Acute medicine & surgery
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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.
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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.
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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.
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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.
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Acute medicine & surgery · Jan 2020
Environmental maintenance with effective and useful zoning to protect patients and medical staff from COVID-19 infection.
The coronavirus disease 2019 (COVID-19) pandemic has accelerated all over the world, and global health-care systems have become overwhelmed with potentially infectious patients seeking testing and care. It is essential to set up effective and useful zoning to prevent the spread of infection to and from medical staff or other patients with effective use of standard precautions with personal protective equipment (PPE). ⋯ Special wards and rooms should be set up for future protection of medical staff and other patients, and prevent the explosion of COVID-19 infection with effective and useful zoning with PPE.