<b>Objective:</b> The purpose of this study was to investigate the effect of right supine endotracheal intubation on respiratory complications and airway pressure of general anesthesia, and to provide guid...<b>Objective:</b> The purpose of this study was to investigate the effect of right supine endotracheal intubation on respiratory complications and airway pressure of general anesthesia, and to provide guidance for clinical application. <b>Methods:</b> Seventy-two children who received oral treatment under general anesthesia from November 2020 to November 2021 in Yantai Stomatological Hospital were randomly divided into three groups, 24 cases in each group. All three groups of children entered the PACU after the surgery. The children in Group I were extubated in the supine position, the children in Group II were immediately changed to the right decubitus after extubation in the horizontal position, and the children in Group III were extubated in the right decubitus. HR, MAP and SpO<sub>2</sub> of T1 (the time point at the beginning of surgery), T2 (the time point at 1 hour after surgery), T3 (the time point after extubation), T4 (the time point at 1 minute after extubation), T5 (the time point at 3 minutes after extubation) in the three groups were observed, t1 (operation time) and t2 (the time of leaving the PACU) were recorded. The airway pressure (P1) in the recumbent position and the airway pressure (P2) in the right decubitus position before extubation were recorded in Group III. The number of sputum suction and complications after extubation were counted. <b>Results:</b> The t2 in Group III was shorter than that in Groups I and II, and the number of sputum suction in Group III was less than that in Groups I and II (P < 0.05). The HR at T3, T4 and T5 in Group III was lower than that in Group I, and the HR at T4 and T5 was lower than that in Group II (P < 0.05). There were significant differences in the incidence of respiratory complications among the three groups (P < 0.05). The incidence of asphyxia, bucking and glossocoma postoperative agitation in Group III was significantly lower than that in Group I, and the incidence of asphyxia and choking was lower than that in Group II (P < 0.05). The incidence of glossoptosis in Group II was significantly lower than that in Group I (P < 0.05). In Group III, the airway pressure P2 in the right decubitus position during endotracheal intubation was higher than that of P1 in the supine position during endotracheal intubation (P < 0.05). The 95% Confidence Interval (CI) of airway pressure difference was 1.416 - 1.834 cmH<sub>2</sub>O. <b>Conclusion:</b> For children undergoing intraoral therapy under general anesthesia, tracheal extubation in the right decubitus position can improve the circulation fluctuation before and after extubation, reducing the number of sputum suction and respiratory tract-related complications, and can shorten the departure time. The body position change during the tracheal intubation will slightly increase the airway pressure, but the supine position after extubation can better ensure the smooth spontaneous breathing of children, which can provide the reference for clinical application.展开更多
Due to the insidious clinical symptoms of early hepatocellular carcinoma (HCC), most of the patients diagnosed at intermediate-to-advanced stage HCC, and they lost the opportunity for curative treatment. Comprehensive...Due to the insidious clinical symptoms of early hepatocellular carcinoma (HCC), most of the patients diagnosed at intermediate-to-advanced stage HCC, and they lost the opportunity for curative treatment. Comprehensive interventional therapy plays an important role in prolonging the median survival of patients with intermediate-to-advanced stage HCC, among which transcatheter hepatic artery chemoembolization (TACE) is the most commonly used minimally invasive treatment. However, TACE may cause many postoperative complications such as liver function damage, biliary tract injury, upper gastrointestinal bleeding. Among them, TACE-related respiratory complications have been reported in a few articles, which are extremely rare but serious, and there are still many uncertainties about their occurrence mechanisms and risk factors. This article is aim to focus on the research progress of the respiratory complications of TACE, thus making progress on TACE-treatment aftercare.展开更多
