scholarly journals A Good Way to Reduce Screening for Retinopathy of Prematurity: Development of the ROP Model in a China Preterm Population

2021 ◽  
Vol 9 ◽  
Author(s):  
Wenqian Ding ◽  
Chenghan Luo ◽  
Xinru Cheng ◽  
Zanyang Shi ◽  
Mengyuan Lei ◽  
...  
Keyword(s):  
Risk Factors ◽  
Mechanical Ventilation ◽  
Weight Gain ◽  
High Risk ◽  
Invasive Mechanical Ventilation ◽  
Gain Rate ◽  
Independent Risk Factors ◽  
High Risk Infants ◽  
Weight Gain Rate ◽  
Rop Screening

Importance: Retinopathy of prematurity (ROP) is a preventable cause of blindness in children. Without treatment, more than 45% of eyes may suffer permanent vision loss. Current ROP screening guidelines, which include a range of birth weights (BWs) and gestational ages (GAs), may require screening many low-risk preemies who might develop severe ROP.Method: All high-risk infants in the neonatal intensive care unit (NICU) of the First Affiliated Hospital of Zhengzhou University from 2017 to 2021 were included in this retrospective cohort study. Each of the 27 candidate risk factors was evaluated in univariate analysis and adjusted for known risk factors (i.e., GA and BW). The significant results were analyzed in a backward selection multivariate logistic regression model. Receiver operating characteristic (ROC) curves and a nomogram were drawn.Results: The study included 2,040 infants who underwent ROP screening. The weight gain rate [OR, 2.65; 95% confidence interval (CI), 1.49–1.21 ≤ 12 g/d vs. > 18 g/d; P = 0.001], blood transfusion (OR, 2.03; 95% CI, 1.14–3.64; P = 0.017), invasive mechanical ventilation (OR, 1.74; 95% CI, 1.15–2.66; P = 0.009) and N-terminal segment of pro-B-type natriuretic peptide (NT-proBNP) ≥ 25,000 ng/L (OR, 1.51; 95% CI, 1.00–2.28; P = 0.048) were four new statistically independent risk factors in addition to GA and BW. The area under the curve (AUC) of the final multivariate model was 0.90 (95% CI, 0.88–0.92; P < 0.001).Conclusions and Relevance: These findings add to our understanding of ROP screening because they include all eligible infants rather than only high-risk infants, as in previous studies. Under the control of BW and GA, low weight gain rate, increased number of blood transfusion, invasive mechanical ventilation and NT-proBNP ≥ 25,000 ng/L were “new” statistically independent risk factors for ROP. The ROP risk can be calculated manually or represented by a nomogram for clinical use.

scholarly journals ICU-Acquired Pneumonia is a Risk Factor of a Poor Health Post-Covid-19 Syndrome

2021 ◽  
Author(s):  
Ignacio Martin-Loeches ◽  
Anna Motos ◽  
Rosario Menéndez ◽  
Albert Gabarrus ◽  
Jessica González ◽  
...  
Keyword(s):  
Risk Factors ◽  
Mechanical Ventilation ◽  
Invasive Mechanical Ventilation ◽  
Poor Health ◽  
Health Post ◽  
Beneficial Effects ◽  
Female Sex ◽  
Icu Stay ◽  
Discharged Patients ◽  
Independent Risk Factors

