scholarly journals Effect of a Care Bundle Combined with Continuous Positive Airway Pressure in the Postanesthesia Care Unit on Rapid Recovery after Pulmonary Tumor Resection

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Yongxiang Yan ◽  
Jianwei Luo ◽  
Liuming Pei ◽  
Jianfeng Zeng ◽  
Wenchan Yan ◽  
...  
Keyword(s):  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Tumor Resection ◽  
Care Bundle ◽  
Postanesthesia Care Unit ◽  
Control Group ◽  
Respiratory Status ◽  
Pulmonary Tumor ◽  
Number Of Patients ◽  
Experimental Group

Objective. To study the effect of a care bundle combined with continuous positive airway pressure (CPAP) in the postanesthesia care unit (PACU) on rapid recovery after pulmonary tumor resection. Methods. A total of 135 patients requiring anesthesia resuscitation after pulmonary tumor resection in our hospital from June 2020 to February 2021 were selected. They were randomly divided into three groups: the PACU experimental group, PACU control group, and operating room resuscitation (OR) group. Subsequently, their intraoperative clinical symptoms, parameters in monitoring postoperative respiratory status, and follow-up results were compared among the three groups. Results. The PACU experimental group had the highest number of right lesions, while the OR group had the highest intraoperative blood transfusion volume, urine volume, intraoperative colloid volume, intrapulmonary shunt, and intraoperative physician handover rate ( P < 0.05 ). Before surgery, serum potassium (K) in the PACU experimental group was significantly higher than that in the OR group but lower than that in the PACU control group ( P < 0.01 ). During the time in the PACU, blood partial pressure of oxygen (PO2) and oxygen index (OI) levels in the PACU experimental group were significantly higher than those in the other groups ( P < 0.01 ). After surgery, total PACU stay time, time from PACU to extubation, and stay after extubation were markedly reduced in the PACU experimental group ( P < 0.05 ). The highest number of patients with drainage was found in the PACU experimental group, while the highest number of patients without drainage was found in the PACU control group. Conclusion. A care bundle combined with CPAP in the PACU can improve the monitoring time of respiratory status and improve blood gas parameters, thus accelerating the postoperative rehabilitation process of patients undergoing pulmonary tumor resection.

scholarly journals Positive Airway Pressure Therapy Adherence with Mask Resupply: A Propensity-Matched Analysis

2021 ◽  
Vol 10 (4) ◽  
pp. 720
Author(s):  
Adam Benjafield ◽  
Liesl Oldstone ◽  
Leslee Willes ◽  
Colleen Kelly ◽  
Carlos Nunez ◽  
...  
Keyword(s):  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Group Versus ◽  
Control Group ◽  
Billing Data ◽  
Pressure Therapy ◽  
Therapy Termination ◽  
Few Data ◽  
And Control ◽  
The Impact

There are currently few data on the impact of mask resupply on longer-term adherence to positive airway pressure (PAP) therapy. This retrospective analysis investigated the effects of mask/mask cushion resupply on the adherence to PAP versus no resupply. Deidentified patient billing data for PAP supply items were merged with telemonitoring data from Cloud-connected AirSense 10/AirCurve 10 devices via AirViewTM (ResMed). Eligible patients started PAP between 1 July 2014 and 17 June 2016, had ≥360 days of PAP device data, and achieved initial U.S. Medicare adherence criteria. Patients who received a resupply of mask systems/cushions (resupply group) were propensity-score-matched with those not receiving any mask/cushion resupply (control group). A total of 100,370 patients were included. From days 91 to 360, the mean device usage was 5.6 and 4.5 h/night in the resupply and control groups, respectively (p < 0.0001). The proportion of patients with a mean device usage ≥4 h/night was significantly higher in the resupply group versus the control group (77% vs. 59%; p < 0.0001). The therapy termination rate was significantly lower in the resupply group versus the control group (14.7% vs. 31.9%; p < 0.0001); there was a trend toward lower therapy termination rates as the number of resupplies increased. The replacement of mask interface components was associated with better longer-term adherence to PAP therapy versus no resupply.

scholarly journals Neonatal outcomes of preterm infants born during COVID-19 community lockdowns in Melbourne, Australia

2021 ◽  
Author(s):  
Brendan Mulcahy ◽  
Daniel Rolnik ◽  
Alexia Matheson ◽  
Yizhen Liu ◽  
Kirsten Palmer ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Continuous Positive Airway Pressure ◽  
Preterm Infants ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Neonatal Morbidity ◽  
Exposed Group ◽  
White Cell ◽  
Neonatal Outcomes ◽  
Control Group

