目的分析儿童复发性眩晕(recurrent vertigo of children,RVC)患儿的各项相关客观检查结果,试图寻找出有意义的客观检查方法。方法选取RVC患儿50例(眩晕发作组29例,眩晕不发作组21例)和非RVC正常对照组儿童20例,所有入组人员行相关客观...目的分析儿童复发性眩晕(recurrent vertigo of children,RVC)患儿的各项相关客观检查结果,试图寻找出有意义的客观检查方法。方法选取RVC患儿50例(眩晕发作组29例,眩晕不发作组21例)和非RVC正常对照组儿童20例,所有入组人员行相关客观检查,包括位置试验、vHIT、头颅MRI、纯音测听或游戏测听、声导抗、高刺激率ABR、脑电图、脉搏氧及PSG检查,分析各项检查结果,比较RVC组及对照组之间的特征性差异。结果①RVC组脉搏氧异常率、高刺激率ABR异常率及AHI异常率均高于对照组,有统计学差异(均为P<0.05);②眩晕发作组脉搏氧异常率、高刺激率ABR异常率高于眩晕不发作组,有统计学差异(P<0.05);③RVC组和正常对照组的纯音听阈(或游戏测听)、声导抗、颅脑MRI、位置试验检查、vHIT均正常。结论连续睡眠脉搏氧、高刺激率ABR与RVC,尤其是眩晕发作期的RVC具有一定的相关性。AHI与RVC有一定相关性,但与眩晕是否处于发作期没有相关性。连续睡眠脉搏氧监测、PSG、高刺激率ABR可作为诊断RVC的辅助检查。展开更多
Background::To investigate the relationship between partial pressure of oxygen(PaO_(2))/fraction of inspired oxygen(FiO_(2))and the probability of delirium in intensive care units(ICUs).Methods::The investigation was ...Background::To investigate the relationship between partial pressure of oxygen(PaO_(2))/fraction of inspired oxygen(FiO_(2))and the probability of delirium in intensive care units(ICUs).Methods::The investigation was a cross-sectional study that involved the collection of data from patients admitted to the Xiang Ya Hospital Cardiothoracic Surgical Care Unit and Comprehensive Intensive Care Unit from 01 September 2016 to 10 December 2016.Delirium was diagnosed using the simplified version of the Chinese Confusion Assessment Method(CAM)for the ICU.Demographic and medical data were obtained within 24 h of each patient admitted in the ICU.The PaO_(2)/FiO_(2) of each patient was recorded 24 h after admission in the ICU.The patients were divided into three groups according to PaO_(2)/FiO_(2) data:normal(PaO_(2)/FiO_(2)≥300 mmHg),slightly low(200≥PaO_(2)/FiO_(2)<300 mmHg),and severely low(PaO_(2)/FiO_(2)<200 mmHg).Baseline characteristics were compared in the three groups.Results of the unadjusted model,minimally adjusted model,and fully adjusted model are presented.Results::A total of 403 participants were included in the study,of which 184(45.7%)developed delirium.Age(P<0.001),Sequential Organ Failure Assessment(SOFA)score(P<0.001),Acute Physiology and Chronic Health Evaluation(APACHE)II score(P<0.001),mechanical ventilation time(P<0.001),history of hypertension(P=0.040),heart disease(P=0.040),sedation(P=0.001),and PaO_(2)/FiO_(2)(P=0.006)were significantly associated with delirium in univariate analysis.Multivariate regression analysis models were used to further analyze the associations between PaO_(2)/FiO_(2) and delirium.In the crude model,for 1 standard deviation(SD)increase in PaO_(2)/FiO_(2),the odds ratio(OR)of delirium was 0.8(95%confidence interval[CI]:0.6-0.9),but there was no significant correlation in the fully adjusted model.There was a non-linear relationship between the PaO_(2)/FiO_(2) and delirium in a generalized additive model.A two-piecewise linear regression model was used to calculate a PaO_(2)/FiO_(2) threshold of 243 mmHg.On the left side of the threshold,the OR was 0.9 and the 95%CI was 0.9-1.0(P=0.013)when PaO_(2)/FiO_(2) increased by 1 SD.Conclusions::PaO_(2)/FiO_(2) was negatively associated with delirium when PaO_(2)/FiO_(2) was below the identified threshold.As a readily available laboratory indicator,PaO_(2)/FiO_(2) has potential value in the clinical evaluation of risk of delirium in ICU patients.展开更多