Abstract Background. Some patients who had previously presented with COVID-19 have been reported to develop persistent COVID-19 symptoms. Whilst this information has been adequately recognised and extensively published with respect to non-critically ill patients, less is known about the prevalence and risk factors and characteristics of persistent COVID_19 . On other hand these patients have very often intensive care unit-acquired pneumonia (ICUAP). A second infectious hit after COVID increases the length of ICU stay and mechanical ventilation and could have an influence in the poor health post-Covid 19 syndrome in ICU discharged patientsMethods: This prospective, multicentre and observational study was done across 40 selected ICUs in Spain. Consecutive patients with COVID-19 requiring ICU admission were recruited and evaluated three months after hospital discharge. Results: A total of 1,255 ICU patients were scheduled to be followed up at 3 months; however, the final cohort comprised 991 (78.9%) patients. A total of 315 patients developed ICUAP (97% of them had ventilated ICUAP) Patients requiring invasive mechanical ventilation had persistent, post-COVID-19 symptoms than those who did not require mechanical ventilation. Female sex, duration of ICU stay, and development of ICUAP were independent risk factors for persistent poor health post-COVID-19.Conclusions: Persistent, post-COVID-19 symptoms occurred in more than two-thirds of patients. Female sex, duration of ICU stay and the onset of ICUAP comprised all independent risk factors for persistent poor health post-COVID-19. Prevention of ICUAP could have beneficial effects in poor health post-Covid 19

scholarly journals Mortality Related Risk Factors in High-Risk Pulmonary Embolism in the ICU

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Begüm Ergan ◽  
Recai Ergün ◽  
Taner Çalışkan ◽  
Kutlay Aydın ◽  
Murat Emre Tokur ◽  
...  
Keyword(s):  
Risk Factors ◽  
Mechanical Ventilation ◽  
Pulmonary Embolism ◽  
High Risk ◽  
Thrombolytic Therapy ◽  
Invasive Mechanical Ventilation ◽  
Apache Ii Score ◽  
Risk Patients ◽  
Group 2 ◽  
Group 1

Introduction. We sought to identify possible risk factors associated with mortality in patients with high-risk pulmonary embolism (PE) after intensive care unit (ICU) admission.Patients and Methods. PE patients, diagnosed with computer tomography pulmonary angiography, were included from two ICUs and were categorized into groups: group 1 high-risk patients and group 2 intermediate/low-risk patients.Results. Fifty-six patients were included. Of them, 41 (73.2%) were group 1 and 15 (26.7%) were group 2. When compared to group 2, need for vasopressor therapy (0 vs 68.3%;p<0.001) and need for invasive mechanical ventilation (6.7 vs 36.6%;p=0.043) were more frequent in group 1. The treatment of choice for group 1 was thrombolytic therapy in 29 (70.7%) and anticoagulation in 12 (29.3%) patients. ICU mortality for group 1 was 31.7% (n=13). In multivariate logistic regression analysis, APACHE II score >18 (OR 42.47 95% CI 1.50–1201.1), invasive mechanical ventilation (OR 30.10 95% CI 1.96–463.31), and thrombolytic therapy (OR 0.03 95% CI 0.01–0.98) were found as independent predictors of mortality.Conclusion. In high-risk PE, admission APACHE II score and need for invasive mechanical ventilation may predict death in ICU. Thrombolytic therapy seems to be beneficial in these patients.

scholarly journals Impact of acute kidney injury on in-hospital outcomes in Chinese patients with community acquired pneumonia

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Dawei Chen ◽  
Hongbo Yuan ◽  
Changchun Cao ◽  
Zhihe Liu ◽  
Linglin Jiang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Mechanical Ventilation ◽  
Acute Kidney Injury ◽  
Invasive Mechanical Ventilation ◽  
Kidney Injury ◽  
Community Acquired Pneumonia ◽  
Chinese Patients ◽  
Vasoactive Drugs ◽  
Hospital Outcomes ◽  
Independent Risk Factors