Background: Community lockdowns during the COVID-19 pandemic may influence preterm birth rates, but mechanisms are unclear. Methods: We compared neonatal outcomes of preterm infants born to mothers exposed to community lockdowns in 2020 (exposed group) to those born in 2019 (control group). Main outcome studied was composite of significant neonatal morbidity or death. Results: Median gestational age was 35+4 weeks (295 infants, exposed group) vs. 35+0 weeks (347 infants, control group) (p = 0.108). The main outcome occurred in 36/295 (12.2%) infants in exposed group vs. 46/347 (13.3%) in control group (p = 0.69). Continuous positive airway pressure (CPAP) use, jaundice requiring phototherapy, hypoglycaemia requiring treatment, early neonatal white cell and neutrophil counts were significantly reduced in the exposed group. Conclusions: COVID-19 community lockdowns did not alter composite neonatal outcomes in preterm infants, but reduced rates of some common outcomes, and early white cell and neutrophil counts.

scholarly journals The role of Continuous Positive Airway Pressure (CPAP) in Delaying or Avoiding Mechanical Ventilation in COVID-19 Respiratory Failure: A Retrospective Cohort Study

2021 ◽  
Author(s):  
Allan Cameron ◽  
Sharif Fattah ◽  
Laura Knox ◽  
Pauline Grose
Keyword(s):  
Mechanical Ventilation ◽  
Cohort Study ◽  
Continuous Positive Airway Pressure ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Invasive Mechanical Ventilation ◽  
Respiratory Support ◽  
Royal Infirmary ◽  
High Dependency ◽  
Number Of Patients

Abstract Background - During the winter of 2020-2021, the second wave of the COVID19 pandemic in the United Kingdom caused increased demand for intensive care unit (ICU) beds, and in particular, for invasive mechanical ventilation (IMV). To alleviate some of this pressure, some centres offered non-invasive continuous positive airway pressure (CPAP), delivered on specialised COVID high dependency units (cHDUs). However, this practice was based largely on anecdotal reports, and it is not clear from the literature how effective CPAP is at delaying or preventing IMV. Methods - This was a retrospective observational cohort study of consecutive patients admitted to a specialised cHDU at Glasgow Royal Infirmary between November 2020 and February 2021. Each patient had a continuous record of the level of respiratory support required, and was followed up to hospital discharge or death. We examined patient outcomes according to age, sex and maximum level of respiratory support, using logistic regression and time-to-event analysis. The number of patients who could not be oxygenated by standard oxygen facemask but could be oxygenated by CPAP was counted and compared to the number of patients admitted to ICU for IMV over the same period.Results - There were 152 admissions to cHDU over the study period. Of these, 125 received CPAP treatment. Of the patients who received support in cHDU, the overall mortality rate was 37.9% (95% CI 30.3% - 46.1%)). Odds of mortality were closely correlated with increasing age and oxygen requirement. Of the 152 patients, 44 patients (28.8%, 95% CI 22.0 – 36.9%) went on to require IMV in ICU. This represents 77.2% of the 57 COVID-19 admissions to ICU during the same period. However, there were also 41 patients who received levels of respiratory support on cHDU which would normally necessitate ICU admission but who never went to ICU, potentially reducing ICU admissions by 41.8% (95% CI 32.1 – 52.2%).Conclusion - Providing respiratory support in cHDU reduced the number of potential ICU admissions by 41.8%, as well as delaying IMV for over 75% of ICU admissions. This represents a significant sparing of ICU capacity at a time when IMV beds were in high demand.

scholarly journals Cost-Effectiveness Analysis of Positive Airway Pressure in Patient with Obstructive Sleep Apnea

2021 ◽  
Vol 28 (2) ◽  
pp. 94-101
Author(s):  
Hansol Kim ◽  
Jin Kook Kim ◽  
Jae Hoon Cho
Keyword(s):  
Obstructive Sleep Apnea ◽  
Cost Effectiveness ◽  
Sleep Apnea ◽  
Treatment Group ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Control Group ◽  
Medical Expenses ◽  
Effectiveness Analysis ◽  
Obstructive Sleep

