AIM:To determine the influence of anthropomorphic parameters on the relationship between patient centering,mean computed tomography(CT) numbers and quantitative image noise in abdominal CT.METHODS:Our Institutional Re...AIM:To determine the influence of anthropomorphic parameters on the relationship between patient centering,mean computed tomography(CT) numbers and quantitative image noise in abdominal CT.METHODS:Our Institutional Review Board approved study included 395 patients(age range 21-108,years;male:female = 195:200) who underwent contrast-enhanced abdominal CT on a 16-section multi-detector row scanner(GE LightSpeed 16).Patient centering in the gantry isocenter was measured from the lateral localizer radiograph(off center S = patient off centered superior to isocenter;off center I = patient off centered inferior to isocenter).Mean CT numbers(Hounsfield Units:HU) and noise(standard deviation of CT numbers:SD) were measured in the anterior(aHU,aSD) and posterior(pHU,pSD) abdominal wall subcutaneous fat and liver parenchyma(LivHU,LivSD) at the level of the porta hepatis.Patients' age,gender,weight,body mass index and maximal anteroposterior diameter were recorded.The data were analyzed using linear regression analysis.RESULTS:Most patients(81%;320/395) were not correctly centered in the gantry isocenter for abdominal CT scanning.Mean CT numbers in the abdominal wall increased significantly with an increase in the offcentering distance,regardless of the direction of the off-center(P < 0.05).There was a substantial increase in pSD(P = 0.01) and LivSD(P = 0.017) with off-centering.Change in mean CT numbers and image noise along the off-center distance was influenced by the patient size(P < 0.01).CONCLUSION:Inappropriate patient centering for CT scanning adversely affects the reliability of mean CT numbers and image noise.展开更多
The ideal range for tracheal tube cuff pressures is usually taken to be between 20 to 30 cm H2 O. This is easily measured with a cuff pressure manometer and should be measured in each instance. The importanceof trache...The ideal range for tracheal tube cuff pressures is usually taken to be between 20 to 30 cm H2 O. This is easily measured with a cuff pressure manometer and should be measured in each instance. The importanceof tracheal tube cuff pressures is highlighted by the spectrum of airway complications that can occur with incorrect cuff pressures. High cuff pressures can result in complications ranging from sore throat and hoarseness to tracheal stenosis, necrosis, and even rupture. In such cases, the postulated causative factor is diminished blood flow to tracheal mucosa due to excessive cuff pressure on the tracheal wall. This hypothesized ischemic injury then produces healing fibrosis months or even years later. On the other hand, cuff pressures that are too low place the patient at risk for aspiration of gastric contents and consequently, aspiration pneumonitis and pneumonia. This is why the authors recommend that cuff pressures be measured following all intubations.展开更多
