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101.
Stephanie M. Cruz Patricio E. Lau Craig G. Rusin Candace C. Style Darrell L. Cass Caraciolo J. Fernandes Timothy C. Lee Christopher J. Rhee Sundeep Keswani Rodrigo Ruano Stephen E. Welty Oluyinka O. Olutoye 《Journal of pediatric surgery》2018,53(1):152-158
Background/purpose
The purpose of this study was to develop a computational algorithm that would predict the need for ECMO in neonates with congenital diaphragmatic hernia (CDH).Methods
CDH patients from August 2010 to 2016 were enrolled in a study to continuously measure cerebral tissue oxygen saturation (cStO2) of left and right cerebral hemispheres. NIRS devices utilized were FORE-SIGHT, CASMED and INVOS 5100, Somanetics. Using MATLAB©, a data randomization function was used to deidentify and blindly group patient's data files as follows: 12 for the computational model development phase (6 ECMO and 6 non-ECMO) and the remaining patients for the validation phase.Results
Of the 56 CDH patients enrolled, 22 (39%) required ECMO. During development of the algorithm, a difference between right and left hemispheric cerebral oxygenation via NIRS (ΔHCO) was noted in CDH patients that required ECMO. Using ROC analysis, a ΔHCO cutoff > 10% was predictive of needing ECMO (AUC: 0.92; sensitivity: 85%; and specificity: 100%). The algorithm predicted need for ECMO within the first 12 h of life and at least 6 h prior to the clinical decision for ECMO with 88% sensitivity and 100% specificity.Conclusion
This computational algorithm of cerebral NIRS predicts the need for ECMO in neonates with CDH.Level of evidence
II 相似文献102.
A comprehensive tractography study of patients with bipolar disorder and their unaffected siblings 下载免费PDF全文
103.
S. Matcan P. Sanabria Carretero M. Gómez Rojo L. Castro Parga F. Reinoso-Barbero 《Revista espa?ola de anestesiología y reanimación》2018,65(3):165-169
Cerebral oximetry based on near infrared spectroscopy (NIRS) technology is used to determine cerebral tissue oxygenation. We hereby present the clinical case of a 12-month old child with right hemiparesis secondary to prior left middle cerebral artery stroke 8 months ago. The child underwent surgical enlargement of the right ventricular outflow tract (RVOT) with cardiopulmonary bypass. During cardiopulmonary bypass, asymmetric NIRS results were detected between both hemispheres. The utilization of multimodal neuromonitoring (NIRS-BIS) allowed acting on both perfusion pressure and anesthetic depth to balance out the supply and demand of cerebral oxygen consumption. No new neurological sequelae were observed postoperatively. We consider bilateral NIRS monitoring necessary in order to detect asymmetries between cerebral hemispheres. Although asymmetries were not present at baseline, they can arise intraoperatively and its monitoring thus allows the detection and treatment of cerebral ischemia-hypoxia in the healthy hemisphere, which if undetected and untreated would lead to additional neurological damage. 相似文献
104.
The sudden and unexpected impact of stroke may have a stressful affect on close relatives. To illuminate the essential meaning in the lived experience of a middle-aged close relative of a person who has suffered a stroke, narrative interviews were conducted with 10 close relatives of people who had suffered their first stroke where both parties were aged over 18 and under 65. A phenomenological-hermeneutic interpretation of the narratives was then conducted. Three intimately intertwined themes emerged during the analysis: 'being called to mission', 'feeling lost and set adrift' and 'struggling to keep going'. The middle-aged close relatives felt unreflectively duty bound. There was a struggle with suffering and enduring the process of coping with life and overcoming a feeling of helplessness. Life turned out to be a struggle with overwhelming feelings. They felt alienated in a restricted life situation, disconnected from themselves and others, and from a world that supports feelings of being lost and set adrift (i.e. feeling homeless). Strength was found in moments when the situation improved, in being related to oneself and others, and when feelings of normality were regained. 相似文献
105.
