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Relationship between neonatal respiratory distress syndrome pulmonary ultrasonography and respiratory distress score,oxygenation index,and chest radiography grading

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World Journal of Clinical Cases 2024年第20期12卷 4154-4165页

作者： Hai Yang Li-Jun Gao Jing Lei Qiang Li Liu Cui Xiao-Hua Li Wu-Xuan Yin Sen-Hua Tian Neonatal Intensive Care Center Liupanshui Maternal and Child Care Service CenterLiupanshui 553000Guizhou ProvinceChina Ultrasound Function Department Liupanshui Maternal and Child Care Service CenterLiupanshui 553000Guizhou ProvinceChina Medical Imaging Department Liupanshui Maternal and Child Care Service CenterLiupanshui 553000Guizhou ProvinceChina

BACKGROUND Accurate condition assessment is critical for improving the prognosis of neonatal respiratory distress syndrome(RDS),but current assessment methods for RDS pose a cumulative risk of harm to ***,a less harmful method for assessing the health of neonates with RDS is *** To analyze the relationships between pulmonary ultrasonography and respiratory distress scores,oxygenation index,and chest X-ray grade of neonatal RDS to identify predictors of neonatal RDS *** This retrospective study analyzed the medical information of 73 neonates with RDS admitted to the neonatal intensive care unit of Liupanshui Maternal and Child Care Service Center between April and December *** pulmonary ultrasonography score,respiratory distress score,oxygenation index,and chest Xray grade of each newborn before and after treatment were *** correlation analysis was performed to determine the relationships among these values and neonatal RDS *** The pulmonary ultrasonography score,respiratory distress score,oxygenation index,and chest X-ray RDS grade of the neonates were significantly lower after treatment than before treatment(Poxygenation index,and chest X-ray grade(ρ=0.429–0.859,Poxygenation index,and chest X-ray *** pulmonary ultrasonography score was an effective predictor of neonatal RDS severity.

关键词： Neonatal respiratory distress syndrome Pulmonary ultrasonography Ultrasonography score Respiratory distress score oxygenation index Chest X-ray grading

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Lymphocytopenia and Neutrophilia Deteriorate at the Lowest oxygenation index Timepoint in COVID-19 Patient

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International Journal of Clinical Medicine 2020年第12期11卷 810-822页

作者： Yiwen Xu Weijun Hong Gang Wu Weiling Li Chunqiang Xu Xiaofei Hu Meixian Zhang Huihui Xu En Wang Shaofa Ke Xiaoping Jin Department of Neurology Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University Linhai China The First Clinical Medical College Wenzhou Medical University Wenzhou China Department of Pharmacy Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University Linhai China Public Experiment Center Medical Research Center Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University Linhai China Laboratory of Gynecologic Oncology Medical Research Center Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University Linhai China

Objective: Coronavirus disease 2019 (COVID-19) spread throughout the world and caused hundreds of thousands of infected people to death. However, the pathogenesis of severe acute respiratory syndrome coronavirus-2 (SARS COV-2) is poorly understood. The objective of this study is to retrospectively explore the pathogenesis of COVID-19 from clinical laboratory findings, taking disease progression into account. Methods: A single-centered, retrospective study was carried out, which included moderate (n = 76) and severe COVID-19 cases (n = 22). The difference of laboratory findings from blood routine examination and hepatorenal function test were retrospectively evaluated between the state of moderate and severe. The disease progression was indicated by oxygenation index. Results: Age is a risk factor for disease progression from moderate to severe. Lymphocytopenia, neutrophilia, liver and kidney function decreasement occurred in severe patients on admission, compared with moderate patients. Lymphocytopenia and neutrophilia deteriorated at the lowest oxygenation index timepoint in the severe patients. And the oxygenation index was associated with ratio of lymphocyte and neutrophil in COVID-19 patients. Conclusions: Lymphocytopenia and neutrophilia, which deteriorate in the progression of severe patients, are the main pathogenesis of COVID-19. More measures need to be taken to control lymphocytopenia and neutrophilia in severe COVID-19. oxygenation index presented potentiality as predictor on the progression of COVID-19.