Background and Objectives: Positive airway pressure (PAP) is effective at reducing the number of complications in patients with obstructive sleep apnea (OSA). To the best of our knowledge, no cost-effectiveness analysis of PAP has been conducted in Korea. Subjects and Method: We classified subjects into two groups, those with moderate-to-severe OSA who used PAP after polysomnography (PAP treatment group) and those who did not receive a diagnosis and treatment (control group), and compared their medical expenses over a period of 10 years. The incidence rate of common complications and accidents (coronary heart disease, heart failure, stroke, depression, diabetes, vehicular accidents, and work-related accidents) with or without PAP was adopted through a literature review. The average medical expenses for treating each complication and accident were found by searching several databases. The analysis consisted of a payer’s perspective and a societal perspective. Results: The incidence of all complications was higher in the control group than in the PAP treatment group. However, since the absolute incidence rate was not high in either group and medical expenses in Korea are low, the expected treatment cost was not high. In contrast, the PAP rental fee was relatively high. To obtain 1 unit of disability-adjusted life year, it costs 40,873,288 won from the payer’s perspective and 31,791,810 won from the societal perspective. Conclusion: PAP treatment reduces patient complications and extends their lifespan, but costs must be considered.

THE APPLICATION OF STATISTICAL METHODS IN EVALUATING THE RESULTS OF CLINICAL FINDINGS OF THE DRUG BOVHUALONIDASE AZOXIMER IN CATS WITH UROLOGICAL DISEASES

2020 ◽  
pp. 212-218
Author(s):  
А. V. Nazarova ◽  
◽  
B. S. Semenov ◽  
Т. Sh. Kuznetsova ◽  
◽  
...  
Keyword(s):  
Relative Risk ◽  
Side Effects ◽  
Risk Reduction ◽  
Absolute Risk ◽  
Control Group ◽  
Control Groups ◽  
Saint Petersburg ◽  
Number Of Patients ◽  
And Control ◽  
Experimental Group

In the period from November 2018 to August 2020, we conducted a randomized blind placebo-controlled confirmatory clinical trial in parallel groups on the basis of network of veterinary clinics in Saint Petersburg and Saint Petersburg state university of veterinary medicine. The purpose of the study: to evaluate the effectiveness of Bovhualonidaze azoximer(BA) in patients subjected to surgical intervention on the urethra and bladder, to prevent postoperative complications and relapses of the underlying disease. The frequency of complications was taken as an indicator of effectiveness. 80 cats were evaluated according to the criteria for inclusion in the study, after evaluation and randomization, 53 patients (24 and 29 cats in the experimental and control groups, respectively) who had indications for surgery on the urethra and/or bladder were included in the study. After the withdrawal of some patients, 38 cats were analyzed (17 and 23 cats in the experimental and control groups, respectively). Animals in the experimental group received BA drugs in addition to conventional therapy, and animals in the control group received placebo. The rate of complications in the experimental group was 11.8 %, in the control group-61.9 %. The relative risk was 19.0 %, and the relative risk reduction was 80.9 %. The chance of developing complications in the animals of the experimental group is 12.2 times lower than in animals of the control group.. Absolute risk reduction — 50.1 %, and the number of patients to be treated — 2 patients. The confidence interval for the risk of side effects of BA drugs in cats was 0.0-10.1 %. Based on the results of our clinical study, we proved that the use of BA drugs is effective for preventing complications during surgical interventions on the urethra and bladder, and the risk of side effects when using BA drugs in cats is insignificant

Precision of customized surgical osteotomy guide (CSOG) in mandibular reconstruction with a customized implant

2019 ◽  
Vol 25 (10) ◽  
pp. 1601-1623
Author(s):  
Sandeep W. Dahake ◽  
Abhaykumar M. Kuthe ◽  
Mahesh B. Mawale
Keyword(s):  
Surgical Planning ◽  
Total Error ◽  
Tumor Resection ◽  
Mandibular Reconstruction ◽  
Control Group ◽  
Implant Fixation ◽  
Content Type ◽  
Mandibular Tumor ◽  
Hand Tumor ◽  
Experimental Group

Purpose This study aims to find the usefulness of the customized surgical osteotomy guide (CSOG) for accurate mandibular tumor resection for boosting the accuracy of prefabricated customized implant fixation in mandibular reconstructions. Design/methodology/approach In all, 30 diseased mandibular RP models (biomodels) were allocated for the study (for experimental group [n = 15] and for control group [n = 15]). To reconstruct the mandible with customized implant in the experimental group, CSOGs and in control group, no CSOG were used for accurate tumor resections. In control group, only preoperative virtual surgical planning (VSP) and reconstructed RP mandible model were used for the reference. Individually each patient’s preoperative mandibular reconstructions data of both the groups were superimposed to the preoperative VSP of respective patient by registering images with the non-surgical side of the mandible. In both the groups, 3D measurements were taken on the reconstructed side and compared the preoperative VSP and postoperative reconstructed mandible data. The sum of the differences between pre and postoperative data was considered as the total error. This procedure was followed for both the groups and compared the obtained error between the two groups using statistical analysis. Findings The use of CSOG for accurate tumor resection and exact implant fixation in mandibular reconstruction produced a smaller total error than without using CSOG. Originality/value The results showed that, benefits provided with the use of CSOG in mandibular reconstruction justified its use over the without using CSOG, even in free hand tumor resection using rotating burr.

