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1.
Article in Chinese | WPRIM | ID: wpr-930839

ABSTRACT

Sepsis caused by bacterial infection is still one of the major causes of death in pediatric intensive care units, and the early and rational use of antibiotics plays a key role in reducing the mortality of sepsis.At present, there are some problems regarding appropriate and excessive use of antibiotics in pediatric intensive care units in China.Therefore, it is of great significance to strengthen the management of the use of antibiotics and avoid inappropriate and excessive use while effectively controlling infection, so as to reduce the occurrence of adverse drug reactions and bacterial drug resistance.

2.
Article in Chinese | WPRIM | ID: wpr-930493

ABSTRACT

Objective:To analyze and summarize the clinical characteristics, diagnosis and treatment, head imaging changes and prognosis of acute necrotizing encephalopathy of childhood (ANEC), aiming to improve the understanding of this disease.Methods:Clinical data of 13 ANEC patients (there were 7 males and 6 females, the median age was 30 months) admitted to the Pediatric Intensive Care Unit (PICU) of Shengjing Hospital, China Medical University from January 2014 to December 2020 were retrospectively analyzed, including clinical manifestations, laboratory examinations, diagnosis and treatment procedures, and head imaging data.Survivors were followed up through telephone.Results:All patients had fever and convulsions before admission, and the median time between fever and consciousness disturbance was 48 hours.The magnetic resonance imaging scans showed symmetrical multifocal brain damages.All 13 patients used glucocorticoid treatment, 10 cases used human immunoglobulin treatment, 8 cases used plasma exchange treatment.A total of 7/13 patients died.Five children were regularly followed up, who presented normal height and weight development and normal immunity.One child had normal motor intelligence with the acceptable Pediatric Overall Performance Category Score, and the remaining 4 children had certain sequelae, mainly manifesting as slow speech speed and limited movement.Conclusions:ANEC mainly occurs in winter and young children with a high mortality.It progresses rapidly, and consciousness disturbance appears soon after fever and convulsion.Survivors usually have sequelae, mostly manifesting as slow speech speed and limited movement, which can be significantly improved after systematic rehabilitation treatment.

3.
Article in Chinese | WPRIM | ID: wpr-908363

ABSTRACT

Objective:This paper makes a comprehensive evaluation on the columns of Chinese Pediatric Emergency Medicine from communication effect and citation effect, and analyzes the advantages and disadvantages of each column setting, so as to provide evidence-based basis for journal soliciting contributions, and guide column selection planning.Methods:The communication index (website browsing frequency, website download frequency, Wanfang download frequency) and citation index (citation frequency, zero citation rate, high citation rate, high citation rate ratio) of columns in Chinese Pediatric Emergency Medicine from 2016 to 2018 were counted, and whether there were statistical differences among the evaluation indexes of columns was analyzed.Results:In terms of communication index: among the top 20 column communication indicators, comments and guidance columns account for a very high proportion; The communication index of comment column and guidance column was significantly higher than that of other columns, and the differences were statistically significant; There was no significant difference between Article column and Clinical application research column.In terms of citation index: the citation frequency and high citation rate of the Article column are the highest, while the zero citation rate is the lowest, and there was no significant difference among the four columns of Expert forum, Clinical application research, Review and Guideline·consensus·interpretation; The high citation rate ratio of the Guideline·consensus·interpretation column is the highest, followed by the Article column, and the two columns are significantly higher than the Expert forum column; Among the top 20 papers with the highest citation frequency, the column of treatise accounts for 65%.Conclusion:Expert forum column and Guidelin·consensus·interpretation column are the key to influence the communication effect of journals.Article column and Guidelin·consensus·interpretation column are the key to influence the citation effect of journals.The absolute value of evaluation index can not scientifically evaluate the academic quality of journals.

