Pub Date : 2020-01-20DOI: 10.3760/CMA.J.ISSN.1673-4912.2020.01.004
B. Zhu, Xuan Xu
Children in the pediatric intensive care unit who continue to have ventilator-assisted breathing are often difficult to get off-line due to respiratory system disease, cardiovascular system disease, nervous system disease, nutritional status, genetic metabolism, abnormal diaphragm movement and other factors.Through the diagnosis and treatment of flexible bronchoscope, the etiology could be identified, the ventilation function is effectively improved, and the cure rate of weaning difficulty increases.This paper discussed the etiological diagnosis and treatment of flexible bronchoscopy in children with difficulty in weaning from pediatric intensive care unit. Key words: Flexible bronchoscope; Difficulty in weaning; Pediatric intensive care unit; Diagnosis; Treatment
{"title":"Etiological diagnosis and treatment of bronchoscopy in pediatric intensive care unit","authors":"B. Zhu, Xuan Xu","doi":"10.3760/CMA.J.ISSN.1673-4912.2020.01.004","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4912.2020.01.004","url":null,"abstract":"Children in the pediatric intensive care unit who continue to have ventilator-assisted breathing are often difficult to get off-line due to respiratory system disease, cardiovascular system disease, nervous system disease, nutritional status, genetic metabolism, abnormal diaphragm movement and other factors.Through the diagnosis and treatment of flexible bronchoscope, the etiology could be identified, the ventilation function is effectively improved, and the cure rate of weaning difficulty increases.This paper discussed the etiological diagnosis and treatment of flexible bronchoscopy in children with difficulty in weaning from pediatric intensive care unit. \u0000 \u0000Key words: \u0000Flexible bronchoscope; Difficulty in weaning; Pediatric intensive care unit; Diagnosis; Treatment","PeriodicalId":68901,"journal":{"name":"中国小儿急救医学","volume":"27 1","pages":"14-17"},"PeriodicalIF":0.0,"publicationDate":"2020-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45466788","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}
Objective: To explore the relationship between BIG scores (basic defect, INR, GCS) and discharge dysfunction (pediatric brain function classification (PCPC) ≥ 4) in children with multiple traumas complicated with brain injury. Design a retrospective cohort study of pediatric trauma databases from 2001 to 2018. The first level trauma project of the Affiliated Pediatric Hospital of the Place University targets children aged 2-17 who have suffered major blunt trauma, including traumatic brain injury (TBI), and meet the trauma group activation criteria. The intervention measures had no measurement method and the main outcome was determined by two investigators who were previously unaware of the BIG score to determine the discharge PCPC score. Measure the BIG score upon arrival at the emergency department. The age of 609 study patients was (9.7 ± 4.4) years old, with a median injury severity score of 22 (IQR 12). 171/609 cases (28%) had PCPC ≥ 4 (primary outcome). After adjusting for neurosurgical surgical requirements (OR 2.83, 95% CI 1.69-4.74), pupil fixation and dilation (OR 3.1, 95% CI 1.49-6.38), on-site or referral hospital intubation (OR 2.82, 95% CI 1.35-5.87), and other assumed predictive factors for poor prognosis, BIG constituted a multivariate predictor of PCPC ≥ 4 (OR 2.39, 95% CI 1.81-3.15). The area under the BIG ROC curve is 0.87 (0.84-0.90). Using the optimal BIG inflection point value ≤ 8, the sensitivity and net present value of dysfunction at discharge were 93% and 96%, respectively. The sensitivity of GCS ≤ 8 is 79%, and the net present value is 91%. The BIG score of children with GCS score 3 is associated with brain death (OR 2.13, 95% CI 1.58-2.36). BIG also predicted the recovery tendency of hospitalized children (OR 2.26, 95% CI 2.17-2.35). Conclusion: The BIG score is a simple and quickly obtainable disease severity score, which is an independent predictor of functional dependence in TBI and other traumatic children upon discharge. The BIG score may help determine the ideal target audience for TBI trials during the treatment window period in trauma and neurointensive care programs.
