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Objective. To explore the effect of high-flow humidified oxygen therapy (HFNC) on patients with respiratory failure after general anesthesia extubation for multiple injuries. Methods. 214 patients with multiple injuries in our hospital who underwent general anesthesia and suffered respiratory failure after weaning extubation and received sequential treatment were included. And, they were divided into control group (HFNC group) and observation group (NIMV group) according to the random number table method. Patients in the control group (125 cases) used high-flow nasal cannula (HFNC) after general anesthesia extubation, while patients in the observation group (89 cases) used NIMV. The respiratory rate, heart rate, finger pulse oxygen, oxygenation index (PaO2/FiO2), and re-tracheal intubation rate in the two groups were compared at 2, 8, and 24 hours after sequential treatment, and the mortality rate and hospital stay of ICU time were whole-course observation. And, the effect of conventional oxygen inhalation or HFNC on oxygenation and prognosis was analyzed. Then, SPSS21.0 software was applied for statistical analysis. To analyze the effect of conventional oxygen inhalation or HFNC on the improvement of oxygenation and prognosis, the receiver operating characteristic (ROC) curve can be used to evaluate the feasibility and treatment effect of high-flow nasal oxygen therapy (HFNC) for patients with respiratory failure after general anesthesia extubation for multiple injuries. Results. Compared with the NIMV group, the respiratory frequency and heart rate of the HFNC group were significantly improved after 2 h, 8 h, and 24 h. At the same time, the finger pulse oxygen and oxygenation index increased significantly and returned to normal levels. HFNC can significantly reduce the reintubation rate, ICU hospital stay, and mortality rate. The area under the ROC curve was 0.9102, with 95% CI (0.8256, 0.9949) and P < 0.0001 . Conclusion. For patients with multiple injuries undergoing general anesthesia and respiratory failure after weaning and extubation, the application of HFNC can moderate patients’ heart rate and respiratory rate faster, increase oxygenation index and finger pulse oxygen, and reduce the reintubation rate, mortality rate, and ICU stay. At the same time, it can effectively improve the respiratory failure of patients after extubation and reduce the occurrence of complications.

ObjectivePostoperative nosocomial pneumonia is a terrible complication, especially for elderly patients. This study attempts to investigate the incidence and risk factors for postoperative nosocomial pneumonia and its influence on hospitalization stay in elderly patients with hip fractures.MethodsThis study retrospectively retrieved hospitalization records of patients who presented a hip fracture and underwent surgeries in our institution between January 2014 and December 2021. Postoperative new-onset pneumonia was determined in accordance with discharge diagnosis. Multivariate logistic regression analysis was performed to identify the associated risk factors with pneumonia, and its influence on total hospitalization stay or postoperative hospitalization stay was investigated by multivariate linear regression analyses.ResultsTotally, 808 patients were included, among whom 54 developed a pneumonia representing the incidence rate of 6.7% (95% CI, 5.0%–8.4%). Six factors were identified as independently associated with pneumonia, including advanced age (OR, 1.50 for each 10-year increment), history of chronic respiratory disease (OR, 4.61), preoperative DVT (OR, 3.51), preoperative delay to operation (OR, 1.07 for each day), surgical duration ≥120 min (OR, 4.03) and arthroplasty procedure (OR, 4,39). When adjusted for above confounders, pneumonia was significantly positively associated with total hospitalization stay (standardized coefficient, 0.110; p &lt; 0.001) and postoperative hospitalization stay (standardized coefficient, 0.139; p &lt; 0.001).ConclusionsThis study identified multiple factors associated with postoperative pneumonia and its influence on prolonging hospitalization stay, which would facilitate preventive targeted intervention into implementation for individuals with different risk profiles.

Acute heart failure (AHF) is life-threatening medical condition requiring hospital admission and appropriate oxygen therapy. High flow nasal cannula oxygen therapy (HFNC) has gained its popularity in treatment of AHF, however, there were less studies have demonstrated the physiological efficacy of HFNC. Purpose of this study was to evaluated the physiological responses and clinical outcomes of HFNC by comparing with noninvasive positive pressure ventilation (NPPV) therapy. A retrospective cohort investigation was conducted at emergency intensive care unit (EICU) and cardiovascular center of our hospital from June 2019 to March 2022, AHF patients with hypoxemia were reviewed. According to the received oxygen therapy model, patients were divided into HFNC and NPPV groups. Demographic data, arterial blood gas (ABG) parameter, echocardiography findings, complications and other related variables were extracted and collected from the electronic medical records (EMRs) by well-trained investigators. Physiological responses and clinical outcomes within and between 2 groups were analyzed. Finally, 156 patients with a mean age of 69.3 ± 7.1 years were reviewed, there were 82 (52.6%) male and 74 (47.4%) female patients in the sample and 70 (44.9%) and 86 (55.1%) patients classified III and IV score were included in this study, 80 patients received HFNC and 76 underwent NPPV oxygen therapy. There were no significant differences of baseline characteristics for the 2 groups patients. Changes of left ventricular function parameters, ABG and clinical outcomes were all improved satisfactorily after 24 h medical interventions in both group, what's more, patients underwent HFNC therapy could acquire a better amelioration when compared with NPPV groups (P < .05). HFNC may be an ideal model for patients with AHF, particularly those with hypoxemia. HFNC therapy could significantly improve several objective parameters of physiological responses and clinical outcomes. Abbreviations: ABG = arterial blood gas, AHF = acute heart failure, APACHE II = physiology and chronic health evaluation-II, FiO 2 = inspired oxygen concentration, HF = heart failure, HFNC = high flow nasal cannula, HR = heart rate, LVEDV = left ventricular end diastolic volume, LVEF = left ventricular ejection fraction, LVESD = left ventricular and systolic diameter, LVESV = left ventricular end systolic volume, NPPV = noninvasive positive pressure ventilation, NT-proBNP = N-terminal pro-B-type natriuretic peptide, PaO 2 = arterial partial pressure of oxygen, RR = respiratory rate, SpO 2 = blood oxygen saturation.

IntroductionThe present study was conducted to explore the expression of serum inflammatory cytokines and oxidative stress markers in patients with coronary heart disease (CHD), with an attempt to analyze their relationship with the coronary artery calcium score (CACS) by coronary computed tomography angiography (CCTA).Material and methodsIt total 81 patients with coronary heart disease and 81 healthy adults were included as the observation group and the control group, respectively. The levels of serum interleukin (IL)-6 and IL-12 of the two groups were detected by ELISA, and serum superoxide dismutase (SOD) was detected by the hydroxylamine oxidation method. Micro-RNA-497-5p (miR-497-5p) was screened out as a possible new CHD biomarker and its serum level was measured by real-time fluorescence quantitative PCR. The CACS of patients in the observation group was calculated by the Agatston method to analyze the correlation between the abovementioned indexes and CACS.ResultsWith increase in the number of CHD lesions, the levels of IL-6, IL-12 and miR-497-5p rose gradually while the level of SOD decreased gradually. In the observation group, IL-6, IL-12 and miR-497-5p were positively correlated with CACS while SOD was negatively correlated with CACS.ConclusionsAbnormal expression levels of serum IL-6, IL-12, SOD and miR-497-5p may be able to reveal the severity of the disease, and the combination with CACS is of potential value in terms of evaluating the condition of patients harboring coronary heart disease.