Zhonghua wei zhong bing ji jiu yi xue
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Zhonghua Wei Zhong Bing Ji Jiu Yi Xue · Jan 2016
Randomized Controlled Trial[The clinical effect of airway pressure release ventilation for acute lung injury/acute respiratory distress syndrome].
To evaluate the effect of airway pressure release ventilation (APRV) in patients with acute lung injury/acute respiratory distress syndrome (ALI/ARDS), to evaluate the extent of ventilator-induced lung injury (VILI), and to explore its possible mechanism. ⋯ APRV was similar to lung protective ventilation strategy in oxygenation and improvements in the lung mechanics parameters. APRV with a higher Pmean can recruit alveolar more effectively, and it had no impact on hemo-dynamics, but might exacerbate VILI.
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Zhonghua Wei Zhong Bing Ji Jiu Yi Xue · Jan 2016
Review Meta Analysis[The progress of light sedation for critically ill adult patients in intensive care unit].
The latest advance of sedation for critically ill adult patients in intensive care unit (ICU) was reviewed in order to provide certain clinical information for the ICU physicians about sedation. Guidelines, clinical research, Meta-analysis, and reviews in recent years were collected using electronic data base. Discussions included: (1) the definition of light sedation, and its effects on clinical outcome, stress, sleep and delirium; (2) light sedation strategies included: the target population, the target sedation strategy and daily sedation interruption, clinical assessment and monitoring of sedation, selection of sedative drugs, light sedation extenuation; (3) light sedation strategies and pain, agitation, delirium control bundles; (4) the problems and prospects of light sedation. ⋯ Routine use of benzodiazepines should be avoided, especially in patients with or at a risk of delirium. Prevention and treatment of agitation with a combination of non-pharmacologic or pharmacologic methods; ICU specification rules for pain, agitation and delirium prevention and treatment should be made. Light sedation is the main ICU sedation strategy in adult patients now, but must be individualized for each patient.
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Zhonghua Wei Zhong Bing Ji Jiu Yi Xue · Jan 2016
Randomized Controlled Trial[Study of prevention and control of delirium in ventilated patients by simulating blockage of circadian rhythm with sedative in intensive care unit].
To explore the effect of giving sedatives according to the circadian rhythm in prevention of occurrence of delirium and the prognosis of patients undergoing mechanical ventilation in intensive care unit (ICU). ⋯ Administration of sedatives according to simulating circadian time could decrease the duration of mechanical ventilation, extubation time, and the length of ICU stay, decrease the dosage of sedative drugs, and reduce the incidence of delirium. Dexmedetomidine could reduce the incidence of delirium, and improve the prognosis of patients.
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Zhonghua Wei Zhong Bing Ji Jiu Yi Xue · Jan 2016
[The value of determination of serum cholinesterase levels in judgment of severity and prognosis in patients with severe pneumonia].
To investigate the value of serum cholinesterase (S-ChE) levels in judgment of severity and prognosis in patients with severe pneumonia. ⋯ S-ChE levels can be considered as an effective and practical index to estimate the severity and prognosis in patients with severe pneumonia. The combined application of S-ChE levels and APACHE II score or MODS score can obviously improve the prognostic power in patients with severe pneumonia.
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Zhonghua Wei Zhong Bing Ji Jiu Yi Xue · Jan 2016
[The application of actively heated humidified high flow nasal cannula oxygen therapy in adults].
Actively heated, humidified high flow nasal cannula oxygen therapy (HFNC) is a new type of oxygen therapy. Because of its unique physiological effects, the clinical application is becoming more and more popular. This article is to summarize the physiological effects, clinical application and short comings of HFNC. ⋯ It can be used for adults with mild to moderate hypoxia, or for patients undergoing palliative care. However, the experience of the use of HFNC in adults is limited, and there is yet no corresponding clinical guideline. Therefore, further research with a large sample is required to determine the long-term effect of this technique, and to identify the adult patient population to whom is most beneficial.