Acute medicine & surgery
-
Acute medicine & surgery · Jan 2020
Comparison of high-flow nasal cannula oxygen therapy and non-invasive ventilation as first-line therapy in respiratory failure: a multicenter retrospective study.
To identify which subgroups of respiratory failure could benefit more from high-flow nasal cannula oxygen therapy (HFNC) or non-invasive ventilation (NIV). ⋯ High-flow nasal cannula oxygen therapy could be more beneficial than NIV in patients with pneumonia or non-hypercapnia, but not in patients with cardiogenic pulmonary edema or hypercapnia.
-
Acute medicine & surgery · Jan 2020
Case ReportsSuccessful treatment with artificial pancreas for a patient who attempted suicide using a high-dose insulin s.c. injection.
Artificial pancreas is usually used to manage hyperglycemia. We controlled prolonged hypoglycemia induced by insulin overdose using artificial pancreas. ⋯ The STG-55 artificial pancreas was very useful and convenient for controlling blood glucose levels in our insulin overdose patient.
-
Acute medicine & surgery · Jan 2020
Impact of non-pharmaceutical interventions for the COVID-19 pandemic on emergency department patient trends in Japan: a retrospective analysis.
The coronavirus disease (COVID-19) pandemic massively impacted emergency department (ED) visits. The unavailability of specific therapies or vaccines has made non-pharmaceutical interventions (NPIs) an alternative strategy for COVID-19. We assessed the impact of NPIs (nationwide school closures and state of emergency) on ED visits during the COVID-19 pandemic in Japan. ⋯ The application of an NPI during the COVID-19 pandemic could have significantly reduced patient attendance in the ED.
-
Acute medicine & surgery · Jan 2020
Activities of daily living status and psychiatric symptoms after discharge from an intensive care unit: a single-center 12-month longitudinal prospective study.
In post-intensive care syndrome (PICS), long-term survivors of critical illness present various physical and mental symptoms that can persist for years after discharge. Post-intensive care syndrome in Japan has not been well described, so this study aims to elucidate its epidemiology. ⋯ At 3 and 12 months after ICU discharge, over half of our Japanese patients suffered ADL disability and/or psychiatric symptoms. The ADL disability improved at 1 year, but psychiatric symptoms did not.
-
Acute medicine & surgery · Jan 2020
Impact of frailty on protocol-based weaning from mechanical ventilation in patients with sepsis: a retrospective cohort study.
Frailty has been shown to be associated with prolonged mechanical ventilation (MV). However, due to limited physiological data, it has been unclear how frailty affects weaning from MV in septic patients subjected to a specific weaning protocol. ⋯ Frailty was independently associated with a longer duration of MV in patients with sepsis who underwent protocol-based weaning. Frail patients were more likely to fail spontaneous breathing trials than nonfrail patients during the weaning process, although the risk after extubation was similar.