Objective： To investigate the effect of preoperative limited fluid resuscitation on the patients with traumatic shock. Methods： Eighty-nine patients with multiple injuries complicating with shock were treated in Cha...Objective： To investigate the effect of preoperative limited fluid resuscitation on the patients with traumatic shock. Methods： Eighty-nine patients with multiple injuries complicating with shock were treated in Changhai Hospital Between January 2002 to October 2005 and were divided into 3 groups according to the preoperative levels of systolic blood pressure （SBP）. SBP of group A and group B were about 70 and 80 mmHg, respectively; and the SBP of group C was over 90 mmHg. Results, （1） There was no significant difference in age, gender, and injury severity score （ISS）, initiated resuscitation time and initiated operation time among the 3 groups. Preoperatively, there was significant difference in the amount of fluid resuscitation and infused erythrocyte suspension among group A, B and C （1687 ± 96 ml, 2096 ± 87 ml, 2976±93 ml, P〈0. 05; and 294±110 ml, 404±113 ml, 798±230 ml, P〈0. 05）. （2） The hemoglobin level in group C （94±45 g/L） was lower than that in group A （110±22 g/L） and group B （103±24 g/L） （P〈0.05）. However, there was no significant difference in the level of hemoglobin between group A and B. （3） There was no significant difference in the incidence of acute renal failure （ARF） among the 3 groups. The incidence of acute respiratory distress syndrome （ARDS） of group C （31.2%） was higher than that of group A （16.7%） and group B （18.2%） （P〈0.05）. The mortality of group C （34.4%） was higher than that of group A （12. 5% ） and group B （12. 1% ） （P〈0.05）. Conclusion： Preoperative limited resuscitation applied on patients with traumatic shock can reduce blood loss, incidence of ARDS and mortality.展开更多
Objective To evaluate the efficacy of the continuation of eardiopulmonary resuscitation （CPR） following transportation to the emergency department in a Chinese hospital after unsuccessful emergency medical services ...Objective To evaluate the efficacy of the continuation of eardiopulmonary resuscitation （CPR） following transportation to the emergency department in a Chinese hospital after unsuccessful emergency medical services （EMS） CPR. Methods From January 2002 to December 2007, emergency records of non-traumatic patients who were transported to a tertiary teaching hospital after unsuccessful EMS CPR were reviewed. Results Eigty-five patients were included, and 13 patients （15%） accomplished restoration of spontaneous circulation in our emergency department. Resuscitative possibility reached zero at around 23 minutes. One patient was discharged with a favourable neurologic outcome. Conclusions This study shows that the continuation of CPR is not futile and may improve outcomes. The outcomes should be re-evaluated in the future when prehospital information can be combined with in-hospital information （J Geriatr Cardio12009; 6：142-146）.展开更多
Backgound The influence of gender on clinical outcomes following transcatheter aortic valve implantation （TAVI） was considerably discrepant in previous studies. We aimed to investigate the impact of gender in our re...Backgound The influence of gender on clinical outcomes following transcatheter aortic valve implantation （TAVI） was considerably discrepant in previous studies. We aimed to investigate the impact of gender in our registry. Methods The study is a retrospective observational analysis of a prospectively designed cohort （546 consecutive patients treated at the University Hospital Zurich who were enrolled in Swiss TAVI Cohort from May 2008 to April 2014）. The Study took place in University Heart Centre at University Hospital Zurich, Switzerland. Results Both genders were equally represented with 51.5 % （n = 281） of the populations being females, who were significantly older and had a more pronounced history of hypertension （P 〈 0.001 ）. Males on the other hand showed a higher incidence of diabetes （P = 0.004）, coronary artery disease （P 〈 0.001）, chronic obstructive pulmonary disease （P 〈 0.001） and renal failure requiring renal replacement therapy （P = 0.018）. Patients were followed up for a median of 391 days with a 100% complete follow-up at one year. The primary outcome （all-cause mortality） occurred in 6.8% （n = 37） and 15% （n = 82） of patients at 30 days and one year, respectively. The 30-day all-cause mortality outcome did not significantly differ between females （7.5%） and males （6.0%） （P = 0.619）, but one year all-cause mortality occurred significantly more in males than in females （18.7% vs. 11.7%, P 〈 0.037）. Conclusion After TAVI implantation for severe aortic stenosis, males have a less favorable long-term （one year） mortality outcome than females.展开更多