Introduction: Measles is a highly contagious infectious disease caused by the measles virus belonging to the morbillivirus genus, the measles morbillivirus species and the Paramyxoviridae families. The aim was to stud...Introduction: Measles is a highly contagious infectious disease caused by the measles virus belonging to the morbillivirus genus, the measles morbillivirus species and the Paramyxoviridae families. The aim was to study respiratory complications due to measles in children aged 1 to 15 in the pediatric ward of the Kindia regional hospital. Materials and Methods: A transversal descriptive study was carried out in the pediatrics department of the Kindia Regional Hospital from October 1, 2019, to March 31, 2020, on children aged 1 to 15 years hospitalized for measles with respiratory complications. Results: 53 cases of measles were recorded, i.e. 11.71% of hospital pathologies including 32 cases of respiratory complications, i.e. 60.38% with an M/F sex ratio of 1.66, male predominance of 62.5%, and a mean age of 4.10 ± 2.8 years. The outcome was favorable in 90.62% of our patients. The mortality was 9.38% with an average hospital stay of 6.8 ± 3.04 days. Conclusion: The respiratory complication of measles is a serious pathology due to the risk of mortality that it can cause, a consultation followed by rapid treatment can contribute to a reduction in complications and a faster cure.展开更多
BACKGROUND There is an ongoing debate regarding the relationship between intraoperative blood transfusions and patient outcomes.Unifying the results is difficult because of differences in surgery type,target populatio...BACKGROUND There is an ongoing debate regarding the relationship between intraoperative blood transfusions and patient outcomes.Unifying the results is difficult because of differences in surgery type,target population and postoperative observation indicators.AIM To evaluate the risk factors for intraoperative blood transfusion and its impact on postoperative outcomes in elderly gastrointestinal cancer patients.METHODS This was a retrospective single-center study of elderly patients(≥65 years old)who underwent elective abdominal surgery for gastrointestinal cancer with general anesthesia.Patients with chronic kidney disease and missing related data were excluded.The primary outcomes included acute kidney injury(AKI),myocardial injury,and respiratory complications during hospitalization.Multivariate logistic regression was performed to explore the exposure-outcome relationship.RESULTS A total of 967 patients were included in this study.A lower preoperative hematocrit level,longer operative time(>300 minutes)and greater amount of blood loss were observed in 145(15.0%)patients who received blood transfusions during surgery(P<0.0005).Among these patients,the incidences of AKI,myocardial injury and respiratory complications were 8.3%(n=12),5.5%(n=8),and 15.9%(n=23),respectively,and these values were significantly greater.Multivariate analysis revealed that receiving a transfusion was an independent risk factor for AKI,myocardial injury and respiratory complications(all P<0.05).CONCLUSION These results demonstrate that intraoperative blood transfusion increases the risk of poorer outcomes in elderly patients receiving gastrointestinal cancer surgery.These findings provide new ideas for improving the prognosis of elderly cancer patients.展开更多
<strong>Objective: </strong><span style="font-family:Verdana;">To assess whether the use of prenatal betamethasone in pregnancies with elective Caesarean section (C-section) at 38 weeks ha&...<strong>Objective: </strong><span style="font-family:Verdana;">To assess whether the use of prenatal betamethasone in pregnancies with elective Caesarean section (C-section) at 38 weeks ha</span><span style="font-family:Verdana;">s</span><span style="font-family:""><span style="font-family:Verdana;"> a similar risk of adverse neonatal respiratory outcomes than elective C-section at 39 weeks. </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> Retrospective cohort study of pregnant patients with singleton pregnancies and elective C-section at term in a one-year period. Cases were C-section at 38 weeks of gestation with a complete course of betamethasone started 48-hours before. As a control group, pregnancies with a C-section at 39 weeks without betamethasone were included. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> During the study period, 186 patients were included. Of these, 91 were delivered at 38 weeks and 95 at 39 weeks. There were no significant differences in maternal age and parity. Moreover, there were no significant differences in respiratory complications (respiratory distress syndrome [RDS] = 0% vs 1.1%;p</span></span><span style="font-family:""> </span><span style="font-family:Verdana;">=</span><span style="font-family:""> </span><span style="font-family:Verdana;">1.0, transitory tachypnea [TT] = 0% vs 0%) and admission to Neonatal Intensive Care Unit (NICU) (8.8% vs 6.3%;p</span><span style="font-family:""> </span><span style="font-family:Verdana;">=</span><span style="font-family:""> </span><span style="font-family:""><span style="font-family:Verdana;">0.7) between deliveries at 38 weeks and 39 weeks, respectively. </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> Prophylactic use of betamethasone in early term pregnancies who undergo an elective C-section at 38 weeks is associated with similar adverse neonatal respiratory outcomes than patients with C-section at 39 weeks without corticosteroids.</span></span>展开更多
