Efficacy of Bronchoalveolar Lavage as Adjunct Therapy in the Treatment of Neonatal Severe Pneumonia: A Prospective Case–Control Study

2020 ◽  
Vol 66 (5) ◽  
pp. 528-533 ◽  
Author(s):  
Jing Liu ◽  
Hui-Rong Zhao ◽  
Hua-Li Wei ◽  
Chen Chen ◽  
Ru-Xin Qiu ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Side Effects ◽  
Bronchoalveolar Lavage ◽  
Invasive Mechanical Ventilation ◽  
Vital Signs ◽  
Length Of Hospital Stay ◽  
Severe Pneumonia ◽  
Control Group ◽  
Adverse Side Effects ◽  
Before And After

Abstract Objective The aim of this study was to investigate the efficacy and safety of bronchoalveolar lavage (BAL) in the treatment of neonatal severe pneumonia (NSP). Methods One hundred patients with severe pneumonia were randomly divided into two groups, the BAL and control groups, with 50 patients in each group. In the BAL group, normal saline was instilled into the endotracheal tube for BAL. Before and after lavage, lung ultrasound (LUS) monitoring was performed to observe the lung pathological changes. Conventional treatment was administered in the control group. The need for and duration of invasive mechanical ventilation, the complication rate, the duration and cost of hospitalization and the mortality rate were compared between the two groups. Results The results of this study showed that there were 35 (70%) patients who meet the indications of the invasive mechanical ventilation (IMV) at admission in the BAL group, while there were only 15 (30%) patients still requiring IMV after BAL therapy. The duration of IMV was 41.7 ± 7.5 vs. 97.7 ± 12.9 h in BAL and controls, the incidence rate of complications was 8.0% vs. 20.0% in both groups, the length of hospital stay was 9.2 ± 1.9 vs. 14.1 ± 2.1 days in both groups, and the expense of hospital cost was 12 557 ± 832 vs. 19 121 ± 929 Chinese Yuan in both groups. All patients had stable vital signs during lavage, and no significant adverse side effects were observed. Conclusion BAL was significantly beneficial for NSP with no significant adverse side effects; LUS is a useful tool for the timely detection of BAL effects.

scholarly journals Efficacy of a New Non-drug Acne Therapy: Aloe Vera Gel Combined With Ultrasound and Soft Mask for the Treatment of Mild to Severe Facial Acne

2021 ◽  
Vol 8 ◽  
Author(s):  
Hongyu Zhong ◽  
Xiang Li ◽  
Wanqi Zhang ◽  
Xiaoxiao Shen ◽  
Yuangang Lu ◽  
...  
Keyword(s):  
Treatment Group ◽  
Side Effects ◽  
Combined Therapy ◽  
Aloe Vera ◽  
Physical Method ◽  
Control Group ◽  
Severe Acne ◽  
Aloe Vera Gel ◽  
Before And After ◽  
Acne Therapy

Background: Acne is a chronic disorder that affects almost 80% of adolescents and young adults, causing psychological and emotional distress. However, the current treatments for acne are either ineffective or have many side effects. This study was designed to confirm and objectively quantify the effect of a new non-drug combined therapy on acne.Methods: This study innovatively utilized ultrasound, which enhanced the absorption of aloe vera gel, and soft mask to make a purely physical method without any drugs. In both the treatment group and control group, the number of papules/pustules and the area of hyperpigmented lesions were counted, and a smart mirror intelligent face system was used before and after the combined therapy. Alterations in the skin functional index were recorded and analyzed statistically.Results: In the treatment group, the combined therapy significantly reduced the number of papules and the area of hyperpigmented lesions and improved skin roughness and local blood circulation. In the control group, there was no obvious improvement over 2 months.Conclusion: This study suggests that the new non-drug combined therapy significantly improved acne, which provided experimental evidence and treatment guidance for patients with mild to severe acne, especially patients with moderate acne. This new therapy may possibly be an appropriate method for patients who seek topical treatments with mild side effects and low antibiotic resistance rates.

scholarly journals Evaluation of the Effect of Shenmai Injection on Chemotherapy Efficacy and Side Effects of Acute Leukemia

