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91.
Abstract: Cardiopulmonary support (CPS) requires durability of the oxygenator. The life span of the oxygenator is affected by various clinical factors, including patient condition, perfusion condition, and equipment usage. Predictors for the durability of oxygenators were evaluated clinically in this study. Thirty-two patients, who had undergone CPS during the last 3 years in our institute were assigned to this study. Fifty oxygenators had been used (Capiox SX in 19, CB Maxima in 23, and AL-6000 in 8). Significant predictors for the durability of oxygenators were evaluated by nonparametric survival analysis and proportional hazards regression analysis. Univariate regression analysis revealed 6 significant predictors for the life span of oxygenators. These were the oxygenator type, type of centrifugal pump, acidosis with blood pH less than 7.35, base excess less than -5, blood glutamic-oxaloacetic transaminase (GOT) levels greater than 1,000 IU, and blood lactate dehydrogenase (LDH) levels greater than 3,000 IU. After multivariate analysis, there remained only 2 significant predictors. An oxygenator used with a noncoated CPS system (Capiox SX with Capiox EBS) proved to have a significantly shorter life span than one used with a heparin-coated system (CB Maxima or AL-6000 with CB BP-80) (hazards ratio, 3.588, p = 0.0065). Patient conditions, which revealed acidosis with less than -5 of base excess, significantly shortened the life of the oxygenator (hazards ratio, 3.595, p = 0.0188).  相似文献   
92.
Abstract: Different mechanical circulatory support systems (MCSS) have been in clinical use since 1987 to keep patients alive by assisting the heart during cardiac recovery after open heart surgery, myocardial infarction, acute graft failure after heart transplantation, or as a bridge to transplantation in heart transplant candidates. Four different hospitals in Germany used the Berlin Heart Assist Device. Up until 1993, there were 22 patients in the "recovery" group; 4 patients were weaned from the system, and only 1 patient was discharged from the hospital. In 112 patients the Berlin Heart Assist Device was implanted for the purpose of a bridge to transplantation, 68 were transplanted and 46 patients left the hospital. It was concluded that patients may be kept alive with this system for weeks and months after any kind of cardiogenic shock. Complete cardiac recovery may be achieved in patients with early posttransplant graft failure. Reliable prediction of outcome in bridge–to–transplantation patients requires further experience and improvement of system components.  相似文献   
93.
    
A knowledge-based alarm system for intensive care monitoring was designed, built, tested on-line, and evaluated. The system is a functional prototype of a highly specific patient monitor providing alarms on hypovolemia, hyperdynamic state, left ventricular failure and hypoventilation. These intelligent alarm functions aim to maintain the quality of patient monitoring even if nurses' attention is temporarily reduced or focused elsewhere. The alarm system has an electronic access to data available in a multichannel patient monitor and the patient data management system of the intensive care unit. Median filtering, trend estimation, and rule-based reasoning are applied when processing the measured variables and estimating the patient's state.  相似文献   
94.
把分段线性函数和斜波脉冲函数进行统一处理,定义成新的函数,使得新的函数既保持了原先两种函数的基本特性,又获得微分和积分递推算法。应用中具有方便,快速计算的优点。  相似文献   
95.
目的:比较三种方案治疗小儿细菌性肺炎的效率(即费用-效果)。方法:2001年-2002年采用前瞻性随性临床试验A组50例,B组50例,C组50例作为分析模型,以深圳市二级甲等医院收费为标准,采用决策树的分析方法,进行费用一效果分析。结果:每治疗1例有效病人,A、B、C三组方案的期望成本分别为4707.45元,3052.51元,结论:同时考虑临床疗效及医疗费用,C组有最好的费用-效果,值得临床推广应用。  相似文献   
96.
We have sought to define a way in which nitrous oxide can be safely and universally used at minimal to low flows by utilising a circle system with a controlled leak provided by a standard gas analyser sampling line and a fresh gas supply of 50% nitrous oxide in oxygen, entering from a trunk interposed between the ventilator and the circle system. Although preliminary calculations suggested that this arrangement was likely to work, it was found that 13 of 23 patients studied prospectively developed an inspired oxygen fraction below 0.3. We conclude that, although this arrangement provides a new means of introducing nitrous oxide into the circle breathing system, it does not appear inherently safer or more convenient than the conventional route.  相似文献   
97.
Stroke rehabilitation is an area of practice that many occupational therapists encounter during their career. The literature promotes a wide range of management techniques and support devices for people who have a stroke-affected upper limb, but little is known about the validity of those that occupational therapists actually use in practice. A questionnaire was sent to occupational therapists working in Queensland and northern New South Wales facilities (n = 35), in which adults with a stroke were likely to be treated. Eighteen respondents answered questions about the management techniques and support devices used in their facility, and their perception of the benefit of these devices in the reduction of hemiplegic shoulder pain. Results are discussed with reference to evidence-based practice and indicate an urgent need for the collation and dissemination of the best current evidence available for the management techniques and support devices used in this area, as well as further research to extend this evidence.  相似文献   
98.
99.
目的 探讨慢性阻塞性肺疾病(慢阻肺)患者的家庭支持与自我概念的关系。方法 用方便抽样法选取108位慢阻肺患者,应用修订的个人资源问卷、自我概念量表和一般资料问卷分别测定其家庭支持、自我概念水平和一般资料。结果 该组患者家庭支持程度为中到高度,自我概念中度积极;家庭支持与总的自我概念呈中度正相关,与自我概念中的体感、自我一致性、理想自我及道德一伦理一精神自我有显著相关.与体象无关。结论 慢阻肺患者的家庭支持水平越高,其自我概念越积极。  相似文献   
100.
提出了文题所述的控制策略,依据输出分布曲线的特征变量选取方法和依据该项信息的规则控制系统。仿真研究得到了满意的结果。在一个实验性二元精馏塔上用IBM-PC进行试验亦获成功。本法对具有非线性特性的分布参数对象,较常规控制策略有明显的优越性。  相似文献   
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