文摘<b>Objective:</b> The purpose of this study was to investigate the effect of right supine endotracheal intubation on respiratory complications and airway pressure of general anesthesia, and to provide guidance for clinical application. <b>Methods:</b> Seventy-two children who received oral treatment under general anesthesia from November 2020 to November 2021 in Yantai Stomatological Hospital were randomly divided into three groups, 24 cases in each group. All three groups of children entered the PACU after the surgery. The children in Group I were extubated in the supine position, the children in Group II were immediately changed to the right decubitus after extubation in the horizontal position, and the children in Group III were extubated in the right decubitus. HR, MAP and SpO<sub>2</sub> of T1 (the time point at the beginning of surgery), T2 (the time point at 1 hour after surgery), T3 (the time point after extubation), T4 (the time point at 1 minute after extubation), T5 (the time point at 3 minutes after extubation) in the three groups were observed, t1 (operation time) and t2 (the time of leaving the PACU) were recorded. The airway pressure (P1) in the recumbent position and the airway pressure (P2) in the right decubitus position before extubation were recorded in Group III. The number of sputum suction and complications after extubation were counted. <b>Results:</b> The t2 in Group III was shorter than that in Groups I and II, and the number of sputum suction in Group III was less than that in Groups I and II (P < 0.05). The HR at T3, T4 and T5 in Group III was lower than that in Group I, and the HR at T4 and T5 was lower than that in Group II (P < 0.05). There were significant differences in the incidence of respiratory complications among the three groups (P < 0.05). The incidence of asphyxia, bucking and glossocoma postoperative agitation in Group III was significantly lower than that in Group I, and the incidence of asphyxia and choking was lower than that in Group II (P < 0.05). The incidence of glossoptosis in Group II was significantly lower than that in Group I (P < 0.05). In Group III, the airway pressure P2 in the right decubitus position during endotracheal intubation was higher than that of P1 in the supine position during endotracheal intubation (P < 0.05). The 95% Confidence Interval (CI) of airway pressure difference was 1.416 - 1.834 cmH<sub>2</sub>O. <b>Conclusion:</b> For children undergoing intraoral therapy under general anesthesia, tracheal extubation in the right decubitus position can improve the circulation fluctuation before and after extubation, reducing the number of sputum suction and respiratory tract-related complications, and can shorten the departure time. The body position change during the tracheal intubation will slightly increase the airway pressure, but the supine position after extubation can better ensure the smooth spontaneous breathing of children, which can provide the reference for clinical application.
文摘Due to the insidious clinical symptoms of early hepatocellular carcinoma (HCC), most of the patients diagnosed at intermediate-to-advanced stage HCC, and they lost the opportunity for curative treatment. Comprehensive interventional therapy plays an important role in prolonging the median survival of patients with intermediate-to-advanced stage HCC, among which transcatheter hepatic artery chemoembolization (TACE) is the most commonly used minimally invasive treatment. However, TACE may cause many postoperative complications such as liver function damage, biliary tract injury, upper gastrointestinal bleeding. Among them, TACE-related respiratory complications have been reported in a few articles, which are extremely rare but serious, and there are still many uncertainties about their occurrence mechanisms and risk factors. This article is aim to focus on the research progress of the respiratory complications of TACE, thus making progress on TACE-treatment aftercare.