目的:通过文献检索分析评价磁导航引导鼻空肠管置管技术在危重症患者鼻空肠管置管中的应用效果。方法:检索中国知网、万方、维普和中国生物医学文献服务系统中文数据库,以及外文数据库PubMed、CINAHL、Cochrane Library、Web of Science...目的:通过文献检索分析评价磁导航引导鼻空肠管置管技术在危重症患者鼻空肠管置管中的应用效果。方法:检索中国知网、万方、维普和中国生物医学文献服务系统中文数据库,以及外文数据库PubMed、CINAHL、Cochrane Library、Web of Science、Embase中关于磁导航引导鼻空肠管置管技术在危重症患者中应用的随机对照试验研究文献,检索时间为2000年1月至2023年9月。检索文献950篇,按照文献纳入与排除标准筛选文献,并对文献进行质量评价,运用RevMan 5.4.1软件对文献中的置管成功率、置管成功所需时间,患者体征恢复时间和满意度4项结局指标进行Meta分析,比较磁导航引导鼻空肠管置管与床旁盲插鼻空肠管的差异。结果:最终纳入7篇文献的7项随机对照试验研究,其中中文文献4篇,英文文献3篇,7篇文献涉及682例患者。磁导航引导鼻空肠管置管成功率高于床旁盲插鼻空肠管,差异有统计学意义[优势比(OR)=4.78,95%置信区间(CI)为(2.16~10.58),P<0.0001];磁导航引导鼻空肠管置管所需时间少于床旁盲插鼻空肠管,差异有统计学意义[均数差(MD)=-12.91,95%CI(-22.93~-2.90),P<0.00001];磁导航引导鼻空肠管置管患者体征恢复时间少于床旁盲插鼻空肠管,差异有统计学意义[MD=-9.11,95%CI(-12.09~-6.13),P<0.00001];磁导航引导鼻空肠管置管的患者满意度高于床旁盲插鼻空肠管患者,差异有统计学意义[OR=11.61,95%CI(3.96~34.01),P<0.00001]。结论:磁导航引导鼻空肠管置管相比床旁盲插鼻空肠管,可显著提高危重症患者鼻空肠管置管成功率,减少鼻空肠管置管成功所需时间和患者体征恢复时间,提高患者满意度。展开更多
目的探讨Suprem e喉罩在老年患者全身麻醉中应用的优越性。方法选择老年全髋置换手术患者100例,ASAⅠ～Ⅲ级,随机双盲分为Suprem e喉罩组(L组,n=50)和气管导管组(T组,n=50)。记录患者麻醉诱导前(T0)、插入喉罩/气管导管前(T1)、插入喉罩...目的探讨Suprem e喉罩在老年患者全身麻醉中应用的优越性。方法选择老年全髋置换手术患者100例,ASAⅠ～Ⅲ级,随机双盲分为Suprem e喉罩组(L组,n=50)和气管导管组(T组,n=50)。记录患者麻醉诱导前(T0)、插入喉罩/气管导管前(T1)、插入喉罩/气管导管后即刻(T2)、插入喉罩/气管导管后5 m in(T3)、拔出喉罩/气管导管前(T4)、拔出喉罩/气管导管后即刻(T5)和拔出喉罩/气管导管后5 m in(T6),收缩压(SBP)、舒张压(DBP)、心率(HR);记录患者围手术期相关并发症。结果插管/拔管期间L组血流动力学较T组稳定。围手术期相关并发症发生率L组明显少于T组(P<0.05)。结论老年患者全身麻醉通气时使用Suprem e喉罩不仅血流动力学相对稳定,而且围手术期相关并发症降低,优点明显大于气管内插管。展开更多
基金Supported by Research funding from GE Healthcare (Waukesha,Wis) (to Kalra MK)
文摘AIM:To determine the influence of anthropomorphic parameters on the relationship between patient centering,mean computed tomography(CT) numbers and quantitative image noise in abdominal CT.METHODS:Our Institutional Review Board approved study included 395 patients(age range 21-108,years;male:female = 195:200) who underwent contrast-enhanced abdominal CT on a 16-section multi-detector row scanner(GE LightSpeed 16).Patient centering in the gantry isocenter was measured from the lateral localizer radiograph(off center S = patient off centered superior to isocenter;off center I = patient off centered inferior to isocenter).Mean CT numbers(Hounsfield Units:HU) and noise(standard deviation of CT numbers:SD) were measured in the anterior(aHU,aSD) and posterior(pHU,pSD) abdominal wall subcutaneous fat and liver parenchyma(LivHU,LivSD) at the level of the porta hepatis.Patients' age,gender,weight,body mass index and maximal anteroposterior diameter were recorded.The data were analyzed using linear regression analysis.RESULTS:Most patients(81%;320/395) were not correctly centered in the gantry isocenter for abdominal CT scanning.Mean CT numbers in the abdominal wall increased significantly with an increase in the offcentering distance,regardless of the direction of the off-center(P < 0.05).There was a substantial increase in pSD(P = 0.01) and LivSD(P = 0.017) with off-centering.Change in mean CT numbers and image noise along the off-center distance was influenced by the patient size(P < 0.01).CONCLUSION:Inappropriate patient centering for CT scanning adversely affects the reliability of mean CT numbers and image noise.