文摘目的分析儿童复发性眩晕(recurrent vertigo of children,RVC)患儿的各项相关客观检查结果,试图寻找出有意义的客观检查方法。方法选取RVC患儿50例(眩晕发作组29例,眩晕不发作组21例)和非RVC正常对照组儿童20例,所有入组人员行相关客观检查,包括位置试验、vHIT、头颅MRI、纯音测听或游戏测听、声导抗、高刺激率ABR、脑电图、脉搏氧及PSG检查,分析各项检查结果,比较RVC组及对照组之间的特征性差异。结果①RVC组脉搏氧异常率、高刺激率ABR异常率及AHI异常率均高于对照组,有统计学差异(均为P<0.05);②眩晕发作组脉搏氧异常率、高刺激率ABR异常率高于眩晕不发作组,有统计学差异(P<0.05);③RVC组和正常对照组的纯音听阈(或游戏测听)、声导抗、颅脑MRI、位置试验检查、vHIT均正常。结论连续睡眠脉搏氧、高刺激率ABR与RVC,尤其是眩晕发作期的RVC具有一定的相关性。AHI与RVC有一定相关性,但与眩晕是否处于发作期没有相关性。连续睡眠脉搏氧监测、PSG、高刺激率ABR可作为诊断RVC的辅助检查。
文摘Background::To investigate the relationship between partial pressure of oxygen(PaO_(2))/fraction of inspired oxygen(FiO_(2))and the probability of delirium in intensive care units(ICUs).Methods::The investigation was a cross-sectional study that involved the collection of data from patients admitted to the Xiang Ya Hospital Cardiothoracic Surgical Care Unit and Comprehensive Intensive Care Unit from 01 September 2016 to 10 December 2016.Delirium was diagnosed using the simplified version of the Chinese Confusion Assessment Method(CAM)for the ICU.Demographic and medical data were obtained within 24 h of each patient admitted in the ICU.The PaO_(2)/FiO_(2) of each patient was recorded 24 h after admission in the ICU.The patients were divided into three groups according to PaO_(2)/FiO_(2) data:normal(PaO_(2)/FiO_(2)≥300 mmHg),slightly low(200≥PaO_(2)/FiO_(2)<300 mmHg),and severely low(PaO_(2)/FiO_(2)<200 mmHg).Baseline characteristics were compared in the three groups.Results of the unadjusted model,minimally adjusted model,and fully adjusted model are presented.Results::A total of 403 participants were included in the study,of which 184(45.7%)developed delirium.Age(P<0.001),Sequential Organ Failure Assessment(SOFA)score(P<0.001),Acute Physiology and Chronic Health Evaluation(APACHE)II score(P<0.001),mechanical ventilation time(P<0.001),history of hypertension(P=0.040),heart disease(P=0.040),sedation(P=0.001),and PaO_(2)/FiO_(2)(P=0.006)were significantly associated with delirium in univariate analysis.Multivariate regression analysis models were used to further analyze the associations between PaO_(2)/FiO_(2) and delirium.In the crude model,for 1 standard deviation(SD)increase in PaO_(2)/FiO_(2),the odds ratio(OR)of delirium was 0.8(95%confidence interval[CI]:0.6-0.9),but there was no significant correlation in the fully adjusted model.There was a non-linear relationship between the PaO_(2)/FiO_(2) and delirium in a generalized additive model.A two-piecewise linear regression model was used to calculate a PaO_(2)/FiO_(2) threshold of 243 mmHg.On the left side of the threshold,the OR was 0.9 and the 95%CI was 0.9-1.0(P=0.013)when PaO_(2)/FiO_(2) increased by 1 SD.Conclusions::PaO_(2)/FiO_(2) was negatively associated with delirium when PaO_(2)/FiO_(2) was below the identified threshold.As a readily available laboratory indicator,PaO_(2)/FiO_(2) has potential value in the clinical evaluation of risk of delirium in ICU patients.