文摘Introduction: Measles is a highly contagious infectious disease caused by the measles virus belonging to the morbillivirus genus, the measles morbillivirus species and the Paramyxoviridae families. The aim was to study respiratory complications due to measles in children aged 1 to 15 in the pediatric ward of the Kindia regional hospital. Materials and Methods: A transversal descriptive study was carried out in the pediatrics department of the Kindia Regional Hospital from October 1, 2019, to March 31, 2020, on children aged 1 to 15 years hospitalized for measles with respiratory complications. Results: 53 cases of measles were recorded, i.e. 11.71% of hospital pathologies including 32 cases of respiratory complications, i.e. 60.38% with an M/F sex ratio of 1.66, male predominance of 62.5%, and a mean age of 4.10 ± 2.8 years. The outcome was favorable in 90.62% of our patients. The mortality was 9.38% with an average hospital stay of 6.8 ± 3.04 days. Conclusion: The respiratory complication of measles is a serious pathology due to the risk of mortality that it can cause, a consultation followed by rapid treatment can contribute to a reduction in complications and a faster cure.
基金Supported by the National Natural Science Foundation of China,No.81901999the Natural Science Foundation of Shanghai Municipality,No.23ZR1410900Wu Jieping Medical Foundation,No.320.6750.2024-05-47.
文摘BACKGROUND There is an ongoing debate regarding the relationship between intraoperative blood transfusions and patient outcomes.Unifying the results is difficult because of differences in surgery type,target population and postoperative observation indicators.AIM To evaluate the risk factors for intraoperative blood transfusion and its impact on postoperative outcomes in elderly gastrointestinal cancer patients.METHODS This was a retrospective single-center study of elderly patients(≥65 years old)who underwent elective abdominal surgery for gastrointestinal cancer with general anesthesia.Patients with chronic kidney disease and missing related data were excluded.The primary outcomes included acute kidney injury(AKI),myocardial injury,and respiratory complications during hospitalization.Multivariate logistic regression was performed to explore the exposure-outcome relationship.RESULTS A total of 967 patients were included in this study.A lower preoperative hematocrit level,longer operative time(>300 minutes)and greater amount of blood loss were observed in 145(15.0%)patients who received blood transfusions during surgery(P<0.0005).Among these patients,the incidences of AKI,myocardial injury and respiratory complications were 8.3%(n=12),5.5%(n=8),and 15.9%(n=23),respectively,and these values were significantly greater.Multivariate analysis revealed that receiving a transfusion was an independent risk factor for AKI,myocardial injury and respiratory complications(all P<0.05).CONCLUSION These results demonstrate that intraoperative blood transfusion increases the risk of poorer outcomes in elderly patients receiving gastrointestinal cancer surgery.These findings provide new ideas for improving the prognosis of elderly cancer patients.
文摘<strong>Objective: </strong><span style="font-family:Verdana;">To assess whether the use of prenatal betamethasone in pregnancies with elective Caesarean section (C-section) at 38 weeks ha</span><span style="font-family:Verdana;">s</span><span style="font-family:""><span style="font-family:Verdana;"> a similar risk of adverse neonatal respiratory outcomes than elective C-section at 39 weeks. </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> Retrospective cohort study of pregnant patients with singleton pregnancies and elective C-section at term in a one-year period. Cases were C-section at 38 weeks of gestation with a complete course of betamethasone started 48-hours before. As a control group, pregnancies with a C-section at 39 weeks without betamethasone were included. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> During the study period, 186 patients were included. Of these, 91 were delivered at 38 weeks and 95 at 39 weeks. There were no significant differences in maternal age and parity. Moreover, there were no significant differences in respiratory complications (respiratory distress syndrome [RDS] = 0% vs 1.1%;p</span></span><span style="font-family:""> </span><span style="font-family:Verdana;">=</span><span style="font-family:""> </span><span style="font-family:Verdana;">1.0, transitory tachypnea [TT] = 0% vs 0%) and admission to Neonatal Intensive Care Unit (NICU) (8.8% vs 6.3%;p</span><span style="font-family:""> </span><span style="font-family:Verdana;">=</span><span style="font-family:""> </span><span style="font-family:""><span style="font-family:Verdana;">0.7) between deliveries at 38 weeks and 39 weeks, respectively. </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> Prophylactic use of betamethasone in early term pregnancies who undergo an elective C-section at 38 weeks is associated with similar adverse neonatal respiratory outcomes than patients with C-section at 39 weeks without corticosteroids.</span></span>
