Chinese Med J Peking
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Chinese Med J Peking · Jan 2014
Comparison of Charlson's weighted index of comorbidities with the chronic health score for the prediction of mortality in septic patients.
Comorbidity is one of the most important determinants of short-term and long-term outcomes in septic patients. Charlson's weighted index of comorbidities (WIC) and the chronic health score (CHS), which is a component of the acute physiology and chronic health evaluation (APACHE) II, are two frequently-used measures of comorbidity. In this study, we assess the performance of WIC and CHS in predicting the hospital mortality of intensive care unit (ICU) patients with sepsis. ⋯ The WIC and CHS scores might be independent determinants for hospital mortality among ICU patients with sepsis. WIC might be an even better predictor of the mortality of septic patients with comorbidities than CHS.
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Chinese Med J Peking · Jan 2014
Midterm results of diagnostic treatment and repair strategy in older patients presenting with nonrestrictive ventricular septal defect and severe pulmonary artery hypertension.
Congenital heart disease with severe pulmonary arterial hypertension (SPAH), previously thought to have irreversible pulmonary vascular disease (PVD), has been recently successfully corrected using diagnostic treatment and repair strategy by our surgery team. This study aimed to evaluate the midterm results of a selected cohort of older patients with nonrestrictive ventricular septal defect (VSD) and SPAH using diagnostic treatment and repair strategy. ⋯ There were no operative deaths. SPO2 and baseline six-minute walk test (SMWT) distance of all selected patients increased significantly and mean pulmonary artery pressure (MPAP) regressed significantly after diagnostic treatment and at late follow-up (P < 0.01). The incidence of late postoperative PAH was seen in six (10.7%) patients and by Logistic regression analysis, early postoperative PAH was an independent risk factor related to late postoperative PAH CONCLUSIONS: Diagnostic treatment and repair strategy was effective and safe for treatment of nonrestrictive VSD and SPAH and the midterm results were excellent. Diagnostic treatment strategy was effective in assessing the reversibility of SPAH in older patients associated with nonrestrictive VSD and the PVD in these selective patients is generally reversible.
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Chinese Med J Peking · Jan 2014
Value of STOP-Bang questionnaire in screening patients with obstructive sleep apnea hypopnea syndrome in sleep disordered breathing clinic.
Obstructive sleep apnea hypopnea syndrome (OSAHS) is the most common sleep-disordered breathing and is still underdiagnosed. This study was designed to evaluate the value of the STOP-Bang questionnaire (SBQ) in screening OSAHS in sleep-disordered breathing clinics in order to extend it into the general Chinese population. ⋯ The STOP-Bang questionnaire has excellent sensitivity in screening OSAHS patients and can predict the severity of OSAHS. More studies will be required to determine the value of SBQ in the general Chinese population.
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Chinese Med J Peking · Jan 2014
Effect of two volume responsiveness evaluation methods on fluid resuscitation and prognosis in septic shock patients.
Few studies have reported the effect of different volume responsiveness evaluation methods on volume therapy results and prognosis. This study was carried out to investigate the effect of two volume responsiveness evaluation methods, stroke volume variation (SVV) and stroke volume changes before and after passive leg raising (PLR-ΔSV), on fluid resuscitation and prognosis in septic shock patients. ⋯ In septic shock patients under controlled ventilation and without arrhythmia, using SVV or PLR-ΔSV methods to evaluate volume responsiveness has a similar effect on volume therapy results and prognosis. The evaluation and dynamic monitoring of volume responsiveness is more important for fluid resuscitation than the evaluation methods themselves. Choosing different methods to evaluate volume responsiveness has no significant influence on the effect of volume therapy and prognosis.
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Chinese Med J Peking · Jan 2014
Epidemiology of acute kidney injury in intensive care septic patients based on the KDIGO guidelines.
Acute kidney injury (AKI) is a common complication of sepsis, which is associated with higher risks of adverse outcomes. Recently, kidney disease: improving global outcomes (KDIGO) recommended a new guideline for AKI, including a little modification on the AKI staging criteria. ⋯ The incidence and 28-day mortality of AKI were very high in ICU septic patients. Greater attention should be paid to AKI-induced hepatic and respiratory dysfunction in clinical practice. Patients with an intra-abdominal source of infection were more likely to develop AKI. KDIGO criteria are reliable in AKI staging.