{"title":"The BIG score and functional outcome at hospital discharge in children with traumatic brain injury","authors":"方伯梁, 钱素云","doi":"10.3760/CMA.J.ISSN.1673-4912.2020.01.103","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4912.2020.01.103","url":null,"abstract":"目的 \u0000探讨多发创伤患儿中合并脑外伤者入急诊科BIG评分(基础缺陷，INR，GCS)与出院时功能障碍[儿科脑功能表现分类(PCPC)≥4]之间的关系。 \u0000 \u0000 \u0000设计 \u00002001至2018年儿科创伤数据库回顾性队列研究。 \u0000 \u0000 \u0000场所 \u0000大学附属儿科医院一级创伤项目 \u0000 \u0000 \u0000对象 \u00002～17岁儿童遭受包括创伤性脑损伤(TBI)在内的重大钝性创伤，并符合创伤小组激活标准。 \u0000 \u0000 \u0000干预措施 \u0000无 \u0000 \u0000 \u0000测量方法与主要结果 \u0000由两名事先不知BIG分值的调查人员确定出院PCPC得分。到达急诊科时测量BIG分值。609例研究患儿年龄(9.7±4.4)岁，中位损伤严重程度评分为22(IQR 12)。171/609例(28%)PCPC≥4(初级结局)。校正神经外科手术需求(OR 2.83，95%CI 1.69-4.74)，瞳孔固定和扩张(OR 3.1，95%CI 1.49-6.38)，现场或转诊医院插管(OR 2.82，95%CI 1.35-5.87)和其他预后不良假定预测因子后，BIG构成了PCPC≥4的多变量预测因子(OR 2.39，95%CI 1.81-3.15)。BIG ROC曲线下面积为0.87(0.84-0.90)。使用最佳BIG拐点值≤8，出院时功能障碍的敏感度和净现值分别为93%和96%。GCS≤8的敏感度为79%，净现值为91%。GCS 3分患儿BIG评分与脑死亡相关(OR 2.13，95%CI 1.58-2.36)。BIG还预测住院患儿康复倾向(OR 2.26，95%CI 2.17-2.35)。 \u0000 \u0000 \u0000结论 \u0000BIG评分是一项简单且可快速获得的疾病严重程度评分，为TBI等创伤患儿出院时功能依赖的独立预测因子。BIG得分可能有助于创伤和神经重症监护项目在治疗窗口期确定TBI试验的理想入组对象。","PeriodicalId":68901,"journal":{"name":"中国小儿急救医学","volume":"27 1","pages":"49-49"},"PeriodicalIF":0.0,"publicationDate":"2020-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47864422","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 : 2020-01-20DOI: 10.3760/CMA.J.ISSN.1673-4912.2020.01.009
Yong Luo, P. Jin, Chun-yi Liu, H. Xie, Yu-ming Zhang
Objective To investigate the effects of critical care chest ultrasonic examination (CCUE) by intensive care physician on fluid management among septic shock patients in pediatric intensive care unit (PICU). Methods Forty children from PICU who were diagnosed as septic shock in Shenzhen Bao′an Maternal and Child Health Hospital were included in this study.Twenty-two of them who were hospitalized in PICU during January 2017 to December 2018, under the care of 4 PICU physicians who had certificates of the Chinese Critical Ultrasound Study Group(CCUSG) were defined as CCUE group.Eighteen PICU patients from January 2014 to December 2015 having no access to CCUE were recruited as control group.Both groups were treated according to the septic shock management guidelines with routine anti-shock and anti-infection therapy, as well as mechanical ventilation.Fluid management following conventional protocol was performed in the control group.While in the CCUE group, CCUE was applied to monitor the hemodynamic status for adjustment in fluid management. Results Compared with the control group, the CCUE group had shorter mechanical ventilation time as well as less fluid intake and output within 48 hours after admission[(4.68±2.06)d vs.(7.33±0.49)d, (6.34±1.85)ml/(kg·h) vs.(8.55±0.39) ml/(kg·h), (2.47±1.22)ml/(kg·h) vs.(6.18±1.72)ml/(kg·h)] (P 0.05). Conclusion Application of CCUE helps to optimize fluid management and shorten the ventilation time among children with septic shock in PICU. Key words: Septic shock; Fluid management; Critical care chest ultrasonic examination in emergency consultation
{"title":"Clinical study of fluid management in children with septic shock guided by ultrasound","authors":"Yong Luo, P. Jin, Chun-yi Liu, H. Xie, Yu-ming Zhang","doi":"10.3760/CMA.J.ISSN.1673-4912.2020.01.009","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4912.2020.01.009","url":null,"abstract":"Objective \u0000To investigate the effects of critical care chest ultrasonic examination (CCUE) by intensive care physician on fluid management among septic shock patients in pediatric intensive care unit (PICU). \u0000 \u0000 \u0000Methods \u0000Forty children from PICU who were diagnosed as septic shock in Shenzhen Bao′an Maternal and Child Health Hospital were included in this study.Twenty-two of them who were hospitalized in PICU during January 