2019 ◽  
Vol 3 (6) ◽  
Author(s):  
Jianling Qiao ◽  
Xuan Kan ◽  
Fei Qin
Keyword(s):  
Bone Marrow ◽  
Side Effects ◽  
Acute Leukemia ◽  
Control Group ◽  
Blood Levels ◽  
Observation Group ◽  
Impaired Liver Function ◽  
Shenmai Injection ◽  
Before And After ◽  
Bone Marrow Blood

Objective: To study the effect of Shenmai injection on the efficacy and side effects of chemotherapy in acute leukemia. Methods: Sixty-two patients with acute leukemia admitted to the hospital between February 2018 and June 2019 were enrolled in this study. All patients were divided into observation and control groups according to different treatment methods in chemotherapy. The control group was treated with chemotherapy alone. The observation group was treated Shenmai injection combined with chemotherapy. The treatment effect of the two groups was compared, and the incidence of bone marrow blood and side effects before and after treatment were compared. Results: The therapeutic effect of the observation group was 93.55% which was much higher than that of the control group of 74.19%, P<0.05. The bone marrow blood levels of WBC, PLT and Hb in the observation group before and after treatment were 23.97±3.05, 6.76±1.27, 69.01±8.15, 66.96±9.46, 91.07±8.15, 89.35±7.46, respectively, compared with the control group. The difference in the situation after treatment was found to be significant. The incidence of toxic side effects such as nausea and vomiting, impaired liver function and renal dysfunction in the observation group was 9.68%, which was lower than that of the control group (32.26%, P<0.05). Conclusion: Shemai injection has significant effects on the efficacy and side effects of chemotherapy in acute leukemia and effectively improves the effect of chemotherapy.

Investigation the Effects of Adding Intravenous Transoxalic Acid and Its Complications in the Prevention of Postpartum Hemorrhage after Vaginal Delivery in Patients Admitted to Ali-ibn-Abitaleb Hospital in Zahedan

2021 ◽  
Author(s):  
Tahereh Hajian ◽  
Maryam Razavi ◽  
Ali Dashipour
Keyword(s):  
Side Effects ◽  
Postpartum Hemorrhage ◽  
Intervention Group ◽  
Vital Signs ◽  
Control Group ◽  
Drug Side Effects ◽  
Blood Samples ◽  
Significant Difference ◽  
The Mean ◽  
Uterine Fundus

Background: This study was designed to investigate the effect of tranexamic acid and its side effects in preventing postpartum hemorrhage in patients referred to Ali ibn Abitaleb Hospital in Zahedan during 2020-2021. Methods: Patients were divided into two groups of 85 patients. Vital signs as well as drug side effects related to tranexamicity are monitored and recorded every15 minutes in the first hour and every 30 minutes in the second hour. Also, blood samples are taken from patients to measure hemoglobin and hematocrit within6 hours after delivery. The number and weight difference of droschitis used during 2 hours after delivery are also measured. In addition, PPH (Postpartum hemorrhage) cases in both groups were checked by repeated examination of the uterine fundus during the first 2 hours and after 6 weeks. Results: There was no statistically significant difference between the two groups in terms of the number of deliveries and further decrease in hemoglobin levels in the control group compared to the intervention group. Nausea, vomiting, and dizziness were observed in the intervention group and thrombosis was not observed in any group. According to the independent samples t-test, there was a statistically significant difference between the mean blood volume lost between the two groups. The mean hematocrit drop was statistically significant between the two groups. No blood transfusion was observed in any of the patients. Conclusion: Tranxamic acid injections can effectively reduce postpartum hemorrhage and reduce maternal hemoglobin and hematocrit following this complication.

Early Use of Sarilumab in Patients Hospitalised with COVID-19 Pneumonia and Features of Systemic Inflammation.

2021 ◽  
Author(s):  
Nicolás Merchante ◽  
Sheila Cárcel ◽  
José Carlos Garrido-Gracia ◽  
Marta Trigo-Rodríguez ◽  
María Ángeles Esteban Moreno ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Systemic Inflammation ◽  
Primary Outcome ◽  
Invasive Mechanical Ventilation ◽  
Control Group ◽  
Controlled Clinical Trial ◽  
Open Label ◽  
Randomized Controlled ◽  
Subcutaneous Dose ◽  
Early Use

