Peritoneal dialysis (PD) is widely used to treat acute kidney injury (AKI) in low-resource and higher income countries. This paper summarizes the key points and improvements of the 2020 International Society for Peritoneal Dialysis guidelines in five aspects of outcomes for AKI treatment, peritoneal access, dialysis solutions, prescription of dialysis with targets of solute clearance and complications, so as to provide references for AKI in clinical practice.
Lung transplantation has been proved to be an effective treatment after more than forty years of fast development, while more than 4000 cases of lung transplantation performed globally each year. Recently, lung transplantation in China has been advanced rapidly, and the number of transplants has increased year by year. Respiratory and Critical Care Medicine team has been recognized to play a crucial role in lung transplantation. It has an irreplaceable role and status in promoting lung transplantation, improving the preoperative evaluation of lung transplantation and the maintenance of donors, and carrying out perioperative management, as well as long-term follow-up. Lung transplantation is a systematic project, requiring the perfect cooperation and collaboration of team members and contributing to recipients’ recovery.
Objective To explore the oxygen therapy effects of high-flow T-tube oxygen therapy on neurointensive care patients who have undergone tracheostomy and are undergoing mechanical ventilation while meeting the criteria for weaning from mechanical ventilation, especially in terms of controlling airway temperature and humidity, promoting mucus dilution, and reducing postoperative complications. MethodsCollected data from 50 neurointensive care patients who underwent tracheostomy and were on mechanical ventilation, meeting the criteria for weaning from mechanical ventilation, treated at West China Hospital of Sichuan University from September 2019 to September 2021. The three groups of patients had different weaning methods: a high-flow T-tube for weaning, a heat and moisture exchanger (artificial nose) for weaning, and a high-flow tracheal joint for weaning. The vital signs, dyspnea and blood gas analysis before and three days after weaning were collected. The primary outcomes were mechanical sputum excretion, postural drainage, phlegm-resolving drugs use, airway-related events (artificial airway blockage, artificial nose blockage, lung infection), stay in ICU (days), and death in ICU. Results Among the 50 patients, 28 were males and 22 were females. There were no significant differences in age, weight, height, gender, finger pulse oxygen saturation, heart rate, APACHEII score, sequential organ failure assessment, or Glasgow coma scale among the three groups (P>0.05). There was no statistical difference in the number of 72-hour mechanical sputum excretion or the use of phlegm-resolving drugs in the three groups (P=0.113, P=1.00). Conclusion The use of high-flow T-tube oxygen therapy in neurointensive care patients who have undergone tracheostomy, are on mechanical ventilation, and meet the criteria for weaning from mechanical ventilation can effectively control airway temperature and humidity, promote mucus dilution for better drainage, thereby reducing post-tracheostomy complications.