2017 to December 2018, under the care of 4 PICU physicians who had certificates of the Chinese Critical Ultrasound Study Group(CCUSG) were defined as CCUE group.Eighteen PICU patients from January 2014 to December 2015 having no access to CCUE were recruited as control group.Both groups were treated according to the septic shock management guidelines with routine anti-shock and anti-infection therapy, as well as mechanical ventilation.Fluid management following conventional protocol was performed in the control group.While in the CCUE group, CCUE was applied to monitor the hemodynamic status for adjustment in fluid management. \u0000 \u0000 \u0000Results \u0000Compared with the control group, the CCUE group had shorter mechanical ventilation time as well as less fluid intake and output within 48 hours after admission[(4.68±2.06)d vs.(7.33±0.49)d, (6.34±1.85)ml/(kg·h) vs.(8.55±0.39) ml/(kg·h), (2.47±1.22)ml/(kg·h) vs.(6.18±1.72)ml/(kg·h)] (P 0.05). \u0000 \u0000 \u0000Conclusion \u0000Application of CCUE helps to optimize fluid management and shorten the ventilation time among children with septic shock in PICU. \u0000 \u0000 \u0000Key words: \u0000Septic shock; Fluid management; Critical care chest ultrasonic examination in emergency consultation","PeriodicalId":68901,"journal":{"name":"中国小儿急救医学","volume":"27 1","pages":"40-44"},"PeriodicalIF":0.0,"publicationDate":"2020-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48725620","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 : 2020-01-20DOI: 10.3760/CMA.J.ISSN.1673-4912.2020.01.011
Lili Li, Rui Li, Guanghua Shao, Hong Jiang, Dongyun Liu
Bronchopulmonary dysplasia(BPD)is a common chronic lung disease that occurs in preterm infants.The infant who with BPD has the feature of small gestational age, low birth weight and immature development of various organ systems.During hospitalization, it is easy to combine with brain injury in premature infant, metabolic bone disease of prematurity, retinopathy of prematurity and cholestasis syndrome, which seriously affect the survival rate and life quality of premature infants.This article reviewed the extrapulmonary complications of BPD in premature infants. Key words: Bronchopulmonary dysplasia; Brain injury in premature infants; Metabolic bone disease of prematurity; Retinopathy of prematurity; Cholestasis syndrome; Extrapolmonary complication
{"title":"Extrapulmonary complications of bronchopulmonary dysplasia in premature infants","authors":"Lili Li, Rui Li, Guanghua Shao, Hong Jiang, Dongyun Liu","doi":"10.3760/CMA.J.ISSN.1673-4912.2020.01.011","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4912.2020.01.011","url":null,"abstract":"Bronchopulmonary dysplasia(BPD)is a common chronic lung disease that occurs in preterm infants.The infant who with BPD has the feature of small gestational age, low birth weight and immature development of various organ systems.During hospitalization, it is easy to combine with brain injury in premature infant, metabolic bone disease of prematurity, retinopathy of prematurity and cholestasis syndrome, which seriously affect the survival rate and life quality of premature infants.This article reviewed the extrapulmonary complications of BPD in premature infants. \u0000 \u0000Key words: \u0000Bronchopulmonary dysplasia; Brain injury in premature infants; Metabolic bone disease of prematurity; Retinopathy of prematurity; Cholestasis syndrome; Extrapolmonary complication","PeriodicalId":68901,"journal":{"name":"中国小儿急救医学","volume":"27 1","pages":"50-54"},"PeriodicalIF":0.0,"publicationDate":"2020-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42579109","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 : 2020-01-20DOI: 10.3760/CMA.J.ISSN.1673-4912.2020.01.010
He Song, Yufeng Zhang, H. Deng, Jun Wang, Pengfei Xu, Juan Yuan, Ruiqing Liu, T. Tang
