Pub Date : 2020-04-15DOI: 10.3760/CMA.J.CN321761-20191025-00010
Yan Xu, S. Shu
Muscle relaxants are wildly used in general anesthesia to block the electrical activity in nerve muscle joints and paralysis the skeletal muscle. However, there is still a lack of guideline and standard for the use of muscle relaxants in children. The paper introduces the usage of muscle relaxants, the classification of muscle relaxants, the interaction between intravenous anesthetics and inhalation anesthetics and muscle relaxants. It also introduces the muscle relaxant antagonist (sugammadex), as well as the endotracheal intubation under general anesthesia without muscle relaxants in those children who have a high risk of difficult airway. This review summarizes the latest progress of the muscle relaxant in children, aims to guide the rational use of muscle relaxant in clinical practice. Key words: Muscle relaxant; Pediatric anesthesia; Tracheal intubation
{"title":"Research progress on the application of muscle relaxant in infants and children","authors":"Yan Xu, S. Shu","doi":"10.3760/CMA.J.CN321761-20191025-00010","DOIUrl":"https://doi.org/10.3760/CMA.J.CN321761-20191025-00010","url":null,"abstract":"Muscle relaxants are wildly used in general anesthesia to block the electrical activity in nerve muscle joints and paralysis the skeletal muscle. However, there is still a lack of guideline and standard for the use of muscle relaxants in children. The paper introduces the usage of muscle relaxants, the classification of muscle relaxants, the interaction between intravenous anesthetics and inhalation anesthetics and muscle relaxants. It also introduces the muscle relaxant antagonist (sugammadex), as well as the endotracheal intubation under general anesthesia without muscle relaxants in those children who have a high risk of difficult airway. This review summarizes the latest progress of the muscle relaxant in children, aims to guide the rational use of muscle relaxant in clinical practice. \u0000 \u0000Key words: \u0000Muscle relaxant; Pediatric anesthesia; Tracheal intubation","PeriodicalId":13847,"journal":{"name":"国际麻醉学与复苏杂志","volume":"41 1","pages":"365-369"},"PeriodicalIF":0.0,"publicationDate":"2020-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48130172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-04-15DOI: 10.3760/CMA.J.CN321761-20190915-00014
Yang Zhang, Yonghao Yu
Apneic oxygenation technology has been widely used in the management of difficult airway in emergency depart- ment and anesthesiology department, and special patient surgery in the recent years. Apneic oxygenation technology refers to a method where a high concentration of oxygen is administered at a high flow through the airway when the body has no repertory exercises, so as to facilitate oxygen exchange in the alveoli, provide passive oxygen in apneic patients and extend the duration of safe apneic time. This article introduces the physiological principles and mechanism of apneic oxygenation technology, summarizes the clinical application of the method, and the current research progress, which will provide reference for clinical use in a safer and more reasonable manner and give new thoughts to researchers in the future. Key words: Airway management; Oxygenation; Apneic oxygenation; Anesthesia
{"title":"Research progress on the clinical application of apneic oxygenation technology","authors":"Yang Zhang, Yonghao Yu","doi":"10.3760/CMA.J.CN321761-20190915-00014","DOIUrl":"https://doi.org/10.3760/CMA.J.CN321761-20190915-00014","url":null,"abstract":"Apneic oxygenation technology has been widely used in the management of difficult airway in emergency depart- ment and anesthesiology department, and special patient surgery in the recent years. Apneic oxygenation technology refers to a method where a high concentration of oxygen is administered at a high flow through the airway when the body has no repertory exercises, so as to facilitate oxygen exchange in the alveoli, provide passive oxygen in apneic patients and extend the duration of safe apneic time. This article introduces the physiological principles and mechanism of apneic oxygenation technology, summarizes the clinical application of the method, and the current research progress, which will provide reference for clinical use in a safer and more reasonable manner and give new thoughts to researchers in the future. \u0000 \u0000Key words: \u0000Airway management; Oxygenation; Apneic oxygenation; Anesthesia","PeriodicalId":13847,"journal":{"name":"国际麻醉学与复苏杂志","volume":"41 1","pages":"387-390"},"PeriodicalIF":0.0,"publicationDate":"2020-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44665068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-04-15DOI: 10.3760/CMA.J.CN321761-20190124-00017
