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Impact of disease severity on gastric residual volume in critical patients 被引量:8
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作者 Chien-Wei Hsu shu-fen sun +4 位作者 David Lin Lee Shoa-Lin Lin Kam-Fai Wong Hsiu-Hua Huang Hung-Ju Li 《World Journal of Gastroenterology》 SCIE CAS CSCD 2011年第15期2007-2012,共6页
AIM: To investigate whether illness severity has an impact on gastric residual volume (GRV) in medical critically ill patients. METHODS: Medical intensive care unit (ICU) patients requiring nasogastric feeding were en... AIM: To investigate whether illness severity has an impact on gastric residual volume (GRV) in medical critically ill patients. METHODS: Medical intensive care unit (ICU) patients requiring nasogastric feeding were enrolled. Sequential Organ Failure Assessment (SOFA) score was assessed immediately preceding the start of the study. Acute Physiology and Chronic Health Evaluation (APACHE) Ⅱ scores were recorded on the first, fourth, seventh, and fourteenth day of the study period. GRV was measured every 4 h during enteral feeding. The relationship be-tween mean daily GRV and SOFA scores and the correlation between mean daily GRV and mean APACHE Ⅱ score of all patients were evaluated and compared. RESULTS: Of the 61 patients, 43 patients were survivors and 18 patients were non-survivors. The mean daily GRV increased as SOFA scores increased (P < 0.001, analysis of variance). Mean APACHE Ⅱ scores of all patients correlated with mean daily GRV (P = 0.011, Pearson correlation) during the study period. Patients with decreasing GRV in the first 2 d had better survival than patients without decreasing GRV (P = 0.017, log rank test). CONCLUSION: GRV is higher in more severely ill medical ICU patients. Patients with decreasing GRV had lower ICU mortality than patients without decreasing GRV. 展开更多
关键词 Critical care OUTCOME Residual volume Severity of illness index Tube feeding
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Iatrogenic pneumothorax related to mechanical ventilation 被引量:10
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作者 Chien-Wei Hsu shu-fen sun 《World Journal of Critical Care Medicine》 2014年第1期8-14,共7页
Pneumothorax is a potentially lethal complication associated with mechanical ventilation. Most of the patients with pneumothorax from mechanical ventilation have underlying lung diseases; pneumothorax is rare in intub... Pneumothorax is a potentially lethal complication associated with mechanical ventilation. Most of the patients with pneumothorax from mechanical ventilation have underlying lung diseases; pneumothorax is rare in intubated patients with normal lungs. Tension pneumothorax is more common in ventilated patients with prompt recognition and treatment of pneumothorax being important to minimize morbidity and mortality. Underlying lung diseases are associated with ventilatorrelated pneumothorax with pneumothoraces occurring most commonly during the early phase of mechanical ventilation. The diagnosis of pneumothorax in critical illness is established from the patients' history, physical examination and radiological investigation, although the appearances of a pneumothorax on a supine radiograph may be different from the classic appearance on an erect radiograph. For this reason, ultrasonography is beneficial for excluding the diagnosis of pneumothorax. Respiration-dependent movement of the visceral pleura and lung surface with respect to the parietal pleura and chest wall can be easily visualized with transthoracic sonography given that the presence of air in the pleural space prevents sonographic visualization of visceral pleura movements. Mechanically ventilated patients with a pneumothorax require tube thoracostomy placement because of the high risk of tension pneumothorax. Small-bore catheters are now preferred in the majority of ventilated patients. Furthermore, if there are clinical signs of a tension pneumothorax, emergency needle decompression followed by tube thoracostomy is widely advocated. Patients with pneumothorax related to mechanical ventilation who have tension pneumothorax, a higher acute physiology and chronic health evaluation Ⅱ score or Pa O2/Fi O2 < 200 mm Hg were found to have higher mortality. 展开更多
关键词 BAROTRAUMA COMPLICATION CRITICAL CARE Mechanical ventilation PNEUMOTHORAX
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Successful management of a tooth with endodontic-periodontal lesion:A case report
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作者 Hamed Alshawwa Jia-Feng Wang +1 位作者 Min Liu shu-fen sun 《World Journal of Clinical Cases》 SCIE 2020年第20期5049-5056,共8页
BACKGROUND Endodontic-periodontal lesion is a commonly encountered dental condition.However,the prognosis of the condition varies from good to poor.Some cases are associated with a poor prognosis that requires tooth e... BACKGROUND Endodontic-periodontal lesion is a commonly encountered dental condition.However,the prognosis of the condition varies from good to poor.Some cases are associated with a poor prognosis that requires tooth extraction.This report presents a case of an endodontic-periodontal lesion in a tooth that was successfully treated by root canal treatment.CASE SUMMARY A 51-year-old female patient with no medical history complained about persistent pain and discomfort in her left mandibular first molar.Clinical examination showed the left mandibular first molar with poor restoration.It was also associated with underlying necrotic pulp and periodontal involvement.Radiographic examination revealed visible bone defects in the apical and periodontal areas.Based on the findings,the patient was diagnosed with a primary endodontic lesion.A root canal treatment for the endodontic lesion was performed.The patient received a coronal all-ceramic endocrown restoration.A follow-up was arranged to check the prognosis.At the 3 mo follow-up,the clinical and radiography evaluations showed complete disappearance of signs and symptoms and an increase in the radiopacity of the root area.CONCLUSION Despite the poor prognosis associated with many endodontic lesions,this case report highlights that a good prognosis is still possible for an endodontic lesion with apical and periodontal bone loss.In this case,it was achieved via successful root canal treatment without the need for periodontal or surgical intervention. 展开更多
关键词 Apical bone defect Endo-perio lesion Primary endodontic lesion Root canal treatment Nonsurgical root canal treatment Conservative Case report
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Glycemic variability in critically ill patients:risk factors and association with mortality 被引量:1
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作者 Chien-Wei Hsu shu-fen sun Huey-Shyan Lin 《Chinese Medical Journal》 SCIE CAS CSCD 2020年第10期1255-1256,共2页
To the Editor:Glycemic variability(GV)has a significant influence on the outcome in critically ill patients.1'4|Diabetic status of the patient affects the relationship between GV and mortality;increased GV is a mo... To the Editor:Glycemic variability(GV)has a significant influence on the outcome in critically ill patients.1'4|Diabetic status of the patient affects the relationship between GV and mortality;increased GV is a more potent risk factor for mortality among patients without diabetes mellitus(DM)than among patients with DM.[5]This retrospective study of 1234 intensive care unit(ICU)patients was conducted to determine the significant factors that contribute to high GV and to assess the association between GV and outcome in critically ill patients. 展开更多
关键词 PATIENTS MORTALITY critically
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