Background Unplanned extubation is associated with adverse outcomes in intensive care unit. The massive burn patient differs from other critically ill patients in many ways. However, little is known about the unplanne...Background Unplanned extubation is associated with adverse outcomes in intensive care unit. The massive burn patient differs from other critically ill patients in many ways. However, little is known about the unplanned decannulation （UD） in Burn Intensive Care Unit. This paper describes the special features of the circumstances and outcome of UD of tracheotomy tube in massive burn patients. Methods A case series study was performed between January 1999 and December 2008 and UD of tracheotomy tube was analyzed retrospectively. A total of 21 patients with 29 UD events were identified. Demographic data, diagnosis, intervention, UD events and outcome of UD patients were collected. Differences in proportions were compared using the chi-square （X2） or Fisher＇s exact test. Results Patients with UD were often burned with head and neck （67%） and combined with inhalation injury （62%）. The majority of them （76%） were transferred patients, occurred early （55%） and were accidental UD （79%）. UD events tended to happen in day shift （90%） and to be associated with the medical procedure that was performing by caregivers at besides （79%）. Loose of the stabilizing rope, medical procedure and tracheotomy malposition were the main causes of UD. Early UD and reintubation failure were associated with patients＇ death. Conclusions UD happened to massive burn patients can lead to patient death. Careful management of respiratory tract was essential for massive burn patients.展开更多
Introduction Human serum albumin(HSA)is a non-glycosylated,negatively charged,single-chain polypeptide composed of 585 amino acid residues with a relative molecular mass of 66.438 kD.It is synthesized by the liver at ...Introduction Human serum albumin(HSA)is a non-glycosylated,negatively charged,single-chain polypeptide composed of 585 amino acid residues with a relative molecular mass of 66.438 kD.It is synthesized by the liver at a rate of approximately 200 mg·kg^(-1)·day^(-1),with a half-life of 21 days,and subjected to catabolism in the muscles,liver,and kidneys at a rate of 4%per day.[1]Albumin,accounting for 60%of the total plasma protein,has various physiological functions,[2]such as maintaining 70%to 80%of effective plasma colloid osmotic pressure,coordinating vascular endothelial integrity,anti-oxidant and anti-inflammatory activities,maintaining the acidbase balance,and participating in the transport,distribution,and metabolism of a variety of endogenous and exogenous substances.展开更多
文摘Background Unplanned extubation is associated with adverse outcomes in intensive care unit. The massive burn patient differs from other critically ill patients in many ways. However, little is known about the unplanned decannulation （UD） in Burn Intensive Care Unit. This paper describes the special features of the circumstances and outcome of UD of tracheotomy tube in massive burn patients. Methods A case series study was performed between January 1999 and December 2008 and UD of tracheotomy tube was analyzed retrospectively. A total of 21 patients with 29 UD events were identified. Demographic data, diagnosis, intervention, UD events and outcome of UD patients were collected. Differences in proportions were compared using the chi-square （X2） or Fisher＇s exact test. Results Patients with UD were often burned with head and neck （67%） and combined with inhalation injury （62%）. The majority of them （76%） were transferred patients, occurred early （55%） and were accidental UD （79%）. UD events tended to happen in day shift （90%） and to be associated with the medical procedure that was performing by caregivers at besides （79%）. Loose of the stabilizing rope, medical procedure and tracheotomy malposition were the main causes of UD. Early UD and reintubation failure were associated with patients＇ death. Conclusions UD happened to massive burn patients can lead to patient death. Careful management of respiratory tract was essential for massive burn patients.
基金the Wisdom Medical Research Project of Shanghai Municipal Health Commission(No.2018ZHYL0227)the Shanghai Science and Technology Commission(No.20DZ2200500).
文摘Introduction Human serum albumin(HSA)is a non-glycosylated,negatively charged,single-chain polypeptide composed of 585 amino acid residues with a relative molecular mass of 66.438 kD.It is synthesized by the liver at a rate of approximately 200 mg·kg^(-1)·day^(-1),with a half-life of 21 days,and subjected to catabolism in the muscles,liver,and kidneys at a rate of 4%per day.[1]Albumin,accounting for 60%of the total plasma protein,has various physiological functions,[2]such as maintaining 70%to 80%of effective plasma colloid osmotic pressure,coordinating vascular endothelial integrity,anti-oxidant and anti-inflammatory activities,maintaining the acidbase balance,and participating in the transport,distribution,and metabolism of a variety of endogenous and exogenous substances.
