The Impact of Extubation Failure in Patients with Good-Grade Subarachnoid Hemorrhage

Wojak, Jann F.; Ditz, Claudia; Abusamha, Abdulkareem; Smith, Evan; Gliemroth, Jan; Tronnier, V.

doi:10.1016/j.wneu.2018.06.027

“…S4 in the additional material). High risk of bias was related to the study participation in eight studies [ 47 , 57 , 78 – 82 , 85 ], to study attrition in one study [ 33 ], to prognostic factor measurement in one study [ 7 ], to the outcome measurement in two studies [ 29 , 77 ] and to study confounding in five studies [ 27 , 65 , 78 , 81 , 85 ]. The remaining studies had low or unclear risk of bias for each of the six domains.…”

Section: Resultsmentioning

confidence: 99%

Prediction of extubation outcome in critically ill patients: a systematic review and meta-analysis

Torrini

¹

,

Gendreau

²

,

Morel

³

et al. 2021

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Background Extubation failure is an important issue in ventilated patients and its risk factors remain a matter of research. We conducted a systematic review and meta-analysis to explore factors associated with extubation failure in ventilated patients who passed a spontaneous breathing trial and underwent planned extubation. This systematic review was registered in PROPERO with the Registration ID CRD42019137003. Methods We searched the PubMed, Web of Science and Cochrane Controlled Register of Trials for studies published from January 1998 to December 2018. We included observational studies involving risk factors associated with extubation failure in adult intensive care unit patients who underwent invasive mechanical ventilation. Two authors independently extracted data and assessed the validity of included studies. Results Sixty-seven studies (involving 26,847 participants) met the inclusion criteria and were included in our meta-analysis. We analyzed 49 variables and, among them, we identified 26 factors significantly associated with extubation failure. Risk factors were distributed into three domains (comorbidities, acute disease severity and characteristics at time of extubation) involving mainly three functions (circulatory, respiratory and neurological). Among these, the physiological respiratory characteristics at time of extubation were the most represented. The individual topic of secretion management was the one with the largest number of variables. By Bayesian multivariable meta-analysis, twelve factors were significantly associated with extubation failure: age, history of cardiac disease, history of respiratory disease, Simplified Acute Physiologic Score II score, pneumonia, duration of mechanical ventilation, heart rate, Rapid Shallow Breathing Index, negative inspiratory force, lower PaO2/FiO2 ratio, lower hemoglobin level and lower Glasgow Coma Scale before extubation, with the latest factor having the strongest association with extubation outcome. Conclusions Numerous factors are associated with extubation failure in critically ill patients who have passed a spontaneous breathing trial. Robust multiparametric clinical scores and/or artificial intelligence algorithms should be tested based on the selected independent variables in order to improve the prediction of extubation outcome in the clinical scenario.

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“…In addition, enteral nutrition infusion pump is also suitable for patients with heavy cranial injury with artificial airway to reduce gastric retention, avoid gastrointestinal irritation, and reduce the occurrence of adverse reactions such as abdominal distension [ 18 ]. The percutaneous endoscopic gastrostomy/jejunostomy can be left in place for a long time, effectively reducing the rate of detachment and avoiding restriction of movement and pressure on the skin and mucosa of patients [ 19 ].…”

Section: Related Workmentioning

confidence: 99%

[Retracted] Clinical Indications for Extubation in Coma Patients with Severe Neurological Craniocerebral Injury with Meta‐Analysis