L. Qin, S. Yao, Y. Shang
Inflammation is an important defense mechanism against external pathogen invasion and tissue damage. However, when the body is in a persistent inflammatory state, excessive accumulation of neutrophils may cause further severely tissue damage, leading to inflammation-related diseases. The cholinergic anti-inflammatory pathway (CAP) links the nervous system and the immune system closely together. Stimulation of the vagus nerve can release acetylcholine (ACh) which then binds to cholinergic receptors on the surface of immune cells and suppress the release of pro-inflammatory cytokines, so as to reduce inflammatory response and facilitate tissue recovery. Acute respiratory distress syndrome (ARDS) is a highly disabling and even fatal clinical syndrome. The pathological manifestations are acute and diffuse inflammatory lung injury. Reducing lung injury in ARDS patients is still a hot topic in recent years. This review summarized the role of CAP in ARDS induced by different models and its possible mechanisms. Key words: Cholinergic anti-inflammatory pathway; Vagus nerve; Acute respiratory distress syndrome; Inflammation
{"title":"Research progress on cholinergic anti-inflammatory pathway in acute respiratory distress syndrome","authors":"L. Qin, S. Yao, Y. Shang","doi":"10.3760/CMA.J.CN321761-20190124-00017","DOIUrl":"https://doi.org/10.3760/CMA.J.CN321761-20190124-00017","url":null,"abstract":"Inflammation is an important defense mechanism against external pathogen invasion and tissue damage. However, when the body is in a persistent inflammatory state, excessive accumulation of neutrophils may cause further severely tissue damage, leading to inflammation-related diseases. The cholinergic anti-inflammatory pathway (CAP) links the nervous system and the immune system closely together. Stimulation of the vagus nerve can release acetylcholine (ACh) which then binds to cholinergic receptors on the surface of immune cells and suppress the release of pro-inflammatory cytokines, so as to reduce inflammatory response and facilitate tissue recovery. Acute respiratory distress syndrome (ARDS) is a highly disabling and even fatal clinical syndrome. The pathological manifestations are acute and diffuse inflammatory lung injury. Reducing lung injury in ARDS patients is still a hot topic in recent years. This review summarized the role of CAP in ARDS induced by different models and its possible mechanisms. \u0000 \u0000Key words: \u0000Cholinergic anti-inflammatory pathway; Vagus nerve; Acute respiratory distress syndrome; Inflammation","PeriodicalId":13847,"journal":{"name":"国际麻醉学与复苏杂志","volume":"41 1","pages":"401-405"},"PeriodicalIF":0.0,"publicationDate":"2020-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42047969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-04-15DOI: 10.3760/CMA.J.CN321761-20190725-00005
Zhenzhen Wan, L. Yue, Ming Chen, Na Li, Lin Chen, Ling Yu
Objective To compare the application of cuffed and uncuffed endotracheal tubes in full-term neonates undergoing congenital intestinal atresia surgery. Methods Sixty newborns who were scheduled to perform congenital intestinal atresia surgery under general anesthesia were selected. They were divided into two groups, according to the random number table method (n= 30): a cuffed endotracheal tube group (group C) and an uncuffed endotracheal tube group (group U). Group C used cuffed endotracheal tubes for surgical procedures, while uncuffed endotracheal tubes were adopted in group U. Both groups were compared for the changing rate of endotracheal tubes and airway condition after surgery [the incidence