4.
Chinese Journal of Biotechnology ; (12): 4373-4381, 2021.
Article in Chinese | WPRIM | ID: wpr-921513

ABSTRACT

Lager yeast is the most popular yeast strain used for beer production in China. The flocculation of yeast plays an important role in cell separation at the end of fermentation. Therefore, appropriately enhancing the flocculation capability of the lager yeast without affecting its fermentation performance would be desirable for beer industry. Our previous study showed that the defect of gene RIM21 might contribute to the enhanced flocculation capability of a lager yeast G03. To further investigate the role of the RIM21 gene in flocculation of strain G03, this study constructed a RIM21-deleted mutant strain G03-RIM21Δ through homologous recombination. Deletion of RIM21 improved the flocculation capability of strain G03 during wort fermentation at 11 °C without changing its fermentation performance significantly. The expression of FLO5, Lg-FLO1 and some other genes involved in cell wall integrity pathway were up-regulated in strain G03-RIM21Δ. In addition, the disruption of RIM21 enhanced resistance of yeast cells to cell wall inhibitors. These results provide a basis for elucidating the flocculation mechanism of lager yeast under low-temperature fermentation conditions.


Subject(s)
Beer , Fermentation , Flocculation , Receptors, Cell Surface , Saccharomyces/metabolism , Saccharomyces cerevisiae/metabolism , Saccharomyces cerevisiae Proteins/metabolism
5.
Article in Chinese | WPRIM | ID: wpr-883210

ABSTRACT

Objective:To evaluate the predictive value of the pediatric sequential organ failure assessment (pSOFA) in predicting the prognosis of infected children.Methods:We performed a retrospective analysis of children with infection or suspected infection who were hospitalized at PICU from January 1, 2018 to December 31, 2018.The worst physiological and laboratory indicators detected within 24 hours after admission were collected.The pSOFA and systemic inflammatory reaction syndrome(SIRS) score were used for diagnosis.Patients with pSOFA≥2 and SIRS score≥2 were included.Pediatric multiple organ dysfunction score(P-MODS), pediatric logistic organ dysfunction(PELOD-2), and pediatric critical illness score were performed for those patients who met the criteria.Survival or death during hospitalization was used to determine the prognosis, and death conditions with different scores of pSOFA and SIRS were analyzed.Receiver operation characteristic curve was used to evaluate the predictive value of pSOFA for the prognosis of children with infection.Results:A total of 755 cases were eligible for infection or suspected infection, among which 303 children were eligible for SIRS and pSOFA score ≥2, 165 cases were eligible for SIRS score ≥2 alone, 85 cases were eligible for pSOFA score ≥2 alone, and 53 cases were eligible for both.The in-hospital fatality rates of pSOFA 2, 3, 4, 5-6 and 7-9 points were 8.97%, 15.38%, 26.09%, 57.64% and 100%, respectively.With the increase of pSOFA, the fatality rate increased gradually.The in-hospital fatality rates of SIRS score 2, 3 and 4 were 3.64%, 12.64% and 4.76%, respectively.The area under the receiver operating characteristic curve of pSOFA was 0.74 (95% CI 0.62, 0.86), which was significantly higher than the other four scores.At a cut-off value of 4 points, it had a sensitivity of 56% and a specificity of 82% to predict prognosis. Conclusion:The pSOFA score has the highest accuracy than the SIRS score, P-MODS, PELOD-2 score and pediatric critical illness score in predicting the hospital mortality of PICU-infected children.

6.
Article in Chinese | WPRIM | ID: wpr-883188

ABSTRACT

Acute kidney injury(AKI)is a syndrome with many different causes and can occur at different stages throughout critical illness.Renal Doppler ultrasonography is the most appropriate imaging test in the evaluation of AKI and has the highest level of recommendation: (1)assessment of intrinsic causes of AKI, (2)distinguishing acute from chronic kidney diseases, (3)detection of the causes of obstruction.The resistive index in patients with AKI will be reviewed with attention to its use for predicting the development and prognosis of AKI.Meanwhile, combined application of cardiopulmonary ultrasound and evaluation of hemodynamics are helpful to evaluate the etiology, supervision and guiding treatment of AKI.

