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Outcomes among immunecompetent and immunocompromised and pneumonia and trachea-bronchitis in mechanical ventilation 免疫功能正常和免疫功能低下、肺炎和气管支气管炎机械通气的结局
Pub Date : 2019-09-28 DOI: 10.1183/13993003.congress-2019.pa2277
Maria Augusta Costa deMoura, J. Moura, V. Moura, M. Moura, R. Stirbulov
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引用次数: 0
Influencing factors on changes of ICU family members satisfaction ICU家庭成员满意度变化的影响因素
Pub Date : 2019-09-28 DOI: 10.1183/13993003.congress-2019.pa4009
Dong Yon Kim, Sung-wook Kang, Hye Ri Choi, C. Choi, Y. Kim, H. Choi, Jung Mi Lee
Influencing factors on the changes of ICU family members’ satisfaction Soyoung Yang, Hye Ri Choi, In-Ho Yang, Mira Song, Jun Ki Min, Minji Lee, Yee Hyung Kim, Sung Wook Kang (1.Department of Internal Medicine, Kyung Hee University Hospital at Gang Dong, Korea, 2.Department of Pulmonary and Critical Care Medicine, Kyung Hee University Hospital at Gang Dong, Korea, 3.School of Health in Social Science, University of Edinburgh, UK)
ICU家属满意度变化的影响因素杨少英,崔慧丽,杨仁浩,宋米拉,闵俊基,李敏智,金尔炯,姜成旭(1)。2.韩国江东庆熙大学医院内科3.韩国江东庆熙大学附属医院肺重症医学科英国爱丁堡大学社会科学卫生学院)
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引用次数: 0
Late Breaking Abstract - Effects of levosimendan on diaphragm contractile efficiency in patients weaning from mechanical ventilation 摘要-左西孟旦对机械通气患者膈肌收缩效率的影响
Pub Date : 2019-09-28 DOI: 10.1183/13993003.congress-2019.pa4027
L. Roesthuis, H. V. D. Hoeven, C. Sinderby, T. Frenzel, C. Ottenheijm, L. Brochard, J. Doorduin, L. Heunks
Introduction: Respiratory muscle weakness frequently develops in critically ill patients and is associated with difficult weaning from mechanical ventilation and increased mortality. No drug has been approved to improve respiratory muscle function. However, we have previously shown that the calcium sensitizer levosimendan improves contractility of diaphragm muscle fibers in vitro and diaphragm contractility in healthy subjects in vivo. Objectives: To investigate the effects of levosimendan on diaphragm contractile efficiency in mechanically ventilated patients. Methods: In a double-blind placebo-controlled trial mechanically ventilated patients (N=39) performed two continuous positive airway pressure (CPAP) trials for 30-minutes each with 5 hour interval. After the first CPAP trial, study medication (either levosimendan 0.2 µg/kg/min or placebo) was administered. During both trials electrical activity of the diaphragm (EAdi), transdiaphragmatic pressure (Pdi) and tidal volume (TV) were continuously measured. Neuromechanical efficiency (primary outcome parameter) was defined as ΔPdi/ΔEAdi. Results: Neuromechanical efficiency did not improve after levosimendan. However, ΔEAdi and tidal volume were higher after levosimendan administration (31% and 11%, respectively). P0.1, a measure for respiratory load, increased in the placebo group by 41%, while it remained constant in the levosimendan group. PaCO2 significantly decreased (44 mmHg vs 42 mmHg) in response to levosimendan administration. Conclusions: Although levosimendan did not improve diaphragm contractile efficiency, tidal volume increased, while P0.1 and PaCO2 decreased.