of hypoxemia within 5 min after extubation (SpO2<95%), laryngospasm and post-operative wheezing], and the incidence of inspiratory pneumonia during follow-up visit one week after surgery. Results Patients in group U presented increases in the changing rate of endotracheal tubes (26.7% vs 3.3%), the incidence of hypoxemia within 5 min after extubation (10.0% vs 0), laryngospasm incidence (10.0% vs 0) and inspiratory pneumonia incidence (10.0% vs 0), compared with those in group C (P 0.05). Conclusions Cuffed endotracheal tubes are superior to uncuffed ones in full-term neonates during congenital intestinal atresia surgery, with good efficacy. Key words: Neonate; Endotracheal tube; Anesthesia, general; Congenital intestinal atresia
目的比较带口气管插管与不带口气管插管在足月新生儿先天性肠闭锁手术中的应用。方法选择60例在全麻下行先天性肠闭锁手术的新生儿。按随机数字表法(n= 30)分为两组:C组采用带口气管插管，U组采用不带口气管插管。比较两组患者术后气管插管更换率及气道状况[拔管后5 min内低氧血症发生率(SpO2<95%)、喉痉挛及术后喘息情况]。术后一周随访中吸入性肺炎的发生率。结果U组气管插管换管率(26.7% vs 3.3%)、拔管后5 min内低氧血症发生率(10.0% vs 0)、喉痉挛发生率(10.0% vs 0)、吸入性肺炎发生率(10.0% vs 0)均高于C组(P < 0.05)。结论足月新生儿先天性肠闭锁手术中，带套气管插管优于不带套气管插管，效果良好。关键词:新生儿;气管内管;麻醉,一般;先天性肠闭锁
{"title":"Comparison of the application of cuffed or uncuffed endotracheal tubes in full-term newborns undergoing congenital intestinal atresia surgery","authors":"Zhenzhen Wan, L. Yue, Ming Chen, Na Li, Lin Chen, Ling Yu","doi":"10.3760/CMA.J.CN321761-20190725-00005","DOIUrl":"https://doi.org/10.3760/CMA.J.CN321761-20190725-00005","url":null,"abstract":"Objective \u0000To compare the application of cuffed and uncuffed endotracheal tubes in full-term neonates undergoing congenital intestinal atresia surgery. \u0000 \u0000 \u0000Methods \u0000Sixty newborns who were scheduled to perform congenital intestinal atresia surgery under general anesthesia were selected. They were divided into two groups, according to the random number table method (n= 30): a cuffed endotracheal tube group (group C) and an uncuffed endotracheal tube group (group U). Group C used cuffed endotracheal tubes for surgical procedures, while uncuffed endotracheal tubes were adopted in group U. Both groups were compared for the changing rate of endotracheal tubes and airway condition after surgery [the incidence of hypoxemia within 5 min after extubation (SpO2<95%), laryngospasm and post-operative wheezing], and the incidence of inspiratory pneumonia during follow-up visit one week after surgery. \u0000 \u0000 \u0000Results \u0000Patients in group U presented increases in the changing rate of endotracheal tubes (26.7% vs 3.3%), the incidence of hypoxemia within 5 min after extubation (10.0% vs 0), laryngospasm incidence (10.0% vs 0) and inspiratory pneumonia incidence (10.0% vs 0), compared with those in group C (P 0.05). \u0000 \u0000 \u0000Conclusions \u0000Cuffed endotracheal tubes are superior to uncuffed ones in full-term neonates during congenital intestinal atresia surgery, with good efficacy. \u0000 \u0000 \u0000Key words: \u0000Neonate; Endotracheal tube; Anesthesia, general; Congenital intestinal atresia","PeriodicalId":13847,"journal":{"name":"国际麻醉学与复苏杂志","volume":"41 1","pages":"340-343"},"PeriodicalIF":0.0,"publicationDate":"2020-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43148761","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-04-15DOI: 10.3760/CMA.J.CN321761-20181229-00013
Chen Xie, Yue Ming, K. Sun, M. Yan
The past decades have witnessed the rapid development of lung ultrasound (LUS) as an auxiliary method for diagnosis of pulmonary disease. Compared with traditional examination methods, LUS is advantageous in non-invasion, portability, non-radia- tion, high accuracy and repeatability which facilitate its use in emergency department and intensive care unit (ICU). Also, lung injury in patients with severe damage can be diagnosed and treated in a real-time manner. This review summarized the progress in the application of LUS score in evaluation of aeration loss, and LUS in common pulmonary diseases, such as atelectasis, pneumonia and pleural effusion. Furthermore, we proposed the application of LUS in the operation room, especially for patients with postoperative hypoxemia and those undergoing thoracic surgery. Key words: Lung ultrasound; Lung ultrasound score; Atelectasis; Pneumonia; Pleural effusion