7.
Article in Chinese | WPRIM | ID: wpr-883159

ABSTRACT

Mycoplasma pneumonia is the smallest free-living and self-replicating prokaryotic microbe being devoid of cell wall, which can not only lead to respiratory system diseases in human, but also play an important role in a wide variety of extrapulmonary diseases, involving cardiovascular, neurological, digestive, skin, hematological systems, and so on.However, the pathomechanisms of mycoplasma pneumonia-related extra-pulmonary diseases(MpEPDs) remain largely unknown.Yet there are three main possible pathomechanisms of mycoplasma pneumonia causing MpEPDs: direct type, immune type and vascular occlusion.They are connected with each other and cooperate on promoting MpEPDs, especially in children and the young.Comprehensive therapeutic strategies cover microbiology, immunology and anticoagulants, while supportive treatments are necessary.Most patients recover from MpEPDs have a favorable prognosis.

8.
Article in Chinese | WPRIM | ID: wpr-883154

ABSTRACT

Objective:To evaluate the diagnostic and therapeutic value of bedside severe ultrasound in children with shock.Methods:Children who were diagnosed shock in the PICU of Shengjing Hospital of China Medical University from May 1, 2019 to April 31, 2020 were included in this study.Rapid ultrasound in shock (RUSH) exam was used to evaluate the morphology and function of heart, lung and abdomen of children with shock, so as to assist the diagnosis and treatment of shock.Results:Twenty-six children with shock were evaluated immediately according to the RUSH exam when they were admitted to hospital.Eight cases were diagnosed as septic shock, six cases as cardiogenic shock, six cases as hypovolemic shock and six cases as mixed shock.The left ventricular ejection fraction (LVEF) of children with cardiogenic shock was (26.5±8.24)%, and the width of inferior vena cava was greater than 10 mm.After the shock was corrected, LVEF increased to (32.17±26.11)%.However, the LVEF of children with septic shock was (73.25±1.28)% at admission and (50.12±31.41)% at shock correction.Nine cases (34.6%) found more B-lines in the lungs after fluid resuscitation for one hour in 26 children with shock.Among them, about 50% of the children with cardiogenic shock found more B-lines in their lungs one hour after fluid resuscitation, and 11 cases(57.9%) of the surviving children showed more B-lines after shock correction, but only six children could hear blisters after physical examination.Conclusion:According to RUSH exam, we can evaluate the volume status, cardiac function, volume responsiveness and focus on infection in children with shock, distinguish the type of shock earlier and more accurately, assist in guiding fluid resuscitation, and facilitate accurate and individualized fluid management and treatment of patients.

