目的分析儿童复发性眩晕(recurrent vertigo of children,RVC)患儿的各项相关客观检查结果,试图寻找出有意义的客观检查方法。方法选取RVC患儿50例(眩晕发作组29例,眩晕不发作组21例)和非RVC正常对照组儿童20例,所有入组人员行相关客观...目的分析儿童复发性眩晕(recurrent vertigo of children,RVC)患儿的各项相关客观检查结果,试图寻找出有意义的客观检查方法。方法选取RVC患儿50例(眩晕发作组29例,眩晕不发作组21例)和非RVC正常对照组儿童20例,所有入组人员行相关客观检查,包括位置试验、vHIT、头颅MRI、纯音测听或游戏测听、声导抗、高刺激率ABR、脑电图、脉搏氧及PSG检查,分析各项检查结果,比较RVC组及对照组之间的特征性差异。结果①RVC组脉搏氧异常率、高刺激率ABR异常率及AHI异常率均高于对照组,有统计学差异(均为P<0.05);②眩晕发作组脉搏氧异常率、高刺激率ABR异常率高于眩晕不发作组,有统计学差异(P<0.05);③RVC组和正常对照组的纯音听阈(或游戏测听)、声导抗、颅脑MRI、位置试验检查、vHIT均正常。结论连续睡眠脉搏氧、高刺激率ABR与RVC,尤其是眩晕发作期的RVC具有一定的相关性。AHI与RVC有一定相关性,但与眩晕是否处于发作期没有相关性。连续睡眠脉搏氧监测、PSG、高刺激率ABR可作为诊断RVC的辅助检查。展开更多
Determining oxygenation targets in acute respiratory distress syndrome(ARDS)remains a challenge.Althoughoxygenation targets have been used since ARDS was first described,they have not been investigated in detail.Howev...Determining oxygenation targets in acute respiratory distress syndrome(ARDS)remains a challenge.Althoughoxygenation targets have been used since ARDS was first described,they have not been investigated in detail.However,recent retrospective and prospective trials have evaluated the optimal oxygenation threshold in patientsadmitted to the general intensive care unit.In view of the lack of prospective data,clinicians continue to relyon data from the few available trials to identify the optimal oxygenation strategy.Assessment of the cost-benefitratio of the fraction of inspired oxygen(FiO_(2))to the partial pressure of oxygen in the arterial blood(PaO_(2))is an additional challenge.A high FiO_(2) has been found to be responsible for respiratory failure and deaths innumerous animal models.Low and high PaO_(2) values have also been demonstrated to be potential risk factors inexperimental and clinical situations.The findings from this literature review suggest that PaO_(2) values rangingbetween 80 mmHg and 90 mmHg are acceptable in patients with ARDS.The costs of rescue maneuvers needed toreach these targets have been discussed.Several recent papers have highlighted the risk of disagreement betweenarterial oxygen saturation(SaO_(2))and peripheral oxygen saturation(SpO_(2))values.In order to avoid discrepanciesand hidden hypoxemia,SpO_(2) readings need to be compared with those of SaO_(2).Higher SpO_(2) values may beneeded to achieve the recommended PaO_(2) and SaO_(2) values.展开更多
文摘目的分析儿童复发性眩晕(recurrent vertigo of children,RVC)患儿的各项相关客观检查结果,试图寻找出有意义的客观检查方法。方法选取RVC患儿50例(眩晕发作组29例,眩晕不发作组21例)和非RVC正常对照组儿童20例,所有入组人员行相关客观检查,包括位置试验、vHIT、头颅MRI、纯音测听或游戏测听、声导抗、高刺激率ABR、脑电图、脉搏氧及PSG检查,分析各项检查结果,比较RVC组及对照组之间的特征性差异。结果①RVC组脉搏氧异常率、高刺激率ABR异常率及AHI异常率均高于对照组,有统计学差异(均为P<0.05);②眩晕发作组脉搏氧异常率、高刺激率ABR异常率高于眩晕不发作组,有统计学差异(P<0.05);③RVC组和正常对照组的纯音听阈(或游戏测听)、声导抗、颅脑MRI、位置试验检查、vHIT均正常。结论连续睡眠脉搏氧、高刺激率ABR与RVC,尤其是眩晕发作期的RVC具有一定的相关性。AHI与RVC有一定相关性,但与眩晕是否处于发作期没有相关性。连续睡眠脉搏氧监测、PSG、高刺激率ABR可作为诊断RVC的辅助检查。
文摘Determining oxygenation targets in acute respiratory distress syndrome(ARDS)remains a challenge.Althoughoxygenation targets have been used since ARDS was first described,they have not been investigated in detail.However,recent retrospective and prospective trials have evaluated the optimal oxygenation threshold in patientsadmitted to the general intensive care unit.In view of the lack of prospective data,clinicians continue to relyon data from the few available trials to identify the optimal oxygenation strategy.Assessment of the cost-benefitratio of the fraction of inspired oxygen(FiO_(2))to the partial pressure of oxygen in the arterial blood(PaO_(2))is an additional challenge.A high FiO_(2) has been found to be responsible for respiratory failure and deaths innumerous animal models.Low and high PaO_(2) values have also been demonstrated to be potential risk factors inexperimental and clinical situations.The findings from this literature review suggest that PaO_(2) values rangingbetween 80 mmHg and 90 mmHg are acceptable in patients with ARDS.The costs of rescue maneuvers needed toreach these targets have been discussed.Several recent papers have highlighted the risk of disagreement betweenarterial oxygen saturation(SaO_(2))and peripheral oxygen saturation(SpO_(2))values.In order to avoid discrepanciesand hidden hypoxemia,SpO_(2) readings need to be compared with those of SaO_(2).Higher SpO_(2) values may beneeded to achieve the recommended PaO_(2) and SaO_(2) values.