In this phase II, open-label, randomized, controlled clinical trial of 115 patients hospitalized with COVID-19 and systemic inflammation, early use of sarilumab was associated with a low risk of acute respiratory distress syndrome requiring high-flow devices or mechanical ventilation. Objective: To investigate the efficacy and safety of early treatment with sarilumab, added to standard of care (SOC), in hospitalised adults with COVID-19. Methods: Phase II, open-label, randomized, controlled clinical trial of hospitalised patients with COVID-19 pneumonia and interleukin (IL)-6 levels ≥ 40 pg/mL and/or D-dimer > 1500 ng/mL. Participants were randomized (1:1:1) to receive SOC (control group), SOC plus a single subcutaneous dose of sarilumab 200 mg (Sarilumab-200) or SOC plus a single subcutaneous dose of sarilumab 400 mg (Sarilumab-400). The primary outcome variable was the development of acute respiratory distress syndrome (ARDS) requiring high-flow nasal oxygenation (HFNO), non-invasive mechanical ventilation (NIMV) or invasive mechanical ventilation (IMV) at day 28. Results: One-hundred and fifteen participants (control group, n = 39; Sarilumab-200, n = 37; Sarilumab-400, n = 39) were included. At randomization, 104 (90%) patients had supplemental oxygen and 103 (90%) received corticosteroids. Eleven (28%) patients in the control group, ten (27%) in Sarilumab-200 and five (13%) in Sarilumab-400 developed the primary outcome (hazard ratio [95% CI] of Sarilumab-400 vs control group: 0.41 [0.14-1.18]; p=0.09). Seven (6%) patients died: three in the control group and four in Sarilumab-200. There were no deaths in Sarilumab-400 (p = 0.079, log-rank test for comparisons with the control group). Conclusion: In patients recently hospitalised with COVID-19 pneumonia and features of systemic inflammation, early IL-6 blockade with a single dose of sarilumab 400 mg was safe and associated with a trend for better outcomes.

scholarly journals Open Tracheostomy for Critically Ill Patients with COVID-19

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Estefanía Hernández-García ◽  
Mar Martínez-RuizCoello ◽  
Andrés Navarro Mediano ◽  
Nuria Pérez-Martín ◽  
Victoria García-Peces ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Hospital Admissions ◽  
Prolonged Mechanical Ventilation ◽  
Invasive Mechanical Ventilation ◽  
Epidemiological Data ◽  
Orotracheal Intubation ◽  
Safe Procedure ◽  
Before And After ◽  
A Prospective Study ◽  
Mean Time

Background. COVID-19 is a worldwide pandemic, with many patients requiring prolonged mechanical ventilation. Tracheostomy can shorten ICU length of stay and help weaning. Aims/Objectives. To describe the long-term evolution of the critically patient with COVID-19 and the need for invasive mechanical ventilation and orotracheal intubation (OTI), with or without tracheostomy. Material and Methods. A prospective study was performed including all patients admitted to the ICU due to COVID-19 from 10th March to 30th April 2020. Epidemiological data, performing a tracheostomy or not, mean time of invasive mechanical ventilation until tracheotomy, mean time from tracheotomy to weaning, and final outcome after one month of minimum follow-up were recorded. The Otolaryngology team was tested for COVID-19 before and after the procedures. Results. Out of a total of 1612 hospital admissions for COVID-19, only 5.8% (93 patients) required ICU admission and IOT. Twenty-seven patients (29%) underwent a tracheostomy. After three months, within the group of tracheotomized patients, 29.6% died and 48.15% were extubated in a mean time of 28.53 days. In the nontracheostomized patients, the mortality was 42.4%. Conclusions. Tracheostomy is a safe procedure for COVID-19 and helps weaning of prolonged OTI. Mortality after tracheostomy was less common than in nontracheostomized patients.

scholarly journals Warm compresses to decrease dysmenorrhea among adolescents

2020 ◽  
Vol 3 (2) ◽  
pp. 110-114
Author(s):  
Dian Nurafifah ◽  
Ihda Mauliyah ◽  
Atiul Impartina
Keyword(s):  
Data Analysis ◽  
Treatment Group ◽  
Side Effects ◽  
Young Women ◽  
Control Group ◽  
Not Given ◽  
Menstrual Pain ◽  
Before And After ◽  
Experience Pain