9.
Chinese Journal of Neurology ; (12): 1168-1175, 2021.
Article in Chinese | WPRIM | ID: wpr-911852

ABSTRACT

Objective:To investigate multimodality imaging characteristics and clinical features of lymphomatosis cerebri (LC) and reasons for misdiagnosis,with the goal of potentially facilitating an early and accurate diagnosis for this often-missed disease.Methods:Clinical data and cerebral multimodality imaging findings from 11 patients with LC proven basing on pathology in the Affiliated Hospital of Guizhou Medical University from November 30, 2011 to December 28, 2020 were retrospectively extracted, analyzed, and reviewed in combination with the literatures.Results:The common presenting symptoms with subacute onset included cognitive decline (8/11), gait disturbance (9/11), and behavioral disturbance (5/11). Test of cerebrospinal fluid showed that the number of cells and the level of protein increased (8/10), the sugar content (2/10) and chloride (4/10) decreased. The imaging manifestations of 11 patients with LC were diffuse lesions of bilateral cerebral white matter in the both deep and lobar lesion distribution, involving the cerebral cortex and subcortical white matter in eight cases (8/11), basal ganglia in seven cases (7/11), thalamus in five cases (5/11), cerebellum in six cases and brain stem in six cases (6/11). All 11 patients showed equal or slightly low-density shadows on CT plain scan and slightly longer T 1WI and T 2WI signals on magnetic resonance imaging. Six cases (6/11) had no obvious enhancement in the early stage, and five cases and six follow-up cases showed heterogenous spots, patches, nodules or clusters of distinct enhancement. Diffusion-weighted imaging showed non restricted diffusion in nine (9/11) cases initially diagnosed, and restricted diffusion in two cases (2/11) and nine follow-up cases, which were hyperintense on diffusion-weighted imaging and hypointense on apparent diffusion coefficient maps. Five patients (5/5) presented a marked decrease in N-acetyl aspartic acid (NAA)/creatine (Cr) and increase in choline (Cho)/Cr on hydrogen proton magnetic resonance spectrum, including an increase in lipid/Cr in three cases. One case (1/3) showed no abnormal increase in lesion metabolism, and two cases (2/3) showed slightly increased uptake on positron emission tomography/CT. Conclusions:Diffuse bilateral cerebral lesions especially in deep and lobar region, without enhancement or with patchy enhancement, marked decrease in NAA/Cr and increase in Cho/Cr and Lip/Cr are suggestive of LC. Misdiagnosis may be mainly due to insufficient understanding and improper brain biopsy.

10.
Chinese Journal of Neurology ; (12): 1071-1082, 2021.
Article in Chinese | WPRIM | ID: wpr-911838

ABSTRACT

The non-motor symptoms of Parkinson′s disease have received more and more attention, and they have become a hot spot in the study of Parkinson′s disease. The non-motor symptoms related to Parkinson′s disease, including sensory disturbances, neuropsychiatric symptoms, sleep disturbances, and autonomic dysfunctions were reviewed in this article, and their clinical manifestations, evaluation methods, and managements were emphasized.

11.
Chinese Journal of Neurology ; (12): 948-953, 2020.
Article in Chinese | WPRIM | ID: wpr-870911

ABSTRACT

Restless legs syndrome is one of the common non-motor symptoms of Parkinson′s disease. Previous studies on Parkinson′s disease with comorbid restless legs syndrome generated mixed results. This article reviews the studies on Parkinson′s disease with restless legs syndrome on aspects of its pathophysiology, epidemiology, clinical symptoms, genetics and biomarkers, radiology and treatment, aiming to provide physicians a comprehensive understanding on the characteristics of two entities.

12.
Article in Chinese | WPRIM | ID: wpr-864990

ABSTRACT

It is one of the ten leading causes of death worldwide and has become one of the leading causes in children.The receptor for advanced glycation end products (RAGE) is a membrane protein that belongs to the immunoglobulin superfamily.Recently, studies have shown that RAGE can be involved in sepsis induced myocardial injury, kidney injury, lung injury, abnormal coagulation function, liver injury and neuropathy, which is closely related with the development and prognosis of sepsis.

13.
Article in Chinese | WPRIM | ID: wpr-864897

ABSTRACT

Infectious disease is common in children.Accurate and rapid pathogen diagnosis can help clinicians to make targeted treatment and improve the outcome of children.The next-generation sequencing has been developed and applied in clinic recently, which has become a new method of pathogen diagnosis.Metagenomicnext-generation sequencing is the most widely used for pathogen detectation in infectious disease.It can detect all pathogens nucleic acids of the samples unbiasedly.This technology includes sample collection, nucleic acid extraction, library preparation, high-throughput sequencing, biological information analysis and report interpretation.As the complication of whole process involving clinical, microbiological and bioinformation fields, the interpretation of the report results needs to be carefully considered and verified by clinicians depends on the situation of patients and other auxiliary diagnostic methods.Clinicians need to understand next-generation sequencing in order to make better use of this technology and serve patients.