Objective To investigate the clinical value of plasma brain natriuretic peptide (BNP) levels in predicting the severity of hand, foot and mouth disease (HFMD) in children with coxsackie virus A6 (CV-A6) infection. Methods A total of 305 children with CV-A6 type HFMD admitted to Xi′an Children′s Hospital from January 2017 to December 2018 were divided into general group (200 cases) and severe group (105 cases) according to the severity of the disease.The receiver operating characteristic curve was used to calculate the value of plasma BNP levels to predict the severe CV-A6 HFMD.Multivariate logistic regression analysis was used to analyze the correlation between the related factors and the severity of CV-A6 HFMD. Results Compared with the normal group, children in the severe group had statistically significant differences in WBC level, BNP level, neurological symptoms, circulatory disorders, and blood glucose levels(all P 15×109/L, blood glucose> 8.3 mmol/L, and BNP>294.85 ng/L were related to the severity of CV-A6 HFMD(OR=2.275, P=0.013; OR=6.057, P=0.028; OR=1.008, P<0.001). Conclusion BNP>294.85 ng/L is closely related to the severity of CV-A6 HFMD and has predictive value.It is an early warning factor for the severity of CV-A6 HFMD. Key words: Hand, foot and mouth disease; Coxsackie virus A6; Brain natriuretic peptide; Risk factors
{"title":"Correlation between the levels of plasma brain natriuretic peptide and coxsackie virus A6 in hand, foot and mouth disease","authors":"He Song, Yufeng Zhang, H. Deng, Jun Wang, Pengfei Xu, Juan Yuan, Ruiqing Liu, T. Tang","doi":"10.3760/CMA.J.ISSN.1673-4912.2020.01.010","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4912.2020.01.010","url":null,"abstract":"Objective \u0000To investigate the clinical value of plasma brain natriuretic peptide (BNP) levels in predicting the severity of hand, foot and mouth disease (HFMD) in children with coxsackie virus A6 (CV-A6) infection. \u0000 \u0000 \u0000Methods \u0000A total of 305 children with CV-A6 type HFMD admitted to Xi′an Children′s Hospital from January 2017 to December 2018 were divided into general group (200 cases) and severe group (105 cases) according to the severity of the disease.The receiver operating characteristic curve was used to calculate the value of plasma BNP levels to predict the severe CV-A6 HFMD.Multivariate logistic regression analysis was used to analyze the correlation between the related factors and the severity of CV-A6 HFMD. \u0000 \u0000 \u0000Results \u0000Compared with the normal group, children in the severe group had statistically significant differences in WBC level, BNP level, neurological symptoms, circulatory disorders, and blood glucose levels(all P 15×109/L, blood glucose> 8.3 mmol/L, and BNP>294.85 ng/L were related to the severity of CV-A6 HFMD(OR=2.275, P=0.013; OR=6.057, P=0.028; OR=1.008, P<0.001). \u0000 \u0000 \u0000Conclusion \u0000BNP>294.85 ng/L is closely related to the severity of CV-A6 HFMD and has predictive value.It is an early warning factor for the severity of CV-A6 HFMD. \u0000 \u0000 \u0000Key words: \u0000Hand, foot and mouth disease; Coxsackie virus A6; Brain natriuretic peptide; Risk factors","PeriodicalId":68901,"journal":{"name":"中国小儿急救医学","volume":"27 1","pages":"45-49"},"PeriodicalIF":0.0,"publicationDate":"2020-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42333949","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 : 2020-01-20DOI: 10.3760/CMA.J.ISSN.1673-4912.2020.01.012
Chunying Peng, G. Lu