Dysmenorrhea is one of discomfort experienced by adolescent during menstruation. A Survey of 10 young women at University of Muhammadiyah Lamongan found 90% had dysmenorrhea. To reduce pain, they take pain relievers. However, the use of drugs can cause side effects, especially if long-term use can lead to addiction or dependence. Research design using Quasy Eksperiment (pretest-posttest). The study was conducted on adolescents who are experiencing dysmenorrhea. They were divided into two groups namely control and treament groups. The study began by assessing pain levels in both groups. The treatment group was given warm compresses but the control group was not given any treatment, after that reassess the level of pain. The study analyzes changes in pain levels and compares pain change in the two groups. The results showed that in the control group most of the adolescents did not experience pain changes during dysmenorrhea (86.7%), whereas in the treatment group most of the adolescents experienced a decrease in pain (93.3%). Data analysis using the Mann Whitney test showed p=0.000 where p0.05 so it can be concluded that there are differences in dysmenorrhea before and after treatment between the warm compress group and the control group. The results of this study are expected to be used as consideration in developing plans to reduce discomfort in the form of menstrual pain in a non-pharmacological manner.

scholarly journals Remdesivir Efficacy in COVID-19 Treatment: A Randomized Controlled Trial

2021 ◽  
Author(s):  
Sherief Abd-Elsalam ◽  
Ossama Ashraf Ahmed ◽  
Noha O. Mansour ◽  
Doaa H. Abdelaziz ◽  
Marwa Salama ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Mortality Rate ◽  
Hospital Stay ◽  
Standard Care ◽  
Controlled Trial ◽  
Length Of Hospital Stay ◽  
Final Analysis ◽  
Secondary Outcome ◽  
Control Group ◽  
Egyptian Patients

To date, no antiviral therapy has shown proven clinical effectiveness in treating patients with COVID-19. We assessed the efficacy of remdesivir in hospitalized Egyptian patients with COVID-19. Patients were randomly assigned at a 1:1 ratio to receive either remdesivir (200 mg on the first day followed by 100 mg daily for the next 9 days intravenously infused over 30–60 minutes) in addition to standard care or standard care alone. The primary outcomes were the length of hospital stay and mortality rate. The need for mechanical ventilation was assessed as a secondary outcome. Two hundred patients (100 in each group) completed the study and were included in the final analysis. The remdesivir group showed a significantly lower median duration of hospital stay (10 days) than the control group (16 days; P < 0.001). Eleven of the patients in the remdesivir group needed mechanical ventilation compared with eight patients in the control group (P = 0.469). The mortality rate was comparable between the two groups (P = 0.602). Mortality was significantly associated with older age, elevated C-reactive protein levels, elevated D-dimer, and the need for mechanical ventilation (P = 0.039, 0.003, 0.001, and < 0.001 respectively). Remdesivir had a positive influence on length of hospital stay, but it had no mortality benefit in Egyptian patients with COVID-19. Its use, in addition to standard care including dexamethasone, should be considered, particularly in low- and middle-income countries when other effective options are scarce.

scholarly journals ASPECTS OF INVASIVE MECHANICAL VENTILATION IN PATIENTS WITH ARDS CAUSED BY COVID-19

2021 ◽  
pp. 9-16
Author(s):  
O. A. Loskutov ◽  
I. A. Kuchynska ◽  
S. M. Nedashkivskyi ◽  
O. S. Demchenko
Keyword(s):  
Mechanical Ventilation ◽  
Multiorgan Failure ◽  
Invasive Mechanical Ventilation ◽  
Severe Pneumonia ◽  
Ideal Body Weight ◽  
Plateau Pressure ◽  
Invasive Ventilation ◽  
Number Of Patients ◽  
Number Of Publications ◽  
Main Components

