Background This study aimed to investigate the influence of positive end-expiratory pressure(PEEP)on the right ventricle(RV)of mechanical ventilation-assisted patients through echocardiography.Methods Seventy-six pati...Background This study aimed to investigate the influence of positive end-expiratory pressure(PEEP)on the right ventricle(RV)of mechanical ventilation-assisted patients through echocardiography.Methods Seventy-six patients assisted with mechanical ventilation were enrolled in this study.Positive end-expiratory pressure was upregulated by 4 cm H_(2)O to treat acute respiratory distress syndrome,wherein echocardiography was performed before and after this process.Hemodynamic data were also recorded.All variables were compared before and after PEEP upregulation.The effect of PEEP was also evaluated in patients with and without decreased static lung compliance(SLC).Results Positive end-expiratory pressure upregulation significantly affected the RV function.Remarkable differences were observed in the following:Tei index(P=0.027),pulmonary artery pressure(P=0.039),tricuspid annular plane systolic excursion(P=0.014),early wave/atrial wave(P=0.002),diaphragm excursion(P<0.001),inferior vena cava collapsing index(P<0.001),and SLC(P<0.001).There were no significant changes in heart rate,respiratory rate,central venous pressure,mean arterial pressure,and base excess(P>0.05).Furthermore,the cardiac output of the RV was not significantly affected.In patients with decreased SLC(n=41),there were more significant changes in diaphragm excursion(P<0.001),inferior vena cava collapse index(P=0.025),pulmonary artery pressure(P<0.001),and tricuspid annular plane systolic excursion(P=0.007)than in those without decreased SLC(n=35).Conclusion Positive end-expiratory pressure upregulation significantly affected the RV function of critically ill patients with acute respiratory distress syndrome,especially in those with decreased SLC.展开更多
Background Recent studies demonstrated that N-terminal pro-brain natriuretic peptide（NT-pro BNP） increases in patients with diabetes mellitus and raised concerns about the diagnostic validity of NT-pro BNP in assess...Background Recent studies demonstrated that N-terminal pro-brain natriuretic peptide（NT-pro BNP） increases in patients with diabetes mellitus and raised concerns about the diagnostic validity of NT-pro BNP in assessment of cardiac function in patients with hyperglycemia.Current investigation was carried out to observe the influence of hyperglycemia on the correlation of NT-pro BNP and cardiac function index in patients with acute coronary syndrome（ACS）.Methods Fifty patients with ACS were enrolled and divided into hyperglycemia group（fasting plasma glucose（FPG） ≥ 6.1 mmol/L） and euglycemia group（FPG 〈 6.1 mmol/L）.All the patients underwent routine transthoracic ecocardiagraphy and tissue Doppler imaging（TDI） investigation.Blood sample were obtained with 24 hours of hospitalization for measuring of NT-proBNP level.Relation between TDI-Tei index and the level of NT-proBNP were analyzed in the two groups respectively.Result TDI-Tei index,systolic index and diastolic index were all significantly higher in hyperglycemia group than that in euglycemia group（0.679 ± 0.139 vs 0.600 ± 0.093,P = 0.022;0.294 ± 0.074 vs 0.258 ± 0.035,P = 0.036;0.385 ± 0.069 vs 0.342 ± 0.068,P = 0.032）.TDI-Tei index was significantly negatively correlated with the level of log NT-pro BNP in both hyperglycemia group and euglycemia group（rp = 0.673,P = 0.000;rp = 0.354,P = 0.000）.Conclusions（1）Cardiac function in patients with ACS complicated with hyperglycemia is inferior to that in patients with euglycemia;（2）Assessment of cardiac function with NT-proBNP is reliable in patients with hyperglycemia.展开更多
Objective: This prospective cohort study was designed to assess the rule of myocardial performance (Tei) index and NT-Pro BNP serum levels in prediction of weaning failure in mechanically ventilated COPD patients. Met...Objective: This prospective cohort study was designed to assess the rule of myocardial performance (Tei) index and NT-Pro BNP serum levels in prediction of weaning failure in mechanically ventilated COPD patients. Methods: Forty patients with respiratory failure due to acute exacerbation of COPD were enrolled to this study. All patients underwent a comprehensive echocardiographic examination including tissue doppler imaging within first 12 hours of admission. NT-pro BNP serum levels were measured on admission. Patients were followed up for outcome of weaning failure. Results: Right ventricular Tei index was higher in patients with failed weaning in comparison to successfully weaned patients (mean 0.66 versus 0.36, P P = 0.007). There was no difference in serum NT-Pro BNP between successfully weaned patients and patients with weaning failure. Right ventricular Tei index showed higher accuracy in predicting weaning failure than the left ventricular Tei index (AUC 0.932 versus 0.754), while serum NT-Pro BNP showed no discrimination in predicting weaning failure (AUC 0.556). Conclusion: Tei index was superior to NT-ProBNP in prediction of weaning failure in COPD patients.展开更多