徐烨 《临床心身疾病杂志》2016,(6):103-104
目的:探讨精神分裂症患者亲属心理健康状况,提高其心理健康水平,从而改善精神分裂症患者愈后。方法应用症状自评量表对100例精神分裂症患者亲属共187人进行测评,并与中国常模进行比较。结果症状自评量表总均分为158.41±49.56;阳性项目数为42.81±22.45。总均分,阳性项目及9个因子评分差异均有显著性( P<0.01)。结论精神分裂症患者亲属存在不同程度的心理健康问题,应及时给予健康宣教及心理干预。 相似文献
106.
107.
目的:分析护理本科生与母系2级亲属体质类型的相关性,为疾病预防保健和健康指导提供依据。方法采用中华中医药学会2009年4月发布实施的标准化中医体质量表,对800名护理本科生及其母系2级亲属进行问卷调查。结果护理本科生中平和质145例,占29.1%,母系2级亲属中外祖母平和质118人,占27.1%,外祖父平和质99人,占27.9%,偏颇体质中位居前三位的是:阳虚质、气虚质、淤血质。相关性分析显示:除了护理本科生平和质与外祖父没有相关性外,其余都与母系2级亲属呈正相关。结论母系2级亲属与护理本科生的体质类型有一定的相关性,结合母系2级亲属体质类型及后天因素调理体质,对防止护生体质状态的偏颇可能有一定的帮助。 相似文献
108.
目的 探讨 2型糖尿病家系一级亲属非糖尿病同胞脂代谢紊乱和胰岛素抵抗的情况。方法 检测了 5 2例 2型糖尿病家系一级亲属非糖尿病同胞 (FDR)和 19例正常对照组的体重指数、腰围、臀围、腰臀比、血压、血糖、血脂和胰岛素水平。采用稳态模式 (HOMA IR)评价胰岛素抵抗。结果 FDR组的腰围 (W )、臀围 (H)、体重指数(BMI)、空腹胰岛素 (FINS)和HOMA IR明显高于对照组 (P <0 .0 1)。多元逐步回归分析显示 ,空腹血糖 (FBG)、BMI和家族史是影响 2型糖尿病家系一级亲属非糖尿病同胞胰岛素抵抗主要的危险因素。结论 2型糖尿病家系一级亲属非糖尿病同胞在未发生糖尿病时已存在高胰岛素血症和胰岛素抵抗 ,并且可能与遗传有关 相似文献
109.
2型糖尿病患者一级亲属胰岛素抵抗与体重关系的研究 总被引:1,自引:0,他引:1
目的探讨2型糖尿病一级亲属胰岛素抵抗与体重的关系。方法2007年10月至2008年10月就诊于中国医科大学附属盛京医院的沈阳地区2型糖尿病患者,经知情同意后,选择其一级亲属(父母、同胞、子女)25例,根据75gOGTT试验分为正常糖耐量(FNGT)组、糖耐量减低(FIGT)组,另外选取性别、年龄与之相匹配,无糖尿病家族史的正常糖耐量12名为对照(NC)组,以正糖高胰岛素钳夹试验求得葡萄糖输注速率(GIR),比较3组间胰岛素敏感性的差异。结果FIGT组、FNGT组、NC组BMI依次为27.28±0.68、25.99±0.98和24.12±0.71,FIGT组明显高于NC组(P0.01),与FNGT组相比差异无统计学意义(P=0.11);FIGT组和FNGT组葡萄糖输注率分别为5.20±0.38和6.38±0.79,均明显低于NC组(9.83±0.86)(P0.01);葡萄糖输注率与BMI的相关系数为0.477(P0.01);多元逐步回归分析显示,BMI、糖尿病家族史均为影响胰岛素抵抗的显著因素(校正r2分别为0.39和0.21,P0.01)。结论2型糖尿病一级亲属不论血糖是否正常均存在胰岛素抵抗,此抵抗和家族史显著相关,独立于肥胖之外。 相似文献
110.