BACKGROUND In brain death donors(BDDs),donor management is the key in the complex donation process.Donor management goals,which are standards of care or clinical parameters,have been considered an acceptable barometer...BACKGROUND In brain death donors(BDDs),donor management is the key in the complex donation process.Donor management goals,which are standards of care or clinical parameters,have been considered an acceptable barometer of successful donor management.AIM To test the hypothesis that aetiology of brain death could influence haemodynamic management in BDDs.METHODS Haemodynamic data(blood pressure,heart rate,central venous pressure,lactate,urine output,and vasoactive drugs)of BDDs were recorded on intensive care unit(ICU)admission and during the 6-h observation period(Time 1 at the beginning;Time 2 at the end).RESULTS The study population was divided into three groups according to the aetiology of brain death:Stroke(n=71),traumatic brain injury(n=48),and postanoxic encephalopathy(n=19).On ICU admission,BDDs with postanoxic encephalopathy showed the lowest values of systolic and diastolic blood pressure associated with higher values of heart rate and lactate and a higher need of norepinephrine and other vasoactive drugs.At the beginning of the 6-h period(Time 1),BDDs with postanoxic encephalopathy showed higher values of heart rate,lactate,and central venous pressure together with a higher need of other vasoactive drugs.CONCLUSION According to our data,haemodynamic management of BDDs is affected by the aetiology of brain death.BDDs with postanoxic encephalopathy have higher requirements for norepinephrine and other vasoactive drugs.展开更多
AIM:To investigate effects of heart automatic nerve variations and hypothermia(HT) therapy on heart rate variation(HRV).METHODS:We studied the dynamic electrocardiagraph(ECG) of 41 cases of severe brain injury.The pat...AIM:To investigate effects of heart automatic nerve variations and hypothermia(HT) therapy on heart rate variation(HRV).METHODS:We studied the dynamic electrocardiagraph(ECG) of 41 cases of severe brain injury.The patients were devided into HT therapy group(n=21,body temprature 32-33℃),non-HT therapy group(n=20) and normal control(n=20).RESULTS:In group 1,the reduction of time domain indexes and frequency domain indexes were 3-6 folds and 30-50folds respectively compared with those of the control group,while the corresponding indexes reduction were 2-3 folds and 4-5folds in the group 2(P<0.05,P<0.01,respectively).The difference between groups were significant(P<0.05-0.01);the HRV reduction was more significant in the cerebrovascular accident patients than that of brain injured(P<0.05-0.01);the HRV indexes increased significantly in resuscitated patients than those in coma(P<0.01);the HRV in dead was much lower than that in survival(P=0.01).CONCLUSION:Injury of central nervous system can induce abnormal function of automatic nerve of heart and reduction of HRV.HT therapy can reduce HRV on a higher level;HRV examination can be applied into the prediction of prognosis of the brain injured.展开更多
The authors reported a case of trauma with uterus rupture at 35 weeks gestation with fetal death in uterus with a trauma of the right</span></span><span><span><span style="font-family:&...The authors reported a case of trauma with uterus rupture at 35 weeks gestation with fetal death in uterus with a trauma of the right</span></span><span><span><span style="font-family:""> </span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">limb injuries during a serious road accident. </span><b><span style="font-family:Verdana;">Aim:</span></b><span style="font-family:Verdana;"> the aim is to show the increasing of road accident with the motorized tricycle and their many risks for pregnant woman. </span><b><span style="font-family:Verdana;">Case Presentation:</span></b><span style="font-family:Verdana;"> our patient was thrown from the back cargo of a motorized tricycle (three-wheeled