关键词： COVID-19 oxygenation index Lymphocytopenia Neutrophilia Glucocorticoids

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Short-term prone positioning for severe acute respiratory distress syndrome after cardiopulmonary bypass:A case report and literature review

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World Journal of Clinical Cases 2022年第36期10卷 13435-13442页

作者： Jian-Hua Yang Shu Wang Yuan-Xiu Gan Xuan-Yun Feng Bai-Lin Niu Department of Intensive Care Medicine Chongqing University Central HospitalChongqing Emergency Medical CenterChongqing Key Laboratory of Emergency MedicineChongqing 400016China Department of Intensive Care Medicine Chongqing University Central HospitalChongqing Emergency Medical CenterChongqing 400016China

BACKGROUND Aortic dissection is a complex and dangerous cardiovascular disease,with many complications in the perioperative period,including severe acute respiratory distress syndrome(ARDS),which affects prognosis and increases *** the effect of prone positioning(PP)in improving oxygenation in patients with severe ARDS,reports about PP early after cardiac surgery are few and such an opt-ion may be an issue in cardiac surgery patients because of the recent *** SUMMARY A 40-year-old male patient diagnosed with acute type A aortic dissection on October 22,2021 underwent ascending artery replacement plus total aortic arch replacement plus stent elephant trunk implantation under cardiopulmonary ***,he developed ARDS on postoperative day *** comprehensive treatment with aggressive pulmonary protective ventilation,fluid management with continuous renal replacement therapy,the condition continued to deteriorate and rapidly progressed to severe ARDS with a minimum oxygenation index of *** are ready to implement salvage therapy,including PP and extracorporeal membrane oxygenation(ECMO).Due to the large amount of pericardial mediastinal and thoracic drainage after thoracotomy,ECMO may result in massive postoperative *** prone ventilation is often inappropriate after ***,we chose short-term PP foroxygenation index greatly improved and the diffuse exudation in both lungs of the patient was significantly reduced with short-term prone *** Intermittent short-term PP can improve early postoperative severe ARDS after acute aortic dissection.

关键词： Aortic dissection Short-term prone positioning Acute respiratory distress syndrome oxygenation index Cardiopulmonary bypass Case report

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Can Dexmedetomidine Improve Arterial oxygenation and Intrapulmonary Shunt during One-lung Ventilation in Adults Undergoing Thoracic Surgery？ A Meta-analysis of Randomized, Placebo-controlled Trials

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Chinese Medical Journal 2017年第14期130卷 1707-1714页

作者： Su-Qin Huang Jian Zhang Xiong-Xin Zhang Lu Liu Yang Yu Xian-Hui Kang Xiao-Min Wu Sheng-Mei Zhu Department of Anesthesiology The First Affiliated Hospital College of Medicine Zhejiang University Hangzhou Zhejiang 310000 China Department of Anesthesiology Zhejiang Provincial People&#39 s Hospital People&#39 s Hospital of Hangzhou Medical College Hangzhou Zhejiang 310014 China