scholarly journals Effect of a telephonic intervention on the adherence of patients

2003 ◽  
Vol 59 (1) ◽  
Author(s):  
A. V. Stewart
Keyword(s):  
Health Behaviour ◽  
Salt Intake ◽  
Health Care Practitioner ◽  
Control Group ◽  
Behaviour Modification ◽  
Risk Factor Modification ◽  
Number Of Patients ◽  
Experimental Group ◽  
Factor Modification ◽  
Better Than

The effectiveness of a telephonic intervention in increasingpatients’ adherence to a health behaviour modification programme was tested. Patients were randomly assigned to two groups, the Experimental group receiving the telephonic intervention. Patients in the Experimental group showed greater adherence to the programme than the Control group (p=0.007). Their knowledge of hypertension improved (p=0.001) and was better than the control group (p=0.03), their exercise capacity improved (p=0.003) but not significantly more than the control group (p=0.09). They had a greater reduction in weight (p=0.004) which was significantly different from the Control group (p= 0.03). They were significantly less tired than the Control group (p=0.008). The Experimental group showed a reduction inthe number of patients with headaches (p=0.05) and dizziness (p=0.001). These changes were significant within the Experimental group but not between the two groups. The self reported risk factor modification revealed that more patients in the Experimental group could control their stress (p=0.05); more were controlling their salt intake (p=0.02) and more knew and were adhering to their medication regime (p=0.05). Both groups showed small reductions in blood pressure. The telephonic intervention involving the support of a health-care practitioner and a family member appeared to be effective in changing aspects of health behaviour.

scholarly journals Observation on the Effect of Local Flap Transfer and Sclera Transplantation in Repairing Skin Defect after Eyelid Tumor Operation

2020 ◽  
Vol 4 (1) ◽  
pp. 28-31
Author(s):  
Ying-Hui Ma ◽  
Gang Liu ◽  
Jie Yang
Keyword(s):  
Skin Flap ◽  
Tumor Resection ◽  
Local Flap ◽  
Control Group ◽  
Skin Defect ◽  
Local Skin ◽  
Eyelid Tumor ◽  
Flap Transfer ◽  
Wide Range ◽  
Experimental Group

Introduction: Eyelid tumor refers to the primary eyelid skin and accessory tumors, which not only affects the appearance and vision, and even local infiltration and distant metastasis, thereby threatening life. Surgical resection is the most important and effective treatment, but tumor resection often leads to a wide range of eyelid defects, significantly affecting the shape and function of the eyelid. Therefore, the eyelid defect must be repaired after resection to achieve the purpose of aesthetic appearance and protection of the eyeball. The objective of the study was to analyze the clinical results of local flap transfer and scleral transplantation in repairing skin defect after eyelid tumor operation. Methods: Forty patients with postoperative skin defects of eyelid tumors admitted from December 2008 to December 2018 were taken for analysis and divided into two groups, 20 cases in each group. The control group underwent autologous lip mucous membrane transfer and nearby skin flap, while the experimental group received local skin flap rotation and scleral allograft repair. The clinical effect of repair of the two groups were compared. Results: In the experimental group, the effect of clinical repairs were better, the difference of height of palpebralfissure and the length of palpebral fissure were compared with the control group, which showed statistical significance favoring the experimental group. Conclusion: Local flap transfer and scleral transplantation has better clinical outcome to repair the skin defect after operation of eyelid tumor.