文摘The ideal range for tracheal tube cuff pressures is usually taken to be between 20 to 30 cm H2 O. This is easily measured with a cuff pressure manometer and should be measured in each instance. The importanceof tracheal tube cuff pressures is highlighted by the spectrum of airway complications that can occur with incorrect cuff pressures. High cuff pressures can result in complications ranging from sore throat and hoarseness to tracheal stenosis, necrosis, and even rupture. In such cases, the postulated causative factor is diminished blood flow to tracheal mucosa due to excessive cuff pressure on the tracheal wall. This hypothesized ischemic injury then produces healing fibrosis months or even years later. On the other hand, cuff pressures that are too low place the patient at risk for aspiration of gastric contents and consequently, aspiration pneumonitis and pneumonia. This is why the authors recommend that cuff pressures be measured following all intubations.
文摘目的:通过文献检索分析评价磁导航引导鼻空肠管置管技术在危重症患者鼻空肠管置管中的应用效果。方法:检索中国知网、万方、维普和中国生物医学文献服务系统中文数据库,以及外文数据库PubMed、CINAHL、Cochrane Library、Web of Science、Embase中关于磁导航引导鼻空肠管置管技术在危重症患者中应用的随机对照试验研究文献,检索时间为2000年1月至2023年9月。检索文献950篇,按照文献纳入与排除标准筛选文献,并对文献进行质量评价,运用RevMan 5.4.1软件对文献中的置管成功率、置管成功所需时间,患者体征恢复时间和满意度4项结局指标进行Meta分析,比较磁导航引导鼻空肠管置管与床旁盲插鼻空肠管的差异。结果:最终纳入7篇文献的7项随机对照试验研究,其中中文文献4篇,英文文献3篇,7篇文献涉及682例患者。磁导航引导鼻空肠管置管成功率高于床旁盲插鼻空肠管,差异有统计学意义[优势比(OR)=4.78,95%置信区间(CI)为(2.16~10.58),P<0.0001];磁导航引导鼻空肠管置管所需时间少于床旁盲插鼻空肠管,差异有统计学意义[均数差(MD)=-12.91,95%CI(-22.93~-2.90),P<0.00001];磁导航引导鼻空肠管置管患者体征恢复时间少于床旁盲插鼻空肠管,差异有统计学意义[MD=-9.11,95%CI(-12.09~-6.13),P<0.00001];磁导航引导鼻空肠管置管的患者满意度高于床旁盲插鼻空肠管患者,差异有统计学意义[OR=11.61,95%CI(3.96~34.01),P<0.00001]。结论:磁导航引导鼻空肠管置管相比床旁盲插鼻空肠管,可显著提高危重症患者鼻空肠管置管成功率,减少鼻空肠管置管成功所需时间和患者体征恢复时间,提高患者满意度。
文摘目的探讨Suprem e喉罩在老年患者全身麻醉中应用的优越性。方法选择老年全髋置换手术患者100例,ASAⅠ～Ⅲ级,随机双盲分为Suprem e喉罩组(L组,n=50)和气管导管组(T组,n=50)。记录患者麻醉诱导前(T0)、插入喉罩/气管导管前(T1)、插入喉罩/气管导管后即刻(T2)、插入喉罩/气管导管后5 m in(T3)、拔出喉罩/气管导管前(T4)、拔出喉罩/气管导管后即刻(T5)和拔出喉罩/气管导管后5 m in(T6),收缩压(SBP)、舒张压(DBP)、心率(HR);记录患者围手术期相关并发症。结果插管/拔管期间L组血流动力学较T组稳定。围手术期相关并发症发生率L组明显少于T组(P<0.05)。结论老年患者全身麻醉通气时使用Suprem e喉罩不仅血流动力学相对稳定,而且围手术期相关并发症降低,优点明显大于气管内插管。
