Mortality and morbidity of children received veno‐arterial extracorporeal membrane oxygenation (VA‐ECMO) support after cardiac surgery remain high despite remarkable advances in medical management and devices. The purpose of this study was to describe outcomes and risk factors of applying VA‐ECMO in the surgical pediatric population. We retrospectively analyzed 85 consecutive pediatric patients (aged <18 years) who received postcardiotomy VA‐ECMO from January 2010 to December 2018. Median (IQR) age at ECMO implantation in this cohort was 12.7 (6.4, 43.2) months, median weight was 8.5 (6.0, 12.8) kg, mean ECMO duration was 143.2 ± 81.6 hours and mean hospital length of stay was 48.4 ± 32.4 days. Seventy‐five patients (88.2%) were indicated for postcardiotomy cardiogenic shock. The successful ECMO weaning rate was 70.6% and in‐hospital mortality was 52.9%. The most common diagnosis was transposition of great arteries (n = 18, 21.2%), while acute kidney injury occurred most often (n = 64, 75.3%). Multivariate logistic regression analysis showed that thrombocytopenia, hemolysis, and nosocomial infection were positively correlated with in‐hospital mortality. Multivariate Cox proportional hazard regression analysis presented that thrombocytopenia significantly increased the 180‐day mortality in patients with successful weaning. Therefore, multiple factors had adverse effects on prognosis. Patient selection and procedures from ECMO implantation to weaning need to be closely monitored and performed in a timely manner to improve outcome. 相似文献
This paper researches the static output‐feedback stabilization of single‐input single‐output (SISO) positive coupled differential‐difference equations (CDDEs) with unbounded time‐varying delays. First, a necessary and sufficient condition is provided for the positivity and asymptotical stability of CDDEs with unbounded time‐varying delays. For this type of system, based on the constructed estimates of its solution, a necessary and sufficient condition on asymptotical stability is provided. Then, based on this criterion, for CDDEs with unbounded time‐varying delays, a kind of static output‐feedback controller is designed to ensure the positivity and asymptotical stability of the corresponding closed‐loop systems. It is also worth pointing out that the controller is designed by the linear programming method without parameterization technique. This design approach can also be applied to the static state feedback stabilization problem of CDDEs with unbounded time‐varying delays. Finally, two illustrative examples are given to show the effectiveness of our results. 相似文献
To analyze the clinical and pathological features of patients with anti-neutrophilic cytoplasmic antibody (ANCA)-associated vasculitic (AASV)-kidney injury (AASVKI).
Methods
From January 2015 to December 2018, a total of 101 AASVKI patients treated in the First Hospital of Jilin University were divided into 2 groups (the pANCA-positive group and the cANCA-positive group) for comparison; 63 patients were performed renal biopsy and divided into 3 groups according to pathological results [the non-crescent nephritis group (non-C), the crescent nephritis group (C), and the sclerotic nephritis group (S)] for comparison.
Results
Compared with the Group pANCA, Group cANCA exhibited higher incidence of eye involvement (P?=?0.039) and skin mucosa destruction (P?=?0.045), higher serum creatinine (Scr) (P?<?0.001), higher 24-h urine protein quantification (P?=?0.045), but lower hemoglobin (Hb) (P?<?0.001). Compared with Group non-C, Group C had higher Scr (P?<?0.001) and urinary red blood cells (P?=?0.010), lower estimated glomerular filtration rate (eGFR) (P?=?0.003), hemoglobin (HD)-dependence (P?=?0.042), and higher mortality rate within 1 year (P?=?0.005); compared with Group S, Group C had faster onset of erythrocyte sedimentation rate (ESR) (P?=?0.031), higher urinary red blood cells (P?=?0.029), and lower incidence of HD-dependence (P?=?0.038).
Conclusions
AASVKI patients with positive cANCA have poor renal function, among whom the patients with crescent type have poorer renal function than those with non-crescent type, have higher urinary red blood cells while lower HD-dependence than those with sclerotic type.
International Urology and Nephrology - Ureteroscopy is widely applied in pregnant women with renal colic, but such patients are easy to experience uterine contraction after surgery. There are many... 相似文献
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