Importance: The best respiratory support technique to reduce intubation and mortality in patients with respiratory failure due to COVID-19 is controversial. Objective: To determine the respiratory support technique th...Importance: The best respiratory support technique to reduce intubation and mortality in patients with respiratory failure due to COVID-19 is controversial. Objective: To determine the respiratory support technique that could reduce the need for tracheal intubation and mortality in patients with respiratory failure due to COVID-19 admitted to intensive care units (ICUs) of Military’s Hospital (HIAOBO) in Gabon. Design, Setting, and Participants-Methodology: Prospective observational study over 10 months (January 2021-October 2021). We included patients admitted to intensive care for SARS Cov2 pneumonia who had benefited from available ventilatory support: high concentration face mask, High Flow Nasal cannula (HFNC), NIV (Non Invasive Ventilation), Continuous Positive Airway Pressure (CPAP). The choice was guided by the clinical condition, and the choice of the prescribing physicians. Recourse to mechanical ventilation was decided when faced with a Glasgow score of less than 13, an SpO<sub>2</sub>/FiO<sub>2</sub> ratio ≤ 300, a FR ≥ 35/min, the impossibility of drainage of secretions. Main Outcomes and Measures: The primary outcome was the proportion of patients requiring intubation. The secondary outcomes were mortality in ICU. Results: The sample included 97 patients, the average age was55.6 years, hypertension was the main comorbidity (51.1%). Mean respiratory rate (RR) was 30.8 cycles/min, admission SpO2 was 83%, respiratory alkalosis was present in 63% of patients, mean CT involvement was 51%.Respiratory support was NIV (56.7%), CPAP (21.65%), high concentration face mask (18.55%). Sixteen percent (16%) of patients were intubated, 93% of them following failure of NIV. Mortality was 30%, mechanical ventilation was an independent risk factor for mortality. Conclusions: Non Invasive Ventilation, CPAP, and high-concentration face mask were frequently used in patients with COVID-related acute respiratory failure. The CPAP has reduced the need for intubation. Mechanical ventilation is a risk factor for death.展开更多
I.单项选择1. John plays football, if not better than, David.A. as well B. as well as C. so well D. so well as2.a teacher,so he must decide what to do and what not to do.A. Being B. As C...I.单项选择1. John plays football, if not better than, David.A. as well B. as well as C. so well D. so well as2.a teacher,so he must decide what to do and what not to do.A. Being B. As C. He is D. Because3. He demanded that the books to the school library at once.A. return B. should returnC. be returned D. would be展开更多
Stephen Hawking who made a speed by using a computer and a voice box is one example of disabled people.Born in 1942,he lived and took doctor's degree in England.But in 1963,he noticed it was difficult to move arou...Stephen Hawking who made a speed by using a computer and a voice box is one example of disabled people.Born in 1942,he lived and took doctor's degree in England.But in 1963,he noticed it was difficult to move around withort fallint out.In 1988,his book became a bestseller.展开更多
The COVID-19 pandemic has significantly changed the mental health care. Treating psychiatric patients with COVID-19 poses multiple challenges in the inpatient psychiatric setting in terms of mitigating transmission of...The COVID-19 pandemic has significantly changed the mental health care. Treating psychiatric patients with COVID-19 poses multiple challenges in the inpatient psychiatric setting in terms of mitigating transmission of the virus. Gracie Square Hospital, a freestanding psychiatric hospital located in New York City, devoted a unit to treating COVID-19 patients requiring inpatient psychiatric treatment. This paper describes our experiences and challenges while managing the psychiatric COVID-19 unit that may serve as a model for other health care facilities during the COVID-19 pandemic.展开更多
文摘Importance: The best respiratory support technique to reduce intubation and mortality in patients with respiratory failure due to COVID-19 is controversial. Objective: To determine the respiratory support technique that could reduce the need for tracheal intubation and mortality in patients with respiratory failure due to COVID-19 admitted to intensive care units (ICUs) of Military’s Hospital (HIAOBO) in Gabon. Design, Setting, and Participants-Methodology: Prospective observational study over 10 months (January 2021-October 2021). We included patients admitted to intensive care for SARS Cov2 pneumonia who had benefited from available ventilatory support: high concentration face mask, High Flow Nasal cannula (HFNC), NIV (Non Invasive Ventilation), Continuous Positive Airway Pressure (CPAP). The choice was guided by the clinical condition, and the choice of the prescribing physicians. Recourse to mechanical ventilation was decided when faced with a Glasgow score of less than 13, an SpO<sub>2</sub>/FiO<sub>2</sub> ratio ≤ 300, a FR ≥ 35/min, the impossibility of drainage of secretions. Main Outcomes and Measures: The primary outcome was the proportion of patients requiring intubation. The secondary outcomes were mortality in ICU. Results: The sample included 97 patients, the average age was55.6 years, hypertension was the main comorbidity (51.1%). Mean respiratory rate (RR) was 30.8 cycles/min, admission SpO2 was 83%, respiratory alkalosis was present in 63% of patients, mean CT involvement was 51%.Respiratory support was NIV (56.7%), CPAP (21.65%), high concentration face mask (18.55%). Sixteen percent (16%) of patients were intubated, 93% of them following failure of NIV. Mortality was 30%, mechanical ventilation was an independent risk factor for mortality. Conclusions: Non Invasive Ventilation, CPAP, and high-concentration face mask were frequently used in patients with COVID-related acute respiratory failure. The CPAP has reduced the need for intubation. Mechanical ventilation is a risk factor for death.
文摘I.单项选择1. John plays football, if not better than, David.A. as well B. as well as C. so well D. so well as2.a teacher,so he must decide what to do and what not to do.A. Being B. As C. He is D. Because3. He demanded that the books to the school library at once.A. return B. should returnC. be returned D. would be
文摘Stephen Hawking who made a speed by using a computer and a voice box is one example of disabled people.Born in 1942,he lived and took doctor's degree in England.But in 1963,he noticed it was difficult to move around withort fallint out.In 1988,his book became a bestseller.
文摘The COVID-19 pandemic has significantly changed the mental health care. Treating psychiatric patients with COVID-19 poses multiple challenges in the inpatient psychiatric setting in terms of mitigating transmission of the virus. Gracie Square Hospital, a freestanding psychiatric hospital located in New York City, devoted a unit to treating COVID-19 patients requiring inpatient psychiatric treatment. This paper describes our experiences and challenges while managing the psychiatric COVID-19 unit that may serve as a model for other health care facilities during the COVID-19 pandemic.
