Despite growing attention to patients,safety worldwide,no data were available on the impact of adverse respiratory events(AREs)on post-anesthesia care and post-operation care in China.This study evaluated the occurren...Despite growing attention to patients,safety worldwide,no data were available on the impact of adverse respiratory events(AREs)on post-anesthesia care and post-operation care in China.This study evaluated the occurrence of AREs,the impact of AREs on length of stay(LOS)in post-anesthesia care unit(PACU)and postoperative time in hospital,and PACU cost and in patient healthcare costs.A retrospective,matched-cohort study was conducted by prospectively collecting the data of 159 AREs in PACU during 2016-2017 in an university hospital in China.Records were reviewed by pre-trained,qualified nurses and/or anesthesiologists.The incidence and the impact of AREs were analyzed.The LOS in PACU and postoperative time in hospital and the costs in PACU and inpatient healthcare costs were also obtained.Results showed that there were 253 AREs involving 156 patients.Hypoxia(n=141,55.73%)and respiratory depression(n=70,27.67%)were the most common AREs.Measurement data including body mass index(BMI)(22.85±4.36 vs.22.32±3.83),duration of procedure(138.47±77.33 min vs.137.44±72.33 min),duration of anesthesia(176.35±82.66 min vs.174.61±78.08 min),LOS(16.53±10.65 days vs.16.57±9.56 days),inpatient healthcare costs($9465.57±9416.33 vs.$8166.51±5762.01),and postoperative LOS(11.26±8.77 days vs.11.9±8.30 days)showed no significant differences between ARE and matched groups(P<0.05).Duration(81.65±54.79 min vs.38.89±26.09 min)and costs($31.99±17.80 vs.$18.72±8.39)in PACU were significantly different in ARE group from those in matched group(P<0.001).Proportion of patients with prolonged stay in PACU was significantly higher in ARE group than in matched group(18.59%vs.1.28%),with an odds ratio(after matching)of 17.58(95%CI=4.11 to 75.10;P<0.001).The AREs that occurred during the immediate postoperative period in PACU increased the incidence rate of prolonged stay,delayed the PACU stay,and increased the costs in PACU,resulting in the need of higher levels of postoperative care than anticipated,but the postoperative LOS and inpati展开更多
Influenza pandemics are unpredictable recurrent events with global health,economic,and social consequences.The objective of this review is to provide an update on the latest developments in early diagnosis and specifi...Influenza pandemics are unpredictable recurrent events with global health,economic,and social consequences.The objective of this review is to provide an update on the latest developments in early diagnosis and specific treatment of the disease and its complications,particularly with regard to respiratory organ failure.Despite advances in treatment,the rate of mortality in the intensive care unit remains approximately 30%.Therefore,early identification of potentially severe viral pneumonia is extremely important to optimize treatment in these patients.The pathogenesis of influenza virus infection depends on viral virulence and host response.Thus,in some patients,it is associated with an excessive systemic response mediated by an authentic cytokine storm.This process leads to severe primary pneumonia and acute respiratory distress syndrome.Initial prognostication in the emergency department based on comorbidities,vital signs,and biomarkers(e.g.,procalcitonin,ferritin,human leukocyte antigen-DR,mid-regional proadrenomedullin,and lactate)is important.Identification of these biomarkers on admission may facilitate clinical decision-making to determine early admission to the hospital or the intensive care unit.These decisions are reached considering pathophysiological circumstances that are associated with a poor prognosis(e.g.,bacterial co-infection,hyperinflammation,immune paralysis,severe endothelial damage,organ dysfunction,and septic shock).Moreover,early implementation is important to increase treatment efficacy.Based on a limited level of evidence,all current guidelines recommend using oseltamivir in this setting.The possibility of drug resistance should also be considered.Alternative options include other antiviral drugs and combination therapies with monoclonal antibodies.Importantly,it is not recommended to use corticosteroids in the initial treatment of these patients.Furthermore,the implementation of supportive measures for respiratory failure is essential.Current recommendations are limited,heterogeneous,an展开更多