{"title":"Research progress on the perioperative application of lung ultrasound in pulmonary disease","authors":"Chen Xie, Yue Ming, K. Sun, M. Yan","doi":"10.3760/CMA.J.CN321761-20181229-00013","DOIUrl":"https://doi.org/10.3760/CMA.J.CN321761-20181229-00013","url":null,"abstract":"The past decades have witnessed the rapid development of lung ultrasound (LUS) as an auxiliary method for diagnosis of pulmonary disease. Compared with traditional examination methods, LUS is advantageous in non-invasion, portability, non-radia- tion, high accuracy and repeatability which facilitate its use in emergency department and intensive care unit (ICU). Also, lung injury in patients with severe damage can be diagnosed and treated in a real-time manner. This review summarized the progress in the application of LUS score in evaluation of aeration loss, and LUS in common pulmonary diseases, such as atelectasis, pneumonia and pleural effusion. Furthermore, we proposed the application of LUS in the operation room, especially for patients with postoperative hypoxemia and those undergoing thoracic surgery. \u0000 \u0000Key words: \u0000Lung ultrasound; Lung ultrasound score; Atelectasis; Pneumonia; Pleural effusion","PeriodicalId":13847,"journal":{"name":"国际麻醉学与复苏杂志","volume":"41 1","pages":"383-386"},"PeriodicalIF":0.0,"publicationDate":"2020-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47177502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-04-15DOI: 10.3760/CMA.J.CN321761-20190617-00004
Meiling Ji, Yi-ran Peng, Bao-xian Yang, Yongsheng Yang, Le Gu, Xianliang Yan, Tie Xu
Objective To explore the effects of age on the use of lactate clearance rate (LCR) to predict prognosis in septic shock patients. Methods Septic shock patients who were admitted into the intensive care unit (ICU) of the Affiliated Hospital of Xuzhou Medical University from January 2015 to August 2018, with complete clinical data, were selected for retrospective analysis. According to their ages, they were divided into a non-elderly group (aged 18-74 years) and an elderly group (≥75 years old). Moreover, according to the outcome of hospitalization, the patients were divided into a survival group and a death group. The level of arterial blood lactate (Lac) was measured when the patients were diagnosed with septic shock (0 h), and 12 h and 24 h after treatment, while the LCRs at 12 h and 24 h were calculated. The scores of Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) and Sequential Organ Failure Assessment (SOFA), the length of hospitalization stay and outcomes were recorded. The differences of above indicators in each group were analyzed. Results A total of 483 septic shock patients were collected, in which 286 patients met inclusion criteria, including 111 cases in the elderly group and 175 in the non-elderly group. There were 61 cases (55.0%) of death in the elderly group and 55 cases (31.4%) of death in the non-elderly group. The COX regression analysis and survival time curve showed that age was an independent risk factor for the prognosis of septic shock patients. The risk of death in the elderly group was 1.95 times higher than that in the non-elderly group. Patients in the death group in different age ranges presented higher APACHE Ⅱ scores, SOFA scores, and blood Lac levels as well as lower 24 h LCR than those in the survival group (P 0.05). APACHE Ⅱ score, SOFA score and blood Lac level were positively related with hospitalization mortality, but negatively related with LCR. Conclusions Age, APACHE Ⅱ score, SOFA score, Lac level and LCR are related factors of hospitalization outcome, where age is an independent risk factor for the prognosis of septic shock patients. LCR cannot be used to accurately evaluate the prognosis of elderly patients with septic shock. Key words: Septic shock; Lactate clearance rate; Prognosis; Age
目的探讨年龄对脓毒性休克患者乳酸清除率(LCR)预测预后的影响。方法选取2015年1月至2018年8月在徐州医科大学附属医院重症监护室(ICU)收治的临床资料完整的感染性休克患者进行回顾性分析。根据年龄分为非老年组(18-74岁)和老年组(≥75岁)。根据住院情况将患者分为生存组和死亡组。分别在诊断为感染性休克时(0 h)、治疗后12 h、24 h测定动脉血乳酸(Lac)水平，计算12 h、24 h的lcr。记录两组患者急性生理与慢性健康评估Ⅱ(APACHEⅡ)、序贯性器官衰竭评估(SOFA)评分、住院时间及预后。分析各组以上指标的差异。结果共收集感染性休克患者483例，符合纳入标准286例，其中老年组111例，非老年组175例。老年组死亡61例(55.0%)，非老年组死亡55例(31.4%)。COX回归分析及生存时间曲线显示，年龄是脓毒性休克患者预后的独立危险因素。老年组的死亡风险是非老年组的1.95倍。不同年龄段死亡组患者APACHEⅡ评分、SOFA评分、血Lac水平均高于生存组，24 h LCR低于生存组(P < 0.05)。APACHEⅡ评分、SOFA评分和血Lac水平与住院死亡率呈正相关，与LCR呈负相关。结论年龄、APACHEⅡ评分、SOFA评分、Lac水平、LCR是影响脓毒性休克患者预后的相关因素，其中年龄是影响脓毒性休克患者预后的独立危险因素。LCR不能准确评价老年感染性休克患者的预后。关键词:感染性休克;乳酸清除率;预后;年龄
