1.The role of high-flow nasal cannula oxygen therapy in patients with high cervical spinal cord injury
Fenglu YANG ; Chunshuang WU ; Xiajing CAO ; Dingqian WU ; Xiao LU
Chinese Journal of Emergency Medicine 2019;28(8):1005-1009
Objective To study the effect of high-flow nasal cannula oxygen therapy (HFNC) in reduction in re-intubation rate, length of ICU stay and improvement of respiratory function in patients with high cervical spinal cord injury.Methods Single center retrospective study was carried out in our intensive care unit from September 2016 to March 2018. Post-operative patients ready for planned extubation with high cervical spinal cord injury were included. The length of ICU stay, re-intubation rate in case of respiratory failure, respiratory rate, pulse rate, MAP, SaO2, PaO2/FiO2, and PaCO2 of patients at 6, 24 and 72 h after extubation were compared between the HFNC and conventional oxygen therapy (COT) groups. Results During the study period, 38 patients were enrolled in the study. Of them, 16 patients were assigned in the HFNC group and 22patients in the COT group. Re-intubation rate was significantly different between the two groups (18.8% vs 27.3%, P<0.05), but the length of ICU stay had no significant difference [(15.5±3.4) days vs (16.6±5.2) days]. The respiratory rate, pulse rate, SaO2 and PaO2/FiO2 at 6 h after extubation in the HFNC group were improved markedly than those in the COT group (P<0.05); and the PaCO2 and PaO2/FiO2 at 24 and 72 h after extubation in the HFNC group had much more improvement than those in the COT group (P<0.05). Conclusions Among individuals with post-operative high cervical spinal cord injury, high-flow oxygen therapy could reduce re-intubation rate, and PaCO2 level, and improve the respiratory function, but cannot reduce the length of ICU stay. High-flow oxygen therapy may offer advantages for patients with high cervical spinal cord injury.
2.Construction and application of an intelligent medical emergency support information platform for the 19th Hangzhou Asian Games
Jungen ZHANG ; Qiang LI ; Yu TIAN ; Baoyun SUN ; Jun HU ; Yijun YUAN ; Fenglu YANG ; Jiangang WANG ; Mao ZHANG ; Jinsong LI
Chinese Journal of Emergency Medicine 2023;32(12):1650-1655
Objective:To construct an intelligent medical emergency information platform for the 19th Hangzhou Asian Games events and evaluate its practical application.Methods:Addressing the medical support demands for Asian Games, based on the " Emergency medical service system for large-scale social activities" developed by Zhejiang Laboratory, a collaborative team comprising Hangzhou Emergency Center, the Second Affiliated Hospital of Zhejiang University,Zhejiang Lab and College of Biomedical Engineering and Instrument Science of ZhejiangUniversity developed an intelligent medical emergency information platform for the Asian Games. This system was implemented during the 19th Hangzhou Asian Games, collecting basic information, initial diagnosis locations, prognoses, severity grading, and occurrences of infectious diseases for all patients treated at support locations from September 16th to October 8th, 2023. The Modified Early Warning Score (MEWS) was employed for assessing patient conditions, and a symptom monitoring system was used to alert the occurrence of infectious diseases. Post-event, a satisfaction evaluation (on a 5-point scale) regarding the system's application was conducted.Results:The successful construction of the intelligent medical emergency information platform comprised a data dashboard display platform, a comprehensive command system on the management center, and a mobile platform covering on-site medical support, ambulances, and designated hospitals. ①A total of 11 068 patients were treated using this system, including 2 979 athletes, 3 429 staff members, 1 421 volunteers,1 051 spectators, and 2 188 others. The proportion of patients seeking treatment due to illnesses was significantly higher than those due to injuries. Among injury-related cases, athletes constituted 41.37%, while staff accounted for 32.5% of illness-related cases. ②The area under the ROC curve for MEWS regarding hospitalization rates was 0.81 for disease patients and 0.60 for injury patients. ③ There were 211 reported cases of infectious diseases during the event, constituting 1.91% of all treated cases.④ Satisfaction ratings: User-friendliness scored 4.47, completeness of functions scored 4.28, data security scored 4.38, and data accuracy scored 4.49. Compared to traditional paper-based reporting methods, 98.11% of users found the system more convenient, 92.45% were satisfied overall, and the recommendation rating was 4.36.Conclusions:The study findings confirm the critical role played by the information platform in enhancing comprehensive, accurate, timely, secure medical support information dissemination for the Asian Games and in early warning and control of infectious diseases.