目的搜集现有文献证据对颈总动脉峰流速变异(Peak velocity variation of common carotid artery,△Vpeak-CA)对机械通气状态下患者容量反应状态的诊断价值进行系统评价。方法全面检索中国知网全文数据库(China National Knowledge Infr...目的搜集现有文献证据对颈总动脉峰流速变异(Peak velocity variation of common carotid artery,△Vpeak-CA)对机械通气状态下患者容量反应状态的诊断价值进行系统评价。方法全面检索中国知网全文数据库(China National Knowledge Infrastructure,CNKI),PubMed,Embase,the Cochrane Database数据库,检索时限为建库至2017-08月。纳入符合要求的评估△Vpeak-CA对机械通气状态下患者容量反应状态诊断价值的临床对照试验,采用随机效应模型计算合并灵敏度、特异度、诊断比值比(95%CI),绘制受试者工作曲线,计算曲线下面积。运用QUADAS-2进行文献质量评价。结果研究共纳入4篇文献,其中包括194例患者。Meta分析显示合并灵敏度、特异度、诊断比值比分别为0.85(95%CI为0.77~0.92),0.86(95%CI为0.77~0.92),38.54(95%CI为16.69~89.00),受试者工作特征曲线下面积(the area under the receiver operating characteristic curve,AUROC)为0.93,各研究间无异质性(P=0.98,I2=0)。结论目前证据显示△Vpeak-CA对机械通气状态下患者容量反应状态具有较高诊断价值,值得进一步探究。展开更多
In this case series we present 3 cases of nasogastric tube misplacement in tracheostomy patients. Although considered safe and it being a common procedure nasogastric tube misplacement can lead to serious and life-thr...In this case series we present 3 cases of nasogastric tube misplacement in tracheostomy patients. Although considered safe and it being a common procedure nasogastric tube misplacement can lead to serious and life-threatening complications. We present three cases of nasogastric tube misplacement in tracheostomized patients. One of the cases presented suffered from pneumothorax. Different time intervals between procedures in these different cases resulted in similar results. We would like to emphasize the importance of due conformation of correct placement of the nasogastric tube in the tracheostomy patient as well as to suggest that over inflation of the balloon securing the tracheostomy apparatus in place during nasogastric tube placement, might prevent misplacement. Nasogastric tube placement in tracheostomized patients has potential for serious complications. As such maintaining safe practice procedure is essential. Considering over inflation of the tracheostomy apparatus balloon might be beneficial as well, by preventing entry of NGT into the trachea.展开更多
文摘目的搜集现有文献证据对颈总动脉峰流速变异(Peak velocity variation of common carotid artery,△Vpeak-CA)对机械通气状态下患者容量反应状态的诊断价值进行系统评价。方法全面检索中国知网全文数据库(China National Knowledge Infrastructure,CNKI),PubMed,Embase,the Cochrane Database数据库,检索时限为建库至2017-08月。纳入符合要求的评估△Vpeak-CA对机械通气状态下患者容量反应状态诊断价值的临床对照试验,采用随机效应模型计算合并灵敏度、特异度、诊断比值比(95%CI),绘制受试者工作曲线,计算曲线下面积。运用QUADAS-2进行文献质量评价。结果研究共纳入4篇文献,其中包括194例患者。Meta分析显示合并灵敏度、特异度、诊断比值比分别为0.85(95%CI为0.77~0.92),0.86(95%CI为0.77~0.92),38.54(95%CI为16.69~89.00),受试者工作特征曲线下面积(the area under the receiver operating characteristic curve,AUROC)为0.93,各研究间无异质性(P=0.98,I2=0)。结论目前证据显示△Vpeak-CA对机械通气状态下患者容量反应状态具有较高诊断价值,值得进一步探究。
文摘In this case series we present 3 cases of nasogastric tube misplacement in tracheostomy patients. Although considered safe and it being a common procedure nasogastric tube misplacement can lead to serious and life-threatening complications. We present three cases of nasogastric tube misplacement in tracheostomized patients. One of the cases presented suffered from pneumothorax. Different time intervals between procedures in these different cases resulted in similar results. We would like to emphasize the importance of due conformation of correct placement of the nasogastric tube in the tracheostomy patient as well as to suggest that over inflation of the balloon securing the tracheostomy apparatus in place during nasogastric tube placement, might prevent misplacement. Nasogastric tube placement in tracheostomized patients has potential for serious complications. As such maintaining safe practice procedure is essential. Considering over inflation of the tracheostomy apparatus balloon might be beneficial as well, by preventing entry of NGT into the trachea.