Rhabdomyolysis-induced acute kidney injury (RIAKI) is a serious clinical disease in intensive care unit, characterized by high mortality and low cure rate. Continuous renal replacement therapy (CRRT) is a common form of treatment for RIAKI. There are currently no guidelines to guide the application of CRRT in RIAKI. To solve this problem, this article reviews the advantages and limitations of CRRT in the treatment of RIAKI, as well as new viewpoints and research progress in the selection of treatment timing, treatment mode, treatment dose and filtration membrane, with the aim of providing theoretical guidance for the treatment of CRRT in RIAKI patients.
Objective To observe the toxic and side effects during the continuous hyperthermic peritoneal perfusion chemotherapy (CHPPC).Methods Abdominal paracentesis and catheterization were performed under ultrasound guidance, then CHPPC was carried out, which was in temperature of 42-44 ℃ for 1 h. The changes of body temperature, heart rate, blood pressure, saturation of blood oxygen and respiratory frequency were recorded in 109 patients during and after perfusion, meanwhile symptoms and physical signs of abdominal region and system status such as abdominal tenderness, rebound tenderness were observed. Results There were no significant differences of body temperature, heart rate, blood pressure, saturation of blood oxygen or respiratory frequency between before and after perfusion (Pgt;0.05). There were 25 patients with abdominal pain, but in which only 3 patients with symptoms of acute abdomen, 26 patients with gastrointestinal symptoms, 20 patients with myelosuppression, and others (22 cases) with aches of puncture position which were released by symptomatic treatment. Conclusion There are less toxic and side effect and better tolerance in patients with CHPPC application 1 month after operation.
ObjectiveTo investigate the safety and effectiveness of low-dose tranexamic acid (TXA) in operation of multi-level continuous thoracic ossification of ligament flavum (TOLF).MethodsA clinical data of 26 patients who underwent operation for multi-level continuous TOLF and met the selection criteria between July 2015 and January 2019 was retrospectively analyzed. Among them, 13 cases (group A) were received intravenous infusion of TXA (10 mg/kg) at 15 minutes before operation, and maintained the infusion at 1 mg/(kg·h) until the end of the operation; 13 cases (group B) were received the same dose of normal saline before and during operation. There was no significant difference in gender, age, body mass index, diseased segment, and preoperative hemoglobin, platelet count, activated partial thromboplastin time, prothrombin time, international normalized ratio (INR) between the two groups (P>0.05). The hemoglobin, platelet count, activated partial thromboplastin time, prothrombin time, INR, the number of deep vein thrombosis of the lower extremities, operation time, intraoperative blood loss, postoperative drainage volume, total blood loss, and the time of drainage tube extubation in the two groups were recorded and compared.ResultsAll operations in the two groups were successfully completed. Compared with group B, the operation time and time of drainage tube extubation in group A were shortened, and the intraoperative blood loss, postoperative drainage volume, and total blood loss were reduced. The differences between the two groups were significant (P<0.05). None of the two groups received blood transfusion, and the hemoglobin level of group A at 24 hours after operation was significantly higher than that of group B (t=5.062, P=0.000). The incisions in both groups healed and sutures were removed within 2 weeks after operation, and no complications occurred. There was no significant difference between the two groups in activated partial thromboplastin time, prothrombin time, INR, and platelet count at 24 hours after operation (P>0.05).ConclusionIn multi-level continuous TOLF operation, intravenous administration of low-dose TXA can effectively reduce blood loss, shorten postoperative drainage time, and does not increase the risk of complications.
ObjectiveTo evaluate the clinical effects of continuous quality improvement (CQI) in the care of peripherally inserted central catheter (PICC).
MethodsWe retrospectively analyzed the clinical data of 40 patients who received PICC treatment in our hospital between January and December 2011, and then we found out the main problems of PICC catheter care, analyzed the related factors for complications of PICC, and formulated corresponding nursing countermeasures. PICC receivers between January and December 2012 were regarded as controls. Then, we compared the complication incidence and satisfaction of patients between the two groups before and after the implementation of CQI.