Abstract Background Acute kidney injury (AKI) is a frequent complication of community acquired pneumonia (CAP). However, the impact of AKI on in-hospital outcomes of patients with CAP in the Chinese population remains unclear. Methods Patients diagnosed with CAP were evaluated in this retrospective observational study. Multiple Cox regression models were employed to identify the association between AKI and in-hospital mortality and 30-day mortality, respectively. Results A total of 4213 patients were recruited; 950 (22.5%) patients were diagnosed with AKI. Independent risk factors for AKI were age, male gender, hypertension, cardiac dysfunction, diabetes, chronic kidney disease, acute respiratory failure, use of diuretics, use of vasoactive drugs, and CURB-65. Cox proportional hazards regression revealed AKI, use of angiotensin receptor blocker, hypertension, CURB-65, acute respiratory failure, and use of vasoactive drugs to be independent risk factors for both in-hospital and 30-day mortality. Compared to patients without AKI, those suffering AKI were found to have 1.31-fold (HR 1.31, 95% CI, 1.04–1.66; P = 0.023) and 1.29-fold (HR 1.29, 95% CI, 1.02–1.62; P = 0.033) increased in-hospital and 30-day mortality risks, respectively. In addition, patients with AKI were likely to require admission to intensive care unit (ICU) (42.9% versus 11.4%; P < 0.001), mechanical ventilation (33.8% versus 9.3%; P < 0.001), invasive mechanical ventilation (25.9% versus 5.8%; P < 0.001), non-invasive mechanical ventilation (25.4% versus 7.1%; P < 0.001), and experienced a longer duration of hospital stay (14 days versus 10 days; P < 0.001) than those without AKI. However, no significant difference in ICU stay (11 days versus 10 days; P = 0.099) and duration of mechanical ventilation (8 days versus 8 days; P = 0.369) between AKI and non-AKI groups was found. Conclusion AKI was common in Chinese patients with CAP. Patients with CAP who developed AKI had worse in-hospital outcomes.

scholarly journals The alteration of ­­­­­­metabolic profiling in the second trimester of GDM and high risk pregnancy, and a nomogram for predicting macrosomia

2019 ◽  
Author(s):  
Man Sun ◽  
Baihui Zhao ◽  
Sainan He ◽  
Ruopeng Weng ◽  
Binqiao Wang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Weight Gain ◽  
High Risk ◽  
Metabolic Profiling ◽  
Metabolic Risk Factors ◽  
Metabolic Risk ◽  
Second Trimester ◽  
Risk Pregnancy ◽  
Independent Risk Factors ◽  
Maternal And Newborn

Abstract Objective Dyslipidemia in the second trimester and associated gestational diabetes are increasing worldwide. Carnitine plays a key role in lipid metabolism. We aim to describe metabolic profiling in the second trimester based on carnitine related metabolomics in GDM and high risk pregnancy, and to find the potential risk factors in GDM and candidate metabolites for diagnosing GDM induced macrosomia.Methods We have randomly investigated 450 pregnant women and their neonates in this retrospective study and 56 (12.4%) GDM cases were diagnosed. We used LC-MS/MS performing metabolic profiling about 12 amino acids and 31 acylcarnitines (containing C0) to assess circulating metabolites concentration in different subgroup according maternal and newborn clinical characteristic. We also calculated the correlation coefficient between maternal and newborn. GDM potential metabolic risk factors were screened by PLS-DA. Multivariate regression analyses were used in identifying independent risk factors for GDM and macrosomia. Based on these carnitine-related factors, a nomogram for estimating macrosomia was developed.Results We found 14 AA (Ala, Arg, Met, BCAA, AAA) and AC (C0, C2, C3, C4DC+C5OH, C5, C16, C18, C18:1) were increased in Age > 35 group, BMI ≥ 30, weight gain > 20 kg group, using assistant reproductive technology group, but the level of C0, Gly were decreased. In fetal clinical data, we obtained AA and AC level in fetuses are higher than their mothers and the metabolic trend was similar with maternal result. PLS-DA showed 15 metabolism(C0, LEU+ILE+PRO-OH, Phe, C18, TYR, etc)play main roles in class separation of GDM. Multivariate analysis showed pre-pregnancy BMI, weight gain, LEU+ILE+PRO-OH, TYR, C0/acylcarnitine, C0, C3, C16, C18 are independent risk factors associated with GDM. Finally, we developed a nomogram predicting macrosomia based on carnitine-related metabolic variables.Conclusion Metabolomics was proved as a powerful tool in identifying the metabolic alteration during the second trimester. These metabolic risk factors in GDM may help understanding of the underlying biochemical pathology of GDM and help physician diagnosing macrosomia.