Mortality among patients with severe pneumonia and / or acute respiratory distress syndrome (ARDS) due to COVID-19 infection, who underwent mechanical ventilation (MV), is characterized by a fairly high frequency. However, despite the large number of patients receiving appropriate treatment, the question of choosing the optimal ventilation parameters remains poorly understood. In our article, we reviewed the available literature data on the indications for mechanical ventilation, parameters of MV, the need for prone-positioning of patients with ARDS caused by COVID-19 infection in intensive care units to identify unresolved issues.Despite the large number of publications about respiratory support in patients with severe coronavirus infection, there are only general principles regarding the indications for switching to invasive ventilation. Most authors identified the following clinical situations: progression of hypoxemia and / or respiratory failure but with constant oxygen support with increasing percentage of oxygen in the respiratory mixture, use of high-flow cannula or non-invasive ventilation for 1 hour without improvement; persistent hypercapnia, multiorgan failure, coma, high risk of aspiration, hemodynamic instability.According to most of the studies analyzed, the main components of the ventilation strategy should be based on the principles of pulmonary protective ventilation and include the use of low tidal volumes (Vt = 4-8 ml / kg of ideal body weight) and ventilation with plateau pressure Pplat <30 cm H2O (plateau pressure - air pressure measured after an inspiratory pause of 0.5 s). At the same time, many authors recommend using prone position and high levels of positive end-expiratory pressure (PEEP) compared to low levels in patients with ARDS on the background of COVID-19.The approach to invasive mechanical ventilation in ARDS caused by SARS-CoV-2 still requires further research and answers to a number of questions.

scholarly journals Clinical Characteristics of Severe Covid Pneumonia: Exploring New Trends in ICU

2020 ◽  
Author(s):  
Aftab Akhtar ◽  
Sheher Bano ◽  
Ahtesham Iqbal ◽  
Moazma Ramzan ◽  
Aayesha Qadeer ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Rare Complication ◽  
Invasive Mechanical Ventilation ◽  
Kidney Injury ◽  
Severe Pneumonia ◽  
Icu Mortality ◽  
Icu Stay ◽  
Vasopressor Support ◽  
Study Population ◽  
Surgical Emphysema

Abstract Background: In late December 2019, Covid-19 emerged as clusters of pneumonia of unknown cause in a province of china, Wuhan. Etiological agent was identified as novel coronavirus that resembles severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East Respiratory syndrome coronavirus (MERS-CoV) and has zoonotic transmission. Covid pneumonia can remain asymptomatic, present as mild infection, severe pneumonia or respiratory failure. Diagnosis is based on rRT-PCR carried out on respiratory secretions. Covid related mortality exceeds 50% once patient requires ICU admission. Objective: To study the characteristics of ICU population admitted to ICU of Shifa International hospital.Results: we prospectively analysed 74 patients which included 43.3% females and 56.7% males. Commonest symptoms were shortness of breath (94.5%), fever (74.3%) and cough (74.3%). Most of our study population consisted of non-smokers (79.7%) and had hypertension (59.4%) followed by diabetes (47.2%). Hydroxychloroquine (HCQ) and azithromycin combination is superior to hydroxychloroquine and doxycycline in reducing mortality (p=0.023) whereas Doxycycline alone resulted in increased mortality (p=0.009). Those who did not require antibiotics or required only narrow spectrum antibiotics had increased survival and reduced requirement of invasive mechanical ventilation (p=< 0.0001). in our study population, (44.9%) developed acute kidney injury, 2.7% needed re-intubations 10.8% developed surgical emphysema and 2.7 % thromboembolic events despite full anticoagulation. ICU mortality was 41.8% and was higher in females (59.4%, p=0.008), those who had SOFA score > 3.5 at time of admission, raised D-Dimers > 931 ng/ml, NLR > 9.2. It was further high in those who required invasive mechanical ventilation and vasopressor support (58.1% mortality p=< 0.001). ICU stay was more prolonged in those requiring invasive mechanical ventilation as compared to those who did not. (23 days vs 6 days, p=0.001). Mean plateau pressure was 19.6 ± 7.6; mean Driving pressures 14.4 ± 4.6; mean PaO2/FiO2 150.7 ± 73.9; mean SPO2/FiO2 173.9 ± 106.9; mean PEEP was 8.2 ±4.33.Conclusion: We concluded that severe covid pneumonia is common amongst males, non-smokers those who had comorbid. HCQ and azithromycin combination is superior to combination of HCQ and doxycycline or doxycycline alone and QT prolongation is a rare complication. Baseline NLR, APACHI II, SOFA, SAPS II, NUTRIC scores, D-Dimers, invasive ventilation and vasopressor support are important tools to predict ICU mortality. Invasive mechanical ventilation carries higher mortality and associated with more prolonged ICU stay. AKI is most common complication followed by shock and surgical emphysema. CRP, Ferritin levels has no impact on outcome.

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