文摘Objective： To investigate the effect of preoperative limited fluid resuscitation on the patients with traumatic shock. Methods： Eighty-nine patients with multiple injuries complicating with shock were treated in Changhai Hospital Between January 2002 to October 2005 and were divided into 3 groups according to the preoperative levels of systolic blood pressure （SBP）. SBP of group A and group B were about 70 and 80 mmHg, respectively; and the SBP of group C was over 90 mmHg. Results, （1） There was no significant difference in age, gender, and injury severity score （ISS）, initiated resuscitation time and initiated operation time among the 3 groups. Preoperatively, there was significant difference in the amount of fluid resuscitation and infused erythrocyte suspension among group A, B and C （1687 ± 96 ml, 2096 ± 87 ml, 2976±93 ml, P〈0. 05; and 294±110 ml, 404±113 ml, 798±230 ml, P〈0. 05）. （2） The hemoglobin level in group C （94±45 g/L） was lower than that in group A （110±22 g/L） and group B （103±24 g/L） （P〈0.05）. However, there was no significant difference in the level of hemoglobin between group A and B. （3） There was no significant difference in the incidence of acute renal failure （ARF） among the 3 groups. The incidence of acute respiratory distress syndrome （ARDS） of group C （31.2%） was higher than that of group A （16.7%） and group B （18.2%） （P〈0.05）. The mortality of group C （34.4%） was higher than that of group A （12. 5% ） and group B （12. 1% ） （P〈0.05）. Conclusion： Preoperative limited resuscitation applied on patients with traumatic shock can reduce blood loss, incidence of ARDS and mortality.
文摘Objective To evaluate the efficacy of the continuation of eardiopulmonary resuscitation （CPR） following transportation to the emergency department in a Chinese hospital after unsuccessful emergency medical services （EMS） CPR. Methods From January 2002 to December 2007, emergency records of non-traumatic patients who were transported to a tertiary teaching hospital after unsuccessful EMS CPR were reviewed. Results Eigty-five patients were included, and 13 patients （15%） accomplished restoration of spontaneous circulation in our emergency department. Resuscitative possibility reached zero at around 23 minutes. One patient was discharged with a favourable neurologic outcome. Conclusions This study shows that the continuation of CPR is not futile and may improve outcomes. The outcomes should be re-evaluated in the future when prehospital information can be combined with in-hospital information （J Geriatr Cardio12009; 6：142-146）.
文摘Backgound The influence of gender on clinical outcomes following transcatheter aortic valve implantation （TAVI） was considerably discrepant in previous studies. We aimed to investigate the impact of gender in our registry. Methods The study is a retrospective observational analysis of a prospectively designed cohort （546 consecutive patients treated at the University Hospital Zurich who were enrolled in Swiss TAVI Cohort from May 2008 to April 2014）. The Study took place in University Heart Centre at University Hospital Zurich, Switzerland. Results Both genders were equally represented with 51.5 % （n = 281） of the populations being females, who were significantly older and had a more pronounced history of hypertension （P 〈 0.001 ）. Males on the other hand showed a higher incidence of diabetes （P = 0.004）, coronary artery disease （P 〈 0.001）, chronic obstructive pulmonary disease （P 〈 0.001） and renal failure requiring renal replacement therapy （P = 0.018）. Patients were followed up for a median of 391 days with a 100% complete follow-up at one year. The primary outcome （all-cause mortality） occurred in 6.8% （n = 37） and 15% （n = 82） of patients at 30 days and one year, respectively. The 30-day all-cause mortality outcome did not significantly differ between females （7.5%） and males （6.0%） （P = 0.619）, but one year all-cause mortality occurred significantly more in males than in females （18.7% vs. 11.7%, P 〈 0.037）. Conclusion After TAVI implantation for severe aortic stenosis, males have a less favorable long-term （one year） mortality outcome than females.