scholarly journals Etiology, incidence, and outcomes of patient–ventilator asynchrony in critically-ill patients undergoing invasive mechanical ventilation

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yongfang Zhou ◽  
Steven R. Holets ◽  
Man Li ◽  
Gustavo A. Cortes-Puentes ◽  
Todd J. Meyer ◽  
...  
Keyword(s):  
Risk Factors ◽  
Mechanical Ventilation ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Invasive Mechanical Ventilation ◽  
Surgical Intensive Care ◽  
Mechanically Ventilated ◽  
History Of ◽  
Training Background ◽  
The Relationship

AbstractPatient–ventilator asynchrony (PVA) is commonly encountered during mechanical ventilation of critically ill patients. Estimates of PVA incidence vary widely. Type, risk factors, and consequences of PVA remain unclear. We aimed to measure the incidence and identify types of PVA, characterize risk factors for development, and explore the relationship between PVA and outcome among critically ill, mechanically ventilated adult patients admitted to medical, surgical, and medical-surgical intensive care units in a large academic institution staffed with varying provider training background. A single center, retrospective cohort study of all adult critically ill patients undergoing invasive mechanical ventilation for ≥ 12 h. A total of 676 patients who underwent 696 episodes of mechanical ventilation were included. Overall PVA occurred in 170 (24%) episodes. Double triggering 92(13%) was most common, followed by flow starvation 73(10%). A history of smoking, and pneumonia, sepsis, or ARDS were risk factors for overall PVA and double triggering (all P < 0.05). Compared with volume targeted ventilation, pressure targeted ventilation decreased the occurrence of events (all P < 0.01). During volume controlled synchronized intermittent mandatory ventilation and pressure targeted ventilation, ventilator settings were associated with the incidence of overall PVA. The number of overall PVA, as well as double triggering and flow starvation specifically, were associated with worse outcomes and fewer hospital-free days (all P < 0.01). Double triggering and flow starvation are the most common PVA among critically ill, mechanically ventilated patients. Overall incidence as well as double triggering and flow starvation PVA specifically, portend worse outcome.

scholarly journals Factors associated with maternal weight gain rate throughout pregnancy in women with normal and excessive pre‐pregnancy weight (LB446)

2014 ◽  
Vol 28 (S1) ◽  
Author(s):  
Ana Beatriz Franco‐Sena ◽  
Fernanda Rebelo ◽  
Thatiana Pinto ◽  
Dayana Farias ◽  
Roberta Mendes ◽  
...  
Keyword(s):  
Weight Gain ◽  
Maternal Weight Gain ◽  
Maternal Weight ◽  
Factors Associated ◽  
Gain Rate ◽  
Pregnancy Weight ◽  
Weight Gain Rate

Research on 304,321,316Lect. Stainless Steel Corrosion under the Calcinating Gas Atmosphere of Ammonium Paramolybdate

2012 ◽  
Vol 602-604 ◽  
pp. 421-425 ◽  
Author(s):  
Chang Sen Luo ◽  
Hong Luo ◽  
Xi Yang He
Keyword(s):  
Stainless Steel ◽  
Weight Gain ◽  
Average Rate ◽  
Steel Corrosion ◽  
Corrosion Layer ◽  
Surface Phase ◽  
Phase Constituent ◽  
Gain Rate ◽  
Gas Atmosphere ◽  
Weight Gain Rate