Ventilator associated pneumonia(VAP)is one of the major source of nosocomial infection in PICU, of which the pathogenesis remains unclear.Recent metataxonomic and metagenomic technologies, from 16S ribosomal RNA to whole genome sequencing, have revealed that healthy lungs harbor a dynamic ecosystem of bacteria and dysbiosis of the respiratory microbiome involved in the pathogenesis and progression of VAP.Recent studies have illustrated that the imbalance of species diversity and abundance of lung microbiome might be the underlying cause of VAP through regulating local mucosal immune response.These methods offer the potential to better interrogate the relationship between an intubated individual′s respiratory microbiota and the underlying disease process to provide important insights into the pathogenesis of VAP, optimizing disease surveillance and multi-drug resistant microbes detection. Key words: Lung microbiome; Ventilator associated pneumonia; Metagenomics; 16S rRNA
{"title":"The lower respiratory tract microbiome in pediatric patients with ventilator-associated pneumonia","authors":"Chunying Peng, G. Lu","doi":"10.3760/CMA.J.ISSN.1673-4912.2020.01.012","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4912.2020.01.012","url":null,"abstract":"Ventilator associated pneumonia(VAP)is one of the major source of nosocomial infection in PICU, of which the pathogenesis remains unclear.Recent metataxonomic and metagenomic technologies, from 16S ribosomal RNA to whole genome sequencing, have revealed that healthy lungs harbor a dynamic ecosystem of bacteria and dysbiosis of the respiratory microbiome involved in the pathogenesis and progression of VAP.Recent studies have illustrated that the imbalance of species diversity and abundance of lung microbiome might be the underlying cause of VAP through regulating local mucosal immune response.These methods offer the potential to better interrogate the relationship between an intubated individual′s respiratory microbiota and the underlying disease process to provide important insights into the pathogenesis of VAP, optimizing disease surveillance and multi-drug resistant microbes detection. \u0000 \u0000Key words: \u0000Lung microbiome; Ventilator associated pneumonia; Metagenomics; 16S rRNA","PeriodicalId":68901,"journal":{"name":"中国小儿急救医学","volume":"27 1","pages":"55-58"},"PeriodicalIF":0.0,"publicationDate":"2020-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49347790","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}
Objective: To explore the clinical, imaging features, and genetic analysis of children with pyruvate dehydrogenase complex deficiency who first manifest as respiratory and cardiac arrest. Method: The clinical characteristics and imaging data of a child with pyruvate dehydrogenase complex deficiency who was diagnosed with sudden respiratory and cardiac arrest at the Bao'an District Maternal and Child Health Hospital in Shenzhen in 2017 were summarized. Using keywords such as "pyruvate dehydrogenase complex deficiency" and "PDHA1", the PubMed database, China Knowledge Infrastructure Engineering (CNKI) database, and Wanfang database were searched for relevant literature until March 2019, Summarize the reported cases in China. The proband male, 2 months and 10 days old, experienced sudden respiratory and cardiac arrest after infection, accompanied by hyperlactatemia and difficult to correct metabolic acidosis. The head MRI examination revealed: (1) abnormal signals in the bilateral basal ganglia of the brain, consistent with the imaging changes of Leigh's disease; (2) There is a slight bleeding under the left ventricular septum. The electroencephalogram indicates abnormal discharge. Mitochondrial disease related gene testing suggests the presence of c.1132C>T, p.H378C hemizygous mutations in the PDHA1 gene. The child died at the age of 1. Conclusion: Pyruvate dehydrogenase complex deficiency often starts with neurological symptoms, and reports of sudden cardiac and respiratory arrest are rare. Timely cardiopulmonary resuscitation and ventilator support can temporarily save lives and buy time for primary disease treatment, but the final prognosis is poor and the mortality rate is high. The c.1132C>T, p.H378C mutation in the PDHA1 gene is the pathogenic factor.