文摘Background This study aimed to investigate the influence of positive end-expiratory pressure(PEEP)on the right ventricle(RV)of mechanical ventilation-assisted patients through echocardiography.Methods Seventy-six patients assisted with mechanical ventilation were enrolled in this study.Positive end-expiratory pressure was upregulated by 4 cm H_(2)O to treat acute respiratory distress syndrome,wherein echocardiography was performed before and after this process.Hemodynamic data were also recorded.All variables were compared before and after PEEP upregulation.The effect of PEEP was also evaluated in patients with and without decreased static lung compliance(SLC).Results Positive end-expiratory pressure upregulation significantly affected the RV function.Remarkable differences were observed in the following:Tei index(P=0.027),pulmonary artery pressure(P=0.039),tricuspid annular plane systolic excursion(P=0.014),early wave/atrial wave(P=0.002),diaphragm excursion(P<0.001),inferior vena cava collapsing index(P<0.001),and SLC(P<0.001).There were no significant changes in heart rate,respiratory rate,central venous pressure,mean arterial pressure,and base excess(P>0.05).Furthermore,the cardiac output of the RV was not significantly affected.In patients with decreased SLC(n=41),there were more significant changes in diaphragm excursion(P<0.001),inferior vena cava collapse index(P=0.025),pulmonary artery pressure(P<0.001),and tricuspid annular plane systolic excursion(P=0.007)than in those without decreased SLC(n=35).Conclusion Positive end-expiratory pressure upregulation significantly affected the RV function of critically ill patients with acute respiratory distress syndrome,especially in those with decreased SLC.
基金supported by Science and Technology Planning Project of Guangdong Province,China (2007B031505009)
文摘Background Recent studies demonstrated that N-terminal pro-brain natriuretic peptide（NT-pro BNP） increases in patients with diabetes mellitus and raised concerns about the diagnostic validity of NT-pro BNP in assessment of cardiac function in patients with hyperglycemia.Current investigation was carried out to observe the influence of hyperglycemia on the correlation of NT-pro BNP and cardiac function index in patients with acute coronary syndrome（ACS）.Methods Fifty patients with ACS were enrolled and divided into hyperglycemia group（fasting plasma glucose（FPG） ≥ 6.1 mmol/L） and euglycemia group（FPG 〈 6.1 mmol/L）.All the patients underwent routine transthoracic ecocardiagraphy and tissue Doppler imaging（TDI） investigation.Blood sample were obtained with 24 hours of hospitalization for measuring of NT-proBNP level.Relation between TDI-Tei index and the level of NT-proBNP were analyzed in the two groups respectively.Result TDI-Tei index,systolic index and diastolic index were all significantly higher in hyperglycemia group than that in euglycemia group（0.679 ± 0.139 vs 0.600 ± 0.093,P = 0.022;0.294 ± 0.074 vs 0.258 ± 0.035,P = 0.036;0.385 ± 0.069 vs 0.342 ± 0.068,P = 0.032）.TDI-Tei index was significantly negatively correlated with the level of log NT-pro BNP in both hyperglycemia group and euglycemia group（rp = 0.673,P = 0.000;rp = 0.354,P = 0.000）.Conclusions（1）Cardiac function in patients with ACS complicated with hyperglycemia is inferior to that in patients with euglycemia;（2）Assessment of cardiac function with NT-proBNP is reliable in patients with hyperglycemia.
文摘Objective: This prospective cohort study was designed to assess the rule of myocardial performance (Tei) index and NT-Pro BNP serum levels in prediction of weaning failure in mechanically ventilated COPD patients. Methods: Forty patients with respiratory failure due to acute exacerbation of COPD were enrolled to this study. All patients underwent a comprehensive echocardiographic examination including tissue doppler imaging within first 12 hours of admission. NT-pro BNP serum levels were measured on admission. Patients were followed up for outcome of weaning failure. Results: Right ventricular Tei index was higher in patients with failed weaning in comparison to successfully weaned patients (mean 0.66 versus 0.36, P P = 0.007). There was no difference in serum NT-Pro BNP between successfully weaned patients and patients with weaning failure. Right ventricular Tei index showed higher accuracy in predicting weaning failure than the left ventricular Tei index (AUC 0.932 versus 0.754), while serum NT-Pro BNP showed no discrimination in predicting weaning failure (AUC 0.556). Conclusion: Tei index was superior to NT-ProBNP in prediction of weaning failure in COPD patients.