In this paper, the corrosion behavior was researched which was happen on the 304,321,316Lect. stainless steel materials in the analogue situation of calcining gas atmosphere of ammonium paramolybdate.The oxidized etch which happened on the sample’s surface, phase constituent and element content of the fracture surface, was analyzed by the means of SEM、XRD.The results showed that the phases of Fe2(MoO4)3,MoO3,MoO2.5(OH)0.5,Cr2O3,Cr2Ti5O13, Fe2O3,Fe3O4 ect. are contained on the surfaces of the 304,316L, 321 samples which are calcined. There is an inside oxidized corrosion layer in 304 316L. The oxidizing film is damaged and the oxygen penetrates into the base to form an oxidized layer. A thin and compact oxidation film was formed between 321 corrosion layer and the alloy interface, which have prevented the base from further corrosion, under this experiment conditions, this steel belonged to the inoxidizability materials. The coating deficiency of 321 steel is shallow; the particles of oxidate is thin and without inner corrosion; the weight gain rate of oxidized etch is slow (average rate 5.2×10-2mg/ (cm2•h)), the weight gain is less and corrosion resistance is fine.

Examining the Effection of Second-and Third-trimester Rate of Gestational Weight Gain on Perinatal Outcomes Among Chinese Twin Gestations Based on the Provisional Guidelines: A Retrospective Cohort Study

2020 ◽  
Author(s):  
Li-hua Lin ◽  
Yi-lin Weng ◽  
Ying-ying Lin ◽  
Xiu-xian Huang ◽  
Yang Lin ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Weight Gain ◽  
Gestational Weight Gain ◽  
Normal Weight ◽  
Premature Delivery ◽  
Third Trimester ◽  
Gestational Weight ◽  
Gain Rate ◽  
Twin Pregnancies ◽  
Weight Gain Rate

Abstract Background: This paper investigated how second and third trimester gestational weight gain relates toperinatal outcomes among normal weight women with twin pregnancies in Fujian, China. Methods: A retrospective study on the medical records of 931 normal weight twin pregant women was conducted in Fujian Maternity and Child Health Hospital from 2014 to 2018.The 2nd and 3rd trimester weekly weight gain rate were calculated and categorized women as gaining below, within, or above the 2009 Institute of Medicine (IOM) recommended rates . The association between trimester-specific weight gain rate and perinatal outcome was performed by traditional regression analysis among groups.Results:A total of 931 pregnant women and 1862 neonates were included for analysis. 25.9% ,19.8% and 54.3%% of women had less than, greater than and within the recommended rates of gain in the 2nd and 3rd trimester, respectively. Multivariate Logistic regression analysis showed that greater than recommended rates of weight gain in 2nd trimester decreased the risks of preeclampsia (adjusted OR:0.458,95% CI:0.255~0.824). Less than recommended rates of weight gain in 3rd trimester increased the risk of premature delivery（adjusted OR=1.926,95%CI:1.403~2.644）, gestational diabetes mellitus (adjusted OR = 2.052,95%CI:1.417~2.972), intrahepatic cholestasis syndrome (adjusted OR = 3.016,95%CI:1.057~8.606), premature rupture of the membrane (adjusted OR = 1.722,95%CI:1.180~2.512) and neonatal respiratory distress syndrome (adjusted OR = 5.135,95%CI:1.701~15.498) and decreased the risk of cesarean section (adjusted OR = 0.587,95%CI:0.385~0.893) .In addition, greater than recommended rates of weight gain in 3rd trimester was associated with increased risks in premature delivery (adjusted OR=1.818,95%CI:1.307~2.527), and gestational hypertension (adjusted OR=2.098,95%CI:1.018~4.324) as well as preeclampsia(adjusted OR:2.029, 95%CI:1.331~3.093). The stratified analysis of weight gain in 3rd trimester showed that there was no significant difference in the incidence of adverse pregnancy outcomes compared to weight gain rate groups in 2nd trimester.Conclusions: While this study showed gestational weight gain rate less than or greater than in 3rd trimester were associated with some adverse maternal and neonatal outcomes, further studies of prospective and multi-center researches are required to explore alternate ranges of gestational weight gain rate in twin pregnancies.

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