危重患者经常出现呼吸肌无力,并伴有机械通气困难脱机和死亡率增加。目前还没有药物被批准用于改善呼吸肌功能。然而,我们之前已经表明,钙敏化剂左西孟旦在体外改善膈肌纤维的收缩力,在体内改善健康受试者的膈肌收缩力。目的:探讨左西孟旦对机械通气患者膈肌收缩效率的影响。方法:在一项双盲安慰剂对照试验中,机械通气患者(N=39)进行两次持续气道正压通气(CPAP)试验,每次30分钟,间隔5小时。在第一次CPAP试验后,给予研究药物(左西孟旦0.2µg/kg/min或安慰剂)。在两次试验中,连续测量膈肌电活动(EAdi)、横膈膜压力(Pdi)和潮气量(TV)。神经机械效率(主要结局参数)定义为ΔPdi/ΔEAdi。结果:左西孟旦后神经力学效率无明显提高。但左西孟旦给药后ΔEAdi和潮气量升高(分别为31%和11%)。衡量呼吸负荷的P0.1在安慰剂组增加了41%,而左西孟旦组保持不变。左西孟旦组PaCO2显著降低(44 mmHg vs 42 mmHg)。结论:左西孟旦虽未提高膈肌收缩效率,但潮气量升高,P0.1和PaCO2降低。
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引用次数: 0
Characterization of patients with pneumonia and chronic structural lung disease admitted to an ICU ICU收治的肺炎和慢性结构性肺病患者的特征分析
Pub Date : 2019-09-28 DOI: 10.1183/13993003.congress-2019.pa2287
Gil Gonçalves, M. Leitão, Luís Linhares, J. P. Baptista, P. Martins
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引用次数: 0
Prognostic factors for extubation failure in high risk patients using high-flow nasal cannula 高危患者使用高流量鼻插管拔管失败的预后因素分析
Pub Date : 2019-09-28 DOI: 10.1183/13993003.congress-2019.pa4022
Paulina Ezcurra, M. Venuti, E. Gogniat, M. Ducrey, J. Dianti, A. Midley, S. Giannasi, E. S. Román, Nicolás Roux
Introduction: High flow nasal cannula (HFNC) is effective in preventing extubation respiratory failure in high risk patients. However there is a lack of information in which variables better predict which patients will not benefit from this intervention. Objective: Our goal is to identify variables that could predict which patients will not benefit with HFNC for extubation failure prevention. Methods: Prospective interventional single center study in an intensive care unit in Argentina. We included patients with at least one pre-specified risk factor who required invasive mechanical ventilation (IMV) for more than 48hs and passed a spontaneous breathing trial. HFNC was administered for the first 24hs following extubation. We divided extubation failure causes into those related with worsening of respiratory variables and non-respiratory related causes. Results: We include 165 patients. 40(24.2%) presented extubation failure, 18(10.9%) of which were for non-respiratory related causes and 22(13.3%) for worsening of respiratory variables. None of the pre-specified risk factors individually or combine between this were associated with extubation failure. The median of days of IMV prior to extubation was the only variable associated with extubation failure (5(3-6) vs 4(3-5), p=0.02) in the failure and success group respectively. Conclusions: Incidence of extubation failure in high risk patients receiving HFNC for extubation failure prevention was similar to that reported in previous trials. None of the pre-specified risk factors predicted extubation failure. Time of IMV prior to extubation was the only variable associated with extubation failure.
高流量鼻插管(HFNC)是预防高危患者拔管呼吸衰竭的有效方法。然而,缺乏关于哪些变量能更好地预测哪些患者不会从这种干预中受益的信息。目的:我们的目标是确定变量,可以预测哪些患者不会受益于HFNC预防拔管失败。方法:对阿根廷某重症监护病房进行前瞻性单中心介入研究。我们纳入了至少有一种预先指定的危险因素,需要有创机械通气(IMV)超过48小时并通过自主呼吸试验的患者。拔管后24小时给予HFNC。我们将拔管失败的原因分为与呼吸变量恶化相关的原因和与呼吸无关的原因。结果:我们纳入了165例患者。其中拔管失败40例(24.2%),非呼吸相关原因18例(10.9%),呼吸变量恶化22例(13.3%)。所有预先指定的危险因素单独或联合与拔管失败无关。拔管前IMV天数中位数是拔管失败组和拔管成功组中唯一与拔管失败相关的变量(分别为5(3-6)vs 4(3-5), p=0.02)。结论:采用HFNC预防拔管失败的高危患者拔管失败发生率与既往试验报道相似。所有预先指定的危险因素都不能预测拔管失败。拔管前IMV时间是拔管失败的唯一变量。
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引用次数: 1
Thirty-Day Readmission Among Patients With Acute Respiratory Distress Syndrome and Effects on Outcomes 急性呼吸窘迫综合征患者30天再入院及其对预后的影响
Pub Date : 2019-09-28 DOI: 10.1183/13993003.congress-2019.oa3297
K. Ho, J. Sheehan, J. Salonia
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引用次数: 2
Possible microRNA-mediated alterations of gene expression in lipoteichoic acid-stimulated neutrophils 微rna介导的脂壁酸刺激中性粒细胞基因表达的可能改变
Pub Date : 2019-09-28 DOI: 10.1183/13993003.congress-2019.pa2268
Po-Lin Kuo, M. Yen, Shu-Fang Jian, M. Tsai
{"title":"Possible microRNA-mediated alterations of gene expression in lipoteichoic acid-stimulated neutrophils","authors":"Po-Lin Kuo, M. Yen, Shu-Fang Jian, M. Tsai","doi":"10.1183/13993003.congress-2019.pa2268","DOIUrl":"https://doi.org/10.1183/13993003.congress-2019.pa2268","url":null,"abstract":"","PeriodicalId":7201,"journal":{"name":"Acute critical care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85354143","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}
引用次数: 0
Survival after intensive care for COPD exacerbation in patients with and without long-term oxygen therapy: a nationwide cohort study 接受和不接受长期氧疗的COPD加重患者重症监护后的生存率:一项全国性队列研究
Pub Date : 2019-09-28 DOI: 10.1183/13993003.congress-2019.pa2184
H. Nyström, J. Berkius, M. Ekström, S. Walther, M. Inghammar
Background: Current knowledge about prognosis after intensive care for COPD exacerbation in patients with long-term oxygen therapy (LTOT) is limited.Aims: To investigate survival after ICU admissio ...