14.
Article in Chinese | WPRIM | ID: wpr-864889

ABSTRACT

Objective:Based on a cross-sectional survey about the status of analgesia and sedation nursing behavior of PICU nurses in Northeast China and Inner Mongolia, to analyze the influencing factors and to provide reference for further constructing standardized training programs and developing standardized for analgesia and sedation nursing process.Methods:The self-designed questionnaire was made for investigation from 435 PICU nurses in 18 hospitals in Northeast China and Inner Mongolia.Results:The average questionnaire score of the analgesia and sedation nursing behavior of PICU nurses was(70.54±13.63)in Northeast China and Inner Mongolia.The behavioral scores were different in each group between different age, nursing age, PICU nursing age, educational background, professional title, and whether was the intensive care unit nurse, whether trained in analgesia and sedation, whether have experience in caring children with analgesia and sedation, and the differences were all statistically significant( P<0.05). The main factors influencing the analgesia and sedation behavior of PICU nurses were whether have received training in analgesia and sedation, whether have experience in caring children with analgesia and sedation treatment and their attitude score to analgesia and sedation. Conclusion:There is still much space for development in analgesia and sedation nursing behavior of PICU nurses in Northeast China and Inner Mongolia.The more analgesia and sedation training PICU nurses take participate in, the more experience and positive attitudes they have in nursing children with analgesia and sedation, their clinical nursing practice ability could become more stronger.

15.
Article in Chinese | WPRIM | ID: wpr-864239

ABSTRACT

Blood purification technology is an effective method for the treatment of severe patients, which has made remarkable advances in recent years and extended from traditional renal replacement to the treatment of multiple diseases and supportive treatment of multiple organ dysfunction.Because of the complexity and variability of severe patients′ conditions, individualized schemes are needed for blood purification.Although blood purification technology has been widely used in the pediatric intensive care unit, it is not well standardized, and there are also cases of blind or excessive use.There are few evidence-based studies related to children, so more clinical studies are needed in the future.

16.
Chinese Journal of Neurology ; (12): 745-751, 2019.
Article in Chinese | WPRIM | ID: wpr-756061

ABSTRACT

Objective To explore the curative effect and safety of botulintum toxin A (BTX?A) on depressive disorder in patients with Parkinson′s disease (PD). Methods Forty?two cases of PD with depression prospectively recruited in the Second Hospital Affiliated to Soochow University from August 2016 to November 2018 were divided into two groups: 28 patients in BTX?A group (administered with 100 U BTX?A injection on patients′eyebrow, forehead, bilateral lateral canthus and temporal region at 20 loci), 14 patients in sertraline (control) group (administered with 50-100 (55.36±14.47) mg/d sertraline). The scores of Hamilton Depression Rating Scale (HAMD), Self?rating Depression Scale (SDS), Hamilton Rating Scale for Anxiety (HAMA), Self?rating Anxiety Scale (SAS) after treatment for 2 weeks, 4 weeks, 8 weeks and 12 weeks were compared with the scores of each emotional rating scale for baseline respectively. Meanwhile, the differences in the scores of each emotional scale between the two treatment groups were compared. In addition, the remission rates of depression and anxiety (defined as HAMD, HAMA scores<7) at each follow?up time point between the two groups were compared to evaluate the efficacy and safety of BTX?A in the treatment of PD patients with depression. Results The scores of HAMD, HAMA, SDS, SAS in the BTX?A group and the sertraline group reduced compared to baseline after treatment (at the 2nd, 4th, 8th, 12th weeks). The scores of HAMD and SDS in the BTX?A group (HAMD scores: F=12.930, P<0.01; SDS scores: F=5.022, P=0.001) and those in the sertraline group (HAMD scores: F=2.883, P=0.030; SDS scores:F=3.427, P=0.013) were significantly lower compared to baseline, but there was no statistically significant difference in the scores of HAMD and SDS between the two groups (P>0.05). HAMD score showed that the remission rate of depression in the BTX?A group (17.9% (5/28), 35.7% (10/28)) was higher than that of the sertraline group (2/14, 4/14) at the 2nd and 4th weeks. At the 8th and 12th weeks, the remission rate of depression in the sertraline group (7/14, 9/14) was higher than that of the BTX?A group (46.4% (13/28), 53.6% (15/28)). There was no statistically significant difference in remission rate of depression between the two groups at each follow?up time point (P>0.05). There was no statistically significant difference in HAMD scores between males and females in the BTX?A group (P>0.05). Two of the 28 patients in the BTX?A group had frown muscle stiffness, which lasted for two weeks and improved in one month. Two patients in the sertraline group had headache and dizziness, and two patients had dry mouth and nausea, which improved after two weeks. There was no statistically significant difference in the incidence of adverse reactions between the two groups (P=0.197). Conclusion BTX?A intraocular facial muscle injection can significantly improve the depressive symptoms of PD patients, and the effect lasts for a long time, with low incidence of side effects and high safety, which can be considered as a safe and effective new method for PD patients with depressive symptoms.