{"title":"Effects of age on the use of lactate clearance rate to predict prognosis in septic shock patients","authors":"Meiling Ji, Yi-ran Peng, Bao-xian Yang, Yongsheng Yang, Le Gu, Xianliang Yan, Tie Xu","doi":"10.3760/CMA.J.CN321761-20190617-00004","DOIUrl":"https://doi.org/10.3760/CMA.J.CN321761-20190617-00004","url":null,"abstract":"Objective \u0000To explore the effects of age on the use of lactate clearance rate (LCR) to predict prognosis in septic shock patients. \u0000 \u0000 \u0000Methods \u0000Septic shock patients who were admitted into the intensive care unit (ICU) of the Affiliated Hospital of Xuzhou Medical University from January 2015 to August 2018, with complete clinical data, were selected for retrospective analysis. According to their ages, they were divided into a non-elderly group (aged 18-74 years) and an elderly group (≥75 years old). Moreover, according to the outcome of hospitalization, the patients were divided into a survival group and a death group. The level of arterial blood lactate (Lac) was measured when the patients were diagnosed with septic shock (0 h), and 12 h and 24 h after treatment, while the LCRs at 12 h and 24 h were calculated. The scores of Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) and Sequential Organ Failure Assessment (SOFA), the length of hospitalization stay and outcomes were recorded. The differences of above indicators in each group were analyzed. \u0000 \u0000 \u0000Results \u0000A total of 483 septic shock patients were collected, in which 286 patients met inclusion criteria, including 111 cases in the elderly group and 175 in the non-elderly group. There were 61 cases (55.0%) of death in the elderly group and 55 cases (31.4%) of death in the non-elderly group. The COX regression analysis and survival time curve showed that age was an independent risk factor for the prognosis of septic shock patients. The risk of death in the elderly group was 1.95 times higher than that in the non-elderly group. Patients in the death group in different age ranges presented higher APACHE Ⅱ scores, SOFA scores, and blood Lac levels as well as lower 24 h LCR than those in the survival group (P 0.05). APACHE Ⅱ score, SOFA score and blood Lac level were positively related with hospitalization mortality, but negatively related with LCR. \u0000 \u0000 \u0000Conclusions \u0000Age, APACHE Ⅱ score, SOFA score, Lac level and LCR are related factors of hospitalization outcome, where age is an independent risk factor for the prognosis of septic shock patients. LCR cannot be used to accurately evaluate the prognosis of elderly patients with septic shock. \u0000 \u0000 \u0000Key words: \u0000Septic shock; Lactate clearance rate; Prognosis; Age","PeriodicalId":13847,"journal":{"name":"国际麻醉学与复苏杂志","volume":"41 1","pages":"335-339"},"PeriodicalIF":0.0,"publicationDate":"2020-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45963542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-04-15DOI: 10.3760/CMA.J.CN321761-20190424-00002
Shih-Wei Li, Fan Li, Yi-dan Huang, Xu-Hong Wei
Objective To investigate the effects of dexmedetomidine (Dex) combined with targeted temperature management (TTM) on the expression of hippocampal P2X7 receptor and antisense hypoxia inducible factor (aHIF)-1α in rats with traumatic brain injury (TBI). Methods A model of TBI was established through controlled cortical impact using rats after 1 week of adaptive feeding. Then, 15 rats were randomly selected as a control group, while the others were set as a model group. The successfully modeled rats were divided into five groups (n=15), according to the random number table method: a sham operation group, a TBI group, a TBI+Dex group, a TBI+TTM group and a TBI+Dex+TTM group. After corresponding treatment, their behaviors were tested, and the expression of tumor necrosis factor (TNF)-α/interleukin (IL)-1β in brain tissue and the expression