{"title":"A case of pyruvate dehydrogenase complex deficiency with sudden respiratory and cardiac arrest","authors":"Moling Wu, H. Xie, Juan Chen, Yong Luo, Gang Zhou, Yuqiong Luo, P. Jin, Jin-ji Xu","doi":"10.3760/CMA.J.ISSN.1673-4912.2020.01.016","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4912.2020.01.016","url":null,"abstract":"目的 \u0000探讨以呼吸心跳骤停为首发表现的丙酮酸脱氢酶复合物缺乏症患儿的临床、影像学特点及基因分析。 \u0000 \u0000 \u0000方法 \u0000对2017年深圳市宝安区妇幼保健院因突发呼吸心跳骤停就诊的1例丙酮酸脱氢酶复合物缺乏症患儿的临床特征、影像学资料进行总结，以\"丙酮酸脱氢酶复合物缺乏症\"、\"PDHA1\"等为关键词，查阅PubMed数据库、中国知识基础设施工程(CNKI)数据库、万方数据库建库至2019年3月相关文献，对国内报道的病例进行总结。 \u0000 \u0000 \u0000结果 \u0000先证者男，2个月10 d，感染后突发呼吸心跳骤停，伴高乳酸血症，难以纠正的代谢性酸中毒。头颅MRI检查提示：(1)双侧大脑基底节区异常信号，符合Leigh病影像学改变；(2)左侧室管膜下少许出血。脑电图提示异常放电。线粒体病相关基因检测提示PDHA1基因存在c.1132C>T，p.H378C半合突变。患儿于1岁时死亡。 \u0000 \u0000 \u0000结论 \u0000丙酮酸脱氢酶复合物缺乏症多以神经系统症状起病，以心跳呼吸骤停为突发表现的报道罕见，及时心肺复苏、呼吸机支持能暂时挽救生命，为原发病治疗争取时间，但最终预后差，病死率高。PDHA1基因c.1132C>T，p.H378C变异是其致病原因。","PeriodicalId":68901,"journal":{"name":"中国小儿急救医学","volume":"27 1","pages":"71-74"},"PeriodicalIF":0.0,"publicationDate":"2020-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45193726","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}
Clear Purpose 95 μ The relationship between arterial blood and blood gas analysis in critically ill children μ Consistency of arterial blood test results. Method: A total of 0.6 ml of arterial blood samples were collected from hospitalized children in the Intensive Care Department of Beijing Children's Hospital, and 195 samples were analyzed using the Rayleigh ABL-835 blood gas analyzer μ L and 95 μ Detect the consistency of blood gas analysis results with different injection volumes and conduct ICC Bland Altman consistency test. Results From October 2016 to May 2018, 150 first-time arterial blood samples were obtained from hospitalized children. The results of different injection volumes showed consistency of pH, PaCO2, PaO2, K+, Ca2+, GLU, BE, HCO3->0.950; Na+, Cl - consistency>0.900; Lac consistency>0.850, indicating good consistency in the 11 numerical tests of blood gas analysis. Conclusion adopts 95 μ Blood gas testing of arterial blood can provide a comparison with 195 μ The consistent results of arterial blood testing are suitable for small weight premature infants and low birth weight infants, and can reduce waste blood or repeated punctures caused by insufficient blood collection.
{"title":"Consistency of blood gas results of different arterial blood volume in the pediatric intensive care unit","authors":"Jie Zhang, Xiaohui Wang, Suyun Qian","doi":"10.3760/CMA.J.ISSN.1673-4912.2020.01.017","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4912.2020.01.017","url":null,"abstract":"目的 \u0000明确95 μl动脉血在危重患儿的血气分析检测中与195 μl动脉血检测结果的一致性。 \u0000 \u0000 \u0000方法 \u0000北京儿童医院重症医学科住院患儿，采集动脉血标本0.6 ml，使用雷度ABL-835型血气分析仪进行195 μl和95 μl不同进样量检测，分析两种进样量血气分析结果的一致性，进行ICC Bland-Altman一致性检验。 \u0000 \u0000 \u0000结果 \u00002016年10月至2018年5月获得150例患儿的入院首次动脉血样本，不同进样量检测结果显示pH值、PaCO2、PaO2、K＋、Ca2＋、GLU、BE、HCO3-一致性>0.950；Na＋、Cl－一致性>0.900；Lac一致性>0.850，即血气分析11项数值检验一致性好。 \u0000 \u0000 \u0000结论 \u0000采用95 μl动脉血进行血气检测可提供与195 μl动脉血检测一致性较好的结果，适用于体重小的早产儿、低出生体重儿，可减少因采血量不足产生的废血或反复穿刺。","PeriodicalId":68901,"journal":{"name":"中国小儿急救医学","volume":"27 1","pages":"75-77"},"PeriodicalIF":0.0,"publicationDate":"2020-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48245130","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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