Objective To compare the changes between deep hypothermic circulatory arrest (DHCA) with deep hypothermic low flow (DHLF) cardiopulmonary bypass (CPB) on pulmonary surfactant (PS) activity in infants with congenital heart disease. Methods Twenty infants with ventricular septum defect and pulmonary hypertension were assigned to either DHCA group or DHLF group according to the CPB methods respectively. Measurements of saturated phosphatidylcholine /total phospholipids (SatPC /TPL), saturated phosphatidylcholine/ total protein (SatPC/TP) and static pulmonary compliance were performed before institution of CPB, 5 minutes after cessation of CPB and 2 hours. Results The length of ICU stay in DHLA group was significantly longer ( P lt;0 05) than that in DHCA group. SatPC/TPL, SatPC/TP and static pulmonary compliance in DHLF group were significantly lower compared with DHCA group ( P lt;0.01). Conclusion DHLF could lower the PS activity level significantly as compared with DHCA in infants with congenital heart disease.
目的:观察七氟醚靶控用于低流量吸入麻醉维持的临床规律及血流动力学变化,寻求靶控下的药物量化指标。方法:选择60例20～60岁手术患者,随机分2组每组30例:P组(丙泊酚)常规实施全凭静脉TCI靶控麻醉;S组(七氟醚),实施低流量七氟醚靶控吸入麻醉(BIS值40)。分别记录诱导前(T1),插管后5(T2)、15(T3)、30(T4)45(T5)、60(T6)、90(T7)、120(T8)min时的、MBP、HR、;Sev组患者加记各个时点的七氟醚IT、ET的MAC值。结果:T2点两组均比T1 降低(Plt;0.05),S 组高于P组(Plt;0.05),两组比较T3至T7无显著性差异(Pgt;0.05);S 组T3 至T7 各点ET值无统计学差异,ET%:2.46,约1.4 MAC。结论:(1)七氟醚诱导较静脉麻醉诱导患者血流动力学稳定,(2)低流量七氟醚靶控吸入麻醉维持平稳,调控简便,效果良好。
ObjectiveTo systematically review the clinical effects of non-humidified versus humidified low-to-moderate flow oxygen inhalation therapy via nasal cannula. MethodsRandomized controlled trials (RCTs), clinical controlled trials (CCTs) and cross-over studies about the clinical effects of non-humidified versus humidified low-to-moderate flow nasal cannula oxygen inhalation therapy in hospitalized adult patients were searched in The Cochrane Library (Issue 3, 2016), The Joanna Briggs Institute Evidence Based Practice (EBP) Database, EMbase, PubMed, Web of Science, CBM, CNKI, VIP and WanFang Data from inception to March 2016. Three reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then meta-analysis was performed using RevMan 5.3 software. ResultsA total of nine RCTs and three CCTs involving 3 756 patients were finally included. The results of meta-analysis indicated that: non-humidified was superior to humidified oxygen therapy in reducing bacterial contamination of oxygen apparatus (P < 0.05) and the time of daily replacement of sterile water oxygen humidifier bottles (P < 0.05), while the two groups were alike in relieving nasal dryness (RR=1.08, 95%CI 0.91 to 1.29, P=0.37), nasal bleeding (RR=1.17, 95%CI 0.66 to 2.08, P=0.59) and discomfort (RR=0.80, 95%CI 0.56 to 1.14, P=0.22). ConclusionCurrent evidence indicates that there is no significant difference between non-humidified and humidified low-to-moderate flow nasal cannula oxygen inhalation therapy in relieving patients' nasal dryness, nasal bleeding and discomfort. But non-humidified oxygen therapy can reduce bacterial contamination of oxygen apparatus, simplify the operation procedures and lessen nurses' operation time.