of hippocampal P2X7 receptor and aHIF- 1α were analyzed. Results Rats in each group did not die. Compared with the TBI, TBI+Dex and TBI+TTM groups, the TBI+Dex+TTM group presented remarkably reduced escape latency on Days 3-5 and shortened exploration duration on Day 6 (P<0.05), as well as decreased expression of TNF-α and IL-1β in brain tissues (P<0.05), reduced expression of hippocampal P2X7 receptor and increased amounts of aHIF- 1α (P< 0.05). Conclusions Dex combined with TTM can effectively decline the concentration of P2X7 receptor, down-regulate the levels of TNF-α and IL-1β, and increase the level of aHIF- 1α, which can be served as a promising therapy for TBI rats. Key words: Brain injuries, traumatic; Dexmedetomidine; Targeted temperature management; P2X7 receptor; Antisense hypoxia inducible factor- 1α
{"title":"Effects of dexmedetomidine combined with targeted temperature management on the expression of hippocampal P2X7 receptor and antisense hypoxia inducible factor-1α in rats with traumatic brain injury","authors":"Shih-Wei Li, Fan Li, Yi-dan Huang, Xu-Hong Wei","doi":"10.3760/CMA.J.CN321761-20190424-00002","DOIUrl":"https://doi.org/10.3760/CMA.J.CN321761-20190424-00002","url":null,"abstract":"Objective To investigate the effects of dexmedetomidine (Dex) combined with targeted temperature management (TTM) on the expression of hippocampal P2X7 receptor and antisense hypoxia inducible factor (aHIF)-1α in rats with traumatic brain injury (TBI). Methods A model of TBI was established through controlled cortical impact using rats after 1 week of adaptive feeding. Then, 15 rats were randomly selected as a control group, while the others were set as a model group. The successfully modeled rats were divided into five groups (n=15), according to the random number table method: a sham operation group, a TBI group, a TBI+Dex group, a TBI+TTM group and a TBI+Dex+TTM group. After corresponding treatment, their behaviors were tested, and the expression of tumor necrosis factor (TNF)-α/interleukin (IL)-1β in brain tissue and the expression of hippocampal P2X7 receptor and aHIF- 1α were analyzed. Results Rats in each group did not die. Compared with the TBI, TBI+Dex and TBI+TTM groups, the TBI+Dex+TTM group presented remarkably reduced escape latency on Days 3-5 and shortened exploration duration on Day 6 (P<0.05), as well as decreased expression of TNF-α and IL-1β in brain tissues (P<0.05), reduced expression of hippocampal P2X7 receptor and increased amounts of aHIF- 1α (P< 0.05). Conclusions Dex combined with TTM can effectively decline the concentration of P2X7 receptor, down-regulate the levels of TNF-α and IL-1β, and increase the level of aHIF- 1α, which can be served as a promising therapy for TBI rats. Key words: Brain injuries, traumatic; Dexmedetomidine; Targeted temperature management; P2X7 receptor; Antisense hypoxia inducible factor- 1α","PeriodicalId":13847,"journal":{"name":"国际麻醉学与复苏杂志","volume":"41 1","pages":"326-330"},"PeriodicalIF":0.0,"publicationDate":"2020-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48475771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-04-15DOI: 10.3760/CMA.J.CN321761-20190823-00012
Yunyu Xiao, Lianhua Chen
Lung ultrasound (LUS) is an important auxiliary examination method in enhanced recovery after surgery, and can evaluate perioperative pulmonary condition in a fast, timely and non-invasive manner. Based on recent literature, this review summarizes LUS examination methods and typical images, explores the feasibility of LUS to recognize perioperative atelectasis and how to evaluate the severity of atelectasis according to ultrasound images. The paper focuses on the monitoring of ultrasound-guided pulmonary ventilation, and the implementation of individualized protective strategy of pulmonary ventilation to reduce the incidence of pulmonary complication. It also analyzes the limits of clinical application of LUS, and discusses the non-alternative advantages of LUS in preventing and monitoring important changes in the respiratory tract in the perioperative period. Key words: Lung ultrasound; Atelectasis; Mechanical ventilation; Protective lung ventilation
