Forty critical patients with respiratory failure in the intensive care unit were randomly divided into two groups,Group A with administration of parenteral nutritino(PN) and Group B,no parenteral nutrition given.Blood gas analysis and respiratory monitoring showed that the respiratory rate,pH、PaO2、PaCO2 and HCO3- had no marked difference between the two groups.But in Group A there was a slight decrease of Pao2/FiO2 and a marked increase of A-aDO2 and the pulmonary shunt.This study indicates that the content of fat emulsion and hydrocarbon in PN may be the main factor that affects the respiratory function.
Objectives To explore the efficacy of humidified and heated high flow oxygen therapy for the critically ill patients in intensive care unit (ICU) after extubation. Methods From January 2014 to December 2016, 487 patients were enrolled. Patients were allocated to two treatment groups randomly, which were humidified and heated high flow oxygen therapy group (236 patients, HFM group, aged 55.3±21.1 years old) and routine oxygen therapy group (251 patients, TO group, aged 58.4±19.3 years old). Blood oxygen saturation, arterial partial pressure of oxygen (PaO2), arterial partial pressure of carbon dioxide (PaCO2), fraction of inspired oxygen (FiO2), respiratory frequency, incidence rate of reintubation, ventilator-free days, ICU length of stay, and hospital stay were assessed and compared between the HFM group and the TO group. Results The hospital stay was similar in two groups. There were more ventilator-free days in the HFM group (P<0.05), fewer patients required reintubation (4.2%vs. 10.4%, P<0.05) and less ICU length of stay [(10.5±6.1) dvs. (14.3±8.5) d, P<0.05]. PaO2/FiO2 of the HFM group were better than the TO group after extubation at 2 h, 4 h, 8 h, 24 h, and 48 h (P<0.05). There were no statistically significant differences in respiratory frequency and PaCO2. Conclusions Humidified and heated high flow oxygen therapy can supply a better oxygenation for patients after extubation in ICU. It could be a common therapy in ICU for the critically patients after extubation.
創傷、手術、感染、燒傷等極度應激狀況下的危重患者常出現應激性高血糖； 非糖尿病危重患者類似糖尿病的癥狀； 糖尿病危重患者則高血糖程度明顯加重。 創傷后出現不同水平的高血糖，隨著血糖的增高，其死亡危險性也呈階梯樣成倍增長［1，2］……
【摘要】 目的 探討甲型H1N1流感危重癥患者的搶救療效。 方法 2009年10月－2010年1月，對我院ICU收治5例甲型H1N1流感危重癥患者采用集束化治療方案進行救治，并就患者的器官功能變化進行評價。 結果 5例患者平均住院天數為（11.8±5.59）d，4 例存活，1例死亡。存活患者在治療過程中急性生理和既往健康 （APACHE）Ⅱ、多器官功能障礙綜合征評分（MODS）、全身性感染相關的器官衰竭評分 （SOFA）總體呈逐漸下降趨勢。死亡者APACHEⅡ、SOFA評分均呈逐漸升高趨勢。 結論 對甲型H1N1流感危重癥患者采取集束化救治療效良好。【Abstract】 Objective To explore the effect of bundle therapy on severe patients with influenza A (H1N1). Methods Bundle therapy were used in 5 severe patients with influenza A from October 2009 to January 2010. The patients’ organ dysfunction were observed for. Results The average in-hospital duration was (11.80±5.59) days. Four patients survived and one died with the survival ratio of 80%. Acute physiology and chronic health evaluation (APACHE) II score, Multiple organ dysfunction syndrome (MODS) score and sepsis-related organ failure assessment (SOFA) score gradually decreased in 4 survived patients, while gradually increased in the died patient. Conclusion Bundle therapy is effective on patients with severe influenza A.