Ma

¹

,

Han

²

,

He

³

et al. 2022

BioMed Research International

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Computer searches of the PubMed, Cochrane Library, and Embase databases for randomized controlled studies on the effects of intensive nutrition on clinical outcomes in patients with severe craniocerebral injury were conducted from the time of database creation to June 11, 2022, along with manual searches of the relevant literature. Two investigators independently screened the literature, extracted data, and evaluated the risk of bias of the included studies before the effect sizes were combined using RevMan 5.3 statistical software provided by the Cochrane Collaboration Network, and publication bias was detected using Stata 12.0 software. Meta-analysis showed that total protein levels were higher in the intensive nutrition group than in the regular nutrition group ( WMD = 4.96 g/L (1.57-8.34), P < 0.001 ); IgA levels were significantly higher in the intensive nutrition group than in the regular nutrition group ( SMD = 0.79 (0.51-1.07), P < 0.001 ; SMD = 0.98 (0.58-1.38), P < 0.001 ); IgG levels were significantly higher in the fortified group than in the regular group ( SMD = 0.98 (0.58-1.38), P < 0.001 ); CD4/CD8 was significantly higher in the fortified patients than in the regular patients with a combined effect size of WMD = 0.33 (0.18-0.48) ( P < RR = 0.45 (0.27-0.75), P = 0.002 ). The results show that effective support of early enteral nutrition can reduce the occurrence of gastrointestinal complications in patients, give them a better adaptation process to the gastrointestinal tract, and ensure the degree of tolerance of their gastric mucosa, thus absorbing more nutrition. Fortification significantly reduced the incidence of gastric retention in patients with craniocerebral injury ( RR = 0.19 (0.07-0.49), P < 0.001 ). In the subgroup analysis of the three groups, it was shown that, depending on the starting time, the total protein level and IgG level were better in the early nutrition at 24 h than in the late nutrition above 24h and that, depending on the starting dose, the total protein level, IgA, IgG, and CD4/CD8 were better in the intervention at doses above 30 mL/h, using the starting dose of 30 mL/h as the cut-off point. In the subgroup analysis based on different nutrition methods (enteral and parenteral nutrition), IgA levels and the incidence of bloating and diarrhea were better than those of parenteral nutrition in the indicators of enteral nutrition.

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“…In a theoretical sense, as the aging of China becomes more and more severe, the number of one-child families is gradually increasing and has become the main family structure in urban areas ( 1 ). Secondly, in the practical sense, if it is not possible to effectively solve the many problems of elderly care for the lost-alone families, it will not only affect the quality of life and happiness index of the lost-alone families, but even hinder the social harmony and stable development ( 2 ).…”

Section: Introductionmentioning

confidence: 99%

The relationship between the mental health status and social support of the lonely elderly with government participation in the Internet context

Guo

¹

,

Wen-hao

²

2022

Front. Public Health

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ObjectiveAt present, urban community aging has become a new way to solve aging problem and has made outstanding contributions to alleviate current aging dilemma. However, there are still deficiencies in the services provided by this new method of community-based elderly care for the elderly who are left alone. Therefore, this paper explores the problems of government policies, facilities and services for the elderly who have lost their independence, analyzes the reasons behind them, and proposes countermeasures.MethodThis paper introduces and compares the government's current services for the elderly who are left alone in the city at the level of community-based elderly care services. From the existing literature, we find that most researchers have studied the single-parent family as an individual, exploring its elderly care dilemma, analyzing the causes and proposing countermeasures. It introduces and summarizes the situation of the elderly left alone in Taiyuan, the government's policies on the elderly left alone and community elderly care, the current community elderly care construction in Taiyuan, and the service models provided by the government.Results/DiscussionThis paper provides a detailed description and in-depth analysis of the lack of elderly care protection in communities, and analyzes the underlying causes. Activity theory suggests that even though older people are no longer in the same mental state as younger people, they can still enhance their self-worth through active participation in social activities and gain a sense of social identity through social activities. The services provided by social organizations are typical services purchased by the Health and Welfare Commission for the elderly who are left alone, and it is feasible to gradually extend the services to provide more specialized community-based elderly care services for the elderly who are left alone. Therefore, this study takes the use of services provided by social organizations as an example to understand the current situation of services received and used by the elderly who are left alone, and concludes that the services are weakly accessible, and finally proposes suggestions to improve the accessibility of services in three aspects: supply, delivery, and use.

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The Impact of Extubation Failure in Patients with Good-Grade Subarachnoid Hemorrhage

Cited by 9 publications

References 22 publications

Prediction of extubation outcome in critically ill patients: a systematic review and meta-analysis

Prediction of extubation outcome in critically ill patients: a systematic review and meta-analysis

[Retracted] Clinical Indications for Extubation in Coma Patients with Severe Neurological Craniocerebral Injury with Meta‐Analysis

The relationship between the mental health status and social support of the lonely elderly with government participation in the Internet context

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