ResultsAfter the implementation of CQI, complication incidence was significantly lower (P<0.05). The satisfaction degree of patients toward caring rose to 87.8%, which was statistically significant (P<0.05).
ConclusionThe implementation of CQI is beneficial to reduce complications of PICC treatment, and patients'satisfaction rate is also significantly increased.
ObjectiveTo explore the practical effects of multi-disciplinary team (MDT) management model in the management of multidrug-resistant organisms (MDROs).MethodsIn 2015, the multi-drug resistant MDT was established, and MDT meetings were held regularly to focus on the problems in the management of MDROs and related measures to prevent and control nosocomial infections of MDROs.ResultsThe detection rate of MDROs from 2014 to 2017 was 9.20% (304/3 303), 7.11% (334/4 699), 8.01% (406/5 072), and 7.81% (354/4 533), respectively. The difference was statistically significant (χ2=11.803, P=0.008), in which the detection rates of carbapenem-resistant Acinetobacter baumannii (CRABA), carbapenem-resistant Pseudomonas aeruginosa, and carbapenem-resistant Enterobacteriaceae (CRE) changed significantly (χ2=39.022, 17.052, 12.211; P<0.05). From 2014 to 2017, the proportion of multi-drug resistant infections decreased year by year, from 84.54% to 52.82%, and the proportion of multi-drug resistant hospital infections also declined, from 46.05% to 23.16%; the nosocomial infection case-time rate decreased from 0.24% to 0.13% year-on-year; the proportion of multi-drug resistant hospital infections in total hospital infections was 9.07%, 11.17%, 10.47%, and 6.16%, respectively; in the distribution of multi-drug resistant nosocomial infection bacteria, the proportion of methicillin-resistant Staphylococcus aureus, CRABA, CRE hospital infections accounted for the number of MDROs detected decreased year by year. The use rate of antibiotics decreased from 46.58% in 2014 to 42.93% in 2017, and the rate of pathogens increased from 64.83% in 2014 to 84.59% in 2017.ConclusionThe MDT management mode is effective for the management and control of MDROs, which can reduce the detection rate, infection rate, hospital infection rate, and antibacterial drug use rate, increase the pathogen detection rate, and make the prevention and control of MDROs more scientific and standardized.
ObjectiveTo explore the effect of family-school-hospital application in continuous nursing care for children with epilepsy. Methods120 children with epilepsy admitted to Children's Hospital Affiliated to Jiangnan University from January 2021 to October 2022 were randomly divided into two groups, each with 60 cases. The control group received routine care, while the experimental group received family-school-hospital continuous care. Compare the awareness of epilepsy knowledge, disease control effectiveness, medication compliance, negative emotions, physical and mental status, and quality of life before and after nursing between the families of two groups of children with epilepsy. ResultsAfter 2 months of nursing care, the scores of family members' knowledge of epilepsy in the experimental group were higher than the control group (P<0.05). The effect of disease control in the experimental group was better the control group (P<0.05). The drug compliance of the experimental group was higher than the control group (P<0.05). The quality of life score in the intervention group was higher than the control group (P<0.05). ConclusionThe application of family-school-hospital in the continuous care of children with epilepsy can improve their family members' awareness of epilepsy knowledge, effectively control the disease, improve medication compliance, improve negative emotions and physical and mental conditions, and thus improve the quality of life of children.
