AIM To characterize the clinical course and outcomes of nasal intermittent mandatory ventilation(NIMV)use in acute pediatric respiratory failure.METHODS We identified all patients treated with NIMV in the pediatric in...AIM To characterize the clinical course and outcomes of nasal intermittent mandatory ventilation(NIMV)use in acute pediatric respiratory failure.METHODS We identified all patients treated with NIMV in the pediatric intensive care unit(PICU)or inpatient general pediatrics between January 2013 and December 2015 at two academic centers.Patients who utilized NIMV with other modes of noninvasive ventilation during the same admission were included.Data included demographics,vital signs on admission and prior to initiation of NIMV,pediatric risk of mortalityⅢ(PRIsM-Ⅲ)scores,complications,respiratory support characteristics,PICU and hospital length of stays,duration of respiratory support,and complications.Patients who did not require escalation to mechanical ventilation were defined as NIMV responders;those who required escalation to mechanical ventilation(MV)were defined as NIMV nonresponders.NIMV responders were compared to NIMV non-responders.RESULTS Forty-two patients met study criteria.six(14%)failed treatment and required MV.The majority of the patients(74%)had a primary diagnosis of bronchiolitis.The median age of these 42 patients was 4 mo(range 0.5-28.1 mo,IQR 7,P=0.69).No significant difference was measured in other baseline demographics and vitals on initiation of NIMV;these included age,temperature,respiratory rate,O2 saturation,heart rate,systolic blood pressure,diastolic blood pressure,and PRIsM-Ⅲscores.The duration of NIMV was shorter in the NIMV nonresponder vs NIMV responder group(6.5 h vs 65 h,P<0.0005).Otherwise,NIMV failure was not associated with significant differences in PICU length of stay(LOs),hospital LOs,or total duration of respiratory support.No patients had aspiration pneumonia,pneumothorax,or skin breakdown.CONCLUSION Most of our patients responded to NIMV.NIMV failure is not associated with differences in hospital LOs,PICU LOs,or duration of respiratory support.展开更多
Objective: to study the treatment of hypoxemia in patients with septic shock. Methods: 150 patients with septic shock treated in our hospital from January 2020 to July 2021 were divided into 3 groups according to the ...Objective: to study the treatment of hypoxemia in patients with septic shock. Methods: 150 patients with septic shock treated in our hospital from January 2020 to July 2021 were divided into 3 groups according to the severity of hypoxemia. All patients received comprehensive treatment, and the blood gas indexes of patients before and after treatment were compared;Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) before resuscitation, 1d and 7d after resuscitation. Results: compared with that before treatment, the above index levels of patients after treatment were significantly improved, P < 0.05. Conclusion: in the clinical treatment of patients with hypoxemia caused by concentration shock, comprehensive treatment methods, especially oxygen therapy, non-invasive intermittent positive pressure breathing therapy, fluid resuscitation therapy and hyperbaric oxygen chamber treatment, can quickly correct the hypoxemia of patients and reduce the body damage, which is worth learning from.展开更多
基金supported by NIH National Center for Advancing Translational Science,No.UL1TR001881
文摘AIM To characterize the clinical course and outcomes of nasal intermittent mandatory ventilation(NIMV)use in acute pediatric respiratory failure.METHODS We identified all patients treated with NIMV in the pediatric intensive care unit(PICU)or inpatient general pediatrics between January 2013 and December 2015 at two academic centers.Patients who utilized NIMV with other modes of noninvasive ventilation during the same admission were included.Data included demographics,vital signs on admission and prior to initiation of NIMV,pediatric risk of mortalityⅢ(PRIsM-Ⅲ)scores,complications,respiratory support characteristics,PICU and hospital length of stays,duration of respiratory support,and complications.Patients who did not require escalation to mechanical ventilation were defined as NIMV responders;those who required escalation to mechanical ventilation(MV)were defined as NIMV nonresponders.NIMV responders were compared to NIMV non-responders.RESULTS Forty-two patients met study criteria.six(14%)failed treatment and required MV.The majority of the patients(74%)had a primary diagnosis of bronchiolitis.The median age of these 42 patients was 4 mo(range 0.5-28.1 mo,IQR 7,P=0.69).No significant difference was measured in other baseline demographics and vitals on initiation of NIMV;these included age,temperature,respiratory rate,O2 saturation,heart rate,systolic blood pressure,diastolic blood pressure,and PRIsM-Ⅲscores.The duration of NIMV was shorter in the NIMV nonresponder vs NIMV responder group(6.5 h vs 65 h,P<0.0005).Otherwise,NIMV failure was not associated with significant differences in PICU length of stay(LOs),hospital LOs,or total duration of respiratory support.No patients had aspiration pneumonia,pneumothorax,or skin breakdown.CONCLUSION Most of our patients responded to NIMV.NIMV failure is not associated with differences in hospital LOs,PICU LOs,or duration of respiratory support.
文摘Objective: to study the treatment of hypoxemia in patients with septic shock. Methods: 150 patients with septic shock treated in our hospital from January 2020 to July 2021 were divided into 3 groups according to the severity of hypoxemia. All patients received comprehensive treatment, and the blood gas indexes of patients before and after treatment were compared;Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) before resuscitation, 1d and 7d after resuscitation. Results: compared with that before treatment, the above index levels of patients after treatment were significantly improved, P < 0.05. Conclusion: in the clinical treatment of patients with hypoxemia caused by concentration shock, comprehensive treatment methods, especially oxygen therapy, non-invasive intermittent positive pressure breathing therapy, fluid resuscitation therapy and hyperbaric oxygen chamber treatment, can quickly correct the hypoxemia of patients and reduce the body damage, which is worth learning from.
