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Journal of Intensive Medicine 2022年第2期2卷 103-109页

作者： Diego Gil Carlos Tiscar Maria Gómez Javier Felices Luis Gajate Patricia Fernandez David Pestaña Tommaso Bardi Department of Anaesthesiology and Critical Care Ramón y Cajal Hospital28034 MadridSpain Department of Psychology Ramón y Cajal Hospital28034 MadridSpain

Background:There are insufficient data regarding the impact of acute respiratory distress syndrome related to coronavirus disease 2019(C-ARDS)–caused by severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)–on health-related quality of life(HRQoL)and the occurrence of stress-related disorders in coronavirus disease 2019(COVID-19)intensive care unit(ICU)survivors.The aim of this study is to assess HRQoL and the occurrence of stress-related disorders(acute stress disorder[ASD]and post-traumatic stress disorder[PTSD])in C-ARDS ICU survivors at 1 and 6 months following hospital discharge.Methods:This prospective observational study included 90 patients treated for C-ARDS between March and May 2020 in the ICU and discharged alive from the hospital.All patients included in the study were contacted by telephone 1 month and 6 months post-hospital discharge to assess the presence of symptoms of stress-related disorders and HRQoL using the 8-item Treatment Outcome Post-traumatic Stress Disorder scale(TOP-8)and 36-item Short Form survey(SF-36).We performed univariate analyses to evaluate differences between patients who developed stress and those who did not.We also compared SF-36 scores in our sample with data from the general Spanish population and from cohorts of non–C-ARDS and severe acute respiratory syndrome coronavirus-1(SARS-CoV-1)survivors.Results:There are 24.1%of patients showed symptoms of ASD;in 13.5%of cases the symptoms persisted 6 months later.Risk factors for the development of symptoms of ASD and PTSD are younger age,female sex,obesity,a previously diagnosed psychiatric disease and disease severity at ICU admission(P<0.05).HRQoL was greatly affected by C-ARDS;however,there was improvement on all scales of the SF-36 at the 6-month follow-up(P<0.05).The mean SF-36 score of our sample was higher than those previously reported in non–C-ARDS survivors(P<0.05)for physical functioning(78.0 vs.52.0),role functioning/physical(51.0 vs.31.0),bodily pain(76.1 vs.57.0),vitality(58.6 vs.48.0),social function(72.6

关键词： COVID-19 Post-intensive care syndrome respiratory distress syndrome,adult Health-related quality of life Post-traumatic stress disorder

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Analysis of high risk factors related to acute respiratory distress syndrome following severe thoracoabdominal injuries

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Chinese Journal of Traumatology 2007年第5期10卷 275-278页

作者：郑国寿白祥军占成业 Department of Traumatic Surgery Tongji HospitalTongji Medical CollegeHuazhong University of Science and Technology

Objective: To investigate the high risk factors related to acute respiratory distress syndrome ( ARDS ) following serious thoracoabdominal injuries.Methods: The clinical data of 282 patients with serious thoracoabdominal injuries were retrospectively studied. Univariate and Cox multivariate regression analysis were used to determine the risk factors related to ARDS following serious thoracoabdominal injuries.Results: The incidence of ARDS was 31.9% (90/282) in patients with serious thoracoabdominal injuries.The mortality caused by ARDS was 37.8% (34/90). The univariate analysis and multivariate analysis demonstrated that the clinical conditions such as elder age, shock,dyspnea, abnormal arterial blood gas, hemopneumothorax,pulmonary contusion, flail chest, coexisting pulmonary diseases, multiple abdominal injury and high ISS score were the independent high risk factors related to ARDS.Conclusion: There are many high risk factors related to ARDS following severe thoracoabdominal injuries, which should be detected early and treated timely to decrease the incidence and mortality of ARDS.

关键词： Thoracic injuries respiratory distress syndrome,adult Abdominal injuries Risk factors

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Effect of radix paeoniae rubra on expression of p38 MAPK/iNOS/HO-1 in rats with lipopolysaccharide·induced acute lung injury

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Chinese Journal of Traumatology 2007年第5期10卷 269-274页

作者：詹丽英夏中元夏芳程邦昌 Department of Anesthesiology People's HospitalWuhan University

Objective: To investigate the effect of radix paeoniae rubra (RPR) on expression of p38 mitogen activated protein kinase ( MAPK )/iNOS/HO-1 in rats with lipopolysaccharide-induced acute lung injury and explore the molecular mechanism.Methods: Forty healthy male Wistar rats, weighing 200-250 g, aged 6-8 weeks (mean =7 weeks), provided by the Experimental Center, Medical College, Wuhan University, Wuhan, China, were employed in this study.Under anesthesia with 7% chloraldurat (5 ml/kg body weight) through intraperitoneal injection, the trachea of the rat was exposed and an arterial puncture needle pricked into the trachea via cricothyroid membrane. Then they were randomly divided into five groups: 8 rats receiving 1 ml normal saline through the puncture needle (Group A),8 receiving 1 ml lipopolysaccharide (LPS, 2.5 mg/kg,Group B), 8 receiving LPS and RPR (30 mg/kg, pumped through the femoral vein for 2 hours, Group C ), 8 receiving RPR 2 hours before dripping LPS ( Group D),and 8 receiving hemin (75 μmol/L through intraperitoneal injection) 18 hours before dripping LPS (Group E). After 6 hours of LPS dripping, blood samples were obtained through the carotid artery to perform blood gas analysis,then all the rats were exsanguinated to death and specimens of lung tissues were obtained. The pathomorphological changes of the lung tissues were observed. The expression of p38 MAPK/iNOS/HO-1, the neutrophil ratio, protein content in alveolar irrigating solution and malonaldehyde (MDA) content in the lung tissues were also detected.Results: Compared with Group A, the expression of p38 MAPK, iNOS and HO-1 markedly increased in Groups B, C, D, and E (P ＜0.01). But in Groups C, D, and E,the expression of p38 MAPK and iNOS were significantly lower than that of Group B, while expression of HO-1 was obviously higher than that of Group B ( P ＜ 0.05 ). The protein content, the ratio of neutrophils in bronchoalveolar lavage fluid ( BALF), the content of MDA and the activities of serum NO in Group B were significantly higher than tho

关键词： respiratory distress syndrome,adult Bronchoalveolar lavage fluid Lipopolysaccharide Radix paeoniae rubra

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