Objective To evaluate the subjective outcomes of sleepiness behavior and mood status applying continuous positive airway pressure（CPAP） in adults of elderly and middle-aged with obstructive sleep apnea syndrome（OSAS）. Methods Nine randomized controlled trails comparing nocturnal CPAP with inactive control appliances in adults with OSAS with the use of computerized search in related medical databases（MEDLINE，EMBASE，CBMdisk，etc） were included.The quality of literature was reviewed，and all data were extracted by two reviewers independently.Meta analysis was conducted used RevMan 4.2 software.Results 9 RCT involving 665 patients of elderly and middle-aged met the inclusion criteria.Meta analysis indicated that the score of Epworth sleepiness scale（ESS） and general health questionnaire-28（GHQ-28） declined significantly after CPAP treatment on effectiveness with WMD（random） －2.94，95 %CI －4.68 to －1.20，or WMD（fixed） －2.26，95 %CI －3.79 to －0.72，Plt;0.01.Nevertheless，hospital anxiety and depression scale（HADS） was not significantly different between CPAP and control with WMD（random） －0.89，95%CI －1.98 to 0.20，Pgt;0.05.Conclusion Current clinical evidence suggested that CPAP was effective in improving day-time subjective outcomes of sleepiness behavior and general mental health status in OSAS patients of elderly and middle-aged，although evidence of improving emotion disorder of anxiety and depression was not confirmed.
ObjectiveTo compare the clinical effects of continuous hyperthermic peritoneal perfusion chemotherapy (CHPPC) and intravenous chemotherapy for advanced gastric cancer patients, and find better nursing methods.
MethodsSixty advanced gastric cancer patients who underwent chemotherapy between June 2013 and June 2014 were divided into CHPPC group (group C, n=30) and intravenous chemotherapy group (group V, n=30). We recorded the nursing methods for both the two groups, patients' satisfaction to the nursing and treatment, peritoneal metastasis rate and quality of life during the chemotherapy.
ResultsThe life quality in group V was lower than that in group C (P<0.05). The differences in patients' satisfaction rate, peritoneal metastasis rate, and one-year survival rate were not significantly different between the two groups (P>0.05).
ConclusionFor patients with advanced gastric cancer requiring chemotherapy, in spite of higher cost and more complicated operations, CHPPC is superior in lower adverse events rate, better quality of life during chemotherapy and doesn't decrease patients' satisfaction to the nursing and treatment.
Continuous renal replacement therapy (CRRT) is one of the important therapeutic techniques for critically ill patients. In recent years, the field of artificial intelligence has developed rapidly and has been widely applied in manufacturing, automotive, and even daily life. The development and application of artificial intelligence in the medical field are also advancing rapidly, and artificial intelligence radiographic imaging result judgment, pathological result judgment, patient prognosis prediction are gradually being used in clinical practice. The development of artificial intelligence in the field of CRRT has also made rapid progress. Therefore, this article will elaborate on the current application status of artificial intelligence in CRRT, as well as its future prospects in CRRT, so as to provide a reference for understanding the application of artificial intelligence in CRRT.
Objective To explore the global research status and trends of continuous renal replacement therapy (CRRT) based on knowledge visualization analysis. Methods Based on the Web of Science Core Collection, studies reporting CRRT research that were published between June 2014 and June 2023 were retrieved and collected after manual review. VOSviewer and CiteSpace softwares were used for bibliometric visualization analysis, including publication trends, geographical distribution characteristics, journal distribution characteristics, author contributions, citations, funding source characteristics, and keyword clustering. Results A total of 2708 papers were analyzed, with an increasing trend in the number of articles and citation frequency from 2015 to 2021. The United States was the most prolific country and France was the most influential country. The University of Pittsburgh in the United States had the highest number of publications among research institutions and showed higher motivation for inter-institutional collaboration. The University of Queensland in the Australia had the highest average citation frequency. Professor Rinaldo Bellomo of Australia was the most productive author and Professor Jeffrey Lipman was the most influential. Jason A. Roberts, Jeffrey Lipman and Claudio Ronco were the three authors who had the highest number of collaborations with other authors. Keyword cluster analysis showed that the prognosis of CRRT for renal disease was the focus of research, with hotspots of research being antibiotics, citrate accumulation, plasma replacement, lactate clearance, acute respiratory distress syndrome, and coronavirus disease 2019. Coupling analysis of the literature showed that exploring the indications for CRRT and optimizing treatment prescription were at the forefront of research. Conclusions The present study of CRRT has generally shown an upward trend in the last decade. The management and efficacy of CRRT remains a hot topic of research. Exploring the indications for CRRT and optimizing treatment prescriptions may be a popular research direction and trend in the future.
