Medicine
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Providing adequate chest compression is essential during infant cardio-pulmonary-resuscitation (CPR) but was reported to be performed poor. The "new 2-thumb technique" (nTTT), which consists in using 2 thumbs directed at the angle of 90° to the chest while closing the fingers of both hands in a fist, was recently introduced. Therefore, the aim of this study was to compare 3 chest compression techniques, namely, the 2-finger-technique (TFT), the 2-thumb-technique (TTHT), and the nTTT in an randomized infant-CPR manikin setting. ⋯ The nTTT provides adequate chest compression depth and rate and was associated with adequate chest decompression and possibility to adequately ventilate the infant manikin. Further clinical studies are necessary to confirm these initial findings.
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Case Reports
Transverse rectus abdominis myocutaneous flap for postpneumonectomy bronchopleural fistula: A case report.
Numerous types of flap coverage have been reported to prevent or to repair bronchopleural fistulas. Most of the flaps were harvested from chest area. However, these pedicled flaps might not be optimal for the patient who has undergone previous radiotherapy on pulmonary parenchyma because the pedicle artery of the flap might have been injured by irradiation. Therefore, an alternative flap outside of the chest area is necessary. ⋯ This case demonstrated that pedicled TRAM flap is a feasible alternative to repair bronchopleural fistula.
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The aim of the study was to determine whether extrapancreatic inflammation on computed tomography (EPIC) is helpful in predicting organ failure in the early phase of acute pancreatitis (AP) as defined by the 2012 revised Atlanta classification. Patients (n = 208) who underwent abdominal computed tomography (CT) within 24 hours after AP onset and admission were retrospectively identified. Each patient's EPIC score, Balthazar score, bedside index of severity in acute pancreatitis (BISAP), and systemic inflammatory response syndrome (SIRS) score were obtained. ⋯ An EPIC score of 3 or greater had a sensitivity and specificity of 80.65% and 63.16%, respectively. EPIC scores correlated moderately with organ failure severity (Spearman r = 0.321) and number of failed organs (r = 0.343). The EPIC scoring system can be useful in predicting the occurrence of organ failure, but it does not differentiate severity and number of failed organs in early phase AP.
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Postdural puncture headache (PDPH), mainly resulting from the loss of cerebral spinal fluid (CSF), is a well-known iatrogenic complication of spinal anesthesia and diagnostic lumbar puncture. Spinal needles have been modified to minimize complications. Modifiable risk factors of PDPH mainly included needle size and needle shape. However, whether the incidence of PDPH is significantly different between cutting-point and pencil-point needles was controversial. Then we did a meta-analysis to assess the incidence of PDPH of cutting spinal needle and pencil-point spinal needle. ⋯ Current evidences suggest that pencil-point spinal needle was significantly superior compared with cutting spinal needle regarding the frequency of PDPH, PDPH severity, and the use of EBP. In view of this, we recommend the use of pencil-point spinal needle in spinal anesthesia and lumbar puncture.
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Comparative Study Observational Study
Comparison of the pediatric risk of mortality, pediatric index of mortality, and pediatric index of mortality 2 models in a pediatric intensive care unit in China: A validation study.
This study was designed with the aim of comparing the performances of the pediatric risk of mortality (PRISM), pediatric index of mortality (PIM), and revised version pediatric index of mortality 2 (PIM2) models in a pediatric intensive care unit (PICU) in China. A total of 852 critically ill pediatric patients were recruited in the study between January 1 and December 31, 2014. The variables required to calculate PRISM, PIM, and PIM2 were collected. ⋯ The standardized mortality rate was 1.14 (95%CI: 0.93-1.36) for PRISM, 1.89 (95%CI: 1.55-2.27) for PIM, and 2.13 (95%CI: 1.75-2.55) for PIM2. The PRISM, PIM, and PIM2 scores demonstrated an acceptable discriminatory performance. With the exception of PIM, the PRISM and PIM2 models had good calibrations.