{"title":"Research progress on the application of ultrasound in evaluating perioperative atelectasis and protective pulmonary ventilation","authors":"Yunyu Xiao, Lianhua Chen","doi":"10.3760/CMA.J.CN321761-20190823-00012","DOIUrl":"https://doi.org/10.3760/CMA.J.CN321761-20190823-00012","url":null,"abstract":"Lung ultrasound (LUS) is an important auxiliary examination method in enhanced recovery after surgery, and can evaluate perioperative pulmonary condition in a fast, timely and non-invasive manner. Based on recent literature, this review summarizes LUS examination methods and typical images, explores the feasibility of LUS to recognize perioperative atelectasis and how to evaluate the severity of atelectasis according to ultrasound images. The paper focuses on the monitoring of ultrasound-guided pulmonary ventilation, and the implementation of individualized protective strategy of pulmonary ventilation to reduce the incidence of pulmonary complication. It also analyzes the limits of clinical application of LUS, and discusses the non-alternative advantages of LUS in preventing and monitoring important changes in the respiratory tract in the perioperative period. \u0000 \u0000Key words: \u0000Lung ultrasound; Atelectasis; Mechanical ventilation; Protective lung ventilation","PeriodicalId":13847,"journal":{"name":"国际麻醉学与复苏杂志","volume":"41 1","pages":"377-382"},"PeriodicalIF":0.0,"publicationDate":"2020-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47490540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-04-15DOI: 10.3760/CMA.J.CN321761-20191203-00015
Rong Wang, S. Yao
Remote ischemic preconditioning (RIPC) is a novel preventative treatment approach that is proposed in recent years. It is a non-invasive and clinically relevant preventative strategy of cardiac muscles, that is, to carry out acute transient ischemia in the distant limb before surgery, so as to possibly relieve ischemia/perfusion injury (I/RI) in distant organs (including the heart and brain, etc.). A large number of animal studies and human clinical trials have demonstrated that remote ischemic preconditioning can reduce myocardial infarction size to prevent reperfusion injury. Unfortunately, it is difficult to transform from experiments to clinical application and finally benefit patients. Therefore, the efficient and effective method has yet to be developed. In this review, now analyzed the studies concerning cardioprotective effects by RIPC and summarized the difficulties of clinical practice. Key words: Remote ischemic preconditioning; Myocardial protection; Ischemia/reperfusion injury; Clinical application
{"title":"Cardioprotective effects of remote ischemic preconditioning and its challenges in clinical application","authors":"Rong Wang, S. Yao","doi":"10.3760/CMA.J.CN321761-20191203-00015","DOIUrl":"https://doi.org/10.3760/CMA.J.CN321761-20191203-00015","url":null,"abstract":"Remote ischemic preconditioning (RIPC) is a novel preventative treatment approach that is proposed in recent years. It is a non-invasive and clinically relevant preventative strategy of cardiac muscles, that is, to carry out acute transient ischemia in the distant limb before surgery, so as to possibly relieve ischemia/perfusion injury (I/RI) in distant organs (including the heart and brain, etc.). A large number of animal studies and human clinical trials have demonstrated that remote ischemic preconditioning can reduce myocardial infarction size to prevent reperfusion injury. Unfortunately, it is difficult to transform from experiments to clinical application and finally benefit patients. Therefore, the efficient and effective method has yet to be developed. In this review, now analyzed the studies concerning cardioprotective effects by RIPC and summarized the difficulties of clinical practice. \u0000 \u0000Key words: \u0000Remote ischemic preconditioning; Myocardial protection; Ischemia/reperfusion injury; Clinical application","PeriodicalId":13847,"journal":{"name":"国际麻醉学与复苏杂志","volume":"41 1","pages":"391-395"},"PeriodicalIF":0.0,"publicationDate":"2020-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48103097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-03-15DOI: 10.3760/CMA.J.ISSN.1673-4378.2020.03.009