17.
Chinese Journal of Neurology ; (12): 607-612, 2019.
Article in Chinese | WPRIM | ID: wpr-756044

ABSTRACT

Objective To observe the digestive system related symptoms in patients with early-middle stage Parkinson's disease (PD) and healthy subjects,and investigate the incidence of the symptoms and the influencing factors.Methods One hundred and eight PD patients with early and middle stage (Hoehn-Yahr staging 1-3) were admitted to Xuzhou Central Hospital and followed up for a long time.A questionnaire,including seven items of digestive system related symptoms selected from the PD Non-Motor Symptom Scale and the Scale for Outcomes in PD for Autonomic Symptoms (taste abnormalities,swallowing disorders,salivation,easy or early satiety,constipation,loose stools,fecal incontinence),and additional five items of digestive system related symptoms (loss of appetite,dry mouth,oral pain,nausea,vomiting),totally 12 items,was used in a survey on PD patients.Seventy-six healthy subjects in the physical examination center of the hospital served as control group,and conducted the same questionnaire survey.Results There was no statistically significant difference in age,gender,height,weight,body mass index (BMI) between the PD and control groups.In 108 PD patients,dry mouth accounted for 64 cases (59.26%),constipation 53 cases (49.07%) and taste abnormalities 40 cases (37.04%),followed by loss of appetite 35 cases (32.41%) and early satiety 26 cases (24.07%),swallowing disorders 20 cases (18.52%),nausea 11 cases (10.19%),salivation 10 cases (9.26%),oral pain seven cases (6.48%),vomiting four cases (3.70%),loose stools one case (0.87%).In 76 controls,taste abnormalities accounted for 13 cases (17.11%),early satiety six cases (7.89%),loss of appetite six cases (7.89%),nausea five cases (6.58%),salivation three cases (3.95%),oral pain one case (1.32%),and the rest zero.The incidence of constipation (x2=52.390,P<0.01),dry mouth (x2=69.050,P<0.01),early satiety (x2=8.128,P=0.004),loss of appetite (x2=16.010,P<0.01),taste abnormalities (x2=8.642,P=0.003) and swallowing disorders (x2=15.790,P<0.01) showed statistically significant difference between the two groups.Analysis of the influencing factors showed that male had an effect on constipation (95%CI 1.371-7.495,OR=3.205),early satiety (95%CI 4.227-282.913,OR=34.582),taste abnormalities (95%CI 6.620-88.942,OR=24.260) and swallowing disorders (95%CI 2.784-88.475,OR=22.906),while other factors such as age,body mass index,disease duration and motor symptom types had no effect on the occurrence of digestive system related symptoms.Conclusions Digestive system related symptoms in patients with PD include dry mouth,constipation,taste abnormalities,loss of appetite,early satiety,and swallowing disorders,which may be their unique symptoms.Male is a risk factor for taste abnormalities,swallowing disorders,early satiety and constipation.

