目的 :研究无创参数SpO_2/FiO_2(S/F)和PaO_2/FiO_2(P/F)之间的关系,探索使用无创参数辨识急性呼吸窘迫综合征(acute respiratory distress syndrome,ARDS)患者疾病严重程度的可能性。方法:访问重症医学信息数据库(Medical Information ...目的 :研究无创参数SpO_2/FiO_2(S/F)和PaO_2/FiO_2(P/F)之间的关系,探索使用无创参数辨识急性呼吸窘迫综合征(acute respiratory distress syndrome,ARDS)患者疾病严重程度的可能性。方法:访问重症医学信息数据库(Medical Information Mart for Intensive Care,MIMIC-Ⅲ),获取患者相关生理参数,将患者数据随机分为训练集和测试集。使用训练集,利用广义线性回归模型,建立lg(S/F)与lg(P/F)之间的线性关系,选择最优的回归方程作为对数线性回归模型,并将lg(S/F)与lg(P/F)之间的线性关系和S/F与P/F之间的线性关系进行对比研究。使用测试集,比较2种模型对于P/F在100(重度ARDS)、200(中度ARDS)、300(轻度ARDS)处的辨识效果。结果:在训练集(n=61 634)上推导出lg(P/F)与lg(S/F)之间的线性关系:lg(S/F)=1.277+0.437×lg(P/F)(r=0.66,P<0.000 1),并确定了P/F在100、200、300处对应的S/F阈值为131、201、271。在测试集(n=26 758)上使用S/F阈值验证了其辨识效果,且较传统线性回归模型辨识结果有了明显改善。结论:通过研究,认为在患者血气分析结果缺失的情况下,可以使用无创参数SpO_2/FiO_2代替PaO_2/FiO_2作为ARDS患者病情诊断的辅助手段。展开更多
Aims: Bathing in deep, Japanese-style bathtubs is associated with high rates of sudden death in the elderly in Japan. The predominant causes of death in such cases are cardiovascular events and drowning. Blood pressur...Aims: Bathing in deep, Japanese-style bathtubs is associated with high rates of sudden death in the elderly in Japan. The predominant causes of death in such cases are cardiovascular events and drowning. Blood pressure changes induced by water pressure and high temperature during bathing may be an important cause of these accidents. Therefore, we investigated the changes in blood pressure, heart rate, and oxygen saturation (SpO2) before and after bathing in elderly Japanese individuals. Methods: Forty-eight elderly (average age, 86.4 ± 7.5 years) persons were enrolled in this study. Results: Changes in systolic blood pressure after bathing correlated negatively with baseline blood pressure before bathing, and participants with baseline systolic blood pressures of <125 mmHg experienced a greater elevation in blood pressure while bathing. Pulse rate was significantly increased after bathing, and the change in pulse rate correlated negatively with the baseline values. SpO2 did not differ significantly during bathing, but changes in SpO2 correlated negatively with baseline values. Lean participants showed a more marked elevation of SpO2, and those with hypertension showed reduced SpO2. Conclusion: These data suggest that the disabled elderly with low blood pressure experience trends in cardiovascular response during bathing which differ from those of young persons.展开更多
目的随着无痛人工流产术(无痛人流)的普及,其麻醉的安全性也越来越为大家所重视。文中旨在观察瑞芬太尼复合丙泊酚在无痛人流麻醉中脉搏氧饱和度(oxygen saturation with pulse oximetry,SpO2)的变化,以探讨麻醉前面罩预给氧对有效预防S...目的随着无痛人工流产术(无痛人流)的普及,其麻醉的安全性也越来越为大家所重视。文中旨在观察瑞芬太尼复合丙泊酚在无痛人流麻醉中脉搏氧饱和度(oxygen saturation with pulse oximetry,SpO2)的变化,以探讨麻醉前面罩预给氧对有效预防SpO2下降的作用。方法 65例选择自愿接受无痛人流的孕妇,美国麻醉医师协会(American society of anes-thesiologists,ASA)分级为Ⅰ～Ⅱ级,随机分为3组:鼻导管吸氧组(Ⅰ组)、面罩吸氧组(Ⅱ组)、麻醉前面罩预给氧组(Ⅲ组)。3个试验组均靶控输注7.5μg/ml的丙泊酚,待达到其靶控血浆浓度后以15 s等速静注瑞芬太尼0.6μg/kg,术中监测平均动脉压(mean aortic pressure,MAP)、心率(heart rate,HR)、心电图(electrocadiogram,ECG)和SpO2,瑞芬太尼静注2 min后行动脉血气分析。结果Ⅲ组术中最低SpO2显著高于其他各组(P<0.05),呼吸抑制发生率为14%,明显低于其余各组(P<0.05);血气分析表明动脉氧分压(arterial oxygen saturation,PaO2)亦高于Ⅰ组和Ⅱ组(P<0.05)。结论麻醉前面罩预给氧可有效预防瑞芬太尼复合丙泊酚无痛人流中脉搏氧饱和度下降。展开更多
文摘目的 :研究无创参数SpO_2/FiO_2(S/F)和PaO_2/FiO_2(P/F)之间的关系,探索使用无创参数辨识急性呼吸窘迫综合征(acute respiratory distress syndrome,ARDS)患者疾病严重程度的可能性。方法:访问重症医学信息数据库(Medical Information Mart for Intensive Care,MIMIC-Ⅲ),获取患者相关生理参数,将患者数据随机分为训练集和测试集。使用训练集,利用广义线性回归模型,建立lg(S/F)与lg(P/F)之间的线性关系,选择最优的回归方程作为对数线性回归模型,并将lg(S/F)与lg(P/F)之间的线性关系和S/F与P/F之间的线性关系进行对比研究。使用测试集,比较2种模型对于P/F在100(重度ARDS)、200(中度ARDS)、300(轻度ARDS)处的辨识效果。结果:在训练集(n=61 634)上推导出lg(P/F)与lg(S/F)之间的线性关系:lg(S/F)=1.277+0.437×lg(P/F)(r=0.66,P<0.000 1),并确定了P/F在100、200、300处对应的S/F阈值为131、201、271。在测试集(n=26 758)上使用S/F阈值验证了其辨识效果,且较传统线性回归模型辨识结果有了明显改善。结论:通过研究,认为在患者血气分析结果缺失的情况下,可以使用无创参数SpO_2/FiO_2代替PaO_2/FiO_2作为ARDS患者病情诊断的辅助手段。
文摘Aims: Bathing in deep, Japanese-style bathtubs is associated with high rates of sudden death in the elderly in Japan. The predominant causes of death in such cases are cardiovascular events and drowning. Blood pressure changes induced by water pressure and high temperature during bathing may be an important cause of these accidents. Therefore, we investigated the changes in blood pressure, heart rate, and oxygen saturation (SpO2) before and after bathing in elderly Japanese individuals. Methods: Forty-eight elderly (average age, 86.4 ± 7.5 years) persons were enrolled in this study. Results: Changes in systolic blood pressure after bathing correlated negatively with baseline blood pressure before bathing, and participants with baseline systolic blood pressures of <125 mmHg experienced a greater elevation in blood pressure while bathing. Pulse rate was significantly increased after bathing, and the change in pulse rate correlated negatively with the baseline values. SpO2 did not differ significantly during bathing, but changes in SpO2 correlated negatively with baseline values. Lean participants showed a more marked elevation of SpO2, and those with hypertension showed reduced SpO2. Conclusion: These data suggest that the disabled elderly with low blood pressure experience trends in cardiovascular response during bathing which differ from those of young persons.