Hai-tao Yu, Yun Liu, Xiaoqin Han
Objective To systematically evaluate the effectiveness of preoperative prewarming for maintenance of intraopera-tive core body temperature, so as to provide clinical evidence for perioperative temperature management. Methods We retrieved PubMed, Web of Science, the Cochrane Library, EMBACE, CINAHL, CNKI, Wanfang Database, CQVIP and China Biology Medicine disc, so as to comprehensively search randomized controlled trials (RCTs) about preoperative prewarming for maintenance of intraopera-tive core body temperature. The retrieval time was limited from January 2000 to April 2019 and the references of the included trials were also reviewed. Two researchers independently screened literature according to the inclusion and exclusion criteria, evaluated the quality of the included literature, and extracted data. RevMan 5.3 software was adopted to perform Meta-analysis. Results Fourteen RCTs involving a total of 902 patients were included. The results of Meta-analysis indicated that the preoperative prewarming group presented a remarkably increased core body temperature 30 min, 60 min, and 90 min after anesthesia induction and at the end of opera-tion, as well as a markedly decreased incidence of intraoperative hypothermia and postoperative hypothermia, compared with the con-trol group (P 0.05). Conclusions Preoperative prewarming can effectively increaese intraoperative core body temperature and reduce the inci-dence of hypothermia. Key words: Prewarming; Intraoperative; Core body temperature; Hypothermia; Meta-analysis
目的系统评价术前预热维持术中核心体温的有效性，为围手术期体温管理提供临床依据。方法检索PubMed、Web of Science、Cochrane Library、EMBACE、CINAHL、CNKI、万方数据库、CQVIP和中国生物医学光盘，综合检索术前预热维持术中核心体温的随机对照试验。检索时间限制在2000年1月至2019年4月，并对纳入试验的参考文献进行了审查。两名研究人员根据纳入和排除标准独立筛选文献，评估纳入文献的质量，并提取数据。采用RevMan 5.3软件进行Meta分析。结果纳入14项随机对照试验，共902名患者。Meta分析结果表明，术前预热组在麻醉诱导后30分钟、60分钟和90分钟以及手术结束时，核心体温显著升高，术中体温过低和术后体温过低的发生率显著降低，结论术前预热能有效提高术中核心体温，降低体温过低的发生率。关键词：预热；术中；核心体温；体温过低；Meta分析
{"title":"Effectiveness of preoperative prewarming for maintenance of intraoperative core body temperature: an Meta-analysis","authors":"Hai-tao Yu, Yun Liu, Xiaoqin Han","doi":"10.3760/CMA.J.ISSN.1673-4378.2020.03.009","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4378.2020.03.009","url":null,"abstract":"Objective \u0000To systematically evaluate the effectiveness of preoperative prewarming for maintenance of intraopera-tive core body temperature, so as to provide clinical evidence for perioperative temperature management. \u0000 \u0000 \u0000Methods \u0000We retrieved PubMed, Web of Science, the Cochrane Library, EMBACE, CINAHL, CNKI, Wanfang Database, CQVIP and China Biology Medicine disc, so as to comprehensively search randomized controlled trials (RCTs) about preoperative prewarming for maintenance of intraopera-tive core body temperature. The retrieval time was limited from January 2000 to April 2019 and the references of the included trials were also reviewed. Two researchers independently screened literature according to the inclusion and exclusion criteria, evaluated the quality of the included literature, and extracted data. RevMan 5.3 software was adopted to perform Meta-analysis. \u0000 \u0000 \u0000Results \u0000Fourteen RCTs involving a total of 902 patients were included. The results of Meta-analysis indicated that the preoperative prewarming group presented a remarkably increased core body temperature 30 min, 60 min, and 90 min after anesthesia induction and at the end of opera-tion, as well as a markedly decreased incidence of intraoperative hypothermia and postoperative hypothermia, compared with the con-trol group (P 0.05). \u0000 \u0000 \u0000Conclusions \u0000Preoperative prewarming can effectively increaese intraoperative core body temperature and reduce the inci-dence of hypothermia. \u0000 \u0000 \u0000Key words: \u0000Prewarming; Intraoperative; Core body temperature; Hypothermia; Meta-analysis","PeriodicalId":13847,"journal":{"name":"国际麻醉学与复苏杂志","volume":"41 1","pages":"271-277"},"PeriodicalIF":0.0,"publicationDate":"2020-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44049083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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