18.
Article in Chinese | WPRIM | ID: wpr-752947

ABSTRACT

Objective To summarize the technical experience of extracorporeal membrane oxygena-tion(ECMO)catheterization in children. Methods Data of patients that received ECMO treatment in the pe-diatric intensive care unit between October 2016 and October 2018 were analyzed retrospectively. The age, weight,diagnosis,complications and the final outcomes of the patients,as well as the working mode,catheter-ization mode and duration of ECMO were collected. Results A total of 15 children were treated with ECMO,including 5 males and 10 females. The median age(range) was 4. 9 (1. 0-11. 0)years and the median weight(range) was 21. 5(8. 5-49. 0)kg. There were 5 cases of fulminant myocarditis,7 cases of severe pneu-monia,3 cases of septic shock,8 cases of venous-arterial bypass( VA mode),and 7 cases of venous-venous bypass(VV mode). All the 15 patients underwent percutaneous catheterization. Two patients that experienced difficulty in percutaneous catheterization turned to open catheterization. None abandoned ECMO due to the difficulty in catheterization. The position and depth of the catheter,and the flow rate required no further ad-justment. The mean ECMO duration was 96. 8(1-366)h. Weaning was successful in 8 cases(53%). One case was transferred and 8 cases were dismissed,and the survival rate was 60%. There were 2 cases of bleeding at the site of catheter entrance,one treated with local compression and the other with suture. There was 1 case of femoral artery thrombosis that was relieved by percutaneous femoral artery angiography and intracavitary for-mation. Another case developed carotid artery thrombosis and had been undergoing antithrombotic therapy and following-up. One case had nerve injury in the left lower extremity that was relieved by oral vitamin Bs and low frequency electrical stimulation. Conclusion Catheterization is the basis of ECMO execution. Catheter-ization method should be individualized. Percutaneous catheterization is the choice of thumb due to its safety and simplicity. In case of failure,or during the extra-cardiac compression,the surgical method should be taken quickly,and the catheter should be placed in an open or partly-open manner. Proficient catheterization tech-nique ensures the smooth application of ECMO in children.

19.
Article in Chinese | WPRIM | ID: wpr-752942

ABSTRACT

Acute respiratory distress syndrome ( ARDS) is a devastating clinical syndrome with the condition of dyspnea,characterized by rapidly progressive hypoxemia with noncardiogenic pulmonary edema. Current therapeutic strategies are based on improving oxygenation and pulmonary compliance while minimizing ventilator-induced lung injury. However,many previous studies had found that the leading risk of ARDS patient′s death is circulatory collapse rather than pulmonary injury or hypoxemia. Additionally,acute cardiac dysfunc-tion caused by increased pulmonary vascular resistance is an important cause of circulatory failure. Besides,with the deepening of the studies,the dysfunction of lung and heart in ARDS patients,also known as severe acute cor pulmonale (ACP),has been shown to be associated with the pathophysiological process of the ARDS and could lead to the increase of right ventricular pressure load,which eventually might result in right ventricular failure. Furthermore,the inappropriate mechanical ventilation could also lead to right ventricular failure,and therefore it′s necessary to closely monitor the function of right ventricular in ARDS patients. To conclude,we will intro-duce the protective ventilation strategy of right ventricular preliminarily in this review.

20.
Article in Chinese | WPRIM | ID: wpr-752912

ABSTRACT

Acute respiratory distress syndrome (ARDS) is a common disease in intensive care unit. ARDS has attracted wide attention of clinicians for its high in-hospital mortality and high incidence of long-term mortality. This expert opinion reviews the available clinical evidence and adjuvant treatment of ventilator support. Based on clinical evidence and experience,we provide suggestions for the management of patients with ARDS. We interpret this expert opinion and some experience in children was added,hoping to provide suggestions for the treatment of children with ARDS.

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