Clinical interventions in aging
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Randomized Controlled Trial
Effects of an Alveolar Recruitment Maneuver During Lung Protective Ventilation on Postoperative Pulmonary Complications in Elderly Patients Undergoing Laparoscopy.
Controversy remains over whether alveolar recruitment maneuvers (ARMs) can reduce postoperative pulmonary complications. We hypothesized that performing an ARM in addition to lung protective ventilation (LPV) could improve intraoperative arterial oxygenation and postoperative pulmonary complications (PPCs) in elderly patients undergoing laparoscopy in the Trendelenburg position. ⋯ This study suggests that performing an ARM during LPV may not improve postoperative respiratory outcomes and intraoperative oxygenation compared to LPV alone in geriatric patients undergoing laparoscopy in the Trendelenburg position. In addition, since the ARM could cause a significant deterioration in hemodynamic parameters, applying ARM to elderly patients should be carefully considered.
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This study is to investigate the risk prediction of severe or critical events of COVID-19 in older adults in China and provide the evidence to support the management of older adults with COVID-19. ⋯ D-dimer and CD4 cells either by themselves or in combination have demonstrated predictive value in risk stratification as well as established the prognosis of severe or critical illness in older adults with COVID-19.
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Simple, easy-to-perform, safe and cost-effective methods for the prediction of adverse outcomes in older adults are essential for the identification of patients who are most likely to benefit from early preventive interventions. ⋯ The TUG test was superior to frailty phenotype measures in predicting one-year incidence of a CE consisting of fall, hospitalization, institutionalization and death in a cohort of healthy-aging community-dwelling early-old adults, although its value as a stand-alone test was limited.
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Severe or critical patients with coronavirus disease 2019 (COVID-19) are at increased risk for developing acute kidney injury (AKI). However, the rate of AKI in patients of different severities and independent predictive factors associated with AKI are not well understood. ⋯ AKI is common among COVID-19 patients admitted to the ICU and is recognized as a marker of disease severity. The proposed nomogram accurately predicted AKI development in ICU patients with COVID-19 based on individual characteristics. Therefore, the strategy for kidney protection against severe or critical pneumonia is appropriate.
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Advancing age is associated with high incidence of colorectal cancer (CRC) and high rates of postoperative complications (POCs). However, the impact of of POC severity - evaluated by Clavien-Dindo classification (CDC) or comprehensive complication index (CCI) - on long-term overall survival (OS) in elderly patients after radical CRC resection is not clear. ⋯ Both CDC grades and the CCI can be used to evaluate POCs and are associated with long-term OS in elderly patients undergoing radical CRC resection.