Relationship between obstructive sleep apnea and endogenous carbon monoxide

2017 ◽  
Vol 122 (1) ◽  
pp. 104-111 ◽  
Author(s):  
Masanori Azuma ◽  
Kimihiko Murase ◽  
Ryo Tachikawa ◽  
Satoshi Hamada ◽  
Takeshi Matsumoto ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Carbon Monoxide ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Surrogate Marker ◽  
Control Group ◽  
Cpap Therapy ◽  
Obstructive Sleep

Endogenous carbon monoxide (CO) levels are recognized as a surrogate marker for activity of heme oxygenase-1, which is induced by various factors, including hypoxia and oxidative stress. Few reports have evaluated endogenous CO in patients with obstructive sleep apnea (OSA). Whether OSA more greatly affects exhaled or blood CO is not known. Sixty-nine patients with suspected OSA were prospectively included in this study. Exhaled and blood CO were evaluated at night and morning. Blood and exhaled CO levels were well correlated both at night and morning ( r = 0.52, P < 0.0001 and r = 0.61, P < 0.0001, respectively). Although exhaled CO levels both at night and morning significantly correlated with total sleep time with arterial oxygen saturation < 90% (ρ = 0.41, P = 0.0005 and ρ = 0.27, P = 0.024, respectively), blood CO levels did not correlate with any sleep parameter. Seventeen patients with an apnea and hypopnea index (AHI) < 15 (control group) were compared with 52 patients with AHI ≥ 15 (OSA group). Exhaled CO levels at night in the OSA group were significantly higher than in the control group (3.64 ± 1.2 vs. 2.99 ± 0.70 ppm, P < 0.05). Exhaled CO levels at night decreased after 3 mo of continuous positive airway pressure (CPAP) therapy in OSA patients ( n = 36; P = 0.016) to become nearly the same level as in the control group ( P = 0.21). Blood CO levels did not significantly change after CPAP therapy. Exhaled CO was positively related to hypoxia during sleep in OSA patients, but blood CO was not. Exhaled CO might better correlate with oxidative stress associated with OSA than blood CO. NEW & NOTEWORTHY Endogenous carbon monoxide (CO) levels are recognized to be a surrogate marker of oxidative stress. No study has evaluated both exhaled and blood CO at the same time in obstructive sleep apnea (OSA) patients. Here we provide evidence that exhaled CO levels positively correlated with hypoxia during sleep in OSA patients, but blood CO levels did not, and that continuous positive airway pressure therapy significantly decreased exhaled CO levels in the OSA group, but did not significantly affect blood CO.

scholarly journals Oxygen Sorption Treatment in the Treatment of Soft Tissue Wounds

2019 ◽  
Vol 12 (4) ◽  
pp. 248-253
Author(s):  
Dmitry Valerievich Arkhipov ◽  
Alexander Alekseevich Andreev ◽  
Dmitry Andreevich Atyakshin ◽  
Anton Petrovich Ostroushko
Keyword(s):  
Soft Tissue ◽  
Group Treatment ◽  
Local Treatment ◽  
Control Group ◽  
Wound Surface ◽  
Oxygen Sorption ◽  
Air Jet ◽  
Number Of Patients ◽  
Treatment Of Wounds ◽  
Experimental Group

Background. The number of patients with soft tissue wounds does not tend to decrease, which is largely due to the growth of patients with injuries, ulcerative defects, skin tumors, comorbid pathology, including diabetes mellitus, antibiotic-resistant strains and other causes. New methods of local treatment of wounds based on the application of the latest achievements of science are constantly being introduced into the work of surgical departments. High efficiency is demonstrated by the use of sorbents and oxygen, which enhance the reparative processes in wounds.The aim of the study was to study in experimental conditions the effectiveness of the method of surgical treatment of soft tissue wounds, based on the use of jet oxygen sorption treatment (SCS).Materials and methods. The study was performed on 150 white Wistar rats in 5 groups of animals. In the 1st control group treatment was not carried out. In the 2nd and 3rd control groups, the wound surface was treated with a jet of air and oxygen, respectively; in the 4th control group, sorbent was applied to the wound surface. In the 1st experimental group conducted scso wound surface. The study of the effectiveness of SCS was carried out using objective, planimetric, histological and histochemical research methods. Results. The use of sorbent (4th control group) and the method of jet oxygen sorption treatment (1st main group) led to the most pronounced positive changes-acceleration of relief of the studied symptoms by 1.1-1.3 times and 1.2 1.5 times, respectively, compared with the data obtained in the 1st control group. Treatment of wounds with oxygen jet (3rd control group) had practically no advantages in comparison with treatment with air jet (2nd control group).Conclusion. Indirectly, the highest activity of reparative processes during the observation period in the 4th control and 1st main groups was confirmed by the average optical density of RNA and SH-groups, and their desire to normalize to 10 days could indicate the completion of processes of stratification in the wound area. In total, the average area of wounds was minimal in the 1st experimental group, where this figure was by the 3rd and 10th days-74.0% and 99.5% compared to the baseline data.

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