Background：One-lung ventilation （OLV） is a common ventilation technology during thoracic surgery that can cause serious clinical *** aimed to conduct a meta-analysis to compare oxygenation and intrapulmonary shunt during OLV in adults undergoing thoracic surgery with dexmedetomidine （Dex） versus placebo to assess the influence and safety of using ***：Randomized controlled trials comparing lung protection in patients who underwent thoracic surgery with Dex or a placebo were retrieved from PubMed,EMBASE,MEDLINE,Cochrane Library,and China CNKI *** following information was extracted from the paper：arterial oxygen partial pressure （PaO2）,PaO2/inspired oxygen concentration （PaO2/FiO2,oxygenation index [OI]）,intrapulmonary shunt （calculated as Qs/Qt）,mean arterial pressure （MAP）,heart rate （HR）,tumor necrosis factor-α （TNF-α）,interleukin （IL）-6,superoxide dismutase （SOD）,and malondialdehyde （MDA）.Results：Fourteen randomized controlled trials were included containing a total of 625 *** with placebo group,Dex significantly increased PaO2/FiO2 （standard mean difference [SMD] =0.98,95% confidence interval [CI] [0.72,1.23],P 〈 0.00001）.Besides,Qs/Qt （SMD=-1.22,95% CI [-2.20,-0.23],P =0.020）,HR （SMD=-0.69,95% CI [-1.20,0.17],P =0.009）,MAP （SMD=-0.44,95% CI [-0.84,0.04],P =0.030）,the concentrations ofTNF-α （SMD =-1.55,95% CI [-2.16,-0.95],P 〈0.001）,and IL-6 （SMD =-1.53,95% CI [-2.37,-0.70],P =0.0003） were decreased in the treated group,when compared to placebo *** significant difference was found in MDA （SMD =-1.14,95% CI [-3.48,1.20],P =0.340） and SOD （SMD =0.41,95% CI [-0.29,1.10],P =0.250） between the Dex group and the placebo *** plots did not detect any significant publication ***：Dex may improve OI and reduce intrapulmonary shunt during OLV in adults undergoing thoracic ***,this conclusion might be weakened by the limited number of pooled studies and patients.

关键词： Dexmedetomidine lntrapulmonary Shunt Meta-anatysis One-lung Ventilation oxygenation index

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Effects of Early-stage Phased Rehabilitation Training on Acute Respiratory Distress Syndrome:A Systematic Review and Meta-analysis

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Medicinal Plant 2023年第5期14卷 72-75页

作者： Wenfu ZHANG Chenyang ZHENG Feng ZHAO Department of Pediatric Rehabilitation Rehabilitation Medicine CenterTaihe HospitalHubei University of MedicineShiyan 442000China Department of Hydrotherapy and Physiotherapy Rehabilitation Medicine CenterTaihe HospitalHubei University of MedicineShiyan 442000China

[Objectives]To systematically evaluate the effects of early-stage phased rehabilitation training on the oxygenation index,ICU length of stay,duration of mechanical ventilation,and occurrence of complications(ventilator-associated pneumonia,pressure ulcers,delirium)in ARDS patients,thus contributing evidence for the clinical application of early-stage phased rehabilitation training.[Methods]The China National Knowledge Infrastructure(CNKI),Wanfang,and other databases were *** screening,data extraction,and systematic analysis of the included studies were performed using Revman software.[Results]Thirteen randomized controlled trials involving a total of 860 patients were included in this *** results of the meta-analysis showed that compared to the traditional rehabilitation training group,the early-stage phased rehabilitation training group demonstrated a significant increase in the oxygenation index of ARDS patients[SMD=1.18,95%CI(1.01,1.35),Poxygenation index,shortens ICU length of stay and duration of mechanical ventilation,and reduces *** findings support the clinical application and promotion of early-stage phased rehabilitation training.

关键词： Early-stage phased rehabilitation training Acute respiratory distress syndrome(ARDS) oxygenation index Systematic review

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Lung recruitment maneuver effects on respiratory mechanics and extravascular lung water index in patients with acute respiratory distress syndrome

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World Journal of Emergency Medicine 2011年第3期2卷 201-205页

作者： Jian-guo Zhan Xiao-juan Chen Fen Liu Zhen-guo Zeng Ke-jian Qian ICU People's Hospital of Linyi Linyi 276000 China ICU First Affiliated Hospital of Nanchang University Nanchang 330006 China