vehicle) after a collision with a truck in a rural area from 150 km to Bobo-Dioulasso. She sustained a closed abdominal injury and a severe right lower limb open injury. At admission in our depart</span><span style="font-family:Verdana;">ment in the Teaching Hospital, she was conscious, shocked with hemodyn</span><span style="font-family:Verdana;">amic instability, including low blood pressure (75/52 mmHg), rapid heart rate (140 pulses per minute), rapid breath rate (40 per minute), and cold extremities. Abdominal examination was painful with uterine hypertonia, 28 cm height uterus, and no fetal heart heartbeat. A laparotomy in</span></span></span></span><span><span><span style="font-family:""> </span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">urgency revealed a rupture of the uterus fundus with a dead fetus. A conservative surgical treatment was performed. An open trauma to the right limb was managed by the orthopedists with a good outcome. </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> Accident trauma during pregnancy is becoming more and more frequent with the increase in means of transport in urban and inter urban areas. The transport ways of the pregnant woman must take into account her safety and that of the fetus.展开更多
Objective: To investigate the epidemiological characteristics and relative factor about hospital death in patients with road traffic trauma. Methods: The age, sex, road-use category, sites of injury, injury severity s...Objective: To investigate the epidemiological characteristics and relative factor about hospital death in patients with road traffic trauma. Methods: The age, sex, road-use category, sites of injury, injury severity scale of 159 hospital death cases in 2436 cases with road traffic trauma were observed, and the relation between the causes of death and time elapsed after injury was also studied with likelihood ratio Chi-square test.展开更多
目的分析2013—2017年重庆市居民伤害死亡特征及变化趋势,为制定伤害干预策略提供依据。方法利用重庆市2013—2017年常住居民死因监测资料,提取伤害死亡病例,计算死亡率和顺位,以2010年全国第6次人口普查标准人口构成计算标化死亡率,使...目的分析2013—2017年重庆市居民伤害死亡特征及变化趋势,为制定伤害干预策略提供依据。方法利用重庆市2013—2017年常住居民死因监测资料,提取伤害死亡病例,计算死亡率和顺位,以2010年全国第6次人口普查标准人口构成计算标化死亡率,使用Joinpoint Regression Program 4.2软件进行趋势分析。结果2013—2017年,重庆市居民年均伤害死亡率53.28/10万,标化死亡率为49.74/10万。总体、男性、65岁以下人群伤害死亡率以及道路交通伤、其他意外伤害和加害死亡率均呈下降趋势(P<0.05),65岁及以上老人伤害死亡率和跌倒死亡率均呈上升趋势(P<0.05)。道路交通伤、跌倒、其他意外伤害、故意自害及淹死为重庆市居民前5位伤害死因,淹死、道路交通伤、跌倒分别为0~14岁儿童、15~64岁劳动力人口、65岁及以上老人的首位伤害死因。结论尽管近5年总体伤害死亡率呈下降趋势,但65岁及以上老年人群伤害死亡率、跌倒死亡率却呈上升趋势,且不同年龄人群,首位伤害死因不同,因此,宜对不同年龄人群、不同类型伤害开展有针对性的伤害干预工作。展开更多
文摘BACKGROUND In brain death donors(BDDs),donor management is the key in the complex donation process.Donor management goals,which are standards of care or clinical parameters,have been considered an acceptable barometer of successful donor management.AIM To test the hypothesis that aetiology of brain death could influence haemodynamic management in BDDs.METHODS Haemodynamic data(blood pressure,heart rate,central venous pressure,lactate,urine output,and vasoactive drugs)of BDDs were recorded on intensive care unit(ICU)admission and during the 6-h observation period(Time 1 at the beginning;Time 2 at the end).RESULTS The study population was divided into three groups according to the aetiology of brain death:Stroke(n=71),traumatic brain injury(n=48),and postanoxic encephalopathy(n=19).On ICU admission,BDDs with postanoxic encephalopathy showed the lowest values of systolic and diastolic blood pressure associated with higher values of heart rate and lactate and a higher need of norepinephrine and other vasoactive drugs.At the beginning of the 6-h period(Time 1),BDDs with postanoxic encephalopathy showed higher values of heart rate,lactate,and central venous pressure together with a higher need of other vasoactive drugs.CONCLUSION According to our data,haemodynamic management of BDDs is affected by the aetiology of brain death.BDDs with postanoxic encephalopathy have higher requirements for norepinephrine and other vasoactive drugs.
