ABSTRACT
OBJECTIVE: To investigate the influencing factors in patients with septic shock and the predictive value of related parameters for AKI.METHODS: Totally 256 patients with septic shock treated in our hospital from January 2015 to December 2018 were collected.The patients were divided into acute kidney injury(AKI)group and non-AKI group.The miRNA-125,IL-6,neutrophil gelatinase associated lipocalin(NGAL)and tumor necrosis factor-a(TNF-a)were compared between two groups.Multi-factor Logistic regression analysis was used to assess the variables in predicting the incidence rate.The patients in AKI group were divided into mild-AKI group(AKI stage 1-2)and severe AKI group(AKI stage 3).The factors were statistically compared between two groups.RESULTS: The levels of miRNA-125 and NGAL in AKI group were significantly higher than those in non-AKI group.The creatinine(OR 1.03,95%CI 0.88-1.36),glomerular filtration rate(OR1.23,95% CI 0.75-2.01),miRNA-125(OR 1.56,95% CI 1.02-2.10)and NGAL(OR 1.32,95%CI 0.83-1.67)were associated with AKI(P<0.05).The levels of miRNA-125,NGAL and TNF-a in severe AKI group were significantly higher than those in mild and moderate AKI group(P<0.05).The area under curve of miRNA-125 was 0.80(95%CI 0.75-0.83),the best cut-off value was 32.1,and the sensitivity and specificity were 81.5% and 76.2%.CONCLUSION: The creatinine,glomerular filtration rate and the level of miRNA-125 and NGAL were independently associated with AKI.The level of miRNA-125 can predict the incidence of AKI.
ABSTRACT
<p><b>BACKGROUND</b>Anxiety and fear frequently causes an aversion to applying a face mask and increases difficulty during pediatric induction. There is at present little study of this problem. Therefore, the aim of this study was to investigate the effect of the combination of mask preconditioning and midazolam pretreatment on mask acceptance during pediatric induction and on postoperative mask fear.</p><p><b>METHODS</b>One hundred and sixty children were randomly assigned into four groups: the mask preconditioning group (MaG), the midazolam pretreatment group (MiG), the mask/midazolam combination group (Ma/MiG), and the saline group (SaG). The Modified Yale Preoperative Anxiety Scale (m-YPAS) was employed to assess the anxiety in the operation room (OR). A Mask Acceptance Score (MAS) was measured during inhalational induction and the incidence of mask fear (MAS ≤ 2) was evaluated postoperatively.</p><p><b>RESULTS</b>The MaG and Ma/MiG groups had the highest mask acceptance scores but there were no differences between these two groups (P < 0.05). The average anxiety level of children entering the OR was much lower in the MaG and Ma/MiG groups than in the SaG group (P < 0.05). During induction, the anxiety level increased in the SaG and MaG groups but decreased in the MiG and Ma/MiG groups (P < 0.05). At the postoperative third day, the incidence of mask fears was as high as 23% in the SaG group, 15% in the MiG group, but only 2.5% in the MaG and Ma/MiG groups.</p><p><b>CONCLUSIONS</b>The single use of mask preconditioning has a better influence than midazolam for increasing mask acceptance during inhalational induction and reducing postoperative mask fear, reducing the anxiety level during induction, improving induction compliance and shortening the total mask time. A mask preconditioning and midazolam combination did not increase mask acceptance during inhalational induction, reduce mask fears postoperatively, improve induction compliance, nor shorten the total mask time. But it can better reduce the anxiety level during induction.</p>
Subject(s)
Child , Child, Preschool , Female , Humans , Male , Anxiety , Fear , Masks , Midazolam , Therapeutic UsesABSTRACT
0.05)in the former part of the surgery that was before the beginning of the surgery via anterior route.But in group B,only propofol for sedation was used for the patients during the latter part of the surgery via the anterior route or while the nerve plexus was blocked; during this time in group A,the addition of fentanyl and vecuronium were still intermittently necessary to maintain the general anesthesia.The duration between the completion of surgery and the recovery of spontaneous breathing,times for initial conscious reaction such as opening the eyes following an order, extubation and from extubation to complete recovery were significantly shorter in group B than those in group A(all P