背景:目前对长期氧疗(LTOT)患者COPD加重重症监护后预后的了解有限。目的:探讨重症监护病房住院患者的生存状况。
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引用次数: 0
A preliminary clinical evaluation of a new portable life support ventilator with invasively ventilated home users 一种新型便携式生命支持呼吸机与有创通气家庭用户的初步临床评价
Pub Date : 2019-09-28 DOI: 10.1183/13993003.congress-2019.pa2278
J. Yarascavitch, C. Vogler, S. Cannon-Bailey
Background: Trilogy Evo (Philips Respironics, Murrysville PA) is a new life support ventilator that provides invasive and non-invasive ventilation to adult and pediatric patients with a minimum weight of 2.5kg. Aims: To evaluate the performance of the Trilogy Evo ventilator compared to parameters from user’s current ventilator. Methods: Patients treated with invasive mechanical ventilation via tracheostomy tube (IPAP 15.9 ± 3.2cmH2O, EPAP 5.3 ± 1.6cmH2O, and tidal volume 263 ± 166ml) were enrolled. At baseline, users were monitored on their current ventilator (LTV or Trilogy) for 15 minutes then were set-up on the Trilogy Evo for at least 15 minutes with one or more of the following circuits: Passive, ActivePAP, Active Flow and Dual Limb. Pulse oximetry (SpO2) and End Tidal CO2 (EtCO2) were recorded. Results: Thirteen participants (7 males, age 11.3 ± 10.1) completed the study. Modes utilized were SIMV-VC (n=9), S/T (n=3), and A/C-PC (n=1). Trilogy Evo passive circuit settings were IPAP 15.4 ± 3.7 cmH2O, EPAP 5.2 ± 1.5 cmH2O, and tidal volume 236 ± 166 ml. No clinical difference in EtCO2 mmHg (baseline 31.6 ± 6.3 vs Trilogy Evo 29.7 ± 6.9) or SpO2% (baseline 97.3 ± 1.8 vs Trilogy Evo 97.6 ± 1.2) were detected. In users with significant leaks around their trach tubes, the tidal volume and/or pressure settings needed to be decreased to match baseline therapy due to leak compensation algorithms with the passive circuit on Trilogy Evo. Conclusion: In this group of patients, Trilogy Evo provided effective ventilation based on SpO2 and EtCO2 values. The leak compensation capabilities may offer benefits to patients with airway leak issues.
背景:Trilogy Evo (Philips呼吸器,Murrysville PA)是一种新型生命支持呼吸机,为成人和儿童患者提供有创和无创通气,最低体重为2.5kg。目的:将Trilogy Evo呼吸机的性能与用户现有呼吸机的参数进行比较。方法:纳入经气管造口管有创机械通气患者(IPAP 15.9±3.2cmH2O, EPAP 5.3±1.6cmH2O,潮气量263±166ml)。在基线时,用户在其当前呼吸机(LTV或Trilogy)上监测15分钟,然后在Trilogy Evo上设置至少15分钟,并使用以下一种或多种电路:被动,ActivePAP, Active Flow和双肢。记录脉搏血氧(SpO2)和末潮CO2 (EtCO2)。结果:13名参与者(7名男性,年龄11.3±10.1岁)完成了研究。采用的模式有SIMV-VC (n=9)、S/T (n=3)和A/C-PC (n=1)。Trilogy Evo被动回路设置为IPAP 15.4±3.7 cmH2O, EPAP 5.2±1.5 cmH2O,潮气量236±166 ml。EtCO2 mmHg(基线31.6±6.3 vs Trilogy Evo 29.7±6.9)或SpO2%(基线97.3±1.8 vs Trilogy Evo 97.6±1.2)无临床差异。对于气管周围有明显泄漏的用户,由于Trilogy Evo上的无源电路的泄漏补偿算法,需要降低潮气量和/或压力设置,以匹配基线治疗。结论:在本组患者中,根据SpO2和EtCO2值,Trilogy Evo提供了有效的通气。泄漏补偿功能可能为气道泄漏问题的患者提供益处。
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引用次数: 0
Plasma level of TNF related apoptosis inducing ligand is associated with severity of disease in patients with sepsis and septic shock 脓毒症和感染性休克患者血浆TNF相关凋亡诱导配体水平与疾病严重程度相关
Pub Date : 2019-09-28 DOI: 10.1183/13993003.congress-2019.pa2272
H. Yoo, Jin Young Lee, Junehee Park, J. Song, S. Zo, K. Jeon
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引用次数: 0
期刊
Acute critical care
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