (35.6%); 67 cIAI (31.0%); and 19 cUTI (8.8%). Doripenem MIC90 values for Pseudomonas aeruginosa, Acinetobacter baumannii, Escherichia coli and Klebsiella pneumoniae were 32, 32, 0.094 and 0.64µg/mL, respectively. Doripenem was used most commonly as monotherapy (86.6%) and as second-line therapy (62.0%). The clinical cure rate in clinically evaluable patients was 86.7% at the end of therapy (EOT) and 87.1% at test of cure (TOC) (7-14 days after EOT). In the ITT population, overall clinical cure rates were 66.2% at EOT and 56.5% at TOC. The median duration of hospital stay, intensive care unit (ICU) stay and mechanical ventilation was 20, 12 and 10 days, respectively. Of 146 discharged patients, 7 were re-admitted within 28 days of EOT; 1 VAP patient was re-admitted to the ICU. The all-cause mortality rate was 22.7% (49/216). The most common treatment-related adverse events were diarrhoea (1.4%) and vomiting (1.4%). Doripenem is a viable option for treating APAC patients with NP, VAP, cIAI or cUTI. [ClinicalTrials.gov: NCT 00986102].