目的探究呼吸重症监护室(intensive care unit,ICU)中患者发生机械通气相关性肺炎(ventilator associated pneumonia,VAP)的原因,并总结相应的护理对策。方法择取2014年12月~2016年12月期间于本院ICU病房接受机械通气治疗并发生VAP的80...目的探究呼吸重症监护室(intensive care unit,ICU)中患者发生机械通气相关性肺炎(ventilator associated pneumonia,VAP)的原因,并总结相应的护理对策。方法择取2014年12月~2016年12月期间于本院ICU病房接受机械通气治疗并发生VAP的80例呼吸重症患者,随机分为例数相等的两组并给予不同护理措施:研究组40例患者行集束化护理;对照组40例患者行常规护理。比较两组患者的治疗、护理效果。结果研究组祛痰率为95.00%,机械通气时间为(6.54±1.05)d,ICU入住时间为(9.08±2.23)d;对照组祛痰率为77.50%,机械通气时间为(11.34±2.35)d,ICU入住时间为(15.92±3.77)d,研究组均优于对照组,统计学有差异(P<0.05)。结论在呼吸重症ICU病房中为VAP患者实行集束化护理,可以增强祛痰效果,缩短机械通气时间与ICU入住时间,使患者更快地康复。展开更多
文摘Despite growing attention to patients,safety worldwide,no data were available on the impact of adverse respiratory events(AREs)on post-anesthesia care and post-operation care in China.This study evaluated the occurrence of AREs,the impact of AREs on length of stay(LOS)in post-anesthesia care unit(PACU)and postoperative time in hospital,and PACU cost and in patient healthcare costs.A retrospective,matched-cohort study was conducted by prospectively collecting the data of 159 AREs in PACU during 2016-2017 in an university hospital in China.Records were reviewed by pre-trained,qualified nurses and/or anesthesiologists.The incidence and the impact of AREs were analyzed.The LOS in PACU and postoperative time in hospital and the costs in PACU and inpatient healthcare costs were also obtained.Results showed that there were 253 AREs involving 156 patients.Hypoxia(n=141,55.73%)and respiratory depression(n=70,27.67%)were the most common AREs.Measurement data including body mass index(BMI)(22.85±4.36 vs.22.32±3.83),duration of procedure(138.47±77.33 min vs.137.44±72.33 min),duration of anesthesia(176.35±82.66 min vs.174.61±78.08 min),LOS(16.53±10.65 days vs.16.57±9.56 days),inpatient healthcare costs($9465.57±9416.33 vs.$8166.51±5762.01),and postoperative LOS(11.26±8.77 days vs.11.9±8.30 days)showed no significant differences between ARE and matched groups(P<0.05).Duration(81.65±54.79 min vs.38.89±26.09 min)and costs($31.99±17.80 vs.$18.72±8.39)in PACU were significantly different in ARE group from those in matched group(P<0.001).Proportion of patients with prolonged stay in PACU was significantly higher in ARE group than in matched group(18.59%vs.1.28%),with an odds ratio(after matching)of 17.58(95%CI=4.11 to 75.10;P<0.001).The AREs that occurred during the immediate postoperative period in PACU increased the incidence rate of prolonged stay,delayed the PACU stay,and increased the costs in PACU,resulting in the need of higher levels of postoperative care than anticipated,but the postoperative LOS and inpati
文摘Influenza pandemics are unpredictable recurrent events with global health,economic,and social consequences.The objective of this review is to provide an update on the latest developments in early diagnosis and specific treatment of the disease and its complications,particularly with regard to respiratory organ failure.Despite advances in treatment,the rate of mortality in the intensive care unit remains approximately 30%.Therefore,early identification of potentially severe viral pneumonia is extremely important to optimize treatment in these patients.The pathogenesis of influenza virus infection depends on viral virulence and host response.Thus,in some patients,it is associated with an excessive systemic response mediated by an authentic cytokine storm.This process leads to severe primary pneumonia and acute respiratory distress syndrome.Initial prognostication in the emergency department based on comorbidities,vital signs,and biomarkers(e.g.,procalcitonin,ferritin,human leukocyte antigen-DR,mid-regional proadrenomedullin,and lactate)is important.Identification of these biomarkers on admission may facilitate clinical decision-making to determine early admission to the hospital or the intensive care unit.These decisions are reached considering pathophysiological circumstances that are associated with a poor prognosis(e.g.,bacterial co-infection,hyperinflammation,immune paralysis,severe endothelial damage,organ dysfunction,and septic shock).Moreover,early implementation is important to increase treatment efficacy.Based on a limited level of evidence,all current guidelines recommend using oseltamivir in this setting.The possibility of drug resistance should also be considered.Alternative options include other antiviral drugs and combination therapies with monoclonal antibodies.Importantly,it is not recommended to use corticosteroids in the initial treatment of these patients.Furthermore,the implementation of supportive measures for respiratory failure is essential.Current recommendations are limited,heterogeneous,an
文摘目的探究呼吸重症监护室(intensive care unit,ICU)中患者发生机械通气相关性肺炎(ventilator associated pneumonia,VAP)的原因,并总结相应的护理对策。方法择取2014年12月~2016年12月期间于本院ICU病房接受机械通气治疗并发生VAP的80例呼吸重症患者,随机分为例数相等的两组并给予不同护理措施:研究组40例患者行集束化护理;对照组40例患者行常规护理。比较两组患者的治疗、护理效果。结果研究组祛痰率为95.00%,机械通气时间为(6.54±1.05)d,ICU入住时间为(9.08±2.23)d;对照组祛痰率为77.50%,机械通气时间为(11.34±2.35)d,ICU入住时间为(15.92±3.77)d,研究组均优于对照组,统计学有差异(P<0.05)。结论在呼吸重症ICU病房中为VAP患者实行集束化护理,可以增强祛痰效果,缩短机械通气时间与ICU入住时间,使患者更快地康复。
