High-dependency units(HDUs)provide high-level care to patients who suffer from single organ failure,with the exception of respiratory failure requiring mechanical ventilation;HDUs serve as an intermediary between gene...High-dependency units(HDUs)provide high-level care to patients who suffer from single organ failure,with the exception of respiratory failure requiring mechanical ventilation;HDUs serve as an intermediary between general wards and Intensive Care Units.Due to military and civilian needs,our hospital has established a unique HDU for patients with liver disease in China.A Chinese military officer in the United Nations Peacekeeping Forces in South Sudan was transferred to our HDU for liver failure treatment in 2018.The patient’s disease status,nutrition,sleep habits,and psychological behaviour were monitored on different scales.The patient was provided with vascular monitoring,telemetry,pulse oximetry,drug treatment,nutritional support,sleep intervention,psychological intervention,and humanistic care by a multidisciplinary treatment team.After treatment,the patient recovered and avoided liver transplantation.Based on the experience with this HDU,this new model may create an efficient treatment process for military and civilian patients with severe liver disease at home or abroad.展开更多
Connectivity is the premise and foundation of networking and routing.For the probabilistic flight path of military aircraft resulting in the difficulty of Aeronautical Ad hoc NETwork(AANET) research,an estimation meth...Connectivity is the premise and foundation of networking and routing.For the probabilistic flight path of military aircraft resulting in the difficulty of Aeronautical Ad hoc NETwork(AANET) research,an estimation method of connectivity probability is proposed.The method takes airspace as the research object,starts with actual flight characteristics,and applies conclusions of random waypoint mobility model.Building a connectivity model by establishing Airspace Unit Circle(AUC) from the perspective of circle-circle coverage,the method obtains a theory of airspace network connectivity.Experiment demonstrates its correctness.Finally,according to the actual condition simulation,relationship between the number of aircraft,communication radius,and the flight area under connectivity probabilities is achieved,results provide reference for creating a network that under certain aerial combat condition.展开更多
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
文摘High-dependency units(HDUs)provide high-level care to patients who suffer from single organ failure,with the exception of respiratory failure requiring mechanical ventilation;HDUs serve as an intermediary between general wards and Intensive Care Units.Due to military and civilian needs,our hospital has established a unique HDU for patients with liver disease in China.A Chinese military officer in the United Nations Peacekeeping Forces in South Sudan was transferred to our HDU for liver failure treatment in 2018.The patient’s disease status,nutrition,sleep habits,and psychological behaviour were monitored on different scales.The patient was provided with vascular monitoring,telemetry,pulse oximetry,drug treatment,nutritional support,sleep intervention,psychological intervention,and humanistic care by a multidisciplinary treatment team.After treatment,the patient recovered and avoided liver transplantation.Based on the experience with this HDU,this new model may create an efficient treatment process for military and civilian patients with severe liver disease at home or abroad.
文摘Connectivity is the premise and foundation of networking and routing.For the probabilistic flight path of military aircraft resulting in the difficulty of Aeronautical Ad hoc NETwork(AANET) research,an estimation method of connectivity probability is proposed.The method takes airspace as the research object,starts with actual flight characteristics,and applies conclusions of random waypoint mobility model.Building a connectivity model by establishing Airspace Unit Circle(AUC) from the perspective of circle-circle coverage,the method obtains a theory of airspace network connectivity.Experiment demonstrates its correctness.Finally,according to the actual condition simulation,relationship between the number of aircraft,communication radius,and the flight area under connectivity probabilities is achieved,results provide reference for creating a network that under certain aerial combat condition.
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.