文摘AIM:To investigate effects of heart automatic nerve variations and hypothermia(HT) therapy on heart rate variation(HRV).METHODS:We studied the dynamic electrocardiagraph(ECG) of 41 cases of severe brain injury.The patients were devided into HT therapy group(n=21,body temprature 32-33℃),non-HT therapy group(n=20) and normal control(n=20).RESULTS:In group 1,the reduction of time domain indexes and frequency domain indexes were 3-6 folds and 30-50folds respectively compared with those of the control group,while the corresponding indexes reduction were 2-3 folds and 4-5folds in the group 2(P<0.05,P<0.01,respectively).The difference between groups were significant(P<0.05-0.01);the HRV reduction was more significant in the cerebrovascular accident patients than that of brain injured(P<0.05-0.01);the HRV indexes increased significantly in resuscitated patients than those in coma(P<0.01);the HRV in dead was much lower than that in survival(P=0.01).CONCLUSION:Injury of central nervous system can induce abnormal function of automatic nerve of heart and reduction of HRV.HT therapy can reduce HRV on a higher level;HRV examination can be applied into the prediction of prognosis of the brain injured.
文摘The authors reported a case of trauma with uterus rupture at 35 weeks gestation with fetal death in uterus with a trauma of the right</span></span><span><span><span style="font-family:""> </span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">limb injuries during a serious road accident. </span><b><span style="font-family:Verdana;">Aim:</span></b><span style="font-family:Verdana;"> the aim is to show the increasing of road accident with the motorized tricycle and their many risks for pregnant woman. </span><b><span style="font-family:Verdana;">Case Presentation:</span></b><span style="font-family:Verdana;"> our patient was thrown from the back cargo of a motorized tricycle (three-wheeled vehicle) after a collision with a truck in a rural area from 150 km to Bobo-Dioulasso. She sustained a closed abdominal injury and a severe right lower limb open injury. At admission in our depart</span><span style="font-family:Verdana;">ment in the Teaching Hospital, she was conscious, shocked with hemodyn</span><span style="font-family:Verdana;">amic instability, including low blood pressure (75/52 mmHg), rapid heart rate (140 pulses per minute), rapid breath rate (40 per minute), and cold extremities. Abdominal examination was painful with uterine hypertonia, 28 cm height uterus, and no fetal heart heartbeat. A laparotomy in</span></span></span></span><span><span><span style="font-family:""> </span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">urgency revealed a rupture of the uterus fundus with a dead fetus. A conservative surgical treatment was performed. An open trauma to the right limb was managed by the orthopedists with a good outcome. </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> Accident trauma during pregnancy is becoming more and more frequent with the increase in means of transport in urban and inter urban areas. The transport ways of the pregnant woman must take into account her safety and that of the fetus.
文摘Objective: To investigate the epidemiological characteristics and relative factor about hospital death in patients with road traffic trauma. Methods: The age, sex, road-use category, sites of injury, injury severity scale of 159 hospital death cases in 2436 cases with road traffic trauma were observed, and the relation between the causes of death and time elapsed after injury was also studied with likelihood ratio Chi-square test.
文摘目的分析2013—2017年重庆市居民伤害死亡特征及变化趋势,为制定伤害干预策略提供依据。方法利用重庆市2013—2017年常住居民死因监测资料,提取伤害死亡病例,计算死亡率和顺位,以2010年全国第6次人口普查标准人口构成计算标化死亡率,使用Joinpoint Regression Program 4.2软件进行趋势分析。结果2013—2017年,重庆市居民年均伤害死亡率53.28/10万,标化死亡率为49.74/10万。总体、男性、65岁以下人群伤害死亡率以及道路交通伤、其他意外伤害和加害死亡率均呈下降趋势(P<0.05),65岁及以上老人伤害死亡率和跌倒死亡率均呈上升趋势(P<0.05)。道路交通伤、跌倒、其他意外伤害、故意自害及淹死为重庆市居民前5位伤害死因,淹死、道路交通伤、跌倒分别为0~14岁儿童、15~64岁劳动力人口、65岁及以上老人的首位伤害死因。结论尽管近5年总体伤害死亡率呈下降趋势,但65岁及以上老年人群伤害死亡率、跌倒死亡率却呈上升趋势,且不同年龄人群,首位伤害死因不同,因此,宜对不同年龄人群、不同类型伤害开展有针对性的伤害干预工作。