BACKGROUND:Animal experiments showed that recruitment maneuver (RM) and protective ventilation strategy of the lung could improve oxygenation and reduce extravascular lung water. This study was to investigate the effects of RM on respiratory mechanics and extravascular lung water index (EVLWI) in patients with acute respiratory distress syndrome (ARDS).;METHODS:Thirty patients with ARDS were randomized into a RM group and a non-RM group. In the RM group, after basic mechanical ventilation stabilized for 30 minutes, RM was performed and repeated once every 12 hours for 3 days. In the non-RM group, lung protective strategy was conducted without RM. oxygenation index (PaO2/FiO2), peak inspiratory pressure (PIP), Plateau pressure (Pplat), static pulmonary compliance (Cst) and EVLWI of patients before treatment and at 12, 24, 48, 72 hours after the treatment were measured and compared between the groups. Hemodynamic changes were observed before and after RM. One-way ANOVA, Student's t test and Fisher's exact test were used to process the data.;RESULTS:The levels of PaO2/FiO2 and Cst increased after treatment in the two groups, but they were higher in the RM group than in the non-RM group (P0.05).;CONCLUSIONS:RM could reduce EVLWI, increase oxygenation and lung compliance. The effect of RM on hemodynamics was transient.

关键词： Acute respiratory distress syndrome Extravascular lung water index Hemodynamics Lung protective ventilation Lung recruitment maneuver oxygenation index Respiratory mechanics

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Effects of high-volume hemofiltration on alveolar- arterial oxygen exchange in patients with refractory septic shock

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World Journal of Emergency Medicine 2011年第2期2卷 127-131页

作者： Hong-sheng Ren Shi-xue Gao Chun-ting Wang Yu-fcng Chu Jin-jiao Jiang Ji-chcng Zhang Mci Mcng Guo-qian Qi Min Ding Intensive Care Unit Provincial Hospital Affiliated to Shandong University Jinan 250021 China Department of Intensive Care Unit Shandong Province Feixian People's Hospital Feixian 273400 China

BACKGROUND:High-volume hemofiltration (HVHF) is technically possible in severe acute pancreatitis (SAP) patients complicated with multiple organ dysfunction syndrome (MODS). Continuous HVHF is expected to become a beneficial adjunct therapy for SAP complicated with MODS. In this study, we aimed to explore the effects of fluid resuscitation and HVHF on alveolar-arterial oxygen exchange, the Acute Physiology and Chronic Health Evaluation II (APACHE II) score in patients with refractory septic shock.;METHODS:A total of 89 refractory septic shock patients, who were admitted to ICU, the Provincial Hospital affiliated to Shandong University from August 2006 to December 2009, were enrolled in this retrospective study. The patients were randomly divided into two groups: fluid resuscitation (group A, n=41), and fluid resuscitation plus high-volume hemofiltration (group B, n=48). The levels of O2 content of central venous blood (CcvO2), arterial oxygen content (CaO2), alveolar-arterial oxygen pressure difference P(A-a)DO2, ratio of arterial oxygen pressure/alveolar oxygen pressure (PaO2/PaO2), respiratory index (RI) and oxygenation index (OI) were determined. The oxygen exchange levels of the two groups were examined based on the arterial blood gas analysis at different times (0, 24, 72 hours and 7 days of treatment) in the two groups. The APACHE II score was calculated before and after 7-day treatment in the two groups.;RESULTS:The levels of CcvO2, CaO2 on day 7 in group A were significantly lower than those in group B (CcvO2: 0.60±0.24 vs. 0.72±0.28, P<0.05; CaO2: 0.84±0.43 vs. 0.94±0.46, P<0.05). The level of oxygen extraction rate (O2ER) in group A on the 7th day was significantly higher than that in group B (28.7±2.4 vs. 21.7±3.4, P<0.01). The levels of P(A-a)DO2 and RI in group B on the 7th day were significantly lower than those in group A. The levels of PaO2/PaO2 and OI in group B on 7th day were significantly higher than those in group A (P<0.05 or P<0.01). The APACH

关键词： Acute Physiology and Chronic Health Evaluation II (APACHE II) Alveolar-arterial oxygen exchange Fluid resuscitation High-volume hemofiltration Oxygen extraction rate oxygenation index PaO2/PaO2 ratio Respiratory index Septic shock

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